Radiation therapy is the mainstay therapeutic modality for nasopharyngeal cancer (NPC), and high-dose radiation is required for curative treatment of the disease. Nasopharynx is in close proximity to the critical structures such as brainstem and brain (temporal lobes), parotid glands, and spinal cord. Irradiating structures close to the nasopharynx may cause symptoms that substantially affect the quality of life of patients after treatment; precise radiation therapy for this malignancy has always been the focus of technology development.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Adams S, Baum RP, Stuckensen T, et al (1998) Prospective comparison of 18F-FDG PET with conventional imaging modalities (CT, MRI, US) in lymph node staging of head and neck cancer. Eur J Nucl Med 25(9):1255–1260
Apisarnthanarax S, Elliott DD, El-Naggar AK, et al (2006) Determining optimal clinical target volume margins in head-and-neck cancer based on microscopic extracapsular extension of metastatic neck nodes. Int J Radiat Oncol Biol Phys 64(3):678–683
Chao KS, Wippold FJ, Ozyigit G, et al (2002) Determination and delineation of nodal target volumes for head-and-neck cancer based on patterns of failure in patients receiving definitive and postoperative IMRT. Int J Radiat Oncol Biol Phys 53(5):1174–1184
Chau RM, Teo PM, Choi PH, et al (2001) Three-dimensional dosimetric evaluation of a conventional radiotherapy technique for treatment of nasopharyngeal carcinoma. Radiother Oncol 58(2):143–153
Chau RM, Teo PM, Kam MK, et al (2007) Dosimetric comparison between 2-dimensional radiation therapy and intensity modulated radiation therapy in treatment of advanced T-classification nasopharyngeal carcinoma: to treat less or more in the planning organ-at-risk volume of the brain-stem and spinal cord. Med Dosim 32(4):263–270
Chong VFH, Ong CK (2008) Nasopharyngeal carcinoma. Eur J Radiol 66:437–447
Chong VF, Fan YF, Khoo JB. Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. Eur J Radiol. 1995;21(2):100–5
Chua DT, Sham JS, Kwong DL, et al. Retropharyngeal lymphade-nopathy in patients with nasopharyngeal carcinoma: a computed tomography-based study. Cancer. 1997;79(5):869–77
Emami B, Sethi A, Petruzzelli GJ (2003) Influence of MRI on target volume delineation and IMRT planning in nasopharyn-geal carcinoma. Int J Radiat Oncol Biol Phys 57(2):481–488
Fisch U (1968) Lymphography of the cervical lymphatic system. WB Saunders, London
Gao Y, Zhu G, Lu JJ, et al (2009) Is prophylactic irradiation to the lower neck necessary for nasopharyngeal cancer patients with N0 disease? Int J Radiat Oncol Biol Phys
Grégoire V, Eisbruch A, Hamoir M, et al (2006) Proposal for the delineation of the nodal CTV in the node-positive and the post-operative neck. Radiother Oncol 79(1):15–20
Grégoire V, Levendag P, Ang KK, et al (2003) CT-based delineation of lymph node levels and related CTVs in the node-negative neck: DAHANCA, EORTC, GORTEC, NCIC,RTOG consensus guidelines. Radiother Oncol 69(3):227–236
Ho JHC (1978) Stage classification of nasopharyngeal carcinoma: a review. In: de The G, Ito Y (eds) Nasopharyngeal carcinoma: etiology and control, Vo l 20. IARC Scientific Publications, Lyon, France, pp 99–113
Kam MK, Teo PM, Chau RM, et al (2004) Treatment of nasopha-ryngeal carcinoma with intensity-modulated radiotherapy: the Hong Kong experience. Int J Radiat Oncol Biol Phys 60(5):1440–1450
Kau RJ, Alexiou C, Laubenbacher C, et al (1999) Lymph node detection of head and neck squamous cell carcinomas by positron emission tomography with fluorodeoxyglucose F 18 in a routine clinical setting. Arch Otolaryngol Head Neck Surg 125(12):1322–1328
King AD, Ahuja AT, Leung SF, et al (2000) Neck node metastases from nasopharyngeal carcinoma: MR imaging of patterns of disease. Head Neck 22(3):275–281
King AD, Ma BB, et al (2008) The impact of 18F-FDG PET/CT on assessment of nasopharyngeal carcinoma at diagnosis. Br J Radiol 81(964):291–298
Kyzas PA, Evangelou E, Denaxa-Kyza D, et al 18F-fluorodeoxyglucose positron emission tomography to evaluate cervical node metastases in patients with head and neck squamous cell carcinoma: a meta-analysis. J Natl Cancer Inst. 2008;100(10):712–20
Lam WW, Chan YL, Leung SF, et al (1997) Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. Head Neck 19(3):176–181
Lee N, Pfister DG, Garden A, et al (2006) RTOG 0615, A phase II study of concurrent chemoradiotherapy using three-dimentional conformal radiotherapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) + bevacizumab (BV) for locally or regionally advanced nasopharyngeal cancer. http://www.rtog.org/members/protocols/0615/0615. pdf Accessed on May 19
Lee N, Xia P, Quivey JM, et al (2002) Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys 53(1):12–22
Lee AW, Sham JS, Poon YF, et al Treatment of stage I nasopha-ryngeal carcinoma: analysis of the patterns of relapse and the results of withholding elective neck irradiation. Int J Radiat Oncol Biol Phys. 1989;17(6):1183–90
Lin S, Pan J, Lu H, et al. (2009) Nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy: report on the 3-year outcome of a prospective series. Int J Radiat Oncol Biol Phys. 2009 Apr 11. [Epub ahead of print]
Liu LZ, Zhang GY, Xie CM, et al (2006) Magnetic resonance imaging of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma: patterns of spread. Int J Radiat Oncol Biol Phys 66(3):721–730
Ma J, Liu L, Tang L, et al (2007) Retropharyngeal lymphade-nopathy in nasopharyngeal carcinoma: prognostic value and staging categories. Clin Cancer Res 13:1445–1452
McLaughlin MP, Mendenhall WM, Mancuso AA, et al Retropharyngeal adenopathy as a predictor of outcome in squamous cell carcinoma of the head and neck. Head Neck. 1995;17(3):190–8
Ng Sh, Chang TC, Ko SF, et al (1997) Nasopharyngeal carcinoma: MRI and CT assessment. Neuroradiology 39(10):741–746
Ng SH, Chan SC, Ye n TC, et al (2009) Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up. Eur J Nucl Med Mol Imaging 36(1):12–22
Ng SH, Chang JT, Chan SC, et al Nodal metastases of nasopha-ryngeal carcinoma: patterns of disease on MRI and FDG PET. Eur J Nucl Med Mol Imaging. 2004;31(8):1073–80.
