Open AccessStereotactic radiotherapy for oligometastases in the lymph nodes
Author(s) -
Francesco Pasqualetti,
Fabio Trippa,
Cynthia Aristei,
Simona Borghesi,
Caterina Colosimo,
M. Cantarella,
Rosario Mazzola,
Gianluca Ingrosso
Publication year - 2022
Publication title -
reports of practical oncology and radiotherapy
Language(s) - English
Resource type - Journals
eISSN - 2083-4640
pISSN - 1507-1367
DOI - 10.5603/rpor.a2022.0007
Subject(s) - stereotactic radiotherapy , radiation therapy , lymph , medicine , medical physics , radiology , computer science , radiosurgery , pathology
Even though systemic therapy is standard treatment for lymph node metastases, metastasis-directed stereotactic radiotherapy (SRT ) seems to be a valid option in oligometastatic patients with a low disease burden. Positron emission tomography-computed tomography (PET-CT ) is the gold standard for assessing metastases to the lymph nodes; co-registration of PET-CT images and planning CT images are the basis for gross tumor volume (GTV ) delineation. Appropriate techniques are needed to overcome target motion. SRT schedules depend on the irradiation site, target volume and dose constraints to the organs at risk (OARs) of toxicity. Although several fractionation schemes were reported, total doses of 48-60 Gy in 4-8 fractions were proposed for mediastinal lymph node SRT, with the spinal cord, esophagus, heart and proximal bronchial tree being the dose limiting OAR s. Total doses ranged from 30 to 45 Gy, with daily fractions of 7-12 Gy for abdominal lymph nodes, with dose limiting OARs being the liver, kidneys, bowel and bladder. SRT on lymph node metastases is safe; late side effects, particularly severe, are rare.