Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Radiother Oncol. 2015 Apr;115(1):96-100. doi: 10.1016/j.radonc.2015.01.021. Epub 2015 Mar 18.
There is an increasing interest for dose differentiation in prostate radiotherapy. The purpose of our study was to analyze the spatial distribution of tumor satellites inside the prostate.
61 prostatectomy specimens were stained with H&E. Tumor regions were delineated by the uro-pathologist. Volumes, distances and cell densities of all delineated tumor regions were measured and further analyzed.
Multifocal disease was seen in 84% of the patients. The median number of tumor foci was 3. The median distance between the index lesion and the satellites was 1.0 cm, with a maximum of 4.4 cm. The index lesions accounted for 88% of the total tumor volume. The contribution of tumor foci<0.1 cm(3) to the total tumor volume was 2%. The median cell density of the index lesion and all satellites, regardless of size, were significantly higher than that of the prostate.
Satellites do not appear in a limited margin around the index lesion (GTV). Consequently, a fixed CTV margin would not effectively cover all satellites. Thus if the aim is to treat all tumor foci, the entire prostate gland should be considered CTV.
在前列腺放射治疗中，剂量区分越来越受到关注。我们研究的目的是分析前列腺内肿瘤卫星的空间分布。
61 份前列腺切除术标本用 H&E 染色。尿病理学家对肿瘤区域进行了描绘。测量并进一步分析了所有描绘肿瘤区域的体积、距离和细胞密度。
84%的患者存在多灶性疾病。肿瘤灶的中位数为 3 个。指数病变与卫星之间的中位数距离为 1.0cm，最大值为 4.4cm。指数病变占总肿瘤体积的 88%。肿瘤灶<0.1cm(3)对总肿瘤体积的贡献为 2%。指数病变和所有卫星（无论大小）的细胞密度中位数均显著高于前列腺。
卫星不会出现在指数病变（GTV）的有限边界内。因此，如果目的是治疗所有肿瘤灶，则整个前列腺应被视为 CTV。
