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Dosimetric comparison of nodal clinical target volume for locally advanced non‑small cell lung cancer: Options for geometric expansion vs. lymph node stations

  • Authors:
    • Shigeo Takahashi
    • Masahide Anada
    • Toshifumi Kinoshita
    • Takamasa Nishide
    • Toru Shibata
  • View Affiliations / Copyright

    Affiliations: Department of Radiation Oncology, Kagawa University Hospital, Miki, Kagawa 761‑0793, Japan
    Copyright: © Takahashi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 57
    |
    Published online on: June 26, 2024
       https://doi.org/10.3892/mco.2024.2755
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Abstract

The purpose of the present retrospective study was to evaluate whether dosimetric differences existed in nodal clinical target volume (CTV) using options for geometric expansion and lymph node (LN) stations based on the European Society for Radiotherapy and Oncology guideline for locally advanced non‑small cell lung cancer (NSCLC). In the treatment planning computed tomographic images of 17 patients with cT4N2M0 NSCLC, nodal CTVs were contoured based on the guideline options of: i) Geometric expansion, with CTV including the nodal gross tumor volume plus 5 mm margin; and ii) LN stations, with CTV including the affected LN stations. Treatment planning of 60 Gy in 30 fractions was performed using volumetric modulated arc therapy; Dmean was the mean irradiated dose to the structure; and VnGy was the volume of the structure receiving ≥n Gy. Dose‑volume parameters were compared between the two options. Consequently, the option of geometric expansion was associated with a significantly lower V60Gy and Dmean of the esophagus, V20Gy, V5Gy and Dmean of the lungs, and Dmean of the heart than the option of LN stations in all patients (P=0.017, P<0.001, P<0.001, P<0.001, P<0.001 and P=0.029, respectively). For the V20Gy of the lungs, the 8 patients (47%) with LN metastases in stations 2 or 3 had significantly larger differences in the values between the two options than the 9 patients (53%) without those metastases; the median values of the difference of V20Gy of the lungs between the two options were 2.8% (range, 0.2 to 9.6%) with LN metastases in stations 2 or 3 and 0.5% (range, ‑0.2 to 5.0%) without these metastases (P=0.027). In conclusion, using the option for geometric expansion might help reduce the V60Gy and Dmean of the esophagus, V20Gy, V5Gy and Dmean of the lungs, and Dmean of the heart in all patients, and the V20Gy of the lungs in patients with LN metastases in stations 2 or 3.
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Copy and paste a formatted citation
Spandidos Publications style
Takahashi S, Anada M, Kinoshita T, Nishide T and Shibata T: Dosimetric comparison of nodal clinical target volume for locally advanced non‑small cell lung cancer: Options for geometric expansion vs. lymph node stations. Mol Clin Oncol 21: 57, 2024.
APA
Takahashi, S., Anada, M., Kinoshita, T., Nishide, T., & Shibata, T. (2024). Dosimetric comparison of nodal clinical target volume for locally advanced non‑small cell lung cancer: Options for geometric expansion vs. lymph node stations. Molecular and Clinical Oncology, 21, 57. https://doi.org/10.3892/mco.2024.2755
MLA
Takahashi, S., Anada, M., Kinoshita, T., Nishide, T., Shibata, T."Dosimetric comparison of nodal clinical target volume for locally advanced non‑small cell lung cancer: Options for geometric expansion vs. lymph node stations". Molecular and Clinical Oncology 21.2 (2024): 57.
Chicago
Takahashi, S., Anada, M., Kinoshita, T., Nishide, T., Shibata, T."Dosimetric comparison of nodal clinical target volume for locally advanced non‑small cell lung cancer: Options for geometric expansion vs. lymph node stations". Molecular and Clinical Oncology 21, no. 2 (2024): 57. https://doi.org/10.3892/mco.2024.2755
Copy and paste a formatted citation
x
Spandidos Publications style
Takahashi S, Anada M, Kinoshita T, Nishide T and Shibata T: Dosimetric comparison of nodal clinical target volume for locally advanced non‑small cell lung cancer: Options for geometric expansion vs. lymph node stations. Mol Clin Oncol 21: 57, 2024.
APA
Takahashi, S., Anada, M., Kinoshita, T., Nishide, T., & Shibata, T. (2024). Dosimetric comparison of nodal clinical target volume for locally advanced non‑small cell lung cancer: Options for geometric expansion vs. lymph node stations. Molecular and Clinical Oncology, 21, 57. https://doi.org/10.3892/mco.2024.2755
MLA
Takahashi, S., Anada, M., Kinoshita, T., Nishide, T., Shibata, T."Dosimetric comparison of nodal clinical target volume for locally advanced non‑small cell lung cancer: Options for geometric expansion vs. lymph node stations". Molecular and Clinical Oncology 21.2 (2024): 57.
Chicago
Takahashi, S., Anada, M., Kinoshita, T., Nishide, T., Shibata, T."Dosimetric comparison of nodal clinical target volume for locally advanced non‑small cell lung cancer: Options for geometric expansion vs. lymph node stations". Molecular and Clinical Oncology 21, no. 2 (2024): 57. https://doi.org/10.3892/mco.2024.2755
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