直肠癌放射治疗的轮廓图谱及要点。

IF 1.9 4区 医学 Q2 BIOLOGY
Keiko Nemoto Murofushi, Kayoko Tsujino, Yoshinori Ito, Masahiko Okamoto, Hiroshi Doi, Hirofumi Ogawa, Masakatsu Onozawa, Terufumi Kawamoto, Norio Katoh, Keiichi Jingu, Atsuya Takeda, Keiji Nihei, Hirokazu Makishima, Hiroshi Mayahara, Hideya Yamazaki, Hiroshi Igaki
{"title":"直肠癌放射治疗的轮廓图谱及要点。","authors":"Keiko Nemoto Murofushi, Kayoko Tsujino, Yoshinori Ito, Masahiko Okamoto, Hiroshi Doi, Hirofumi Ogawa, Masakatsu Onozawa, Terufumi Kawamoto, Norio Katoh, Keiichi Jingu, Atsuya Takeda, Keiji Nihei, Hirokazu Makishima, Hiroshi Mayahara, Hideya Yamazaki, Hiroshi Igaki","doi":"10.1093/jrr/rraf013","DOIUrl":null,"url":null,"abstract":"<p><p>In the last decade, the role of radiotherapy in rectal cancer has changed significantly with the introduction of total neoadjuvant therapy (TNT) and nonoperative management (NOM). For the setting of irradiation field in rectal cancer, the pararectal, lateral lymph nodes, and those along the inferior mesenteric artery (IMA) are most important. In total mesorectal excision (TME), the root of the IMA is dissected. In the atlas of pelvic irradiation for rectal cancer, the setting of the upper margin of the mesorectum varies from atlas to atlas, and no atlas sets the upper margin of the mesorectum to the root of the IMA. In particular, there is no consensus on the definition of anatomical boundaries regarding the lymph nodes along the superior rectal artery (SRA). The upper margin of the irradiation field in clinical trials of preoperative radiotherapy and TNT is generally set at the level of the internal and external iliac artery branches, L5/S1, or S2/S3. However, it is not necessary to include the entire mesorectum to the root of the IMA in patients undergoing preoperative radiotherapy plus TME. Conversely, for patients receiving NOM, the irradiation field may have to include the mesorectum to the IMA root, though the incidence of lymph node metastasis and gastrointestinal adverse events merits consideration. It is increasingly important to determine the extent of clinical target volume around the SRA region and the setting of the upper margin of the irradiation field after formulating the treatment policy together with the surgeons and medical oncologists.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Contouring atlas and essential points for radiotherapy in rectal cancer.\",\"authors\":\"Keiko Nemoto Murofushi, Kayoko Tsujino, Yoshinori Ito, Masahiko Okamoto, Hiroshi Doi, Hirofumi Ogawa, Masakatsu Onozawa, Terufumi Kawamoto, Norio Katoh, Keiichi Jingu, Atsuya Takeda, Keiji Nihei, Hirokazu Makishima, Hiroshi Mayahara, Hideya Yamazaki, Hiroshi Igaki\",\"doi\":\"10.1093/jrr/rraf013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>In the last decade, the role of radiotherapy in rectal cancer has changed significantly with the introduction of total neoadjuvant therapy (TNT) and nonoperative management (NOM). For the setting of irradiation field in rectal cancer, the pararectal, lateral lymph nodes, and those along the inferior mesenteric artery (IMA) are most important. In total mesorectal excision (TME), the root of the IMA is dissected. In the atlas of pelvic irradiation for rectal cancer, the setting of the upper margin of the mesorectum varies from atlas to atlas, and no atlas sets the upper margin of the mesorectum to the root of the IMA. In particular, there is no consensus on the definition of anatomical boundaries regarding the lymph nodes along the superior rectal artery (SRA). The upper margin of the irradiation field in clinical trials of preoperative radiotherapy and TNT is generally set at the level of the internal and external iliac artery branches, L5/S1, or S2/S3. However, it is not necessary to include the entire mesorectum to the root of the IMA in patients undergoing preoperative radiotherapy plus TME. Conversely, for patients receiving NOM, the irradiation field may have to include the mesorectum to the IMA root, though the incidence of lymph node metastasis and gastrointestinal adverse events merits consideration. It is increasingly important to determine the extent of clinical target volume around the SRA region and the setting of the upper margin of the irradiation field after formulating the treatment policy together with the surgeons and medical oncologists.</p>\",\"PeriodicalId\":16922,\"journal\":{\"name\":\"Journal of Radiation Research\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-03-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Radiation Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/jrr/rraf013\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Radiation Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jrr/rraf013","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

