Guidelines for the delineation of the lymph nodes areas in gynecological malignancies [Recommandations pour la délinéation des aires ganglionnaires dans les cancers gynécologiques]

摘要

Gynecological cancers are lymphophilic cancers, which require the systematic inclusion of nodal areas in the clinical target volume when irradiation is planned in the therapeutic strategy for these cancers. Radiotherapy with intensity modulation that achieves better saving of healthy tissue is more often used. However, the very steep dose gradients generated by this technique can lead to poorer coverage of target volumes if they are not defined very precisely by taking into account their anatomical location. This is particularly true for lymph node target volumes, so the purpose of this article is to present recommendations from a literature review focused on this issue, in terms of selection and delineation of lymph node in irradiation of cervix and endometrial cancers.