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The aim of this study was to determine the dosimetrically optimal CTV margin for lymph nodes in patients with gastric cancer treated with 3DCRT. We derived three PTVs for every patient: PTV 5 mm, PTV 7 mm and PTV 10 mm. For each patient, 3DCRT treatment plans were prepared for each of the three PTVs. From DVHs, for every patient and margin size, mean values and ranges of doses to organs at risk, as well as mean values and ranges of V28, V23, V20 and V12 for both kidneys were recorded. Standard deviations of data were also calculated for every particular case. Statistical hypotheses were tested for α=0.05 significance level, i.e. differences between the examined groups were considered significant if p<0.05. As a result we got that: The difference is significantly lower in the mean dose to liver for CTV 5 mm and CTV 10 mm, as well as for CTV 7 mm and CTV 10 mm; the difference is not significant for CTV 5 mm and CTV 7 mm; A significantly lower difference is seen in the mean dose to the right and left kidneys for CTV 5 mm and CTV 10 mm, CTV 7 mm and CTV 10 mm, while no significant difference is observed for CTV 5 mm and CTV 7 mm. We concluded that the margin of the nodal CTV of 7 mm in 3DCRT of gastric cancer dosimetrically spares liver and kidneys better than the CTV 10 mm margin.

journal of nuclear medicine and radiation therapy

Influence of Lymph Node Clinical Target Volume Margin Size on Liver and Kidneys in Three Dimensional Conformal Radiotherapy of Gastric Cancer: A Dosimetric Analysis