Julian Biau1, Michel Lapeyre2, Idriss Troussier3, Wilfried Budach4, Jordi Giralt5, Cai Grau6, Joanna Kazmierska7, Johannes A Langendijk8, Mahmut Ozsahin3, Brian O'Sullivan9, Jean Bourhis3, Vincent Grégoire10. 1. Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Radiation Oncology, Jean Perrin Cancer Center, Clermont-Ferrand, France. Electronic address: Julian.biau@clermont.unicancer.fr. 2. Department of Radiation Oncology, Jean Perrin Cancer Center, Clermont-Ferrand, France. 3. Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 4. Department of Radiation Oncology, University Hospital Düsseldorf, Germany. 5. Department of Radiation Oncology, Vall d'Hebron University Hospital, Barcelona, Spain. 6. Department of Oncology, Aarhus University Hospital, Denmark. 7. Department of Radiation Oncology, Greater Poland Cancer Centre, University of Medical Sciences, Poznan, Poland. 8. Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, the Netherlands. 9. Department of Radiation Oncology, University of Toronto, The Princess Margaret Hospital, Canada. 10. Radiation Oncology Department, Léon Bérard Cancer Center, Lyon, France. Electronic address: Vincent.gregoire@lyon.unicancer.fr.
Abstract
BACKGROUND AND PURPOSE: In 2000, a panel of experts published a proposal for the selection of lymph node target volumes for definitive head and neck radiation therapy (Radiother Oncol, 2000; 56: 135-150). Hereunder, this selection is updated and extended to also cover primary sites not previously covered. PATIENTS AND METHODS: The lymphatic spread of head and neck cancers into neck lymph nodes was comprehensively reviewed based on radiological, surgical and pathological literature regarding both initial involvement and patterns of failure. Then a panel of worldwide head and neck radiotherapy experts agreed on a consensus for the selection of both high- and low-risk lymph node target volumes for the node negative and the node positive neck. RESULTS: An updated selection of lymph node target volumes is reported for oral cavity, oropharynx, hypopharynx, larynx, nasopharynx, paranasal sinuses, nasal cavity and carcinoma of unknown primary as a function of the nodal staging (UICC 8th edition). CONCLUSIONS: The selection of lymph node target volumes for head and neck cancers treated with IMRT/VMAT or other highly conformal techniques (e.g. proton therapy) requires a rigorous approach. This updated proposal of selection should help clinicians for the selection of lymph nodes target volumes and contribute to increase consistency.
BACKGROUND AND PURPOSE: In 2000, a panel of experts published a proposal for the selection of lymph node target volumes for definitive head and neck radiation therapy (Radiother Oncol, 2000; 56: 135-150). Hereunder, this selection is updated and extended to also cover primary sites not previously covered. PATIENTS AND METHODS: The lymphatic spread of head and neck cancers into neck lymph nodes was comprehensively reviewed based on radiological, surgical and pathological literature regarding both initial involvement and patterns of failure. Then a panel of worldwide head and neck radiotherapy experts agreed on a consensus for the selection of both high- and low-risk lymph node target volumes for the node negative and the node positive neck. RESULTS: An updated selection of lymph node target volumes is reported for oral cavity, oropharynx, hypopharynx, larynx, nasopharynx, paranasal sinuses, nasal cavity and carcinoma of unknown primary as a function of the nodal staging (UICC 8th edition). CONCLUSIONS: The selection of lymph node target volumes for head and neck cancers treated with IMRT/VMAT or other highly conformal techniques (e.g. proton therapy) requires a rigorous approach. This updated proposal of selection should help clinicians for the selection of lymph nodes target volumes and contribute to increase consistency.
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