Optimal Clinical Target Volume of Radiotherapy Based on Microscopic Extension around the Primary Gross Tumor in Non-Small-Cell Lung Cancer: A Systematic Review

A crucial issue in radical radiation therapy for non-small-cell lung cancer is how to define the clinical target volume (CTV). Although the scope of microscopic extension (ME) and microscopic proximal bronchial extension (PBE) from a primary tumor should be considered when defining the CTV, there ha...

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Published inCancers Vol. 14; no. 9; p. 2318
Main Authors Tamaki, Yukihisa, Aibe, Norihiro, Komiyama, Takafumi, Nagasaka, Satoshi, Imagumbai, Toshiyuki, Itazawa, Tomoko, Onishi, Hiroshi, Akimoto, Tetsuo, Nagata, Yasushi, Nakayama, Yuko
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 07.05.2022
MDPI
Subjects
Cancer therapies
Lung cancer
Non-small cell lung carcinoma
Radiation therapy
Reviews
Systematic Review
Tomography
Tumors
gross tumor volume
systematic review
radiation therapy
non-small-cell lung cancer
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Summary:A crucial issue in radical radiation therapy for non-small-cell lung cancer is how to define the clinical target volume (CTV). Although the scope of microscopic extension (ME) and microscopic proximal bronchial extension (PBE) from a primary tumor should be considered when defining the CTV, there has been limited research on ME and PBE. Therefore, we conducted this systematic review. The PubMed, ICHUSHI (Japanese database), and Cochrane Library databases were searched, and 816 articles were initially retrieved. After primary and secondary screenings, eight articles were ultimately selected. The results of this systematic review suggest the importance of a 0 mm margin in stereotactic radiotherapy for early-stage cancer and a 5-8 mm margin in curative irradiation for locally advanced cancer. Regarding PBE, this review yielded the conclusion that it is appropriate to consider the addition of an approximately 15 mm margin from the bronchial vasculature. Although there were few articles with a high level of evidence, this systematic review enabled us to collate results from previous studies and to provide recommendations, to some extent, regarding the CTV margin in the current clinical environment, where high-precision radiation therapy, such as image-guided radiotherapy and intensity-modulated radiotherapy, is predominant.
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These authors contributed equally to this work.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14092318