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Radiation Oncology • Gastrointestinal Cancers
For esophageal cancers with large gaps between the primary and PET positive lymph nodes, do you treat the gaps with continuous volumes or only involved areas?
For example, in an upper or mid-esophageal cancer with a PET positive lesser gastric curvature node. Is it reasonable to treat PET positive areas only with the usual expansions, or would you bridge the area between primary and node to cover subclinical lymphatic disease even if the heart and lung doses would be greater and potentially not meet constraints?
Answer from: Radiation Oncologist at Academic Institution
As is true for much in medicine, there is no simple answer to this question. For a patient with a cervical esophageal cancer, perigastric lymph nodes are essentially metastatic. There is no clear dividing line as to when a node is metastatic vs regional disease. We know that for tumors of the lower ...
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Answer from: Radiation Oncologist at Community Practice
IJROBP pre-proof just out: Involved-Field Irradiation in Definitive Chemoradiotherapy for Locoregional Esophageal Squamous Cell Carcinoma: Results from the ESO-Shanghai 1 Trial (Zhu et al., PMID 33677048). Interesting data with low isolated uninvolved nodal field recurrence rate. I wonder whether th...
Comments
Radiation Oncologist at University of Florida
Treat the gap.
Treat the gap.
Radiation Oncologist at Holy Cross Hosp Biennes Cancer Center
How would you treat a young healthy asymptomatic p...
How would you treat a young healthy asymptomatic p...