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Forschungsdatenbank PMU-SQQUID

Definition of elective lymphatic target volume in ductal carcinoma of the pancreatic head based on histopathologic analysis.
Brunner, TB; Merkel, S; Grabenbauer, GG; Meyer, T; Baum, U; Papadopoulos, T; Sauer, R; Hohenberger, W
INT J RADIAT ONCOL. 2005; 62(4): 1021-1029.
Originalarbeiten (Zeitschrift)


Papadopoulos Thomas


Purpose: In chemoradiation for pancreatic carcinoma three-dimensional target volume definitions could maximize tolerability and therapeutic effect at the same time because toxicity correlates with treatment volume. We aimed to define guidelines for elective treatment of nodal areas based on pathologic nodal involvement to optimize treatment volume for this tumor. Methods and Materials: Pathologic patterns of regional nodal spread in 175 patients who underwent primary pancreatoduodenectomy with >= 10 assessed nodes and literature data on para-aortic spread were the base of the definition of the target volume. Significant correlations between spread to lymphatic areas and tumor characteristics were determined using Fisherxxxs exact test. Computed tomography scans and a Pinnacle(3) (Philips, Best, The Netherlands) system were used for treatment planning. Results: Among 175 resected tumors without pretreatment, 76% had regional nodal metastasis and 22% had spread to distant nodes. High-risk lymphatic areas were identified and selected for elective treatment. A standardized planning procedure was derived and tested under treatment conditions. Conclusions: Histopathologic data allowed us to develop recommendations for standardized treatment planning for ductal carcinoma of the pancreatic head. These are proposed for quality assurance in multicenter studies and routine use. (c) 2005 Elsevier Inc.

Useful keywords (using NLM MeSH Indexing)



Aged, 80 and over

Carcinoma, Pancreatic Ductal/radiotherapy*

Carcinoma, Pancreatic Ductal/secondary

Carcinoma, Pancreatic Ductal/surgery



Lymph Node Excision

Lymphatic Irradiation/methods

Lymphatic Irradiation/standards*

Lymphatic Metastasis


Middle Aged

Pancreatic Neoplasms/pathology

Pancreatic Neoplasms/radiotherapy*

Pancreatic Neoplasms/surgery


Practice Guidelines as Topic

Radiotherapy Dosage

Radiotherapy Planning, Computer-Assisted

Radiotherapy, Conformal/standards

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