Table 4.
Locations of regional nodes outside RTOG, ESTRO, RADCOMP and RUIJIN guidelines
| ALN-I | Coverage of substructures | Directions of substructures outside the CTVs | |||||||
|
Inside
n (%) |
Outside
n (%) |
Cranial
n (%) |
Caudal
n (%) |
Anterior
n (%) |
Posterior
n (%) |
Lateral
n (%) |
Meidal
n (%) |
||
| RTOG guideline | 75/109 (68.8%) | 34/109 (31.2%) | 1/109 (0.9%) a1 | 0/109 (0%) a2 | 34/109 (31.2%) a3 | ||||
| ESTRO guideline | 65/109 (59.6%) | 44/109 (40.4%) | 1/109 (0.9%) a1 | 16/109 (14.7%) b2 | 34/109 (31.2%) a3 | ||||
| RADCOMP guideline | 75/109 (68.8%) | 34/109 (31.2%) | 1/109 (0.9%) a1 | 0/109 (0%) a2 | 34/109 (31.2%) a3 | ||||
| RUIJIN guideline | 75/109 (68.8%) | 34/109 (31.2%) | 1/109 (0.9%) a1 | 0/109 (0%) a2 | 34/109 (31.2%) a3 | ||||
| ALN-II | Coverage of substructures | Directions of substructures outside the CTVs | |||||||
|
Inside
n (%) |
Outside
n (%) |
Cranial
n (%) |
Caudal
n (%) |
Anterior
n (%) |
Posterior
n (%) |
Lateral
n (%) |
Meidal
n (%) |
||
| RTOG guideline | 14/46 (30.4%) | 32/46 (70.0%) | 4/46 (8.7%) a4 | 31/46 (67.4%) a5 | |||||
| ESTRO guideline | 42/46 (91.3%) | 4/46 (8.7%) | 4/46 (8.7%) a4 | 0/46 (0%) b5 | |||||
| RADCOMP guideline | 46/46 (100%) | 0/46 (0%) | 0/46 (0%) a4 | 0/46 (0%) b5 | |||||
| RUIJIN guideline | 42/46 (91.3%) | 4/46 (8.7%) | 4/46 (8.7%) a4 | 0/46 (0%) b5 | |||||
| ALN-III | Coverage of substructures | Directions of substructures outside the CTVs | |||||||
|
Inside
n (%) |
Outside
n (%) |
Cranial
n (%) |
Caudal
n (%) |
Anterior
n (%) |
Posterior
n (%) |
Lateral
n (%) |
Meidal
n (%) |
||
| RTOG guideline | 32/36 (88.9%) | 4/36 (11.1%) | 1/36 (2.8%) a6 | 3/36 (8.3%) a7 | |||||
| ESTRO guideline | 27/36 (75.0%) | 9/46 (25.0%) | 7/36 (19.4%) a6 | 2/36 (5.6%) a7 | |||||
| RADCOMP guideline | 35/36 (97.2%) | 1/36 (2.8%) | 1/36 (2.8%) a6 | 0/36 (0%) a7 | |||||
| RUIJIN guideline | 32/36 (88.9%) | 4/36 (11.1%) | 1/36 (2.8%) a6 | 3/36 (8.3%) a7 | |||||
| RN | Coverage of substructures | Directions of substructures outside the CTVs | |||||||
|
Inside
n (%) |
Outside
n (%) |
Cranial
n (%) |
Caudal
n (%) |
Anterior
n (%) |
Posterior
n (%) |
Lateral
n (%) |
Meidal
n (%) |
||
| RTOG guideline | 17/17 (100%) | 0/17 (0%) | |||||||
| ESTRO guideline | 17/17 (100%) | 0/17 (0%) | |||||||
| RADCOMP guideline | 17/17 (100%) | 0/17 (0%) | |||||||
| RUIJIN guideline | 17/17 (100%) | 0/17 (0%) | |||||||
| SC-M | Coverage of substructures | Directions of substructures outside the CTVs | |||||||
|
Inside
n (%) |
Outside
n (%) |
Cranial
n (%) |
Caudal
n (%) |
Anterior
n (%) |
Posterior
n (%) |
Lateral
