Original articlePractical contouring guidelines with an MR-based atlas of brainstem structures involved in radiation-induced nausea and vomiting
Section snippets
Population: Working group
A multidisciplinary working group (WG) was created to develop these new recommendations for central nervous system (CNS) substructures involved in RINV. All physicians who contributed to the creation of these guidelines are listed as co-authors of this manuscript. The general principles guiding the activities of the WG were: (1) to integrate as accurately as possible anatomic knowledge and previously defined surgical and radiological guidelines into a set of recommendations based on axial CT
Results
After the working group (WG) delineated the DVC and the three parts of the brainstem in patient A, a first interobserver analysis (Time 1) was performed and the variability in delineation was discussed. Subsequently, the WG agreed on consensus definitions for these structures and formulated the final consensus guidelines for these structures implicated in RINV (available in Supplemental data). A second interobserver analysis (Time 2) confirmed that the delineation of the DVC and the three parts
Discussion
Radiation-induced nausea and vomiting (RINV) were rare side effects with 3-dimensional conformal radiation therapy (3D-CRT) techniques. RINV seems to be more frequent since the development of new technologies such as intensity-modulated radiation therapy (IMRT) for the treatment of locally advanced head and neck cancer (HNC). The RINV atlas described above has thus been designed to prospectively assess dose–volume effects for structures previously identified as being involved in RINV.
In 2008,
Conflicts of interest
None declared.
Acknowledgments
The authors acknowledge AQUILAB SAS for their contribution to this study.
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