关键词: Breast cancer Delineation guidelines Radiation therapy Regional nodal irradiation

Mesh : Axilla Breast / pathology Breast Neoplasms / blood supply pathology radiotherapy Consensus Female Humans Lymph Nodes / pathology Lymphatic Metastasis Mammary Glands, Human Retrospective Studies Tomography, X-Ray Computed

来  源:   DOI:10.1016/j.radonc.2014.11.008

Abstract:
OBJECTIVE: A national project to improve the quality of breast radiation therapy was started, named PROCAB (PROject on CAncer of the Breast). One of the objectives was to reach a national consensus guideline for the delineation of the regional lymph node areas in breast radiation therapy.
METHODS: The realization of the new guidelines was a step by step process that started with multiple expert meetings where the existing guidelines were analyzed and the delineations of the lymph node regions were performed together with a surgeon, specialized in the anatomy of the drainage of the breast.
RESULTS: The delineation guidelines are vessel-based. Since the occurrence of pathological lymph nodes is typically around the veins, the cranial and caudal borders of all different nodal regions are based on a 5mm margin around the veins, except for the parasternal lymph node area. Compared to the existing guidelines there are some major changes.
CONCLUSIONS: With this project a national as well as a European (ESTRO) consensus guideline for the delineation of the regional lymph node areas in breast RT is reached. The new delineation atlas is vessel-based and no longer field-based.
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