Lymph drainage and cervical fascia anatomy-oriented differential nodal CTV delineation at the supraclavicular region for esophageal cancer and nasopharyngeal cancer

医学 锁骨上淋巴结 背景(考古学) 食管癌 轮廓 淋巴结 放射科 筋膜 转移 解剖 癌症 病理 内科学 古生物学 工程制图 工程类 生物
作者
Zuxian Zhong,Dan Wang,Yi Liu,Shilong Shao,Sihao Chen,Shanshan He,Ningjing Yang,Churong Li,Jing Ren,Yue Zhao,Qifeng Wang,Guotai Wang,Chuntang Sun,Shichuan Zhang
出处
期刊:Radiotherapy and Oncology [Elsevier BV]
卷期号:177: 113-120 被引量:4
标识
DOI:10.1016/j.radonc.2022.10.036
摘要

Purpose To determine the differences in supraclavicular lymph node metastasis between esophageal cancer (EC) and nasopharyngeal cancer (NPC) and explore the feasibility of differential supraclavicular clinical target volume (CTV) contouring between these two diseases based on the involvement of different fascial spaces. Materials and methods One hundred patients with supraclavicular nodes positive for EC or NPC were enrolled, and their pre-treatment images were reviewed. The distribution patterns of nodes between the two diseases were compared in the context of node levels defined by the 2017 Japanese Esophageal Society and 2013 International Consensus on Cervical Lymph Node Level Classification. Grouping supraclavicular nodes based on sub-compartments formed by the cervical fascia was discussed, and the feasibility of differential CTV contouring based on the differences in the involvement of these sub-compartments between EC and NPC was explored. Results The 2013 Consensus on cervical node levels and 2017 Japanese Esophageal Society node station could not practically guide supraclavicular CTV contouring. We divided the supraclavicular space into six sub-compartments: the para-esophageal space (PES), carotid sheath space (CSS), sub-thyroid pre-trachea space (STPTS), pre-vascular space (PVS), and vascular lateral space (VLS) I and II. EC mainly spread to the PES, STPTS, CSS, and VLS I, whereas NPC tended to spread to the CSS, VLS I, and VLS II. These combinations of sub-compartments may help constitute the supraclavicular CTVs for EC and NPC. Conclusions The fascia anatomy-based sub-compartments sufficiently distinguished metastasis to the supraclavicular space between EC and NPC, thus facilitating differential CTV contouring between these two diseases.
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