Subclinical Lesions of the Primary Clinical Target Volume Margin in Esophageal Squamous Cell Carcinoma and Association With FDG PET/CT

Conclusions: To cover 94.5% of ESCC subclinical lesions in the CTVp, a 3-cm margin along the cranial-caudal axis should be added to the primary gross tumor volume as defined by FDG-PET/CT, as well as a cutoff SUVmax value of 2.5. Although preoperative FDG PET/CT images may not reveal lesions directly, the SUVmax and MTV measurements together could predict their presence. Background Esophageal carcinoma often occurs as squamous cell carcinoma (ESCC), a highly aggressive malignancy with a poor prognosis worldwide. The incidence rates of ESCC are particularly high in China (1). Most patients with ESCC have locally advanced disease (2, 3). Important treatment strategies for locally advanced ESCC include neoadjuvant chemoradiation and definitive chemoradiation or radiation therapy. However, the overall survival and local control rates remain unsatisfactory—the 2-year survival rate is merely 30–40%, and the local relapse rate may reach up to 50% (4–6). In ESCC radiotherapy, an accurate delineation of the primary clinical target volume (CTVp) importantly influences the success of the outcome, with higher local regional control, and less toxicity. Wu et al. suggested that CTVp is generally a 3–4 cm superior and inferior expansion of the gross tumor volume (GTV) and a 1 cm radial expansion, according to an expert consensus (7). However, when basing the CTVp on the size of the primary gross tumor, there are no established or standard guidelines for how ...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research

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