Academic Journal
Coverage of lateral lymph nodes in rectal cancer patients with routine radiotherapy practice and associated locoregional recurrence rates
| العنوان: | Coverage of lateral lymph nodes in rectal cancer patients with routine radiotherapy practice and associated locoregional recurrence rates |
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| المؤلفون: | Sluckin, T.C., Hazen, S.M.J.A., Horsthuis, K., Beets-Tan, R.G.H., Antonisse, I.E., Berbee, M., Bockel, L.W. van, Boer, A.H., Ceha, H.M., Cnossen, J.S., Geijsen, E.D., Hartogh, M.D. den, Hendriksen, E.M., Intven, M.P.W., Leseman-Hoogenboom, M.M., Meijnen, P., Muller, K., Oppedijk, V., Rozema, T., Rutten, H., Spruit, P.H., Stam, T.C., Velema, L.A., Verrijssen, A.S.E., Vos-Westerman, J., Tanis, P.J., Marijnen, C.A.M., Kusters, M., Dutch Snapshot Res Grp |
| المصدر: | International Journal of Radiation Oncology - Biology - Physics |
| سنة النشر: | 2023 |
| المجموعة: | Leiden Repository (Leiden University) |
| الوصف: | Background & purpose: Involved internal iliac and obturator lateral lymph nodes (LLNs) are a known risk factor for ipsi-lateral local recurrences (LLR) in rectal cancer. This study examined coverage of LLNs with routine radiotherapy practice in the Netherlands and associated LLR rates. Materials & methods: Patients with a primary tumor ≤8cm of the anorectal junction, cT3-4 stage and at least one internal iliac or obturator LLN with short-axis ≥5mm who received neoadjuvant (chemo)radiotherapy, were selected from a national, cross-sectional study of rectal cancer patients treated in the Netherlands in 2016. MR-images and radiotherapy treatment plans were reviewed regarding segmented LLNs as gross-tumor volume (GTV), location of LLNs within clinical target volume (CTV), and received proportion of the planned radiotherapy dose. Results: A total of 223 out of 3057 patients with at least one LLN ≥5mm were selected. Of those, 180 (80.7%) LLNs were inside the CTV, of which 60 (33.3%) were segmented as GTV. Overall, 202 LLNs (90.6%) received >95% of the planned dose. Four-year LLR rates were not significantly higher for LLNs situated outside the CTV compared to inside (4.0% vs. 12.5%, p=.092) or when receiving <95% versus >95% of the planned radiotherapy dose (7.1% vs. 11.3%, p=.843), respectively. Two of seven patients who received a dose-escalation of 60Gy developed a LLR (4-year LLR rate 28.6%). Conclusion: This evaluation of routine radiotherapy practice showed that adequate coverage of LLNs was still associated with considerable 4-year LLR rates. Techniques resulting in better local control for patients with involved LLNs need to be explored further. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| Relation: | https://www.sciencedirect.com/science/article/pii/S0360301623003802?via%3Dihub; lumc-id: 184343057; https://hdl.handle.net/1887/3663525 |
| DOI: | 10.1016/j.ijrobp.2023.04.013 |
| الاتاحة: | https://hdl.handle.net/1887/3663525 https://www.sciencedirect.com/science/article/pii/S0360301623003802?via%3Dihub https://doi.org/10.1016/j.ijrobp.2023.04.013 |
| رقم الانضمام: | edsbas.D4C472DC |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.ijrobp.2023.04.013 |
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