[Optimized definition and delineation of supraclavicular lymph nodes target in postmastectomy radiotherapy for breast cancer patients]
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Shujing Huang1, Xiaobo Huang2, Xicheng Wang3
1State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer.
Objective:
To explore the optimized methods to define and delineate supraclavicular lymph nodal target in postmastectomy radiotherapy for breast cancer patients.
Methods:
From September 2012 to August 2013, a total of 10 breast cancer patients at Sun Yan-sen University Cancer were selected for mastectomy plus postoperative radiotherapy. The clinical target volume (CTV) of every patient was delineated on CT-slices after computed tomography (CT) simulation by 6 radiation oncologists. Then the coverage discrepancy in anatomic lymphatic drainage subregions was analyzed among both CTVs by different oncologists and CTVs for patients with different clinical characters.
Results:
The average volume of SCLN-CTVs was 110 ± 28 cm(3). All SCLN, neck-IV and axilla III regions were covered in CTV, none of axillaIregion. The covergy rates of nonsurgery-axillaII, Rotter-LN, intraclavicular-LN, neck-Vb, scalenus gap, neck-III and surgery-axilla IIregions was 75%, 85%, 73%, 88%, 68%, 10%, 17% , respectively.
Conclusion:
SCLN, neck-IV and axilla III regions should be covered according to consensus. However, the opinions of nonsurgery-axillaII, Rotter-LN, intraclavicular-LN, neck-Vb, scalenus gap, neck-III and surgery-axilla IIremain divisive.
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