Pattern of lymph node metastases and its implication in radiotherapeutic clinical target volume in patients with thoracic esophageal squamous cell carcinoma: A report of 1077 cases

Huang, Wei; Li, Baosheng; Gong, Huaqing; J, Yu; Sun, Hao; Zhou, Tao; Zhang, Zicheng; Liu, Xibin

doi:10.1016/j.radonc.2010.01.006

Cited by 75 publications

(65 citation statements)

References 30 publications

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“…Most studies report that the neck and upper mediastinum are the regions most commonly affected by nodal metastasis in patients with upper ec [11][12][13] . The present study …”

Section: Discussionmentioning

confidence: 99%

“…In a cohort of upper ec patients receiving esophagectomy with 3-field lymph node dissection, Jang et al 12 reported that the nodes of the mediastinum (74.2%) were most commonly affected, followed by the cervical lymph nodes (46.2%) and the abdominal lymph nodes (24.7%). In addition, Huang et al 13 reported that the rate of lymph node metastasis in patients with upper thoracic tumours was 16.7% for cervical, 38.9% for upper mediastinal, 11.1% for middle mediastinal, 5.6% for lower mediastinal, and 5.6% for abdominal lymph nodes. Metastatic rates for lymph nodes vary in different studies.…”

Section: Figurementioning

confidence: 99%

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Computed Tomography–Based Distribution of Involved Lymph Nodes in Patients with Upper Esophageal Cancer

Liu

et al. 2015

Current Oncology

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“…Most studies report that the neck and upper mediastinum are the regions most commonly affected by nodal metastasis in patients with upper ec [11][12][13] . The present study …”

Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Computed Tomography–Based Distribution of Involved Lymph Nodes in Patients with Upper Esophageal Cancer

Liu

et al. 2015

Current Oncology

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“…In recent years, a number of studies on radiotherapy combined with ENI have been conducted. ENI aims to reduce the local recurrence rate, particularly that in regional lymph nodes (5,6). However, certain studies demonstrated that, in patients who underwent radiotherapy rather than ENI, the lymph node recurrence rate outside the field was 2-8% (7,8).…”

Section: Discussionmentioning

confidence: 99%

“…It was previously reported that, compared with involved-field irradiation (IFI), ENI does not improve the local control rate or long-term survival of patients with esophageal cancer (4). Previous studies have indicated that ENI may prevent regional lymph node metastasis (5,6), whereas other studies (7)(8)(9) reported that the isolate out-of-field nodal failure rate was low and overall survival did not decrease when IFI was used (6,7). Ji et al (10) reported the results of a prospective study on 3D-CRT in 39 patients with esophageal cancer without distant metastases, and revealed that lymph node stations in close proximity to esophageal malignant tumors receive considerable incidental radiation doses with IFI, which may contribute to the elimination of subclinical lesions.…”

Section: Introductionmentioning

confidence: 99%

Radiation dose to the lymph drainage area in esophageal cancer with involved-field irradiation

