A GORTEC survey on low-risk CTV-P2 delineation in head and neck cancers
Purpose: An international consensus was established in 2018 to standardise practice using geometric (5 + 5 mm) expansion around GTV-P for definitive radiotherapy of squamous cell carcinomas of the head and neck (HNC). The GORTEC (French HNC Oncology and Radiotherapy Group) conducted a survey to asse...
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Elsevier
2025-07-01
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| Series: | Clinical and Translational Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630825000722 |
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| author | Michel Lapeyre Yoann Pointreau Marc Alfonsi Pierre Boisselier Julian Biau Pierre Blanchard Joël Castelli Pierre Graff Florence Huguet Laurent Martin Séverine Racadot Xu Shan Sun Yungan Tao Jean Bourhis Juliette Thariat |
| author_facet | Michel Lapeyre Yoann Pointreau Marc Alfonsi Pierre Boisselier Julian Biau Pierre Blanchard Joël Castelli Pierre Graff Florence Huguet Laurent Martin Séverine Racadot Xu Shan Sun Yungan Tao Jean Bourhis Juliette Thariat |
| author_sort | Michel Lapeyre |
| collection | DOAJ |
| description | Purpose: An international consensus was established in 2018 to standardise practice using geometric (5 + 5 mm) expansion around GTV-P for definitive radiotherapy of squamous cell carcinomas of the head and neck (HNC). The GORTEC (French HNC Oncology and Radiotherapy Group) conducted a survey to assess the level of agreement about CTV-P2 delineation using a “formalised consensus method”. Methods: The 32 proposals of the 2018 consensus on CTV-P2 and 6 additional GORTEC proposals were submitted to 13 GORTEC radiation oncologists (RO). Proposals were rated as “suitable” for median scores ≥7, “unsuitable” for scores ≤3.5 or “uncertain.” The degree of agreement was high (≥85 %), moderate (75–84 %) or low (<75 %). Suitable proposals were reviewed by 40 other RO for final recommendations. Results: The 2018 proposals were “uncertain” with low degrees of agreement (41.5–69 %), except for T1 tumors, which had 89 % agreement. Five out of 6 GORTEC proposals were “suitable” and one “uncertain.” The final recommendation was “suitable and to be retained” by 97.5 % of RO, as follows: To obtain CTV-P2, GORTEC recommends applying a “geo-anatomical” approach. Using the geometric concept, 10 mm-isotropic margins are applied to the GTV, for all locations but the hypopharynx (10 mm antero-posterior, laterally and 15 mm craniocaudally). CTV-P2 is further modified using the anatomical concept (anatomical barriers, dissemination routes) and accounting the benefit/risk balance and proximity of organs at risk. Conclusion: The GORTEC survey derived from the 2018 international CTV-Ps delineation consensus suggests a “geo-anatomical” approach for the delineation of CTV-P2 in HNC. |
| format | Article |
| id | doaj-art-8523b606fedb4d15aae2c3ae837e58bb |
| institution | OA Journals |
| issn | 2405-6308 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
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| series | Clinical and Translational Radiation Oncology |
| spelling | doaj-art-8523b606fedb4d15aae2c3ae837e58bb2025-08-20T02:36:59ZengElsevierClinical and Translational Radiation Oncology2405-63082025-07-015310098010.1016/j.ctro.2025.100980A GORTEC survey on low-risk CTV-P2 delineation in head and neck cancersMichel Lapeyre0Yoann Pointreau1Marc Alfonsi2Pierre Boisselier3Julian Biau4Pierre Blanchard5Joël Castelli6Pierre Graff7Florence Huguet8Laurent Martin9Séverine Racadot10Xu Shan Sun11Yungan Tao12Jean Bourhis13Juliette Thariat14Department of Radiation Therapy, Jean Perrin Centre, 58 Rue Montalembert, BP 5026, 63011 Clermont Ferrand Cedex 1, France; Corresponding author.Department of Radiation Therapy, Inter-Regional Institute of Oncology (ILC, Institut inter-régionaL de Cancérologie), Jean Bernard Centre, Sarthe Oncology Centre 64 Rue de Degré 72000 Le Mans, FranceDepartment of Radiation Therapy, Sainte-Catherine Institute – Avignon-Provence Cancer Institute, CS 80005, 250 Chemin de Baigne Pieds, 84918 Avignon Cedex 9, FranceDepartment of Radiation Therapy, Montpellier Regional Cancer Institute, Parc Euromédecine, 208 rue des Apothicaires, 34090 Montpellier, FranceDepartment