PURPOSE: To investigate the pattern of lymph node spread on magnetic resonance lymphography (MRL) in prostate cancer patients and compare this pattern to the clinical target volume for elective pelvis irradiation as defined by the radiation therapy oncology group (RTOG-CTV). METHODS AND MATERIALS: The charts of 60 intermediate and high risk prostate cancer patients with non-enlarged positive lymph nodes on MRL were reviewed. Positive lymph nodes were assigned to a lymph node region according to the guidelines for delineation of the RTOG-CTV. Five lymph node regions outside this RTOG-CTV were defined: the para-aortal, proximal common iliac, pararectal, paravesical and inguinal region. RESULTS: Fifty-three percent of the patients had an MRL-positive lymph node in a lymph node region outside the RTOG-CTV. The most frequently involved aberrant sites were the proximal common iliac, the pararectal and para-aortal region, which were affected in 30%, 25% and 18% respectively. CONCLUSION: More than half of the patients had an MRL-positive lymph node outside the RTOG-CTV. To reduce geographical miss while minimizing the toxicity of radiotherapy, image based definition of an individual target volume seems to be necessary.
PURPOSE: To investigate the pattern of lymph node spread on magnetic resonance lymphography (MRL) in prostate cancerpatients and compare this pattern to the clinical target volume for elective pelvis irradiation as defined by the radiation therapy oncology group (RTOG-CTV). METHODS AND MATERIALS: The charts of 60 intermediate and high risk prostate cancerpatients with non-enlarged positive lymph nodes on MRL were reviewed. Positive lymph nodes were assigned to a lymph node region according to the guidelines for delineation of the RTOG-CTV. Five lymph node regions outside this RTOG-CTV were defined: the para-aortal, proximal common iliac, pararectal, paravesical and inguinal region. RESULTS: Fifty-three percent of the patients had an MRL-positive lymph node in a lymph node region outside the RTOG-CTV. The most frequently involved aberrant sites were the proximal common iliac, the pararectal and para-aortal region, which were affected in 30%, 25% and 18% respectively. CONCLUSION: More than half of the patients had an MRL-positive lymph node outside the RTOG-CTV. To reduce geographical miss while minimizing the toxicity of radiotherapy, image based definition of an individual target volume seems to be necessary.
Authors: Hanneke J M Meijer; Oscar A Debats; Emile N J Th van Lin; Marco van Vulpen; J Alfred Witjes; Wim J G Oyen; Jelle O Barentsz; Johannes H A M Kaanders Journal: Nat Rev Urol Date: 2013-05-28 Impact factor: 14.432
Authors: Mark K Buyyounouski; Peter L Choyke; Jesse K McKenney; Oliver Sartor; Howard M Sandler; Mahul B Amin; Michael W Kattan; Daniel W Lin Journal: CA Cancer J Clin Date: 2017-02-21 Impact factor: 508.702
Authors: Ansje S Fortuin; Robert Jan Smeenk; Hanneke J M Meijer; Alfred J Witjes; Jelle O Barentsz Journal: Curr Urol Rep Date: 2014-03 Impact factor: 3.092
Authors: Ansje S Fortuin; Roger Brüggemann; Janine van der Linden; Ilia Panfilov; Bas Israël; Tom W J Scheenen; Jelle O Barentsz Journal: Wiley Interdiscip Rev Nanomed Nanobiotechnol Date: 2017-04-06
Authors: Hanneke J M Meijer; Oscar A Debats; Emile N J Th van Lin; Johannes Alfred Witjes; Johannes H A M Kaanders; Jelle O Barentsz Journal: Radiat Oncol Date: 2013-07-30 Impact factor: 3.481