et al. 2015

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Abstract. The aim of this study was to quantify the radiation dose to the corresponding lymph drainage area in esophageal cancer using three-dimensional conformal radiation therapy (3D-CRT) with involved-field irradiation (IFI) and to analyze associated factors. A retrospective analysis of 81 patients with esophageal cancer was conducted. According to the location of the lesions, the lymph drainage area was delineated and the dosimetric parameters were calculated. The 1-, 3-, 5-and 8-year survival rates of the patients were 67.90, 33.33, 20.99 and 11.11%, respectively. Based on the dose-volume histogram in the treatment plan, we calculated the volume percentage of the planning target volume including clinically positive lymph nodes (PTV-N) receiving radiation doses of 30, 35, 40, ). The median values of V PTV-N30-50 were 73, 70, 67, 64 and 58%, respectively. The prescribed dose size exhibited no correlation with V PTV-N30-35 , but did exhibit a significant correlation with V PTV-N40-50 ; the radiation field was not correlated with V PTV-N30-45 , but exhibited a significant correlation with V PTV-N50 ; the length of the lesion on esophageal barium meal X-ray and the PTV were significantly correlated with V PTV-N30-50 . The analysis of variance revealed that the V PTV-NX value in the upper thoracic segment was higher compared with that in the middle and lower thoracic segments; V PTV-N30-35 values differed significantly according to the different locations of the lesions, whereas V PTV-N40-50 values exhibited no significant differences. The value of V PTV-NX exerted no significant effect on long-term patient survival. Therefore, the corresponding lymph drainage area of esophageal cancer is subjected to a certain radiation dose when patients undergo 3D-CRT with IFI, which may play a role in the prevention of regional nodal metastasis. However, this hypothesis requires confirmation by further clinical studies. IntroductionThere is significant controversy regarding target region delineation by esophageal cancer radiotherapy in different regions. In the RTOG85-01 randomized trial (1), irradiation of the entire esophagus for esophageal cancer was recommended. In the RTOG94-05 trial (2), an area with a margin of 2-5 cm surrounding the gross tumor volume (GTV) was defined as the clinical target volume (CTV). The supraclavicular nodes were included only when the tumor was located in the cervical esophageal area. However, the results of these two trials were not satisfactory, as the survival and local control rates did not improve significantly. In the RTOG01-33 trial (3), three-dimensional conformal radiation therapy (3D-CRT) technology was applied. The CTV included a 3-cm margin around the GTV, while the planning target volume (PTV) included a margin of ≤2 cm around the CTV. Over the last few years, an increasing number of studies have been conducted on elective nodal irradiation (ENI) for esophageal cancer; however, their conclusions have been inconsistent. It was previously reported that, compared with involved-field ...

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“…The clinical tumour volume of the first-phase RT included the primary tumour spreading by 3 cm in the craniocaudal direction and involved regional lymph node groups. [23][24][25] According to the lymph node groups defined by Japanese guidelines, 26,27 the neck and upper chest oesophageal SLN irradiation fields cover Group 104, Group 107 and part of Group 108. For lesions involving the middle part of the oesophagus, the radiation field should include Group 104 and Groups 106-108, as well as some part of Group 110.…”

Section: Radiation Therapymentioning

confidence: 99%

Phase I study of concurrent selective lymph node late-course accelerated hyperfractionated radiotherapy and S-1 plus cisplatin for locally advanced oesophageal squamous cell carcinoma

Li¹,

Fu²,

Zhang³

et al. 2016

BJR

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). In the initial five patients, two patients developed DLTs. As MTD was not reached, five additional patients were treated with the same dose level, and DLTs occurred in only one patient. Similar results were found in the last five patients. After CCRT, the objective response rates were 100% for primary tumours and 86.2% for metastatic lymph nodes, respectively. Totally, the observed Grade 3 toxicities during CCRT were leukopenia (20%), neutropenia (20%) and dermatitis (13.3%), and no Grade 4 toxicity occurred. The Kaplan-Meier-estimated overall and progression survival rates were 86.7% and 66.7% (1 year), 73.3% and 60% (2 years) and 73.3% and 60% (3 years). Conclusion:The concurrent SLN LCAF IMRT and chemotherapy with S-1 and CDDP was well tolerated and showed promising efficacy. The dose of S-1 in this regimen was recommended with 80 mg m 22 orally twice daily on Days 1-14 and Days 22-35. Advances in knowledge: CCRT with S-1 plus CDDP exhibited encouraging results with milder toxicities, high objective response rates and ideal overall survival time.

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Pattern of lymph node metastases and its implication in radiotherapeutic clinical target volume in patients with thoracic esophageal squamous cell carcinoma: A report of 1077 cases

Cited by 75 publications

References 30 publications

Computed Tomography–Based Distribution of Involved Lymph Nodes in Patients with Upper Esophageal Cancer

Computed Tomography–Based Distribution of Involved Lymph Nodes in Patients with Upper Esophageal Cancer

Radiation dose to the lymph drainage area in esophageal cancer with involved-field irradiation

Phase I study of concurrent selective lymph node late-course accelerated hyperfractionated radiotherapy and S-1 plus cisplatin for locally advanced oesophageal squamous cell carcinoma

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