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[Radiotherapy of retroperitoneal lymph node (RP) in colorectal cancer. Modification of our RP field in order to improve local efficacy].
Due to a lack of reporting of individual data in most of the retrospective studies, it is difficult to get a realistic idea of the efficacy of radiation therapy in any geographical area. By contrast, the present study represents the large series of data coming from a referral center. This study was carried out by the oncology group in Nice on 300 consecutive patients with cancers of the colon or rectum and/or stomach. The endpoints were tumor and nodal response. The cancers of the colon and rectum consisted of 162 locally advanced cancers and 138 local cancers (TNM Dukes B-III); the cancers of the stomach were 109 early cancers (TNM Dukes A). Treatment consisted of external beam radiation for locally advanced cancers and a conventionally fractionated EBRT with a dose of 40 Gy followed by a boost, for local cancers. Subsequently, chemotherapy was added if indicated. The RP regions were sub-divided into four equal sub-areas: by a three-dimensional conformal radiation treatment planning system and on the basis of clinical information. Subtraction of all the doses covered by the ipsilateral and contralateral organs, from the dose delivered to the target defined by the sum of all the volumes irradiated by the target, showed a mean of absolute dose reduction of 18% and 18% for the sub-areas of the external iliac, external, and internal iliac; 23% and 21% for the sub-areas of obturator and common iliac. Treatment in the clinical target volume (CTV) was graded as satisfying if less than 70 Gy were delivered. The local tumor response was satisfactory in 48% and 59% of locally advanced and local cancers, respectively. The nodal response was satisfactory in 30% and 13% of invaded and non-infiltr 0b46394aab
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