Mapping patterns of locoregional recurrence following contemporary treatment with radiation therapy for breast cancer: A multi-institutional validation study of the ESTRO consensus guideline on clinical target volume

Jee Suk Chang, Jeongshim Lee, Mison Chun, Kyung Hwan Shin, Won Park, Jong Hoon Lee, Jin Hee Kim, Won Sup Yoon, Ik Jae Lee, Juree Kim, Hye Li Park, Yong Bae Kim

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background and purpose: To validate the ESTRO guideline on clinical target volume (CTV) delineation for breast cancer using a multi-centre dataset. Materials and methods: Patients with axial imaging of gross locoregional recurrence (LRR) were identified from 10 participating institutions. All patients received RT, albeit not to all regional node. The location of LRR was transferred to the corresponding area on representative axial computed tomography images and compared with ESTRO-CTV. Results: The locations of LRRs in 234 patients with 337 recurrence lesions were mapped. The ESTRO-CTV encompassed 97.6% of all LRRs, except in lymph node level 4 and the pectoralis muscle. Although 8.8% of level 4 failures occurred outside the ESTRO-CTV, cranial to the subclavian artery, all nodes were located within 6 mm cranially. Another 20% occurred posterolateral to anterior scalene muscles; however, 11/16 cases had simultaneous multiple lymph node recurrences, and 8/16 initially had N2-3 tumours. Local recurrence at the pectoralis muscle was prominent in patients undergoing mastectomy but not breast-conservation surgery (28% vs. 2.9%, P =.001). Conclusions: Our mapping data demonstrated that the ESTRO-CTV, with some considerations, successfully encompassed most LRRs in patients undergoing contemporary management, thus validating ESTRO-CTV to be valuable for highly conformal radiation therapy techniques.

Original languageEnglish
Pages (from-to)139-147
Number of pages9
JournalRadiotherapy and Oncology
Volume126
Issue number1
DOIs
Publication statusPublished - 2018 Jan

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Validation Studies
Radiotherapy
Guidelines
Breast Neoplasms
Recurrence
Pectoralis Muscles
Lymph Nodes
Therapeutics
Subclavian Artery
Mastectomy
Breast
Tomography
Muscles
Neoplasms

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Chang, Jee Suk ; Lee, Jeongshim ; Chun, Mison ; Shin, Kyung Hwan ; Park, Won ; Lee, Jong Hoon ; Kim, Jin Hee ; Yoon, Won Sup ; Lee, Ik Jae ; Kim, Juree ; Park, Hye Li ; Kim, Yong Bae. / Mapping patterns of locoregional recurrence following contemporary treatment with radiation therapy for breast cancer : A multi-institutional validation study of the ESTRO consensus guideline on clinical target volume. In: Radiotherapy and Oncology. 2018 ; Vol. 126, No. 1. pp. 139-147.
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abstract = "Background and purpose: To validate the ESTRO guideline on clinical target volume (CTV) delineation for breast cancer using a multi-centre dataset. Materials and methods: Patients with axial imaging of gross locoregional recurrence (LRR) were identified from 10 participating institutions. All patients received RT, albeit not to all regional node. The location of LRR was transferred to the corresponding area on representative axial computed tomography images and compared with ESTRO-CTV. Results: The locations of LRRs in 234 patients with 337 recurrence lesions were mapped. The ESTRO-CTV encompassed 97.6{\%} of all LRRs, except in lymph node level 4 and the pectoralis muscle. Although 8.8{\%} of level 4 failures occurred outside the ESTRO-CTV, cranial to the subclavian artery, all nodes were located within 6 mm cranially. Another 20{\%} occurred posterolateral to anterior scalene muscles; however, 11/16 cases had simultaneous multiple lymph node recurrences, and 8/16 initially had N2-3 tumours. Local recurrence at the pectoralis muscle was prominent in patients undergoing mastectomy but not breast-conservation surgery (28{\%} vs. 2.9{\%}, P =.001). Conclusions: Our mapping data demonstrated that the ESTRO-CTV, with some considerations, successfully encompassed most LRRs in patients undergoing contemporary management, thus validating ESTRO-CTV to be valuable for highly conformal radiation therapy techniques.",
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Mapping patterns of locoregional recurrence following contemporary treatment with radiation therapy for breast cancer : A multi-institutional validation study of the ESTRO consensus guideline on clinical target volume. / Chang, Jee Suk; Lee, Jeongshim; Chun, Mison; Shin, Kyung Hwan; Park, Won; Lee, Jong Hoon; Kim, Jin Hee; Yoon, Won Sup; Lee, Ik Jae; Kim, Juree; Park, Hye Li; Kim, Yong Bae.

