Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis

Background and purposeThis study aimed to analyze the impact of interobserver variability (IOV) on clinical dosimetry and prognosis, specifically investigating the correlation between IOV and clinical prognosis in the context of intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcino...

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Main Authors: Meining Chen, Yinglin Peng, Ruotong Chen, Qiuying Xie, Dengyuan Chen, Jinping Shi, Rong Huang, Jun Zhang, Chong Zhao, Li Chen, Xiaowu Deng, Yimei Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1510568/full
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author Meining Chen
Yinglin Peng
Ruotong Chen
Qiuying Xie
Dengyuan Chen
Jinping Shi
Rong Huang
Jun Zhang
Chong Zhao
Li Chen
Xiaowu Deng
Yimei Liu
author_facet Meining Chen
Yinglin Peng
Ruotong Chen
Qiuying Xie
Dengyuan Chen
Jinping Shi
Rong Huang
Jun Zhang
Chong Zhao
Li Chen
Xiaowu Deng
Yimei Liu
author_sort Meining Chen
collection DOAJ
description Background and purposeThis study aimed to analyze the impact of interobserver variability (IOV) on clinical dosimetry and prognosis, specifically investigating the correlation between IOV and clinical prognosis in the context of intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC).Materials and methodsTwelve NPC patients who underwent IMRT were selected. Four radiotherapy physicians from two different-tier cancer centers independently delineated target volumes and organs at risk (OARs) for each patient. These delineations were compared against gold standard structures from a regional cancer center. The IOV among physicians and its effect on clinical and prognosis were analyzed. The relationships between the IOV, dosimetry, and prognosis were investigated using spearman’s correlation analysis.ResultsThe target volume and OARs delineation differed significantly among physicians. This variability led to reduced prescription dose coverage (PDC) of the planning target volume (PTV) and increased doses to OARs, impacting tumor control probability (TCP) and normal tissue complication probability (NTCP). Compared to standard delineations, all four physicians showed decreased TCPs (average decrease in ΔTCP >1%) and a significant increase in NTCPs of OARs. The relative volume difference (ΔV) of target volumes correlated strongly with ΔPDC (R=0.686) and ΔTCP (R=0.703). Moreover, in the validation set, ΔV also strongly correlated with ΔTCP (R = 0.778).ConclusionSubstantial IOV in delineating NPC target volumes and OARs for IMRT was observed. This variability affects plan optimization, dose distribution, and clinical prognosis. ΔV can serve as a risk predictor for assessing delineation variability in NPC radiotherapy treatment planning.
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spelling doaj-art-d1e3f09ef0834775bba795f4da0b7acc2025-08-20T03:53:12ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15105681510568Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysisMeining Chen0Yinglin Peng1Ruotong Chen2Qiuying Xie3Dengyuan Chen4Jinping Shi5Rong Huang6Jun Zhang7Chong Zhao8Li Chen9Xiaowu Deng10Yimei Liu11Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, the First People’s Hospital of Foshan, Foshan, ChinaDepartment of Radiation Oncology, Luoding People’s Hospital, Yunfu, ChinaDepartment of Radiation Oncology, the First People’s Hospital of Foshan, Foshan, ChinaDepartment of Radiation Oncology, the First People’s Hospital of Foshan, Foshan, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaBackground and purposeThis study aimed to analyze the impact of interobserver variability (IOV) on clinical dosimetry and prognosis, specifically investigating the correlation between IOV and clinical prognosis in the context of intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC).Materials and methodsTwelve NPC patients who underwent IMRT were selected. Four radiotherapy physicians from two different-tier cancer centers independently delineated target volumes and organs at risk (OARs) for each patient. These delineations were compared against gold standard structures from a regional cancer center. The IOV among physicians and its effect on clinical and prognosis were analyzed. The relationships between the IOV, dosimetry, and prognosis were investigated using spearman’s correlation analysis.ResultsThe target volume and OARs delineation differed significantly among physicians. This variability led to reduced prescription dose coverage (PDC) of the planning target volume (PTV) and increased doses to OARs, impacting tumor control probability (TCP) and normal tissue complication probability (NTCP). Compared to standard delineations, all four physicians showed decreased TCPs (average decrease in ΔTCP >1%) and a significant increase in NTCPs of OARs. The relative volume difference (ΔV) of target volumes correlated strongly with ΔPDC (R=0.686) and ΔTCP (R=0.703). Moreover, in the validation set, ΔV also strongly correlated with ΔTCP (R = 0.778).ConclusionSubstantial IOV in delineating NPC target volumes and OARs for IMRT was observed. This variability affects plan optimization, dose distribution, and clinical prognosis. ΔV can serve as a risk predictor for assessing delineation variability in NPC radiotherapy treatment planning.https://www.frontiersin.org/articles/10.3389/fonc.2025.1510568/fullintensity-modulated radiotherapyinterobserver variabilitynormal tissue complication probabilitytumor control probabilitynasopharyngeal carcinoma
spellingShingle Meining Chen
Yinglin Peng
Ruotong Chen
Qiuying Xie
Dengyuan Chen
Jinping Shi
Rong Huang
Jun Zhang
Chong Zhao
Li Chen
Xiaowu Deng
Yimei Liu
Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis
Frontiers in Oncology
intensity-modulated radiotherapy
interobserver variability
normal tissue complication probability
tumor control probability
nasopharyngeal carcinoma
title Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis
title_full Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis
title_fullStr Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis
title_full_unstemmed Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis
title_short Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis
title_sort interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma a dosimetric and prognostic analysis
topic intensity-modulated radiotherapy
interobserver variability
normal tissue complication probability
tumor control probability
nasopharyngeal carcinoma
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1510568/full
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