By Giampiero Ausili Cefaro, Carlos A. Perez, Domenico Genovesi, Annamaria Vinciguerra
From the reviews:
"This is a concise advisor to radiological definitions of lymph node teams for radiation therapy making plans. … the first viewers is radiation oncologists in any respect levels in their careers. citizens and scholars may still locate this a really beneficial anatomical consultant. The authors are renowned in radiation oncology and/or radiology. … it is a precious consultant for the lymph node anatomy of the main affliction website regions." (James G. Douglas, Doody’s assessment provider, July, 2009)
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Extra resources for A Guide for Delineation of Lymph Nodal Clinical Target Volume in Radiation Therapy
Specifically, progress in radiotherapy technology and the introduction of conformational techniques have made it necessary to provide exact definition of the boundaries of anatomical structures which are sites of macroscopic or microscopic tumors. In this regard, a landmark guide is provided by the volume published by Gregoire, Scalliet, and Ang in 2004  which defines the criteria for appropriate definition of clinical target volumes (CTVs) [7, 8] in modern conformal radiotherapy and in intensity modulated radiation therapy (IMRT).
These authors proposed a system including nine major lymph node groups: •• Group 1. Para-aortic lymph nodes •• Group 2. 7 – Subdivision of paraaortic and pelvic lymph nodes Type Description Para-aortic lymph nodes Paracaval nodes Located to the right of the vena cava Precaval nodes Located anterior to the vena cava Postcaval nodes Located posterior to the vena cava when the vein is mobilized to the left Deep intercavoaortic nodes To the right of the aorta, between the aorta and the vena cava, above the lumbar vessels Superficial intercavoaortic nodes To the right of the aorta, between the aorta and the vena cava, below the lumbar vessels Preaortic nodes Anterior to the aorta Para-aortic nodes Lateral to the aorta Postaortic nodes Posterior to the aorta Pelvic lymph nodes Common iliac nodes Around the common iliac vessels – Medial subgroup – Superficial lateral subgroup – Deep lateral subgroup External iliac nodes Internal iliac nodes Deep obturator nodes Superficial obturator nodes Presacral nodes Parametrial nodes 26 In a space delimited laterally by the psoas muscle, medially by the common iliac vein and by the two iliolumbar veins, and posteriorly by the ischiatic nerve and by the origin of the obturator nerve 2 Lymph Node Classification •• •• •• •• Groups 3 and 4.
On the other hand, rectal cancer requires a prone setup, possibly with the support of systems for displacing the small bowel (especially in the event of preoperative treatment). Radiotherapy of prostate cancer is mostly performed in the supine position, but the prone position has been reported for this tumor as well. Moreover, supports may be placed under the patient’s knees to improve relaxation of the back, hindered by the rigid treatment couch. Since foot displacements can also change the relative position of bony landmarks that are crucial for determining * This chapter has been written with the contributions of Raffaella Basilico, Antonella Filippone, Maria Luigia Storto, and Armando Tartaro 39 A Guide for D elineation of Lymph Nodal Clinical Target Volume in R adiation Therapy the accuracy of setup, specific “foot-blocking” supports can also be used.
A Guide for Delineation of Lymph Nodal Clinical Target Volume in Radiation Therapy by Giampiero Ausili Cefaro, Carlos A. Perez, Domenico Genovesi, Annamaria Vinciguerra