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The CTV in head-and-neck cancer
• ‘‘Delineation of the CTV is currently based on clinical experience”.
•
Imaging-based volume vs. pathology-based volume:
•
Microscopic disease – “tumor cells lying outside the gross tumor that
could only be identified at a microscopic level”.
•
Microscopic disease probability 5-10%
•
Margins
• Delineation methods:
•
Volumetric (isotropic) expansion using margins.
•
Anatomic/compartmental: including anatomic compartments bounded by
anatomic barriers.
ICRU report 83. 2010;10:41-46.
Camplbell et al.
IJROBP
2012;82:574-81.