A Prospectively Randomized Study of Clinical Target Volume Margins for 3-dimensional Conformal Radiation Therapy in Patients With Squamous Cell Carcinoma of Thoracic Esophagus

2012 ◽  
Vol 84 (3) ◽  
pp. S41
Author(s):  
X. Qiao ◽  
M. Li ◽  
Z. Zhou ◽  
C. Zhen ◽  
Y. Song ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Radiation Therapy ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical Target Volume ◽  
Randomized Study ◽  
Target Volume ◽  
Thoracic Esophagus ◽  
Conformal Radiation Therapy ◽  
3 Dimensional

scholarly journals Mapping patterns of metastatic lymph nodes for postoperative radiotherapy in thoracic esophageal squamous cell carcinoma: a recommendation for clinical target volume definition

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jing Yu ◽  
Wen Ouyang ◽  
Chunyang Li ◽  
Jiuling Shen ◽  
Yu Xu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical Target Volume ◽  
Postoperative Radiotherapy ◽  
Target Volume ◽  
Thoracic Esophagus ◽  
Axial Ct

Abstract Background The clinical target volume (CTV) for postoperative radiotherapy for thoracic esophageal squamous cell carcinoma (TESCC) needs to be defined. The study aim was to map metastatic lymph nodes (LNMs) in a computed tomography (CT)-based atlas and delineate the postoperative radiotherapy target area. Methods Sixty-nine TESCC patients with first recurrent regional LNMs after esophagectomy were included. The LNM epicenters were registered onto corresponding anatomic axial CT images of a standard patient in the treatment position, with reference to the surrounding vascular and bony structures. The LNM sites were based on lymph node map of esophageal cancer, AJCC 8th. The lymph metastasis risk for different segments of thoracic esophagus was assessed. Results One hundred and seventy-nine LNMs were mapped onto standard axial CT images. The upper-middle mediastinum region (station 1 to 8 M) contained 97% of metastases in the upper segment of thoracic esophagus, 90% in the middle segment, and 66% in the lower one. Advanced pathological stage (≥IIIB) might be a predictive factor for upper abdominal region (UAR) relapse in lower TESCC. Lower cervical para-tracheal LNMs were within a 4.3-cm bilaterally expanded area from the midline of the body and a 2.2-cm expanded area from the anterior of vertebral body, from the superior border of the C7, to the inferior border of the first thoracic vertebra. Conclusion A modified target from the upper border of C7 to the lower border of caudal margin of the inferior pulmonary vein level could cover the high-risk area of TESCC underwent postoperative radiotherapy. UAR seems to be an elective irradiation target for lower TESCC at pathological IIIB stage and higher.

scholarly journals Pattern of Recurrence in 428 Patients With Thoracic Esophageal Squamous Cell Carcinoma After Radical Surgery and Its Implication in Postoperative Radiotherapeutic Clinical Target Volume

2021 ◽  
Vol 11 ◽  
Author(s):  
Tiantian Cui ◽  
Hongjiao Zhang ◽  
Tao Yu ◽  
Yiru Chen ◽  
Chengxin Liu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical Target Volume ◽  
Radical Surgery ◽  
Regional Lymph Node ◽  
Postoperative Radiotherapy ◽  
Target Volume ◽  
Recurrence Patterns

PurposeThis study aimed to analyze the recurrence patterns of thoracic esophageal squamous cell carcinoma (ESCC) after radical surgery, and to understand its implication in the clinical target volume (CTV) design of postoperative radiotherapy (PORT) in patients with ESCC.Methods and materialsA total of 428 recurrent ESCC patients after radical surgery between 2014 and 2018 were included in this study. Recurrence patterns, especially anastomotic and regional lymph node recurrence (LNR), were analyzed. A T-shaped CTV were proposed for PORT and were evaluated whether it could cover most of regional LNR.ResultsThese patients all experienced anastomotic and/or regional LNR. Among the 428 patients, 27 cases (6.3%) had anastomotic recurrence only, and184 cases (43.0%) had LNR only. Those sites with an LNR rate higher than 15% in upper thoracic ESCC were as follows: No.101, No.104R, No.104L, No.106recR, No.106recL, No.106pre, No.106tb, No.107, and No. 109. Those with middle thoracic ESCC were as follows: No.104R, No.104L, 106recR, No.106recL, No.106pre, No.106tb, and No.107. Lastly, individuals with lower thoracic ESCC were as follows: No.104L, 106recR, No.106recL, No. 106pre, No. 106tb, No.107, and abdominal No. 3. The proportion of LNR not included in the proposed T-shaped CTV was 12.5% (1/8), 4.7% (6/128), and 10.4% (5/48) in the upper, middle, and lower thoracic segments, respectively.ConclusionsLNR was the most common type of local-regional recurrence in patients after radical surgery. Supraclavicular, superior and middle mediastinal lymph nodes had the highest recurrence rate, the rate of LNR which was outside T-shaped PORT CTV we proposed was less than 15%.

Patterns of local failure after definitive radiotherapy in patients with esophageal squamous cell carcinoma: Implications for the longitudinal clinical target volume design.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15504-e15504
Author(s):  
Bo Cheng ◽  
Xue Meng
Keyword(s):  
Squamous Cell Carcinoma ◽  
Radiation Dose ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Primary Tumor ◽  
Clinical Target Volume ◽  
Target Volume ◽  
Definitive Radiotherapy ◽  
Recurrence Patterns

e15504 Background: The correlation between the clinical target volume (CTV) margin and esophageal squamous cell carcinoma (ESCC) recurrence pattern is not completely clear. Our aim was to retrospectively evaluate the recurrence patterns in ESCC patients who received definitive radiotherapy (RT) with different CTVs, and determine the optimum longitudinalmargin. Methods: Patients with histologically proven ESCC (N = 134) were classified into the following three groups according to the initial expanding margin of CTV at the recurrence side: CTV1 with longitudinal margin ≥ 3cm (N = 73), CTV2 with 2-3cm (N = 37), and CTV3 with < 2cm (N = 24). The recurrence patterns were analyzed relative to the CTV margins, as well as the radiation dose, tumor stage, comorbidities etc. Results: The recurrence sites were significantly different between the CTV1 and CTV3 (p < 0.001), but not between the CTV1 and CTV2 groups (p = 0.052). In addition, 42 (91.3%) of the 46 patients that received low-dose (55-60Gy) RT showed recurrence at the site of the primary tumor, an obviously greater proportion compared to those who underwent a high-dose ( > 60Gy) treatment (77.3%, p = 0.018). Drinking was also a clear contributing factor (p = 0.025). Age, smoking, comorbidities,tumor location, stage and treatment mode were not significant prognostic factors for ESCC recurrence. Conclusions: CTV with a 2-3cm longitudinal expansion to the gross tumor volume (GTV) is acceptable for radical RT for ESCC, and recurrence at the primary tumor site is associated with low radiation dose ( < 60Gy).

Sign in / Sign up

Export Citation Format

Share Document