Proposed definition of the vaginal cuff and paracolpium clinical target volume in postoperative uterine cervical cancer

Naoya Murakami; Yoshiki Norihisa; Fumiaki Isohashi; Keiko Murofushi; Takuro Ariga; Tomoyasu Kato; Koji Inaba; Hiroyuki Okamoto; Yoshinori Ito; Takafumi Toita; Jun Itami

doi:10.1016/j.prro.2015.04.008

Proposed definition of the vaginal cuff and paracolpium clinical target volume in postoperative uterine cervical cancer

Pract Radiat Oncol. 2016 Jan-Feb;6(1):5-11. doi: 10.1016/j.prro.2015.04.008.

Authors

Affiliations

¹ Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan. Electronic address: namuraka@ncc.go.jp.
² Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Radiation Therapy, Bell Land General Hospital, Osaka, Japan.
³ Department of Radiation Oncology, Osaka University Hospital, Osaka, Japan.
⁴ Department of Radiation Oncology, University of Tsukuba, Ibaraki, Japan.
⁵ Department of Radiology, Graduate School of Medicine, University of Ryukyus, Okinawa, Japan.
⁶ Department of Gynecological Oncology, National Cancer Center Hospital, Tokyo, Japan.
⁷ Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.

PMID: 26767622
DOI: 10.1016/j.prro.2015.04.008

Abstract

Purpose: The aim of this study was to develop an appropriate definition for vaginal cuff and paracolpium clinical target volume (CTV) for postoperative intensity modulated radiation therapy in patients with uterine cervical cancer.

Methods and materials: A working subgroup was organized within the Radiation Therapy Study Group of the Japan Clinical Oncology Group to develop a definition for the postoperative vaginal cuff and paracolpium CTV in December 2013. The group consisted of 5 radiation oncologists who specialized in gynecologic oncology and a gynecologic oncologist. A comprehensive literature review that included anatomy, surgery, and imaging fields was performed and was followed by multiple discreet face-to-face discussions and e-mail messages before a final consensus was reached.

Results: Definitions for the landmark structures in all directions that demarcate the vaginal cuff and paracolpium CTV were decided by consensus agreement of the working group. A table was created that showed boundary structures of the vaginal cuff and paracolpium CTV in each direction.

Conclusions: A definition of the postoperative cervical cancer vaginal cuff and paracolpium CTV was developed. It is expected that this definition guideline will serve as a template for future radiation therapy clinical trial protocols, especially protocols involving intensity modulated radiation therapy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Female
Humans
Postoperative Period
Practice Guidelines as Topic*
Prognosis
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Intensity-Modulated
Tomography, X-Ray Computed
Tumor Burden
Uterine Cervical Neoplasms / pathology*
Uterine Cervical Neoplasms / radiotherapy
Vagina / surgery*
Vaginal Neoplasms / pathology*
Vaginal Neoplasms / radiotherapy