Oncotarget

Research Papers:

Determination of radiotherapeutic target zones for thoracic esophageal squamous cell cancer with lower cervical lymph node metastasis according to CT-images

Xingde Li, Jin Zhao _, Ming Liu, Fushan Zhai, Zhengfei Zhu, Feng Yu, Mingyun Zhang, Lijie Han, Yue Zhao and Haiyan Wang

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Oncotarget. 2016; 7:35865-35873. https://doi.org/10.18632/oncotarget.9094

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Abstract

Xingde Li1, Jin Zhao1, Ming Liu2, Fushan Zhai2, Zhengfei Zhu3, Feng Yu4, Mingyun Zhang1, Lijie Han1, Yue Zhao1 and Haiyan Wang1

1 Cangzhou Central Hospital, Cangzhou, China

2 Hospital No. 3 of Hebei Medical University, Hebei, China

3 Tumor Hospital of Fudan University, Shanghai, China

4 People’s Hospital of Qidong City, Nantong, China

Correspondence to:

Jin Zhao, email:

Keywords: esophageal cancer; radiotherapy; lower cervical lymph node; CT-images; supraclavicular zone

Received: December 07, 2015 Accepted: April 16, 2016 Published: April 28, 2016

Abstract

Esophageal squamous cell carcinoma (ESCC) is a leading cause of cancer-related deaths worldwide. And radical synchronized chemoradiotherapy has become an important treatment measures for this disease. It is necessary to define the therapeutic target zone based on computer tomography(CT)-images for precise radiotherapy. Therefore, we retrospectively analyzed the regularity of lymph node metastasis in lower cervical section of thoracic esophageal cancer based on CT-images and discussed the range of radiotherapy in supraclavicular zone. The lower cervical lymphatic drainage area was divided into cervical tracheoesophageal groove (CTG), medial supraclavicular zone (MSC zone) and lateral supraclavicular zone (LSC zone) based on CT-images. We found that the rate of lymph node metastasis to medial CTG and MSC zone was relatively high. And rate of lymph node metastasis to the above two zones from middle thoracic section was on an increasing trend with the progress of T stage. Patients at stage T3 and T4 with lymph node metastasis in tracheoesophageal groove in middle thoracic section showed a higher rate of lymph node metastasis in MSC zone. These results demonstrated that the CTG and MSC zone should be clinically included in the supraclavicular target zone for radical radiotherapy, and the T-stage and tumor location should be considered simultaneously.


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