Journal Article

DKFZ-2023-01891

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Contouring variation affects estimates of normal tissue complication probability for breast fibrosis after radiotherapy.

Jaikuna, T. ; Osorio, E. V. ; Azria, D. ; Chang-Claude, J.DKFZ* ; De Santis, M. C. ; Gutiérrez-Enríquez, S. ; van Herk, M. ; Hoskin, P. ; Lambrecht, M. ; Lingard, Z. ; Seibold, P.DKFZ* ; Seoane, A. ; Sperk, E. ; Symonds, R. P. ; Talbot, C. J. ; Rancati, T. ; Rattay, T. ; Reyes, V. ; Rosenstein, B. S. ; de Ruysscher, D. ; Vega, A. ; Veldeman, L. ; Webb, A. ; West, C. M. L. ; Aznar, M. C.

2023
Elsevier Amsterdam [u.a.]

This record in other databases:  

Please use a persistent id in citations: doi:10.1016/j.breast.2023.103578

Abstract: Normal tissue complication probability (NTCP) models can be useful to estimate the risk of fibrosis after breast-conserving surgery (BCS) and radiotherapy (RT) to the breast. However, they are subject to uncertainties. We present the impact of contouring variation on the prediction of fibrosis.280 breast cancer patients treated BCS-RT were included. Nine Clinical Target Volume (CTV) contours were created for each patient: i) CTV_crop (reference), cropped 5 mm from the skin and ii) CTV_skin, uncropped and including the skin, iii) segmenting the 95% isodose (Iso95%) and iv) 3 different auto-contouring atlases generating uncropped and cropped contours (Atlas_skin/Atlas_crop). To illustrate the impact of contour variation on NTCP estimates, we applied two equations predicting fibrosis grade ≥ 2 at 5 years, based on Lyman-Kutcher-Burman (LKB) and Relative Seriality (RS) models, respectively, to each contour. Differences were evaluated using repeated-measures ANOVA. For completeness, the association between observed fibrosis events and NTCP estimates was also evaluated using logistic regression.There were minimal differences between contours when the same contouring approach was followed (cropped and uncropped). CTV_skin and Atlas_skin contours had lower NTCP estimates (-3.92%, IQR 4.00, p < 0.05) compared to CTV_crop. No significant difference was observed for Atlas_crop and Iso95% contours compared to CTV_crop. For the whole cohort, NTCP estimates varied between 5.3% and 49.5% (LKB) or 2.2% and 49.6% (RS) depending on the choice of contours. NTCP estimates for individual patients varied by up to a factor of 4. Estimates from 'skin' contours showed higher agreement with observed events.Contour variations can lead to significantly different NTCP estimates for breast fibrosis, highlighting the importance of standardising breast contours before developing and/or applying NTCP models.

Keyword(s): Breast cancer ; Fibrosis ; Inter-observer variation ; Late effects ; NTCP modelling ; Radiotherapy

---

Contributing Institute(s):

1. C020 Epidemiologie von Krebs (C020)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2023

---

Database coverage:
; ; Article Processing Charges ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DOAJ Seal ; Essential Science Indicators ; Fees ; IF < 5 ; JCR ; Nationallizenz ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

---