Atlas of the thoracic lymph nodal delineation and recommendations for lymph nodal CTV of esophageal squamous cell cancer in radiation therapy from China

作者：Huang Wei; Huang Yong; Sun Jujie; Liu Xibin; Zhang Jian; Zhou Tao; Zhang Baijiang; Li Baosheng^*

来源：Radiotherapy and Oncology, 2015, 116(1): 100-106.

DOI：10.1016/j.radonc.2015.06.024

• Esophageal cancer
• Radiation therapy
• Lymph nodes
• Computed tomography

Purpose: To construct an anatomical atlas of thoracic lymph node regions of esophageal cancer (EC) based on definitions from The Japan Esophageal Society (JES) and generate a consensus to delineate the nodal clinical target volume (CTVn) for elective nodal radiation (ENI) of esophageal squamous cell carcinoma (ESCC).
Methods and materials: An interdisciplinary group including two dedicated radiation oncologists, an experienced radiologist, a pathologist and two thoracic surgeons were gathered to generate a three-dimensional radiological description for the mediastinal lymph node regions of EC on axial CT scans. Then the radiological boundaries of lymph node regions were validated by a relatively large number of physicians in multiple institutions.
Results: An atlas of detailed anatomic boundaries of lymph node station No. 105-114 was defined on axial CT, along with illustrations. From the previous work, the study provided a guide of CTVn contouring for ENI of thoracic ESCC from a single center.
Conclusion: It is feasible to use such an atlas of thoracic lymph node stations for radiotherapy planning. A phase III study based on the atlas is ongoing in China to measure quantitatively the ENI received by patients with ESCC.

• 出版日期2015-7
• 单位山东省医学科学院