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勾画标准培训对乳腺癌保乳术后放疗靶区勾画的作用
徐敏, 李建彬, 于志强, 杨涛, 王晓东, 周新, 张广龙, 刘同海
250117 济南,山东省医学科学院 山东省肿瘤重点实验室山东省肿瘤医院和研究所放疗科
The influence of delineating criteria training on the delineation of tumor bed and whole breast target after breast-conserving surgery
XU Min, LI Jian-bin, YU Zhi-qiang, YANG Tao, WANG Xiao-dong, ZHOU Xin, ZHANG Guang-long, LIU Tong-hai
Department of Radiation Oncology, Shandong Tumor Hospital ＆ Institute;Shandong Provincial Key Laboratory of Radiation Oncology;Shandong Academy of Medical Sciences;Ji′nan 250117, China Corresponding author:LI Jian-bin, Email:lijianbin@msn.com
Abstract：Objective To explore the influence of delineator and contouring criteria training on the delineation of the tumor bed and whole breast target after breast-conserving surgery. Methods Twelve breast cancer patients after breast conserving surgery were selected. Tumor bed marked by clips was defined as gross target volume 1(GTV1), tumor bed formed by seroma was defined as GTV2 and the whole breast was defined as clinical target volume (CTV). Five junior radiation oncologists first delineated GTV1, GTV2 and CTV for each patient following their own criteria. After contouring criteria training, they then delineated GTV1, GTV2 and CTV for the same group of patients again. The differences of the volumes of GTV1, GTV2 and CTV before and after training among different delineators were compared. One-way ANOVA or matching t-test was performed. Results The inter-delineator variability on GTV1, GTV2 and CTV delineation before training was statistically significant (F=11.16,7.54 and 3.78,P=0.000,0.000 and 0.009). After training, the inter-delineator variability on GTV1 and GTV2 delineation had statistical significance (t=4.78 and 4.24,P=0.002 and 0.005), but the inter-delineator variability on CTV delineation had no statistical significance (t=1.52,P=0.209). The coefficient of variance of the GTV1, GTV2 and CTV before and after training was significantly different (t=3.14, 2.81, 2.70, P=0.009, 0.017 and 0.021). The matching index of GTV1, GTV2 and CTV before and after training was significantly different (F=16.08, 8.61, 8.48, P=0.000, 0.000 and 0.000). Conclusions In delineating the target of breast cancer, application of the criteria of target delineation can reduce the difference among the delineators, especially for CTV.
XU Min,LI Jian-bin,YU Zhi-qiang et al. The influence of delineating criteria training on the delineation of tumor bed and whole breast target after breast-conserving surgery[J]. Chinese Journal of Radiation Oncology, 2012, 21(6): 534-537.
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