[Optimized definition and delineation of supraclavicular lymph nodes target in postmastectomy radiotherapy for breast cancer patients].

OBJECTIVE

To explore the optimized methods to define and delineate supraclavicular lymph nodal target in postmastectomy radiotherapy for breast cancer patients.

METHODS

From September 2012 to August 2013, a total of 10 breast cancer patients at Sun Yan-sen University Cancer were selected for mastectomy plus postoperative radiotherapy. The clinical target volume (CTV) of every patient was delineated on CT-slices after computed tomography (CT) simulation by 6 radiation oncologists. Then the coverage discrepancy in anatomic lymphatic drainage subregions was analyzed among both CTVs by different oncologists and CTVs for patients with different clinical characters.

RESULTS

The average volume of SCLN-CTVs was 110 ± 28 cm(3). All SCLN, neck-IV and axilla III regions were covered in CTV, none of axillaIregion. The covergy rates of nonsurgery-axillaII, Rotter-LN, intraclavicular-LN, neck-Vb, scalenus gap, neck-III and surgery-axilla IIregions was 75%, 85%, 73%, 88%, 68%, 10%, 17% , respectively.

CONCLUSION

SCLN, neck-IV and axilla III regions should be covered according to consensus. However, the opinions of nonsurgery-axillaII, Rotter-LN, intraclavicular-LN, neck-Vb, scalenus gap, neck-III and surgery-axilla IIremain divisive.