BACKGROUND AND AIM External beam radiotherapy (EBRT) combined with brachytherapy has an essential role in the curative treatment of primary vaginal cancer. EBRT is associated with significant tumour shrinkage, making primary vaginal cancer suitable for image guided adaptive brachytherapy (IGABT). The aim of these recommendations is to introduce an adaptive target volume concept for IGABT of primary vaginal cancer. METHODS In December 2013, a task group was initiated within GYN GEC-ESTRO with the purpose to introduce an IGABT target concept for primary vaginal cancer. All participants have broad experience in IGABT and vaginal cancer brachytherapy. The target concept was elaborated as consensus agreement based on an iterative process including target delineation and dose planning comparison, retrospective analysis of clinical data and expert opinions. RESULTS Gynaecological examination and MR imaging are the modalities of choice for local tumour assessment. A specific template for standardised documentation with clinical drawings for vaginal cancer was developed. The adaptive target volume concept comprises different response-related target volumes. For EBRT these are related to the primary tumour and the lymph nodes, while for IGABT these are related to the primary tumour and are consisting of the residual gross tumour volume (GTV-Tres) and the high-, and intermediate risk clinical target volumes (CTV-THR, CTV-TIR). CONCLUSION This target concept for IGABT of primary vaginal cancer defines adaptive target volumes for volumetric dose prescription and should improve comparability of different radiotherapy schedules of this rare disease. A prospective evaluation of the target volume concept within a multicentre study is planned.

中文翻译：

---

妇科 (GYN) GEC-ESTRO 工作组的建议 – ACROP：原发性阴道癌图像引导自适应近距离放射治疗的目标概念

背景与目的外照射放疗（EBRT）联合近距离放射治疗在原发性阴道癌的治愈性治疗中具有重要作用。EBRT 与显着的肿瘤缩小相关，使得原发性阴道癌适用于图像引导的自适应近距离放射治疗 (IGABT)。这些建议的目的是为原发性阴道癌 IGABT 引入自适应目标体积概念。方法 2013 年 12 月，在 GYN GEC-ESTRO 内启动了一个任务组，目的是为原发性阴道癌引入 IGABT 目标概念。所有参与者在 IGABT 和阴道癌近距离放射治疗方面都有广泛的经验。目标概念被详细阐述为基于迭代过程的共识协议，包括目标描述和剂量计划比较，临床资料和专家意见的回顾性分析。结果 妇科检查和 MR 成像是局部肿瘤评估的首选方式。开发了带有阴道癌临床图纸的标准化文档的特定模板。自适应目标体积概念包括不同的响应相关目标体积。对于 EBRT，这些与原发肿瘤和淋巴结有关，而对于 IGABT，这些与原发肿瘤相关，由残留的总肿瘤体积 (GTV-Tres) 和高、中风险临床靶体积组成。 CTV-THR、CTV-TIR）。结论 原发性阴道癌 IGABT 的这一目标概念定义了容积剂量处方的适应性目标体积，并应提高这种罕见疾病不同放疗计划的可比性。计划在多中心研究中对目标体积概念进行前瞻性评估。