The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey.
Date
2023-11-01ICR Author
Author
Davey, A
Pan, S
Bryce-Atkinson, A
Mandeville, H
Janssens, GO
Kelly, SM
Hol, M
Tang, V
Davies, LSC
Siop-Europe Radiation Oncology Working Group
Aznar, M
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND AND PURPOSE: Children receiving radiotherapy for head-and-neck tumours often experience severe dentofacial side effects. Despite this, recommendations for contouring and dose constraints to dentofacial structures are lacking in clinical practice. We report on a survey aiming to understand current practice in contouring and dose assessment to dentofacial structures. METHODS: A digital survey was distributed to European Society for Paediatric Oncology members of the Radiation Oncology Working Group, and member-affiliated centres in Europe, Australia, and New Zealand. The questions focused on clinical practice and aimed to establish areas for future development. RESULTS: Results from 52 paediatric radiotherapy centres across 27 countries are reported. Only 29/52 centres routinely delineated some dentofacial structures, with the most common being the mandible (25 centres), temporo-mandibular joint (22), dentition (13), orbit (10) and maxillary bone (eight). For most bones contoured, an 'As Low As Reasonably Achievable' dose objective was implemented. Only four centres reported age-adapted dose constraints.The largest barrier to clinical implementation of dose constraints was firstly, the lack of contouring guidance (49/52, 94%) and secondly, that delineation is time-consuming (33/52, 63%). Most respondents who routinely contour dentofacial structures (25/27, 90%) agreed a contouring atlas would aid delineation. CONCLUSION: Routine delineation of dentofacial structures is infrequent in paediatric radiotherapy. Based on survey findings, we aim to 1) define a consensus-contouring atlas for dentofacial structures, 2) develop auto-contouring solutions for dentofacial structures to aid clinical implementation, and 3) carry out treatment planning studies to investigate the importance of delineation of these structures for planning optimisation.
Collections
Subject
Contouring
Dentofacial
Dose-volume constraints
Late adverse effects
Paediatrics
Radiotherapy
Research team
Paed & Adolesc Radiother
Language
eng
Date accepted
2023-09-21
License start date
2023-11-01
Citation
Clinical and Translational Radiation Oncology, 2023, 43 pp. 100681 -
Publisher
ELSEVIER IRELAND LTD