In: Radiotherapy and Oncology, Vol. 126, No. 1, 01.2018, p. 139-147.

Research output: Contribution to journalArticle

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T1 - Mapping patterns of locoregional recurrence following contemporary treatment with radiation therapy for breast cancer

T2 - A multi-institutional validation study of the ESTRO consensus guideline on clinical target volume

AU - Chang, Jee Suk

AU - Lee, Jeongshim

AU - Chun, Mison

AU - Shin, Kyung Hwan

AU - Park, Won

AU - Lee, Jong Hoon

AU - Kim, Jin Hee

AU - Yoon, Won Sup

AU - Lee, Ik Jae

AU - Kim, Juree

AU - Park, Hye Li

AU - Kim, Yong Bae

PY - 2018/1

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N2 - Background and purpose: To validate the ESTRO guideline on clinical target volume (CTV) delineation for breast cancer using a multi-centre dataset. Materials and methods: Patients with axial imaging of gross locoregional recurrence (LRR) were identified from 10 participating institutions. All patients received RT, albeit not to all regional node. The location of LRR was transferred to the corresponding area on representative axial computed tomography images and compared with ESTRO-CTV. Results: The locations of LRRs in 234 patients with 337 recurrence lesions were mapped. The ESTRO-CTV encompassed 97.6% of all LRRs, except in lymph node level 4 and the pectoralis muscle. Although 8.8% of level 4 failures occurred outside the ESTRO-CTV, cranial to the subclavian artery, all nodes were located within 6 mm cranially. Another 20% occurred posterolateral to anterior scalene muscles; however, 11/16 cases had simultaneous multiple lymph node recurrences, and 8/16 initially had N2-3 tumours. Local recurrence at the pectoralis muscle was prominent in patients undergoing mastectomy but not breast-conservation surgery (28% vs. 2.9%, P =.001). Conclusions: Our mapping data demonstrated that the ESTRO-CTV, with some considerations, successfully encompassed most LRRs in patients undergoing contemporary management, thus validating ESTRO-CTV to be valuable for highly conformal radiation therapy techniques.

AB - Background and purpose: To validate the ESTRO guideline on clinical target volume (CTV) delineation for breast cancer using a multi-centre dataset. Materials and methods: Patients with axial imaging of gross locoregional recurrence (LRR) were identified from 10 participating institutions. All patients received RT, albeit not to all regional node. The location of LRR was transferred to the corresponding area on representative axial computed tomography images and compared with ESTRO-CTV. Results: The locations of LRRs in 234 patients with 337 recurrence lesions were mapped. The ESTRO-CTV encompassed 97.6% of all LRRs, except in lymph node level 4 and the pectoralis muscle. Although 8.8% of level 4 failures occurred outside the ESTRO-CTV, cranial to the subclavian artery, all nodes were located within 6 mm cranially. Another 20% occurred posterolateral to anterior scalene muscles; however, 11/16 cases had simultaneous multiple lymph node recurrences, and 8/16 initially had N2-3 tumours. Local recurrence at the pectoralis muscle was prominent in patients undergoing mastectomy but not breast-conservation surgery (28% vs. 2.9%, P =.001). Conclusions: Our mapping data demonstrated that the ESTRO-CTV, with some considerations, successfully encompassed most LRRs in patients undergoing contemporary management, thus validating ESTRO-CTV to be valuable for highly conformal radiation therapy techniques.

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