RT Journal Article
SR Electronic
T1 Clinical Target Volume in Biliary Carcinoma: A Systematic Review of Pathological Studies
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 955
OP 961
VO 37
IS 3
A1 ILARIA MARINELLI
A1 ALESSANDRA GUIDO
A1 LORENZO FUCCIO
A1 ANDREA FARIOLI
A1 VALERIA PANNI
A1 LUCIA GIACCHERINI
A1 ALESSANDRA ARCELLI
A1 GIORGIO ERCOLANI
A1 GIOVANNI BRANDI
A1 SILVIA CAMMELLI
A1 ANDREA GALUPPI
A1 GABRIELLA MACCHIA
A1 REZARTA FRAKULLI
A1 GIAN C. MATTIUCCI
A1 FRANCESCO CELLINI
A1 MILLY BUWENGE
A1 MATTEO RENZULLI
A1 FRANCESCO DEODATO
A1 SAVINO CILLA
A1 VINCENZO VALENTINI
A1 VINCENZO TOMBOLINI
A1 RITA GOLFIERI
A1 ALESSIO G. MORGANTI
YR 2017
UL http://ar.iiarjournals.org/content/37/3/955.abstract
AB Background/Aim: Radiotherapy is a treatment option for both adjuvant and neo-adjuvant settings for biliary tract cancer. Guidelines on the delineation of the target volume of lymph nodes are lacking; only generic indications are available, without specific recommendations for different primary tumour locations (e.g. intrahepatic, extrahepatic biliary tract or gallbladder cancer). The aim of this study was to systematically review available literature to provide recommendations on lymph node target volume delineation in patients with unresectable biliary tumour. Materials and Methods: A systematic search of electronic databases was performed up to July 2016. The primary outcome measure was the rate of lymph node involvement according to the location of primary biliary tumour. Sites with ≥5% of nodal metastases were considered in the clinical target volume for radiotherapy planning. Results: Twelve studies (1075 patients) were included. The most frequent site of lymph node metastasis in intrahepatic biliary tree carcinoma was retroportal (61.1%, 95% confidence interval (CI)=50.7-70-6%). Other frequently involved lymph nodes were along the hepatoduodenal ligament [frequency=38.7%, 95% CI=31.0-47.0%], those along the common hepatic artery (17.0%, 95% CI=8.2-31.9%) and the hilar nodes (16.9%, 95% CI=13.2-21.4%). In extrahepatic biliary tree cancer, the most frequently involved lymph nodes were the pericholedochal (42.7%, 95% CI=33.8-52.1%) and those along the hepatoduodenal ligament (40.3%, 95% CI=32.4-48.8%). Other commonly involved nodal regions included retroportal lymph nodes (30.9%, 95% CI=23.0-40.1%), pancreaticoduodenal anterior and posterior nodes (30.1%, 95% CI=12.2-57.1%), those along the common hepatic artery (19.7%, 95% CI=11.8-31.0%) and para_aortic nodes (15.2%, 95% CI=8.0-27.0%). The most common site of metastases in gallbladder cancer were the pericholedochal nodes (25.2%, 95% CI=18.6-33.2%), those along the cystic duct (23%, 95% CI=16.6-30.8%), and retroportal nodes (17.1%, 95% CI=11.6-24.5%). Conclusion: Biliary tract cancer has a high propensity for regional lymphatic metastases. An evidence-based nodal target definition of biliary tract cancer based on primary tumour location was proposed.