of Radiation Therapy, Jean Perrin Centre, 58 Rue Montalembert, BP 5026, 63011 Clermont Ferrand Cedex 1, FranceDepartment of Radiation Therapy, Gustave Roussy Institute, 114 Rue Edouard Vaillant, 94805 Villejuif, FranceDepartment of Radiation Therapy, Eugène Marquis Centre, Av. de la Bataille Flandres-Dunkerque CS 44229, 35000 Rennes, FranceDepartment of Radiation Therapy, Curie Institute, 26 rue d’Ulm, 75248 Paris Cedex 05, FranceDepartment of Radiation Therapy, Tenon Hospital, 4 rue de la Chine, 75020 Paris, FranceGuillaume Le Conquérant Centre, 61 Rue Denfert Rochereau, 76600 Le Havre, FranceDepartment of Radiation Therapy, Léon Berard Centre, 28 Rue Laennec, 69008 Lyon, FranceDepartment of Radiation Therapy, Franche-Comté North Hospital in Montbéliard & Besançon CHRU (Centre hospitalier régional universitaire [Regional University Hospital]), 1 Rue Henri Becquerel, 25200 Montbéliard, FranceDepartment of Radiation Therapy, Gustave Roussy Institute, 114 Rue Edouard Vaillant, 94805 Villejuif, FranceDepartment of Radiation Therapy, Lausanne University Hospital (CHUV, Centre Hospitalier Universitaire Vaudois), Rue du Bugnon 46, 1005 Lausanne, SwitzerlandDepartment of Radiation Therapy, Comprehensive Cancer Centre François Baclesse, 3 Avenue du General Harris, 14000 Caen, FrancePurpose: An international consensus was established in 2018 to standardise practice using geometric (5 + 5 mm) expansion around GTV-P for definitive radiotherapy of squamous cell carcinomas of the head and neck (HNC). The GORTEC (French HNC Oncology and Radiotherapy Group) conducted a survey to assess the level of agreement about CTV-P2 delineation using a “formalised consensus method”. Methods: The 32 proposals of the 2018 consensus on CTV-P2 and 6 additional GORTEC proposals were submitted to 13 GORTEC radiation oncologists (RO). Proposals were rated as “suitable” for median scores ≥7, “unsuitable” for scores ≤3.5 or “uncertain.” The degree of agreement was high (≥85 %), moderate (75–84 %) or low (<75 %). Suitable proposals were reviewed by 40 other RO for final recommendations. Results: The 2018 proposals were “uncertain” with low degrees of agreement (41.5–69 %), except for T1 tumors, which had 89 % agreement. Five out of 6 GORTEC proposals were “suitable” and one “uncertain.” The final recommendation was “suitable and to be retained” by 97.5 % of RO, as follows: To obtain CTV-P2, GORTEC recommends applying a “geo-anatomical” approach. Using the geometric concept, 10 mm-isotropic margins are applied to the GTV, for all locations but the hypopharynx (10 mm antero-posterior, laterally and 15 mm craniocaudally). CTV-P2 is further modified using the anatomical concept (anatomical barriers, dissemination routes) and accounting the benefit/risk balance and proximity of organs at risk. Conclusion: The GORTEC survey derived from the 2018 international CTV-Ps delineation consensus suggests a “geo-anatomical” approach for the delineation of CTV-P2 in HNC.http://www.sciencedirect.com/science/article/pii/S2405630825000722CancerHead and neckDelineationCTV definitionConsensus Guidelines |
| spellingShingle | Michel Lapeyre Yoann Pointreau Marc Alfonsi Pierre Boisselier Julian Biau Pierre Blanchard Joël Castelli Pierre Graff Florence Huguet Laurent Martin Séverine Racadot Xu Shan Sun Yungan Tao Jean Bourhis Juliette Thariat A GORTEC survey on low-risk CTV-P2 delineation in head and neck cancers Clinical and Translational Radiation Oncology Cancer Head and neck Delineation CTV definition Consensus Guidelines |
| title | A GORTEC survey on low-risk CTV-P2 delineation in head and neck cancers |
| title_full | A GORTEC survey on low-risk CTV-P2 delineation in head and neck cancers |
| title_fullStr | A GORTEC survey on low-risk CTV-P2 delineation in head and neck cancers |
| title_full_unstemmed | A GORTEC survey on low-risk CTV-P2 delineation in head and neck cancers |
| title_short | A GORTEC survey on low-risk CTV-P2 delineation in head and neck cancers |
| title_sort | gortec survey on low risk ctv p2 delineation in head and neck cancers |
| topic | Cancer Head and neck Delineation CTV definition Consensus Guidelines |
| url | http://www.sciencedirect.com/science/article/pii/S2405630825000722 |
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