983 / 1816
General considerations
•
Recent comments on RTOG atlases ( & probably also valid for ESTRO
atlas):
•
In case of massive involvement supraclavicular nodes: nodes extend
beyond CTVn_L4
should atlas be adapted ?
(Brown et al, IJRBOP 2015; Jing et
al IJRBOP 2015)
•
To cover 95% of lymph nodes at cranial and anterior borders of level 1,
CTVn_L1 should be increased considerably: i.e. take into account
nodal involvement seen before surgery/ chemotherapy
(Gentile et al, IJRBOP
2015).
•
NB: ESTRO guidelines are meant for elective irradiation of early stage
breast cancer; i.e. in case of clinically overt pathological nodes:
individualise target volume delineation !