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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Loco-regional conformal radiotherapy of the breast: delineation of the regional lymph node clinical target volumes in treatment position.
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Loco-regional conformal radiotherapy of the breast: delineation of the regional lymph node clinical target volumes in treatment position.

机译：乳房局部区域适形放疗：划定治疗部位区域淋巴结的临床目标量。

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BACKGROUND AND PURPOSE: As the location of the regional lymph nodes (LNs) of the breast varies largely between patients and may be dependant on the position of the arm, adequate localization of these nodes is mandatory in order to fully take advantage of optimized conformal radiotherapy. For this purpose, the anatomical boundaries of the regional lymph node (LN) clinical target volumes (CTVs) for delineation on transverse CT-slices, made in treatment position, were established. PATIENTS AND METHODS: Anatomical and surgical descriptions of the regional LNs of the breast, as well as a shoulder dissection, were studied. Axial slices of a human cadaver with one arm in abduction and the other in adduction were investigated, to assess the displacement of LNs by abduction of the arm into treatment position. Based on these findings, we defined the anatomical boundaries of the regional LN CTVs visible on transverse CT-slices. RESULTS: Standard anatomical and surgical descriptions appeared to be inadequate for determination of the boundaries of the regional LN CTVs in treatment position. With abduction of the arm, a change in position of all regional LNs, except for the medial supraclavicular LNs and internal mammary LNs, was observed in the anatomical cross-sections. This was also taken into account in our delineation protocol proposal. CONCLUSIONS: Anatomically based guidelines for delineation of the regional LN CTVs for loco-regional irradiation of the breast on transverse CT-slices, made in treatment position, have been developed in this study. These could be used as a basis for conformal radiotherapy.
机译：背景与目的：由于患者之间乳房区域淋巴结（LN）的位置差异很大，并且可能取决于手臂的位置，因此必须充分定位这些淋巴结，以便充分利用优化的适形放射疗法。为此，在治疗位置上建立了用于在横向CT切片上划定轮廓的区域淋巴结（LN）临床目标体积（CTV）的解剖边界。患者与方法：研究了乳房区域LN以及肩部解剖的解剖学和外科手术描述。研究了人类尸体的轴向切片，其中一只手臂被绑架，另一只手臂被绑架，以通过将手臂绑架到治疗位置来评估LN的位移。基于这些发现，我们定义了在横向CT切片上可见的区域LN CTV的解剖边界。结果：标准的解剖学和外科手术描述似乎不足以确定治疗位置的局部LN CTV的边界。随着手臂的外展，在解剖截面中观察到了除内侧锁骨上LN和乳腺内LN以外的所有区域LN的位置变化。我们的划界协议提案中也考虑了这一点。结论：在本研究中，已经制定了基于解剖学的指南，用于在横向CT切片上划定局部LN CTV，以在横向CT切片上对乳房进行局部照射。这些可以用作保形放疗的基础。

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