title: Determination of radiotherapeutic target zones for thoracic esophageal squamous cell cancer with lower cervical lymph node metastasis according to CT-images.
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.
authors.affiliation: Cangzhou Central Hospital, Cangzhou, China.
authors.forename: Xingde
authors.initials: X
authors.lastname: Li
authors.affiliation: Cangzhou Central Hospital, Cangzhou, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Hospital No. 3 of Hebei Medical University, Hebei, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.affiliation: Hospital No. 3 of Hebei Medical University, Hebei, China.
authors.forename: Fushan
authors.initials: F
authors.lastname: Zhai
authors.affiliation: Tumor Hospital of Fudan University, Shanghai, China.
authors.forename: Zhengfei
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: People's Hospital of Qidong City, Nantong, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Yu
authors.affiliation: Cangzhou Central Hospital, Cangzhou, China.
authors.forename: Mingyun
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Cangzhou Central Hospital, Cangzhou, China.
authors.forename: Lijie
authors.initials: L
authors.lastname: Han
authors.affiliation: Cangzhou Central Hospital, Cangzhou, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Cangzhou Central Hospital, Cangzhou, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D013909:Thorax / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: CT-images; esophageal cancer; lower cervical lymph node; radiotherapy; supraclavicular zone