在过去的十年中,随着全新辅助治疗(TNT)和非手术治疗(NOM)的引入,放疗在直肠癌中的作用发生了显著变化。直肠旁淋巴结、外侧淋巴结和肠系膜下动脉(IMA)旁淋巴结是直肠癌放射场的重要部位。在全直肠系膜切除术(TME)中,IMA的根被切开。在直肠癌盆腔照射寰椎中,肠系膜上缘的位置因寰椎而异,没有寰椎将肠系膜上缘置于IMA根部。特别是,关于沿直肠上动脉(SRA)的淋巴结的解剖边界的定义尚无共识。在术前放疗和TNT的临床试验中,一般将照射场上缘设定在髂内外动脉分支水平,L5/S1或S2/S3。然而,在术前放疗加TME的患者中,没有必要包括整个直肠系膜至IMA根部。相反,对于接受NOM的患者,照射范围可能必须包括直肠系膜到IMA根,尽管淋巴结转移和胃肠道不良事件的发生率值得考虑。在与外科医生和内科肿瘤学家共同制定治疗政策后,确定SRA区域周围的临床靶体积范围和照射场上边界的设置变得越来越重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Contouring atlas and essential points for radiotherapy in rectal cancer.

In the last decade, the role of radiotherapy in rectal cancer has changed significantly with the introduction of total neoadjuvant therapy (TNT) and nonoperative management (NOM). For the setting of irradiation field in rectal cancer, the pararectal, lateral lymph nodes, and those along the inferior mesenteric artery (IMA) are most important. In total mesorectal excision (TME), the root of the IMA is dissected. In the atlas of pelvic irradiation for rectal cancer, the setting of the upper margin of the mesorectum varies from atlas to atlas, and no atlas sets the upper margin of the mesorectum to the root of the IMA. In particular, there is no consensus on the definition of anatomical boundaries regarding the lymph nodes along the superior rectal artery (SRA). The upper margin of the irradiation field in clinical trials of preoperative radiotherapy and TNT is generally set at the level of the internal and external iliac artery branches, L5/S1, or S2/S3. However, it is not necessary to include the entire mesorectum to the root of the IMA in patients undergoing preoperative radiotherapy plus TME. Conversely, for patients receiving NOM, the irradiation field may have to include the mesorectum to the IMA root, though the incidence of lymph node metastasis and gastrointestinal adverse events merits consideration. It is increasingly important to determine the extent of clinical target volume around the SRA region and the setting of the upper margin of the irradiation field after formulating the treatment policy together with the surgeons and medical oncologists.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.60
自引率
5.00%
发文量
86
审稿时长
4-8 weeks
期刊介绍: The Journal of Radiation Research (JRR) is an official journal of The Japanese Radiation Research Society (JRRS), and the Japanese Society for Radiation Oncology (JASTRO). Since its launch in 1960 as the official journal of the JRRS, the journal has published scientific articles in radiation science in biology, chemistry, physics, epidemiology, and environmental sciences. JRR broadened its scope to include oncology in 2009, when JASTRO partnered with the JRRS to publish the journal. Articles considered fall into two broad categories: Oncology & Medicine - including all aspects of research with patients that impacts on the treatment of cancer using radiation. Papers which cover related radiation therapies, radiation dosimetry, and those describing the basis for treatment methods including techniques, are also welcomed. Clinical case reports are not acceptable. Radiation Research - basic science studies of radiation effects on livings in the area of physics, chemistry, biology, epidemiology and environmental sciences. Please be advised that JRR does not accept any papers of pure physics or chemistry. The journal is bimonthly, and is edited and published by the JRR Editorial Committee.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信