n (%) |
Meidal
n (%) |
||
| RTOG guideline | 59/68 (88.7%) | 9/68 (13.3%) | 1/68 (1.5%) a8 | 2/68 (2.9%) a9 | 6/68 (8.8%) a10 | 0/68 (0%) a11 | |||
| ESTRO guideline | 23/68 (33.8%) | 45/68 (66.2%) | 44/68 (64.7%) b8 | 2/68 (2.9%) a9 | 1/68 (1.5%) a10 | 3/68 (4.4%) a11 | |||
| RADCOMP guideline | 66/68 (97.1%) | 2/68 (2.9%) | 1/68 (1.5%) a8 | 0/68 (0%) a9 | 1/68 (1.5%) a10 | 0/68 (0%) a11 | |||
| RUIJIN guideline | 64/68 (94.1%) | 4/68 (5.9%) | 1/68 (1.5%) a8 | 2/68 (2.9%) a9 | 1/68 (1.5%) a10 | 0/68 (0%) a11 | |||
| SC-L | Coverage of substructures | Directions of substructures outside the CTVs | |||||||
|
Inside
n (%) |
Outside
n (%) |
Cranial
n (%) |
Caudal
n (%) |
Anterior
n (%) |
Posterior
n (%) |
Lateral
n (%) |
Meidal
n (%) |
||
| RTOG guideline | 0/36 (0%) | 36/36 (100%) | not contoured in RTOG guideline | ||||||
| ESTRO guideline | 0/36 (0%) | 36/36 (100%) | not contoured in ESTRO guideline | ||||||
| RADCOMP guideline | 34/36 (94.4%) | 2/36 (5.6%) | 2/36 (5.6%) a12 | 0/36 (0%) a13 | 0/36 (0%) a14 | ||||
| RUIJIN guideline | 30/36 (83.3%) | 6/36 (16.7%) | 2/36 (5.6%) a12 | 2/36 (5.6%) a13 | 2/36 (5.6%) a14 | ||||
| IMN | Coverage of substructures | Directions of substructures outside the CTVs | |||||||
|
Inside
n (%) |
Outside
n (%) |
Cranial
n (%) |
Caudal
n (%) |
Anterior
n (%) |
Posterior
n (%) |
Lateral
n (%) |
Meidal
n (%) |
||
| RTOG guideline | 8/36 (22.2%) | 28/36 (77.8%) | 1/36 (2.8%) a15 | 5/36 (13.9%) a16 | 11/36 (30.6%) a17 | 13/36 (36.1%) a18 | |||
| ESTRO guideline | 28/36 (77.8%) | 8/36 (22.2%) | 1/36 (2.8%) a15 | 0/36 (0%) a16 | 4/36 (11.1%)a17,b17 | 4/36 (11.1%)a18,b18 | |||
| RADCOMP guideline | 33/36 (91.7%) | 3/36 (8.3%) | 1/36 (2.8%) a15 | 0/36 (0%) a16 | 2/36 (5.6%) b17 | 0/36 (0%) b18 | |||
| RUIJIN guideline | 31/36 (86.1%) | 5/36 (13.9%) | 1/36 (2.8%) a15 | 0/36 (0%) a16 | 2/36 (5.6%) b17 | 2/36 (5.6%) b18 | |||
ALN-I, axillary lymph node level I; ALN-II, axillary lymph node level II; ALN-III, axillary lymph node level III; ESTRO, European Society for Radiation Therapy and Oncology; IMN, internal mammary nodes; RADCOMP, Radiotherapy Comparative Effectiveness; RN, Rotter’s nodes; RTOG, Radiation Therapy Oncology Group; SC-L, lateral supraclavicular; SC-M, medial supraclavicular.
Indications: A Bonferroni-adjusted significance threshold of p=0.008 (0.05/6) was used to compare the coverage between different guidelines. There was a statistically significant difference in proportions between groups with different marks (“a” vs “b”), while no significant difference was found between groups with the same mark (“a” vs “a”).