In response to Dr. Yazici et al

Abstract

Dr. Yazici confirms our observation that relying on bony landmarks to outline field borders for treatment of gynecologic malignancy is not optimal because it fails to cover adequately some of the intended nodal volume in some patients and treats excessive volume in others. Our data demonstrated that, based on the outline of the contoured vessels, the entire common iliac chain was inadequately covered in the majority ( 1 Finlay M. Ackerman I. Tirona R. et al. Use of CT simulation for treatment of cervical cancer to assess the adequacy of lymph node coverage of conventional pelvic fields based on bony landmarks. Int J Radiat Oncol Biol Phys. 2006; 64: 205-209 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar ). Use of CT simulation for treatment of cervical cancer to assess the adequacy of lymph node coverage of conventional pelvic fields based on bony landmarks: In regard to Finlay et al. (Int J Radiat Oncol Biol Phys 2006;64:205–209)International Journal of Radiation Oncology, Biology, PhysicsVol. 65Issue 5PreviewSuperior border of pelvic field for treatment of cervical cancer remains unsettled. In the recent article of Finlay et al. (1), based on their observation that 79.1% of the common iliac nodes were not covered when the superior margin was placed at the L5-S1 interspace, the authors concluded that common iliac artery bifurcations with a 15–20 mm margin around the vessels should be included in the field for an adequate coverage of the common iliac lymph nodes. However, the superior margin of L5-S1 interspace adopted in this study is below the conventional L4-L5 interspace recommended for the adequate coverage of the common iliac nodes (2). Full-Text PDF