Ng WT, Lee AW, Kan WK, et al. (2007) N-staging by magnetic resonance imaging for patients with nasopharyngeal carcinoma: pattern of nodal involvement by radiological levels. Radiother Oncol 82:70–75
Ogura I, Kaneda T, Kato M, et al (2004) MR study of lateral retropharyngeal lymph nodes at different ages. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98(3):355–358
Olmi P, Fallai C, Colagrande S, et al (1995) Staging and follow-up of nasopharyngeal carcinoma: magnetic resonance imaging versus computerized tomography. Int J Radiat Oncol Biol Phys 32(3):795–800
Robbins KT, Medina JE, Wolfe GT et al (1991) Standardizing neck dissection terminolog y. Official report of the Academy's Committee for Head and Neck Surgery and Oncology. Arch Otolaryngol Head Neck Surg 117: 601–605
Robbins KT, Clayman G, Levine PA, et al (2002) Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg 128(7):751–758
Robbins KT, Shaha AR, Medina JE, et al (2008) Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg 134(5):536–538
Rouvière H. (Tobiar MT, Edwards JW, trans.) Anatomy of the Human Lymphatic System. Ann Arbor, MI, 1948
Sham JS, Choy D, Wei WI (1990) Nasopharyngeal carcinoma: orderly neck node spread. Int J Radiat Oncol Biol Phys 19(4):929–933
Som PM (1992) Detection of metastasis in cervical lymph nodes: CT and MR criteria and differential diagnosis. AJR Am J Roentgenol 158(5):961–969
Tang L, Mao Y, Liu L, et al The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma: analysis of the spread patterns in lymph nodes by magnetic resonance imaging. Cancer. 2009;115(3):680–8
Tang L, Mao Y, Liu L, et al (2009) The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma: analysis of the spread patterns in lymph nodes by magnetic resonance imaging. Cancer 115(3):680–688
Tham IW, Hee SW, Ye o RM et al. (2009a) Treatment of Nasopharyngeal Carcinoma Using Intensity-Modulated Radiotherapy-The National Cancer Centre Singapore Experience. Int J Radiat Oncol Biol Phys. 2009 Apr 20. [Epub ahead of print]
Tham IW, Hee SW, Yap SP, et al (2009b) Retropharyngeal nodal metastasis related to higher rate of distant metastasis in patients with N0 and N1 nasopharyngeal cancer. Head and Neck 31(4):468–474
van den Brekel MW, Stel H V, Castelijns JA, et al (1990) Cervical lymph node metastasis: assessment of radiologic criteria. Radiology 177(2):379–384
Wakisaka M, Mori H, Fuwa N, et al (2000) MR analysis of nasopharyngeal carcinoma: correlation of the pattern of tumor extent at the primary site with the distribution of metastasized cervical lymph nodes. Preliminary results. Eur Radiol 10(6):970–977
Wang XS, Hu CS, Ying HM, et al (2009) Patterns of retropha-ryngeal node metastasis in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 73(1):194–201
Wang X, Li L, Hu C, et al. Patterns of level II node metastasis in nasopharyngeal carcinoma. Radiother Oncol. 2008;89(1):28–32
Wolden SL, Chen WC, Pfister DG, et al (2006) Intensity-modulated radiation therapy (IMRT) for nasopharynx cancer: update of the Memorial Sloan-Kettering experience. Int J Radiat Oncol Biol Phys 64(1):57–62
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Lu, J.J., Grégoire, V., Lin, S. (2010). Selection and Delineation of Target Volumes in Intensity-Modulated Radiation Therapy for Nasopharyngeal Cancer. In: Lu, J.J., Cooper, J.S., Lee, A.W.M. (eds) Nasopharyngeal Cancer. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-92810-2_17
Download citation
DOI: https://doi.org/10.1007/978-3-540-92810-2_17
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-92809-6
Online ISBN: 978-3-540-92810-2
eBook Packages: MedicineMedicine (R0)