Three-dimensional analysis of patterns of locoregional recurrence after treatment in breast cancer patients: Validation of the ESTRO consensus guideline on target volume

Jee Suk Chang, Hwa Kyung Byun, Jun Won Kim, Kyung Hwan Kim, Jeongshim Lee, Yeona Cho, Ik Jae Lee, Ki Chang Keum, Chang Ok Suh, Yong Bae Kim

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24 Citations (Scopus)


Background and purpose To explore the validity of the ESTRO-clinical target volume (CTV), we conducted three-dimensional analyses of locoregional recurrence (LRR) patterns according to the ESTRO- and RTOG-CTVs. Moreover, we explored which factors contribute to metastasis development outside the recommended CTV. Materials and methods We identified patients with post-treatment LRR explicitly exhibited on computed tomography (CT) images. All recurrences on CT were overlaid on representative CT images at the equivalent location, based on reference anatomic structures. Results A total of 235 recurrent lesions were identified in 129 patients. We depicted all LRR patterns in relation to the ESTRO- and RTOG-CTVs on CT and maximum intensity projection images. The ESTRO-CTV successfully contained the extent of the LRR within the RTOG-CTV in 96.4% of all early-stage breast-conserved women. Geographic misses of local recurrence were frequently observed in mastectomy patients (P = .002) and tended to originate from deep, but thin, chest walls. The rate of geographic misses of regional recurrence was low (3.6%) at the early stage, but increased in patients aged <45 years and with triple-negative tumors (P < .05). Conclusions Application of the ESTRO-CTV in early-stage disease seems justified.

Original languageEnglish
Pages (from-to)24-29
Number of pages6
JournalRadiotherapy and Oncology
Issue number1
Publication statusPublished - 2017 Jan 1


All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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