The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey.
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Embargo End Date
ICR Authors
Authors
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
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
Document Type
Journal Article
Date
2023-11-01
Date Accepted
2023-09-21
Abstract
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.
Citation
Clinical and Translational Radiation Oncology, 2023, 43 pp. 100681 -
Source Title
Clinical and Translational Radiation Oncology
Publisher
ELSEVIER IRELAND LTD
ISSN
2405-6308
eISSN
2405-6308
2405-6308
2405-6308
Collections
Research Team
Paed & Adolesc Radiother