[Clinical target volume delineation for radiotherapy of the esophagus]

Abstract

The dense lymphatic network of the esophagus facilitates tumour spreading along the cephalo-caudal axis and to locoregional lymph nodes. A better understanding of microscopic invasion by tumour cells, based on histological analysis of surgical specimens and analysis of recurrence sites, has justified a reduction in radiotherapy target volumes. The delineation of the clinical target volume (CTV) depends on tumour characteristics (site, histology) and on its spread as assessed on endoscopic ultrasonography and ((18)F)-fluorodeoxyglucose positron-emission tomography (FDG-PET). We propose that positive and negative predictive values for FDG-PET should be used to adapt the CTV according to the risk of nodal involvement.

Keywords: Cancer de l’œsophage; Clinical target volume; Conformal radiotherapy; Esophageal cancer; FDG-PET; Negative predictive value; Positive predictive value; Radiothérapie conformationnelle; TEP au FDG; Valeur prédictive négative; Valeur prédictive positive; Volume cible anatomoclinique.