Table 2.
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 |
|
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.