Evidence map›Paper›PMID 26104943›Full record

GuidelineInternational journal of radiation oncology, biology, physics2015

Expert Consensus Contouring Guidelines for Intensity Modulated Radiation Therapy in Esophageal and Gastroesophageal Junction Cancer.

Abraham J Wu, Walter R Bosch, Daniel T Chang, Theodore S Hong, Salma K Jabbour, Lawrence R Kleinberg, Harvey J Mamon, Charles R Thomas, Karyn A Goodman

Abstract readConsensus StatementPractice Guideline
In one paragraph

Guideline in International journal of radiation oncology, biology, physics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

76 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Evaluation of PET-detected nodal upstaging and planning target volume expansion in esophageal cancer radiotherapy planning.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
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16 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Abraham J WuMemorial Sloan-Kettering Cancer Center, New York, New York. Electronic address: wua@mskcc.org.
Walter R BoschWashington University, St. Louis, Missouri.
Daniel T ChangStanford Cancer Institute, Stanford, California.
Theodore S HongMassachusetts General Hospital, Boston, Massachusetts.
Salma K JabbourRutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
Lawrence R KleinbergJohns Hopkins Medical Center, Baltimore, Maryland.
Harvey J MamonBrigham and Women's Hospital, Boston, Massachusetts.
Charles R ThomasKnight Cancer Institute, Oregon Health & Sciences University, Portland, Oregon.
Karyn A GoodmanMemorial Sloan-Kettering Cancer Center, New York, New York.

Funding

IROC: Enhancing local enrolling site radiological data capture capabilities for NCTN trialsU24CA180803 · NCI · AMERICAN COLLEGE OF RADIOLOGY · PI Thomas J. FitzGerald, MICHAEL V KNOPP · 2014 to 2026
$116.2M
ADVANCED TECHNOLOGY QA CENTERU24CA081647 · NCI · WASHINGTON UNIVERSITY · PI MICHALSKI, JEFF M. · 1999 to 2013
$22.8M
NCI NIH HHS U24 CA081647NCI NIH HHS U24 CA180803NCI NIH HHS U24CA81647
6 · The paper itself

Abstract

PURPOSE/OBJECTIVE(S): Current guidelines for esophageal cancer contouring are derived from traditional 2-dimensional fields based on bony landmarks, and they do not provide sufficient anatomic detail to ensure consistent contouring for more conformal radiation therapy techniques such as intensity modulated radiation therapy (IMRT). Therefore, we convened an expert panel with the specific aim to derive contouring guidelines and generate an atlas for the clinical target volume (CTV) in esophageal or gastroesophageal junction (GEJ) cancer. METHODS AND MATERIALS: Eight expert academically based gastrointestinal radiation oncologists participated. Three sample cases were chosen: a GEJ cancer, a distal esophageal cancer, and a mid-upper esophageal cancer. Uniform computed tomographic (CT) simulation datasets and accompanying diagnostic positron emission tomographic/CT images were distributed to each expert, and the expert was instructed to generate gross tumor volume (GTV) and CTV contours for each case. All contours were aggregated and subjected to quantitative analysis to assess the degree of concordance between experts and to generate draft consensus contours. The panel then refined these contours to generate the contouring atlas.

resultsThe κ statistics indicated substantial agreement between panelists for each of the 3 test cases. A consensus CTV atlas was generated for the 3 test cases, each representing common anatomic presentations of esophageal cancer. The panel agreed on guidelines and principles to facilitate the generalizability of the atlas to individual cases.

conclusionsThis expert panel successfully reached agreement on contouring guidelines for esophageal and GEJ IMRT and generated a reference CTV atlas. This atlas will serve as a reference for IMRT contours for clinical practice and prospective trial design. Subsequent patterns of failure analyses of clinical datasets using these guidelines may require modification in the future.

Indexed as

Esophagogastric JunctionMedical IllustrationOrgans at RiskRadiotherapy, Intensity-ModulatedAlgorithmsConsensusEsophageal NeoplasmsHumansLymph NodesPositron-Emission TomographyRadiation InjuriesRadiation OncologyTomography, X-Ray ComputedTumor Burden

Identifiers

PMID26104943
PMCPMC4481325

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.