GEC-ESTRO/ABS/CARO recommendations on target definition in vaginal recurrences
SP-0098
Abstract
GEC-ESTRO/ABS/CBG recommendations on target definition in vaginal recurrence
Authors: M KAMRAVA.1, E LEUNG.2, REMI NOUT.3
1CEDARS SINAI MEDICAL CENTER, DEPARTMENT OF RADIATION ONCOLOGY, LOS ANGELES, USA; 2SUNNYBROOK HEALTH SCIENCES CENTRE- ODETTE CANCER CENTRE, DEPARTMENT OF RADIATION ONCOLOGY, TORONTO, Canada; 3ERASMUS MEDICAL CENTER ROTTERDAM, DEPARTMENT OF RADIATION ONCOLOGY, ROTTERDAM, The Netherlands
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Abstract Text
Abstract textPurpose or Objective
During the last decade image guided adaptive brachytherapy (IGABT) using MRI/CT based volumetric imaging has greatly evolved. Target volume concept recommendations issued by the Gynaecological Groupe Européen de Curiethérapie and the European Society for Radiotherapy & Oncology (GYN GEC-ESTRO) working group and the following multicenter introduction and evaluation of IGABT for cervical cancer in the EMBRACE study provided clinical validation of these concepts for cervical cancer that have more recently found their way into the ICRU-89 report.
While single institution experiences of IGABT in primary vaginal cancer and recurrences have been published, a common target concept is lacking, hampering further advancement of brachytherapy for these women. In 2013 a task group was initiated in GYN GEC-ESTRO with the purpose to introduce IGABT for vaginal cancer, leading to the recently published recommendations for primary vaginal cancer. There are distinct differences between primary vaginal cancer and vaginal recurrence, in particular with regard to site, involvement, histology and previous oncological treatment(s) For the topic of vaginal recurrence an international collaboration between GEC-ESTRO, the American Brachytherapy Society (ABS) and the Canadian Brachytherapy Group (CBG) was established, and the aim of this presentation is to provide an update of these proceedings.
Methods and Materials
A 2-day workshop style consensus meeting was organized prior to ABS 2019, with equal contribution from all societies. Prior to the workshop a questionnaire on existing practice with regard to IGABT and target volume concepts was circulated and 3 cases were contoured based on institutional practice. During the workshop existing literature and views within the three societies were discussed, followed by an in depth evaluation and discussion of target delineation based on the 3 cases. Finally, summary points for joint target concept recommendations were formulated. As next steps the group agreed on combining the review process of full text recommendations with a second round of target delineation.
ResultsAn update will be provided of proceedings from the workshop in 2019. These include of summary points for definition of the residual GTV, a high risk CTV and intermediate risk CTV at time of brachytherapy.
Conclusion
In order to further improve outcomes of women with vaginal recurrences a joint effort was initiated by GEC-ESTRO, ABS and CBG to establish common target concept recommendations.