Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma
- Department of Radiation Oncology, Beijing University First Hospital, Beijing (China)
- Department of Radiation Oncology, Hebei Medical University Fourth Hospital, Shijiazhuang (China)
- Department of Thoracic Surgery, Hebei Medical University Fourth Hospital, Shijiazhuang (China)
- Department of Pathology, Hebei Medical University Fourth Hospital, Shijiazhuang (China)
- Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
- 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, Vol. 67, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2006.09.015; PII: S0360-3016(06)02986-5; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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