Evidence map›Paper›PMID 34012808›Full record

ReviewTranslational lung cancer research2021

Challenges in the target volume definition of lung cancer radiotherapy.

Susan Mercieca, José S A Belderbos, Marcel van Herk

Abstract readReview
In one paragraph

Review in Translational lung cancer research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
–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

17 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Monitoring lung tumour volume on daily cone beam CT; is it achievable in a real-world setting?Technical innovations & patient support in radiation oncology · 2025
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Thorax radiotherapy usingFrontiers in oncology · 2022
    Article
  17. Article
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

3 authors.

Susan MerciecaFaculty of Health Science, University of Malta, Msida, Malta.
José S A BelderbosDepartment of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Marcel van HerkUniversity of Manchester, Manchester Academic Health Centre, The Christie NHS Foundation Trust, Manchester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Radiotherapy, with or without systemic treatment has an important role in the management of lung cancer. In order to deliver the treatment accurately, the clinician must precisely outline the gross tumour volume (GTV), mostly on computed tomography (CT) images. However, due to the limited contrast between tumour and non-malignant changes in the lung tissue, it can be difficult to distinguish the tumour boundaries on CT images leading to large interobserver variation and differences in interpretation. Therefore the definition of the GTV has often been described as the weakest link in radiotherapy with its inaccuracy potentially leading to missing the tumour or unnecessarily irradiating normal tissue. In this article, we review the various techniques that can be used to reduce delineation uncertainties in lung cancer.

Indexed as

auto-segmented contours can provide a good starting pointeventually reducing the delineation time and interobserver variation. Improvements in image quality can also reduce the delineation uncertainty in some cases. The main factor leading to interobserver variation is image interpretation differences between clinicians. Thereforeit is still not possible to eliminate interobserver variation in the definition of GTV. Positron Emission Tomography (PET-CT) has an important role in improving the staging accuracy and the definition of the tumour. Various autosegmentation tools have also been proposed to fully or partially automate the delineation process. Howevermanual delineation is still considered to be the gold standard. NeverthelessprotocolsThe findings of this review indicate that to datetheir development is currently hindered by the unavailability of absolute gold standards that can be used to train and validate these algorithms. Hencetraining and peer review checks of delineated contours are essential to address this challenge. The development of the MR-linac will also present new challenges and opportunities in optimising the definition of the target volume as well as in the development of adaptive radiotherapy strategies

Identifiers

PMID34012808
PMCPMC8107734

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Registered trials

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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.