Comparison of Locoregional versus Extended Locoregional Radiation Volumes for @entity1 with Nonmetastatic Gastro-esophageal Junction XXXX .

@entity1 @entity5 @entity1161 @entity189 @entity4558 @entity344 @entity260
INTRODUCTION: To delineate an optimal clinical target volume (CTV) for @entity5 by comparing locoregional versus extended locoregional @entity1161 ( @entity1161 ) volumes. MATERIALS: This retrospective analysis examined 222 @entity1 (111 matched pairs treated with locoregional versus extended locoregional @entity1161 ) with nonmetastatic @entity189 treated with concurrent chemoradiation    surgery. The CTV for locoregional volumes was defined as gross @entity5 volume + elective coverage of first-echelon nodes and sometimes the celiac axis. The CTV for extended locoregional volumes was defined as gross @entity5 volume + elective coverage of celiac and @entity4558 (  porta) nodes. Variables used for matching included sex, stage, performance status, histology, receipt of induction chemotherapy, type of concurrent chemotherapy, @entity1161 modality, receipt of surgery, type of surgery, and Siewert classification. Regression models stratified by matched pairs were fit to estimate effect of @entity1161 volume on clinical endpoints. RESULTS: Adjusting p values for multiple testing, @entity1 treated with extended locoregional versus locoregional @entity1161 had increased odds of grade 2+ acute chemoradiation-associated @entity344 (odds ratio: 2.92, adj. p = 0.0447). However, differing @entity1161 volumes were not significantly associated with @entity260 rates, pathologic T-stage, frequency of positive perigastric/regional nodes on surgical specimen, distant-metastases progression-free survival, locoregional progression-free survival, or overall survival (adj. p > 0.05). Of the @entity1 who did (n = 124) and did not (n = 72) receive elective celiac @entity1161 , two (1.6%) and two @entity1 (2.8%), respectively, relapsed in the celiac nodes. No @entity1 failed in the @entity4558 or porta nodes. CONCLUSIONS: Most @entity5 can be safely treated without elective inclusion of @entity4558 /porta nodes.
