Enhanced head and neck radiotherapy target definition through multidisciplinary delineation and peer review: A prospective single-center study

• DOI: 10.1016/j.ctro.2024.100837
• Publication Date: 2024-08-09T01:47:21Z
• Authors: Tatiana Dragan; Kaoutar Soussy; Sylvie Beauvois; Yolene Lefebvre; Marc Lemort; Elcin Ozalp; Akos Gulyban; Manuela Burghelea; Clémence Al Wardi; Clementine Marin; Sofian Benkhaled; Dirk Van Gestel
• Keywords: Single Center; Center (category theory)

This study evaluates the benefit of weekly delineation and peer review by a multidisciplinary team (MDT) radiation oncologists (ROs), radiologists (RXs), nuclear medicine (NM) physicians in defining primary lymph node tumor volumes (GTVp GTVn) for head neck cancer (HNC) radiotherapy. includes 30 consecutive HNC patients referred definitive curative (chemo)-radiotherapy. Imaging data including MRI, [18F]-FDG-PET CT scan were evaluated MDT. The RO identified 'undeniable' as GTVp_core determined GTVp_max, representing maximum tumoral volume. MDT (MDT-D) RX NM outlined their respective GTVs (GTVp_RX GTVp_NM). During meeting (MDT-M), these contours discussed to reach consensus on final GTV (GTVp_final). In comparative analysis various GTVp delineations, we performed descriptive statistics assessed two MDT-M factors: 1) added value MDT-M, which section GTVp_final outside but within GTVp_RX or GTVp_NM, 2) part that deviates from area missed RO. For GTVn, discussions extent malignancy, documenting findings frequency disagreements. average core max 19.5 cc (range: 0.4-90.1) 22.1 0.8-106.2), respectively. Compared GTVp_core, MDT-D an 3.3 0-25.6) spared 1.3 (0-15.6). -M 2.7 0-20.3) removed 2.3 (0-21.3). most frequent GTVn included morphologically suspicious nodes not fixing small negative retropharyngeal nodes. Multidisciplinary target is essential accurate treatment planning, ensuring precise delineation, potentially improving local control reducing toxicity.