Original Article

Selective omission of level V nodal coverage for patients with oropharyngeal cancer: Clinical validation of intensity-modulated radiotherapy experience and dosimetric significance

Corresponding Author

Pranshu Mohindra MD, MBBS

orcid.org/0000-0002-4873-7496

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland

Corresponding author: P. Mohindra, Department of Radiation Oncology, 22 S. Greene St., Rm GGJ 35, Baltimore, MD-21201. E-mail: [email protected] and P. Harari, Department of Human Oncology, K4/ B100, 600 Highland Avenue, Madison, WI 53792. E-mail: [email protected]Search for more papers by this author

Erich Urban PhD,

Erich Urban PhD

Department of Radiation Oncology, Aurora Cancer Center, Grafton, Wisconsin

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Jonathan D. Pagan MD,

Jonathan D. Pagan MD

University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas

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Heather M. Geye MS,

Heather M. Geye MS

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

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Vatsal B. Patel MD, MBA,

Vatsal B. Patel MD, MBA

University of Connecticut, School of Medicine, Farmington, Connecticut

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R. Adam A. Bayliss PhD,

R. Adam A. Bayliss PhD

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

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Edward T. Bender PhD,

Edward T. Bender PhD

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

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Paul M. Harari MD,

Corresponding Author

Paul M. Harari MD

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

Pranshu Mohindra MD, MBBS,

Corresponding Author

Pranshu Mohindra MD, MBBS

orcid.org/0000-0002-4873-7496

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland

Erich Urban PhD,

Erich Urban PhD

Department of Radiation Oncology, Aurora Cancer Center, Grafton, Wisconsin

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Jonathan D. Pagan MD,

Jonathan D. Pagan MD

University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas

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Heather M. Geye MS,

Heather M. Geye MS

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

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Vatsal B. Patel MD, MBA,

Vatsal B. Patel MD, MBA

University of Connecticut, School of Medicine, Farmington, Connecticut

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R. Adam A. Bayliss PhD,

R. Adam A. Bayliss PhD

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

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Edward T. Bender PhD,

Edward T. Bender PhD

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

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Paul M. Harari MD,

Corresponding Author

Paul M. Harari MD

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

First published: 01 December 2014

https://doi.org/10.1002/hed.23924

Citations: 8

This work was presented at the 95th American Radium Society (ARS) annual meeting, April 27–May 1, 2013, Scottsdale, Arizona.

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ABSTRACT

Background

We sought to validate the consensus recommendation and assess dosimetric significance of selective omission of nodal level V from intensity-modulated radiotherapy (IMRT) clinical target volume (CTV) for oropharyngeal cancer.

Methods

IMRT plans and clinical outcomes for 112 patients with oropharyngeal cancer (nodal classification N0–N2b) were analyzed for coverage of ipsilateral and contralateral nodal level V. Additionally, new IMRT plans were generated in 6 randomly selected patients to assess its dosimetric impact.

Results

With median follow-up of 3.4 years, there were no failures identified in nodal level V with or without nodal level V omission. Upon dosimetric evaluation, significant reduction in integral dose, V_{10 Gy}, V_{20 Gy}, V_{30 Gy}, V_{40 Gy}, and V_{50 Gy} was observed by excluding unilateral and bilateral level V from the CTV.

Conclusion

We clinically validate the consensus recommendation for selective omission of level V nodal coverage in IMRT planning of patients with oropharyngeal cancer and demonstrate significant dosimetric advantages. © 2016 Wiley Periodicals, Inc. Head Neck 38: 499–505, 2016

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Volume38, Issue4

April 2016

Pages 499-505

Selective omission of level V nodal coverage for patients with oropharyngeal cancer: Clinical validation of intensity-modulated radiotherapy experience and dosimetric significance

ABSTRACT

Background

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Results

Conclusion

REFERENCES

Citing Literature

References

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Selective omission of level V nodal coverage for patients with oropharyngeal cancer: Clinical validation of intensity-modulated radiotherapy experience and dosimetric significance

ABSTRACT

Background

Methods

Results

Conclusion

REFERENCES

Citing Literature

References

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