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. 2018 Feb 7;9:42–47. doi: 10.1016/j.ctro.2018.01.005

Table 2.

Recommendations on nodal target volume selection.

Site CTV2 CTV3 Spared level(s) Caveats
Oropharynx
T1-T3 N0-2a (lateralized T, mainly tonsillar fossa/pillars: BOT not involved, T < 1 cm soft palate)		 ipsilateral II, III, IV controlateral II bilateral IB and V, controlateral III, IV, RF if pathologic node is IIA, ipsilateral IB should be in CTV2



Oropharynx
T1-T3 N2a (BOT, soft palate, median tumors) or T1-T3 N2b		 ipsilateral II, III, IV and V controlateral II and III bilateral IB, controlateral IV and V, RF
  • •

    if pathologic node is IIA, ipsilateral IB should be in CTV2

  • •

    if posterior pharyngeal wall is infiltrated, RF should be in CTV2



Oropharynx
T4N0 (median or bulky tumors)		 bilateral II bilateral III bilateral IB, IV and V, RF if posterior pharyngeal wall is infiltrated, RF should be in CTV2



Oropharynx
T4, N1-N2b		 ipsilateral II, III, IV and V and controlateral II controlateral III, IV and V bilateral IB and RF (See above caveats)



Oropharynx
Any T, N2c or N3		 bilateral II, III, IV and V consider avoiding CTV3 bilateral IB and RF (See above caveats)



Hypopharynx
T1/T2 N2a (lateral wall of pyriform sinus)		 ipsilateral II, III, IV controlateral II and III bilateral IB and V, controlateral IV, RF if pathologic node is IIA, ipsilateral IB should be in CTV2



Hypopharynx
T1/T2 N2b (lateral wall of pyriform sinus)		 ipsilateral II, III, IV and V controlateral II and III bilateral IB, controlateral IV and V, RF (See above caveats)



Hypopharynx
T3/T4N0		 bilateral II and III bilateral IV bilateral IB and V, RF if posterior pharyngeal wall is infiltrated, RF should be in CTV2



Hypopharynx
T4, N1-N2b		 ipsilateral II, III, IV and V and controlateral II, III controlateral IV and V bilateral IB and RF (See above caveats)



Hypopharynx
Any T, N2c or N3		 bilateral II, III, IV and V consider avoiding CTV3 bilateral IB and RF (See above caveats)



Larynx
T3/T4N0		 bilateral II and III bilateral IV bilateral IB and V, RF if posterior pharyngeal wall is infiltrated, RF should be in CTV2



Larynx
Any T, N1-N2b		 ipsilateral II, III, IV and V and controlateral II, III controlateral IV and V bilateral IB and RF (See above caveats)



Larynx
Any T, N2c or N3		 bilateral II, III, IV and V consider avoiding CTV3 bilateral IB and RF (See above caveats)

BOT: base of tongue; CTV: clinical target volume; RF: retropharyngeal nodes.