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Topics:
Radiation Oncology • Gynecologic Cancers
For a cervical cancer patient who had involved para-aortic lymph nodes, how much higher do you extend the superior edge of your field if there are nodes close to the renal vessels (i.e. usual superior extend of field)?
A certain cm above the superior-most involved node? A certain number of vertebral body above? To the diaphragm and include retrocrural nodes?
Answer from: Radiation Oncologist at Community Practice
In this dataset from us, next station was retrocrural nodes with involvement more than 25% and for that reason, we extend CTV for 2-3 cm above renal vessel to include retrocrural nodal region and space.Kabolizadeh et al., PMID 23849691
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Answer from: Radiation Oncologist at Academic Institution
In cervical cancer, the most frequent para-aortic metastasis is the below renal vessels, usually L1/L2 interspace. However, if there are positive nodes close to the renal vessels, I would extend para-aortic fields, 1 or 2 vertebral body cranial to the highest positive nodal which makes better anatom...
Answer from: Radiation Oncologist at Community Practice
Generally, for these situations, I would go to the level of the diaphragm and include the retrocrural nodes.