Rationale and Objectives
The treatment of locally advanced lung cancer (LALC) with radiotherapy (RT) can be
challenging. Multidisciplinary collaboration between radiologists and radiation oncologists
(ROs) may optimize RT planning, reduce uncertainty in follow-up imaging interpretation,
and improve outcomes.
Materials and Methods
In this prospective clinical treatment trial (clinicaltrials.gov NCT04844736), 37 patients receiving definitive RT for LALC, six attending ROs, and three thoracic
radiologists were consented and enrolled across four treatment centers. Prior to RT
plan finalization, representative computed tomography (CT) slices with overlaid outlines
of preliminary irradiation targets were shared with the team of radiologists. The
primary endpoint was to assess feasibility of receiving feedback no later than 4 business
days of RT simulation on at least 50% of plans.
Results
Thirty-seven patients with lung cancer were enrolled, and 35 of 37 RT plans were reviewed.
Of the 35 patients reviewed, mean age was 69 years. For 27 of 37 plans (73%), feedback
was received within 4 or fewer days (interquartile range 3–4 days). Thirteen of 35
cases (37%) received feedback that the delineated target potentially did not include
all sites suspicious for tumor involvement. In total, changes to the RT plan were
recommended for over- or undercoverage in 16 of 35 cases (46%) and implemented in
all cases. Radiology review resulted in no treatment delays and substantial changes
to irradiated volumes: gross tumor volume, −1.9 to +96.1%; planning target volume,
−37.5 to +116.5%.
Conclusion
Interdisciplinary collaborative RT planning using a simplified workflow was feasible,
produced no treatment delays, and prompted substantial changes in RT targets.
Key Words
Abbreviations:
CTV (clinical target volume), GTV (gross tumor volume), IQR (interquartile range), LALC (locally advanced lung cancer), PDF (portable document format), PTV (planning target volume), ROs (radiation oncologists), RT (radiotherapy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 07, 2023
Accepted:
January 15,
2023
Received in revised form:
January 5,
2023
Received:
December 13,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
