2008
DOI: 10.1080/02841860701654317
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Incidental irradiation of mediastinal and hilar lymph node stations during 3D-conformal radiotherapy for non-small cell lung cancer

Abstract: To estimate the doses of incidental irradiation in particular lymph node stations (LNS) in different extents of elective nodal irradiation (ENI) in 3D-conformal radiotherapy (3D-CRT) for non-small cell lung cancer (NSCLC). Methods. Doses of radiotherapy were estimated for particular LNS delineated according to the recommendations of the University of Michigan in 220 patients treated using 3D-CRT with different (extended, limited and omitted) extents of ENI. Minimum doses and volumes of LNS receiving 40 Gy or m… Show more

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Cited by 10 publications
(7 citation statements)
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“…The quantity of the incidental dose, elective nodal coverage, and its adequacy for the microscopic disease control was not tended in our PSM cohorts; however, these issues were addressed by Polish and Japanese retrospective studies [ 22 , 23 ]. Kepka et al estimated the incidental doses and V 40 values of 3D-CRT for specific LN stations with varying ENI extents (extended, limited, and omitted) in 220NSCLC patients [ 22 ].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…The quantity of the incidental dose, elective nodal coverage, and its adequacy for the microscopic disease control was not tended in our PSM cohorts; however, these issues were addressed by Polish and Japanese retrospective studies [ 22 , 23 ]. Kepka et al estimated the incidental doses and V 40 values of 3D-CRT for specific LN stations with varying ENI extents (extended, limited, and omitted) in 220NSCLC patients [ 22 ].…”
Section: Discussionmentioning
confidence: 99%
“…The quantity of the incidental dose, elective nodal coverage, and its adequacy for the microscopic disease control was not tended in our PSM cohorts; however, these issues were addressed by Polish and Japanese retrospective studies [ 22 , 23 ]. Kepka et al estimated the incidental doses and V 40 values of 3D-CRT for specific LN stations with varying ENI extents (extended, limited, and omitted) in 220NSCLC patients [ 22 ]. They have noticed that the incidental irradiation of unintended LNs was apparent in case of limited ENI, such as uninvolved stations of 5 and 6, and lower parts of 3A and 3P were already irradiated while electively irradiating stations of 4R, 4L, 7, and ipsilateral hilum, but these stations were not adequately covered in IFRT, and levels 1 and 2 were not covered in any scenario.…”
Section: Discussionmentioning
confidence: 99%
“…(3) Concurrent or sequential use of chemotherapy with radiotherapy may also help control local diseases. (4) Although the elective nodal regions are not included in IFRT, they are incidentally irradiated with prophylactic doses, and the prophylactic doses may contribute to the low incidence of ENF [ 23 26 ]. Before this meta-analysis, despite the widespread abandoning of ENI for NSCLC patients, we still take a conservative approach in our department because existing evidence for this is insufficient.…”
Section: Discussionmentioning
confidence: 99%
“…To our knowledge this is the first study examining the dose distribution in elective lymph node stations adjacent to the CTV in the context of IF-IMRT in NSCLC. Several planning studies examined the potential benefits of incidental nodal irradiation of uninvolved lymph node regions when using 3D-CRT [ 7 , 8 , 20 , 21 ]. Even with PET-based IF-RT of stage III NSCLC, rates of out-of-field nodal recurrences can be as high as 10 % and therefore cannot be considered as insignificant [ 22 ].…”
Section: Discussionmentioning
confidence: 99%