+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Explore the radiotherapeutic clinical target volume delineation for thoracic esophageal squamous cell carcinoma from the pattern of lymphatic metastases



Explore the radiotherapeutic clinical target volume delineation for thoracic esophageal squamous cell carcinoma from the pattern of lymphatic metastases



Journal of Thoracic Oncology 8(3): 359-365



Esophageal carcinoma is characterized by a high frequency of lymph node metastasis (LNM). It is difficult to accurately define the radiotherapeutic clinical target volume in patients with thoracic esophageal squamous cell carcinoma (ESCC), because the LNM rate and the included node level varied greatly among previous studies. This study aimed to determine which node level should be included for radiotherapy by analyzing LNM rate in thoracic ESCC patients. The clinicopathological factors related to LNM were analyzed using the χ test. The sites with LNM rate higher than 15%, an empirical cutoff value, were considered as high-risk areas and were included in clinical target volume of thoracic ESCC patients for radiotherapy. This study included 1893 thoracic ESCC patients treated at Shandong Cancer Hospital, Jinan, China. The rates of LNM in patients with upper thoracic tumors were 14.6% cervical, 29.3% upper mediastinal, 8.5% middle mediastinal, 9.8% lower mediastinal, and 7.3% abdominal, respectively. The rates of LNM in patients with middle thoracic tumors were 4.3%, 5.0%, 32.9%, 2.5%, and 14.9%, respectively. The rates of LNM in patients with lower thoracic tumors were 2%, 2.2% 15.4%, 38.1%, and 27.5%, respectively. Independent prognostic factors for LNM included length of tumor, histologic differentiation, and depth of tumor invasion (p < 0.001). Irradiation of the selective regional lymph node and the correlated lymphatic drainage regions should be performed according to the clinicopathological factors. For the large, deeply invasive longer tumors and poorly differentiated thoracic ESCC, the irradiation field should be enlarged appropriately.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 053138710

Download citation: RISBibTeXText

PMID: 23263689

DOI: 10.1097/jto.0b013e31827e1f6d


Related references

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. RadioTherapy and Oncology 95(2): 229-233, 2010

Precise delineation of clinical target volume for crossing-segments thoracic esophageal squamous cell carcinoma based on the pattern of lymph node metastases. Journal of Thoracic Disease 7(12): 2313-2320, 2015

Impact of the pattern of lymph node metastasis on the clinical target volume in radiotherapy for thoracic esophageal squamous cell carcinoma. Zhonghua Zhong Liu Za Zhi 32(3): 225-228, 2010

Pattern of relapse in surgical treated patients with thoracic esophageal squamous cell carcinoma and its possible impact on target delineation for postoperative radiotherapy. RadioTherapy and Oncology 96(1): 104-107, 2010

Pattern of lymph node metastases and its implication in radiotherapeutic clinical target volume delineation of regional lymph node in patients with gastric carcinoma. RadioTherapy and Oncology 96(2): 223-230, 2010

Postoperative radiation in esophageal squamous cell carcinoma and target volume delineation. Oncotargets and Therapy 9: 4187-4196, 2016

Distribution pattern of lymph node metastases and its implication in individualized radiotherapeutic clinical target volume delineation of regional lymph nodes in patients with stage IA to IIA cervical cancer. Radiation Oncology 10: 40, 2015

The pattern of lymphatic metastasis and influencing factors of thoracic esophageal squamous cell carcinoma. Practical Radiation Oncology 3(2 Suppl 1): S32-S33, 2014

Exploration of the Radiotherapeutic Clinical Target Volume Delineation for Gastric Cancer from Lymph Node Metastases. Anticancer Research 37(8): 4629-4634, 2017

Pattern of Lymph Node Metastases and Its Implication for Radiotherapeutic Clinical Target Volume in Patients With cN0 Supraglottic Carcinoma: Ipsilateral or Bilateral Neck Irradiation. International Journal of Radiation Oncology*biology*physics 99(2): E385-E386, 2017

Pattern of lymphatic spread in thoracic esophageal squamous cell carcinoma: A single-institution experience. Journal of Thoracic and Cardiovascular Surgery 144(4): 778-85; Discussion 785-6, 2012

Patterns of failure after radical surgery among patients with thoracic esophageal squamous cell carcinoma: implications for the clinical target volume design of postoperative radiotherapy. Plos one 9(5): E97225, 2014

Recurrence Pattern of Squamous Cell Carcinoma in the Middle Thoracic Esophagus: Implications for the Clinical Target Volume Design of Postoperative Radiation Therapy. International Journal of Radiation Oncology*Biology*Physics 96(2): E166-E167, 2016

Characteristics of the local recurrence pattern after curative resection and values in target region delineation in postoperative radiotherapy for lower thoracic esophageal squamous cell cancer. Thoracic Cancer 8(6): 630-633, 2017

Pattern of lymph node metastases of esophageal squamous cell carcinoma based on the anatomical lymphatic drainage system. Diseases of the Esophagus 24(1): 33-38, 2011