Research progress on microscopic extension in defining clinical target volume
Wang Xiaohang, Geng Jianhao, Zhang Siyuan, Zhu Xianggao, Wang Weihu
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China
Abstract：Microscopic extension (subclinical lesion) is the key factor for defining clinical target volume in radiotherapy. In this article, the research progresses on microscopic extension or extracapsular extension in esophageal cancer, lung cancer, hepatocellular carcinoma, prostate cancer, bladder cancer, rectal cancer, breast cancer, non-melanoma skin cancer and metastatic lymph nodes were reviewed. These results provide important basis for the definition of clinical target volume. However, a series of questions remain to be properly resolved.
Wang Xiaohang,Geng Jianhao,Zhang Siyuan et al. Research progress on microscopic extension in defining clinical target volume[J]. Chinese Journal of Radiation Oncology, 2020, 29(9): 809-812.
[1] Gao XS, Qiao X, Wu F, et al. Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma[J]. Int J Radiat Oncol Biol Phys, 2007, 67(2):389-396. DOI:10.1016/j.ijrobp.2006.09.015. [2] Wang ZW, Zhang W, Dong W, et al. Pathological analysis of extracapsular extension of metastatic lymph node and its potential impact on nodal clinical target volume in the radiotherapy of esophageal squamous cell carcinoma[J]. Neoplasma, 2014, 61(3):324-330. DOI:10.4149/neo_2014_042. [3] Giraud P, Antoine M, Larrouy A, et al. Evaluation of microscopic tumor extension in non-small-cell lung cancer for three-dimensional conformal radiotherapy planning[J]. Int J Radiat Oncol Biol Phys, 2000, 48(4):1015-1024. DOI:10.1016/s0360-3016(00)00750-1. [4] Grills IS, Fitch DL, Goldstein NS, et al. Clinicopathologic analysis of microscopic extension in lung adenocarcinoma:defining clinical target volume for radiotherapy[J]. Int J Radiat Oncol Biol Phys, 2007, 69(2):334-341. DOI:10.1016/j.ijrobp.2007.03.023. [5] 许金良,于庆凯,刘先本,等. 肺癌侵袭近端支气管壁的临床病理探讨[J]. 中华肿瘤杂志, 1998, 20(6):448-450. Xu JL, Yu QK, Liu XB, et al. Proximal bronchial invasion of lung cancer:a clinicopathological study[J]. Chin J Oncol, 1998, 20(6):448-450. [6] Yuan S, Meng X, Yu J, et al. Determining optimal clinical target volume margins on the basis of microscopic extracapsular extension of metastatic nodes in patients with non-small-cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2007, 67(3):727-734. DOI:10.1016/j.ijrobp.2006.08.057. [7] Wang MH, Ji Y, Zeng ZC, et al. Impact factors for microinvasion in patients with hepatocellular carcinoma:possible application to the definition of clinical tumor volume[J]. Int J Radiat Oncol Biol Phys, 2010, 76(2):467-476. DOI:10.1016/j.ijrobp.2009.01.057. [8] Wang W, Feng X, Zhang T, et al. Prospective evaluation of microscopic extension using whole-mount preparation in patients with hepatocellular carcinoma:definition of clinical target volume for radiotherapy[J]. Radiat Oncol, 2010, 5(1):73. DOI:10.1186/1748-717X-5-73. [9] Sohayda C, Kupelian PA, Levin HS, et al. Extent of extracapsular extension in localized prostate cancer[J]. Urology, 2000, 55(3):382-386. DOI:10.1016/s0090-4295(99)00458-6. [10] Teh BS, Bastasch MD, Wheeler TM, et al. IMRT for prostate cancer:defining target volume based on correlated pathologic volume of disease[J]. Int J Radiat Oncol Biol Phys, 2003, 56(1):184-191. DOI:10.1016/s0360-3016(03)00085-3. [11] Chao KK, Goldstein NS, Yan D, et al. Clinicopathologic analysis of extracapsular extension in prostate cancer:should the clinical target volume be expanded posterolaterally to account for microscopic extension?[J]. Int J Radiat Oncol Biol Phys, 2006, 65(4):999-1007. DOI:10.1016/j.ijrobp.2006.02.039. [12] Schwartz DJ, Sengupta S, Hillman DW, et al. Prediction of radial distance of extraprostatic extension from pretherapy factors[J]. Int J Radiat Oncol Biol Phys, 2007, 69(2):411-418. DOI:10.1016/j.ijrobp.2007.03.016. [13] Jenkins P, Anjarwalla S, Gilbert H, et al. Defining the clinical target volume for bladder cancer radiotherapy treatment planning[J]. Int J Radiat Oncol Biol Phys, 2009, 75(3):1379-1384. DOI:10.1016/j.ijrobp.2009.01.063. [14] MERCURY Study Group. Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer:results of the MERCURY study[J]. Radiology, 2007, 243(1):132-139. DOI:10.1148/radiol.2431051825. [15] Vicini FA, Kestin LL, Goldstein NS. Defining the clinical target volume for patients with early-stage breast cancer treated with lumpectomy and accelerated partial breast irradiation:a pathologic analysis[J]. Int J Radiat Oncol Biol Phys, 2004, 60(3):722-730. DOI:10.1016/j.ijrobp.2004.04.012. [16] Nguyen BT, Deb S, Fox S, et al. A prospective pathologic study to define the clinical target volume for partial breast radiation therapy in women with early breast cancer[J]. Int J Radiat Oncol Biol Phys, 2012, 84(5):1116-1122. DOI:10.1016/j.ijrobp.2012.02.038. [17] Choo R, Woo T, Assaad D, et al. What is the microscopic tumor extent beyond clinically delineated gross tumor boundary in nonmelanoma skin cancers?[J]. Int J Radiat Oncol Biol Phys, 2005, 62(4):1096-1099. DOI:10.1016/j.ijrobp.2004.12.069. [18] Khan L, Choo R, Breen D, et al. Recommendations for CTV margins in radiotherapy planning for non melanoma skin cancer[J]. Radiother Oncol, 2012, 104(2):263-266. DOI:10.1016/j.radonc.2012.06.013. [19] Apisarnthanarax S, Elliott DD, El-Naggar AK, et al. Determining optimal clinical target volume margins in head-and-neck cancer based on microscopic extracapsular extension of metastatic neck nodes[J]. Int J Radiat Oncol Biol Phys, 2006, 64(3):678-683. DOI:10.1016/j.ijrobp.2005.08.020. [20] Ghadjar P, Schreiber-Facklam H, Grater R, et al. Quantitative analysis of extracapsular extension of metastatic lymph nodes and its significance in radiotherapy planning in head and neck squamous cell carcinoma[J]. Int J Radiat Oncol Biol Phys, 2010, 76(4):1127-1132. DOI:10.1016/j.ijrobp.2009.03.065.
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