350-351 / 1676
Unilateral or
bilateral
elective
irradiation
Guidelines: Do they work?
Oral cavity carcinoma
Stage and primary site
Ipsilateral neck
Contralateral neck, if inidicated (see figure x)
Level
Ia
Level
Ib
Level
II
Level
III
Level
IV
Level
V
Level
VI
RP Level
Ia
Level
Ib
Level
II
Level
III
Level
IV
Level
V
Level
VI
RP
pN0 and pN1
R1
R1
pN2a-pN2b and pN3
R1
R1
pN2c
R1
R5
R1
R5
Oropharyngeal carcinoma
Stage and primary site
Ipsilateral neck
Contralateral neck, if inidicated (see figure x)
Level
Ia
Level
Ib
Level
II
Level
III
Level
IV
Level
V
Level
VI
RP Level
Ia
Level
Ib
Level
II
Level
III
Level
IV
Level
V
Level
VI
RP
pN0 and pN1
R2
pN2a-pN2b and pN3
pN2c
R5
R5
R5
R5
Hypopharyngeal carcinoma
Stage and primary site
Ipsilateral neck
Contralateral neck, if inidicated (see figure x)
Level
Ia
Level
Ib
Level
II
Level
III
Level
IV
Level
V
Level
VI
RP Level
Ia
Level
Ib
Level
II
Level
III
Level
IV
Level
V
Level
VI
RP
pN0
R3 R2
R3 R2
pN1-pN2a-pN2b
R3
R3 R2
pN2c
R5
R5 R3
R5
R5
pN3
R3
Laryngeal carcinoma
Stage and primary site
Ipsilateral neck
Contralateral neck, if inidicated (see figure x)
Level
Ia
Level
Ib
Level
II
Level
III
Level
IV
Level
V
Level
VI
RP Level
Ia
Level
Ib
Level
II
Level
III
Level
IV
Level
V
Level
VI
RP
pN0 and pN1
R4
R4
pN2a - pN2b
R4
R4
pN2c
R5
R5 R4
R5
R5 R4
pN3
R4
R4
NOTE: LEVELS ADJACENT TO POSITIVE LYMPH NODE AREAS SHOULD ALWAYS BE INCLUDED IN THE ELECTIVE CTV.
R5: according to N-stage on each side of the neck.
RP: retropharyngeal nodes.
R1: Include level Ia only in case of anterior tongue or anterior floor of mouth extension.
R2: Include retropharyngeal nodes for posterior pharyngeal wall tumour extension.
R3: include level VI in case of extension apex of prirform sinus or esophageal extension.
R4: include level VI in case of trans- or subglottis extension.