Abstract
Background: A major obstacle in the delivery of postoperative radiation therapy (RT) for prostate cancer is accurate delineation of the tumor targets and organs at risk. Although postoperative prostate cancer contouring atlases are quite common, there is still no widely accepted contouring guideline. The purpose of this study is to critically review the various postoperative prostate RT treatment planning consensus guidelines or atlases currently available. Methods: A literature search was conducted using various electronic databases with the key terms: prostate, contour, planning tumour volume, clinical target volume, delineation or definition, guidelines or atlas, and radiation oncology. The search was limited to English publications from the years 1985 to 2011. Results: A total of seven publications relating to contouring guidelines for postoperative prostate radiotherapy were identified. There are four distinct consensus guidelines developed by major institutions: Princess Margaret Hospital, the Australian and New Zealand Radiation Oncology Genito-Urinary Group, the European Organization for Research and Treatment of Cancer, and the Radiation Therapy Oncology Group. Conclusions: After reviewing the consensus contouring guidelines for postoperative prostate cancer radiation therapy that were available in the literature, it is clear that there disagreement with regards to what anatomical borders should be used for delineating an appropriate prostate bed CTV. Additional studies comparing the reproducibility of the various guidelines as well as the performance of these guidelines on clinically important outcomes are needed.
Highlights
Postoperative radiation therapy (RT) is indicated in the treatment of post-prostatectomy patients with high-risk of local recurrence [1]
The purpose of this study is to critically review the various postoperative prostate RT treatment planning consensus guidelines or atlases currently available with emphases on the methodology and validity of each atlas
There are four distinct consensus guidelines developed by major institutions: Princess Margaret Hospital (PMH) [17], the Australian and New Zealand Radiation Oncology Genito-Urinary Group (FROGG) [19], the European Organization for Research and Treatment of Cancer (EORTC) [21], and the Radiation Therapy Oncology Group (RTOG) [22]
Summary
Postoperative radiation therapy (RT) is indicated in the treatment of post-prostatectomy patients with high-risk of local recurrence [1]. Two randomised controlled trials suggest adjuvant RT directly following surgery provides improved progression-free survival, biochemical relapse-free survival, and local control over watchful waiting protocols [3, 11]. A long-term follow-up of one of these trials suggests that adjuvant RT improves metastasis-free survival and overall survival compared with observation alone [2], there is insufficient long-term follow-up data available to adequately assess the effect on these treatment outcomes. A major obstacle in the delivery of postoperative radiation therapy (RT) for prostate cancer is accurate delineation of the tumor targets and organs at risk. The purpose of this study is to critically review the various postoperative prostate RT treatment planning consensus guidelines or atlases currently available
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