head + neck volumes

Started by BraggPeak
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BraggPeak

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15+ Year Member
Is there a resource somewhere with guidelines for how to delineate tumors for primary site for head and neck? I know you typically contour GTV + 2.5 cm margin, etc; however, I heard for exam situations often times, they would like to hear you describe all the different anatomical areas you want to cover rather than just saying with tumor + margin. I haven't as yet found a good resource for this.
 
Agree with Ang/Garden suggestion. Also, Nancy Lee and Jiade Lu have a new book out: _Target Volume Delineation and Field Setup_. Lots of contours, and guidelines listed in tabular format. Covers all sites, not just HN.
 
Thanks, that was really helpful! Anyone use the Nancy Lee book as yet? Sounds like it will be a great resource for oral boards prep??
 
If you have a T2 N0 Supraglottic larynx tumor, how far superior and inferior would you take your CTV 70? And CTV 60?
 
I'd put 1-1.5cm sup inf on GTV for CTV70 (tend to be more generous here than other sites b/c of potential organ motion). I tend to make sure the entire larynx is in CTV 60...I guess you could cover levels II-III in CTV 60 too, but I don't think its necessary for N0. CTV 50, I'd do levels II-IV bilaterally...stopping at transverse process C1/post belly digastric superiorly.
 
One more thing. Assuming no chemo, I'd treat this patient with altered fractionation. If you want to stay with 50, 60, 70 Gy volumes, then 6 fractions per week would be an option.
 
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