Enhancing the precision and uniformity of clinical target volume delineation for cervical cancer through a structured educational program

To evaluate the short-term impact of a structured educational program on the accuracy and consistency of clinical target volume (CTV) delineation for external beam radiotherapy (EBRT) in cervical cancer among Chinese radiation oncologists. A total of 45 radiation oncologists participated in a multi-component training course covering guideline-based principles of cervical cancer EBRT, case-based contouring exercises, expert-led reviews, and live demonstrations. Participants performed pre- and post-training delineations on two representative cases (definitive and postoperative radiotherapy) and completed corresponding questionnaires. Delineation quality was assessed using spatial overlap, boundary accuracy, and interobserver variability metrics, with two automated systems included for performance ranking. Correlations between subjective self-assessments and objective metrics were analyzed. Significant post-training improvements were observed in both subjective confidence and objective contouring performance. The primary outcomes, Dice Similarity Coefficient (DSC) and Average Surface Distance (ASD), improved significantly in both clinical cases (p < 0.05), together with several secondary geometric metrics. Interobserver variability decreased across multiple indices. Exploratory analyses suggested alignment between subjective self-assessment and objective contouring quality after training, while more modest improvements were observed in anatomically complex subregions. This study demonstrates that a structured educational intervention significantly enhances the accuracy, consistency, and self-perceived competency of cervical cancer target delineation among radiation oncologists. These findings support the integration of such programs into routine professional development to standardize radiotherapy planning and improve clinical outcomes.