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Head and Neck Cancer

  • Chapter
Target Volume Definition in Radiation Oncology

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Abstract

Accurate delineation of the therapeutic targets and organs at risk is essential to maximizing the potential of intensity-modulated radiation therapy (IMRT) in the treatment of head and neck cancer. Precise definition of gross tumor volumes and potential sites of subclinical disease using clinical and radiographic information is required to minimize the risk of marginal or out-of-field locoregional recurrences, while identification and prioritization of normal tissue avoidance structures serve a crucial role in preserving patient quality of life. Appropriate clinical target volume definition is dependent on the appreciation of (a) the natural history and patterns of spread of head and neck cancer and (b) the ever-growing published experience on the use of IMRT, which guides the optimized application of this technology to balance cure with the functional consequences of head and neck radiotherapy. This chapter will outline the important steps in target definition for the treatment of head and neck cancer and will highlight important clinical concerns for these patients and their management.

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Abbreviations

CN:

Cranial nerve

CT:

Computed tomography

CTV:

Clinical target volume

FDG:

18-Fluorodeoxyglucose

Fmiso:

Fluoromisonidazole

GTV:

Gross tumor volume

HNC:

Head and neck cancer

IMRT:

Intensity-modulated radiation therapy

MRI:

Magnetic resonance imaging

OAR:

Organ at risk

PET:

Positron emission tomography

PTV:

Planning target volume

RP:

Retropharyngeal

RT:

Radiotherapy

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Authors and Affiliations

  1. Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA

    Jeffrey M. Vainshtein MD

  2. Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI, USA

    Avraham Eisbruch MD

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  1. Jeffrey M. Vainshtein MD
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Correspondence to Jeffrey M. Vainshtein MD .

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  1. Department of Radiation Oncology, University Medical Center Freiburg, Freiburg, Germany

    Anca-Ligia Grosu

  2. Department of Oncology, Nordland Hospital, Bodo, Norway

    Carsten Nieder

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Vainshtein, J.M., Eisbruch, A. (2015). Head and Neck Cancer. In: Grosu, AL., Nieder, C. (eds) Target Volume Definition in Radiation Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45934-8_4

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