Background and purpose: The Global Quality Assurance of Radiation Therapy Clinical Trials Harmonization Group (GHG) is a collaborative group of Radiation Therapy Quality Assurance (RTQA) Groups harmonizing and improving RTQA for multi-institutional clinical trials. The objective of the GHG OAR Working Group was to unify OAR contouring guidance across RTQA groups by compiling a single reference list of OARs in line with AAPM TG 263 and ASTRO, together with peer-reviewed, anatomically defined contouring guidance for integration into clinical trial protocols independent of the radiation therapy delivery technique.
Materials and methods: The GHG OAR Working Group comprised of 22 multi-professional members from 6 international RTQA Groups and affiliated organizations conducted the work in 3 stages: (1) Clinical trial documentation review and identification of structures of interest (2) Review of existing contouring guidance and survey of proposed OAR contouring guidance (3) Review of survey feedback with recommendations for contouring guidance with standardized OAR nomenclature.
Results: 157 clinical trials were examined; 222 OAR structures were identified. Duplicates, non-anatomical, non-specific, structures with more specific alternative nomenclature, and structures identified by one RTQA group were excluded leaving 58 structures of interest. 6 OAR descriptions were accepted with no amendments, 41 required minor amendments, 6 major amendments, 20 developed as a result of feedback, and 5 structures excluded in response to feedback. The final GHG consensus guidance includes 73 OARs with peer-reviewed descriptions (Appendix A).
Conclusion: We provide OAR descriptions with standardized nomenclature for use in clinical trials. A more uniform dataset supports the delivery of clinically relevant and valid conclusions from clinical trials.
Keywords: Contouring; Delineation; Nomenclature; Quality assurance; Radiotherapy; Standardization.
Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.
Yang H, Mir R, Díez P, Tsang Y, Conibear J, Simões R, Cox S, Webster A, Nabi Z, Eaton D, Naismith O, Whilde N, Miles E. Yang H, et al. Clin Oncol (R Coll Radiol). 2020 Feb;32(2):e60-e66. doi: 10.1016/j.clon.2019.09.054. Epub 2019 Oct 11. Clin Oncol (R Coll Radiol). 2020. PMID: 31607614
Wright JL, Yom SS, Awan MJ, Dawes S, Fischer-Valuck B, Kudner R, Mailhot Vega R, Rodrigues G. Wright JL, et al. Pract Radiat Oncol. 2019 Mar;9(2):65-72. doi: 10.1016/j.prro.2018.12.003. Epub 2018 Dec 18. Pract Radiat Oncol. 2019. PMID: 30576843
Melidis C, Bosch WR, Izewska J, Fidarova E, Zubizarreta E, Ulin K, Ishikura S, Followill D, Galvin J, Haworth A, Besuijen D, Clark CH, Miles E, Aird E, Weber DC, Hurkmans CW, Verellen D. Melidis C, et al. Int J Radiat Oncol Biol Phys. 2014 Dec 1;90(5):1242-9. doi: 10.1016/j.ijrobp.2014.08.348. Int J Radiat Oncol Biol Phys. 2014. PMID: 25539374
Cox S, Cleves A, Clementel E, Miles E, Staffurth J, Gwynne S. Cox S, et al. Radiother Oncol. 2019 Aug;137:1-8. doi: 10.1016/j.radonc.2019.04.012. Epub 2019 Apr 28. Radiother Oncol. 2019. PMID: 31039468 Review.
Nielsen MH, Berg M, Pedersen AN, Andersen K, Glavicic V, Jakobsen EH, Jensen I, Josipovic M, Lorenzen EL, Nielsen HM, Stenbygaard L, Thomsen MS, Vallentin S, Zimmermann S, Offersen BV; Danish Breast Cancer Cooperative Group Radiotherapy Committee. Nielsen MH, et al. Acta Oncol. 2013 May;52(4):703-10. doi: 10.3109/0284186X.2013.765064. Epub 2013 Feb 19. Acta Oncol. 2013. PMID: 23421926
Malhotra A, Carpentier EE, Duzenli C. Malhotra A, et al. J Appl Clin Med Phys. 2024 Aug;25(8):e14416. doi: 10.1002/acm2.14416. Epub 2024 May 29. J Appl Clin Med Phys. 2024. PMID: 38812120 Free PMC article.
Covington EL, Suresh K, Anderson BM, Barker M, Dess K, Price JG, Moncion A, Vaccarelli MJ, Santanam L, Xiao Y, Mayo C. Covington EL, et al. J Appl Clin Med Phys. 2024 Jun;25(6):e14359. doi: 10.1002/acm2.14359. Epub 2024 Apr 30. J Appl Clin Med Phys. 2024. PMID: 38689502 Free PMC article.
Barry N, Koh ES, Ebert MA, Moore A, Francis RJ, Rowshanfarzad P, Hassan GM, Ng SP, Back M, Chua B, Pinkham MB, Pullar A, Phillips C, Sia J, Gorayski P, Le H, Gill S, Croker J, Bucknell N, Bettington C, Syed F, Jung K, Chang J, Bece A, Clark C, Wada M, Cook O, Whitehead A, Rossi A, Grose A, Scott AM. Barry N, et al. Phys Imaging Radiat Oncol. 2024 Mar 13;30:100568. doi: 10.1016/j.phro.2024.100568. eCollection 2024 Apr. Phys Imaging Radiat Oncol. 2024. PMID: 38585372 Free PMC article.
Niño SB, Bernardino J, Domingues I. Niño SB, et al. Sensors (Basel). 2024 Mar 8;24(6):1752. doi: 10.3390/s24061752. Sensors (Basel). 2024. PMID: 38544015 Free PMC article. Review.
Sarria GR, Kugel F, Roehner F, Layer J, Dejonckheere C, Scafa D, Koeksal M, Leitzen C, Schmeel LC. Sarria GR, et al. Adv Radiat Oncol. 2023 Oct 26;9(3):101394. doi: 10.1016/j.adro.2023.101394. eCollection 2024 Mar. Adv Radiat Oncol. 2023. PMID: 38292888 Free PMC article.