Combining radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours: potential effects on treatment volumes and patterns of failure
Background and purpose: Target definition is one of the greatest uncertainties in the radiotherapy process. We aimed to investigate whether a radiologist specialized in head and neck can improve the target definition of hypopharyngeal cancers. Materials and methods: We retrospectively identified 54...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-09-01
|
| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630825001144 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849406791709884416 |
|---|---|
| author | Gabriella Alexandersson von Döbeln Eva Onjukka Halla Sif Ólafsdóttir Sara Jonmarker Jaraj Mattias Hedman |
| author_facet | Gabriella Alexandersson von Döbeln Eva Onjukka Halla Sif Ólafsdóttir Sara Jonmarker Jaraj Mattias Hedman |
| author_sort | Gabriella Alexandersson von Döbeln |
| collection | DOAJ |
| description | Background and purpose: Target definition is one of the greatest uncertainties in the radiotherapy process. We aimed to investigate whether a radiologist specialized in head and neck can improve the target definition of hypopharyngeal cancers. Materials and methods: We retrospectively identified 54 patients with hypopharyngeal cancer who received curative-intent radiotherapy between 2009–2015. New target structures were defined incorporating head and neck radiology expertise and updated delineation guidelines. The new structures were subsequently compared both quantitively and qualitatively to the original delineations. Loco-regional failures were analyzed in relation to radiotherapy dose and target volumes. Results: There was a significant reduction in gross tumour volume (GTV) for the primary tumour, decreasing from 14.4 to 9.2 cm3 (−47 %), and in clinical target volume (CTV), decreasing from 203.7 to 93.8 cm3 (−54 %). Mean quantitative values indicated a large overestimation of the original GTV (Dice Coefficient 0.58 ± 0.2 SD, Jaccard index 0.44 ± 0.19 SD, Positive predictive value 0.53 ± 0.24 SD). Only 39 % of the original primary tumour GTV and 19 % of the original lymph node GTV were assessed as acceptable. Twelve patients (22 %) had a locoregional recurrence. In relation to both the original radiation dose and the updated dose distribution, nine recurrences were classified as in field, two as marginal, and one could not be evaluated. The 3-year and 5-year locoregional progression free survival (PFS) was 75.5 % and 66.6 % respectively. Conclusion: Incorporating radiological expertise in the delineation of hypopharyngeal tumours leads to large changes in tumour volumes and possibly a decrease in radiation volumes which may lead to reduced side effects. |
| format | Article |
| id | doaj-art-7b3c3447f922467bad65308aaa245877 |
| institution | Kabale University |
| issn | 2405-6308 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj-art-7b3c3447f922467bad65308aaa2458772025-08-20T03:36:15ZengElsevierClinical and Translational Radiation Oncology2405-63082025-09-015410102210.1016/j.ctro.2025.101022Combining radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours: potential effects on treatment volumes and patterns of failureGabriella Alexandersson von Döbeln0Eva Onjukka1Halla Sif Ólafsdóttir2Sara Jonmarker Jaraj3Mattias Hedman4Department of Radiation Oncology, Karolinska University Hospital, 171 76 Stockholm, Sweden; Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-141 52 Huddinge, SwedenDepartment of Nuclear Medicine and Medical Physics, Karolinska University Hospital, 171 76 Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, 171 77 Stockholm, SwedenDepartment of Radiation Oncology, Karolinska University Hospital, 171 76 Stockholm, Sweden; Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-141 52 Huddinge, SwedenDepartment of Neuroradiology, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Radiation Oncology, Karolinska University Hospital, 171 76 Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, 171 77 Stockholm, Sweden; Corresponding author at: Karolinska University Hospital, 171 76 Stockholm, Sweden.Background and purpose: Target definition is one of the greatest uncertainties in the radiotherapy process. We aimed to investigate whether a radiologist specialized in head and neck can improve the target definition of hypopharyngeal cancers. Materials and methods: We retrospectively identified 54 patients with hypopharyngeal cancer who received curative-intent radiotherapy between 2009–2015. New target structures were defined incorporating head and neck radiology expertise and updated delineation guidelines. The new structures were subsequently compared both quantitively and qualitatively to the original delineations. Loco-regional failures were analyzed in relation to radiotherapy dose and target volumes. Results: There was a significant reduction in gross tumour volume (GTV) for the primary tumour, decreasing from 14.4 to 9.2 cm3 (−47 %), and in clinical target volume (CTV), decreasing from 203.7 to 93.8 cm3 (−54 %). Mean quantitative values indicated a large overestimation of the original GTV (Dice Coefficient 0.58 ± 0.2 SD, Jaccard index 0.44 ± 0.19 SD, Positive predictive value 0.53 ± 0.24 SD). Only 39 % of the original primary tumour GTV and 19 % of the original lymph node GTV were assessed as acceptable. Twelve patients (22 %) had a locoregional recurrence. In relation to both the original radiation dose and the updated dose distribution, nine recurrences were classified as in field, two as marginal, and one could not be evaluated. The 3-year and 5-year locoregional progression free survival (PFS) was 75.5 % and 66.6 % respectively. Conclusion: Incorporating radiological expertise in the delineation of hypopharyngeal tumours leads to large changes in tumour volumes and possibly a decrease in radiation volumes which may lead to reduced side effects.http://www.sciencedirect.com/science/article/pii/S2405630825001144RadiotherapyHypopharyngeal cancerTarget definitionOutcome |
| spellingShingle | Gabriella Alexandersson von Döbeln Eva Onjukka Halla Sif Ólafsdóttir Sara Jonmarker Jaraj Mattias Hedman Combining radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours: potential effects on treatment volumes and patterns of failure Clinical and Translational Radiation Oncology Radiotherapy Hypopharyngeal cancer Target definition Outcome |
| title | Combining radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours: potential effects on treatment volumes and patterns of failure |
| title_full | Combining radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours: potential effects on treatment volumes and patterns of failure |
| title_fullStr | Combining radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours: potential effects on treatment volumes and patterns of failure |
| title_full_unstemmed | Combining radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours: potential effects on treatment volumes and patterns of failure |
| title_short | Combining radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours: potential effects on treatment volumes and patterns of failure |
| title_sort | combining radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours potential effects on treatment volumes and patterns of failure |
| topic | Radiotherapy Hypopharyngeal cancer Target definition Outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2405630825001144 |
| work_keys_str_mv | AT gabriellaalexanderssonvondobeln combiningradiologicalandradiationoncologyexpertiseinthedelineationofhypopharyngealtumourspotentialeffectsontreatmentvolumesandpatternsoffailure AT evaonjukka combiningradiologicalandradiationoncologyexpertiseinthedelineationofhypopharyngealtumourspotentialeffectsontreatmentvolumesandpatternsoffailure AT hallasifolafsdottir combiningradiologicalandradiationoncologyexpertiseinthedelineationofhypopharyngealtumourspotentialeffectsontreatmentvolumesandpatternsoffailure AT sarajonmarkerjaraj combiningradiologicalandradiationoncologyexpertiseinthedelineationofhypopharyngealtumourspotentialeffectsontreatmentvolumesandpatternsoffailure AT mattiashedman combiningradiologicalandradiationoncologyexpertiseinthedelineationofhypopharyngealtumourspotentialeffectsontreatmentvolumesandpatternsoffailure |