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Defining the target volume for post-operative radiotherapy after D2 dissection in gastric cancer by CT-based vessel-guided delineation

 Hong In Yoon  ;  Jee Suk Chang  ;  Joon Seok Lim  ;  Sung Hoon Noh  ;  Woo Jin Hyung  ;  Ji Yeong An  ;  Yong Chan Lee  ;  Sun Young Rha  ;  Kyung Hwan Kim  ;  Woong Sub Koom 
 RADIOTHERAPY AND ONCOLOGY, Vol.108(1) : 72-77, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Gastrectomy/methods* ; Humans ; Lymph Node Excision/methods* ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms/diagnostic imaging ; Stomach Neoplasms/pathology ; Stomach Neoplasms/radiotherapy* ; Stomach Neoplasms/surgery ; Tomography, X-Ray Computed/methods* ; Tumor Burden
CT-guidance ; Gastric cancer ; Gross tumor volume ; Recurrent node ; Vasculature
PURPOSE: To determine the recurrent nodal gross tumor volume (rnGTV) based on CT-guided vascular structure to refine the clinical target volume (CTV) delineation in postoperative radiotherapy for advanced gastric cancer following radical gastrectomy with D2 dissection. MATERIALS AND METHODS: We retrospectively reviewed follow-up images from 91 patients with their first regional recurrence after D2 dissection in stage III gastric cancer with N3 disease. We defined rnGTV as recurrent nodes shown in follow-up CT images, in which one diagnostic radiologist with specialty of gastrointestinal tract investigated. We drew rnGTVs at the equivalent location based on the same vessels of reference comparing CT images to recurrence CT images. RESULTS: We propose vessel-based locations of rnGTVs on CT images with axial and coronal views. We show different patterns of regional recurrence according to the location of primary gastric cancer using CT and digitally reconstructed radiograph (DRR) images. Frequently recurred sites, overlapped by more than five rnGTVs, are depicted in a DRR image. CONCLUSIONS: This study suggests vessel-based delineations of rnGTVs on CT images depending on nodal recurrence sites from follow-up images after D2 lymphadenectomy. Our results could help reduce the inter-observer variation of CTV delineation after D2 dissection in gastric cancer.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chang, Jee Suk Paul(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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