Neck Levels

[Haybrant]

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Do you guys have a resource about what neck levels to cover based on head and neck subsite and involved nodes. Kind of annoying how things are so standardized in our field but this issue is so non standard. I was taught to cover the adjacent nodal level to that which is positive but I work with someone who has not heard this and insists they are correct bc they learned it 20 years ago (old timer). Also do you take an involved nodal levels to a higher dose or just boost the positive node? And what do you do with your brachial plexus? Thanks

 

[Gfunk6]

There are a few contouring handbooks that are very helpful. I currently use "Target Volume Delineation and Field Setup" by Nancy Lee (editor), published by Springer. There is a lot of detail on what nodes to treat for various sites with a very helpful illustrated atlas. This handbook also talks about specific dose levels.

For brachial plexus specifically, there is an excellent article with illustrations which I always use published in 2008 in the Red Journal (William Hall first author).

Link: https://www.ncbi.nlm.nih.gov/pubmed/18448267

 

[medgator]

Amazon product ASIN 1451175817
Amazon product ASIN 1608316866
Would use quantec for questions about normal tissue toxicity, in the red journal

 

[drj313]

Check out this publication from the Italian Assoc of Rad Onc, good ref for H/N CA.

 

[Treat]

I second Gfunk's recommendation of "Target Volume Delineation and Field Setup" by Nancy Lee (editor)!