Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma

Journal Article · Thu Feb 01 04:00:00 EST 2007 · International Journal of Radiation Oncology, Biology and Physics

OSTI ID:20944678

Xianshu, Gao ^[1]; Xueying, Qiao ^[2]; Fengpeng, Wu ^[2]; Li, Cao ^[2]; Xianli, Meng ^[3]; Zhiming, Dong ^[4]; Xiaoling, Wang ^[4]; Guodong, Gao ^[4]; Wu, T -T ^[5]; Komaki, Ritsuko ^[6]; Chang, Joe Y ^[6]

---

1. Department of Radiation Oncology, Beijing University First Hospital, Beijing (China)
2. Department of Radiation Oncology, Hebei Medical University Fourth Hospital, Shijiazhuang (China)
3. Department of Thoracic Surgery, Hebei Medical University Fourth Hospital, Shijiazhuang (China)
4. Department of Pathology, Hebei Medical University Fourth Hospital, Shijiazhuang (China)
5. Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
6. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

Purpose: To clarify the radiotherapy clinical target volume (CTV) margin needed for esophageal squamous-cell carcinoma (SCC) and gastroesophageal junction (GEJ) adenocarcinoma. Methods and Materials: Surgical specimens of esophageal SCC (n = 34) and GEJ adenocarcinoma (n = 32) were prospectively collected and analyzed for microscopic spread along the esophagus and GEJ both proximally and distally from gross tumor and for lymph node (LN) metastasis. Results: For SCC, the mean microscopic spread beyond the gross tumor was 10.5 {+-} 13.5 mm proximally (<30 mm in 32 of 34 cases) and 10.6 {+-} 8.1 mm distally (<30 mm in 33 of 34 cases). For GEJ adenocarcinoma, the spread was 10.3 {+-} 7.2 mm proximally (<30 mm in 29 of 29 cases) and 18.3 {+-} 16.3 mm distally (<30 mm in 27 of 32 cases). The extent of microscopic spread of cancer was significantly associated with pathologic T stage (p = 0.012). LN metastases were observed in 12 (35%) of 34 patients with middle and lower esophageal SCC and 15 (47%) of 32 patients with GEJ adenocarcinoma. Conclusions: The extent of microscopic spread within esophagus (recommended CTV margin) was <30 mm in about 94% of cases of esophageal cancer, except for distal microscopic spread in GEJ adenocarcinoma, in which 50 mm was needed to cover about 94% of cases.

• OSTI ID: 20944678
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 67; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
ESOPHAGUS
LYMPH NODES
METASTASES
PATIENTS
RADIOTHERAPY
SURGERY