Radiat Oncol J.
2012 Mar;30(1):36-42. 10.3857/roj.2012.30.1.36.
Radial displacement of clinical target volume in node negative head and neck cancer
- Affiliations
-
- 1Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. wuhg@snu.ac.kr
- 2Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
- 3Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
- 4Department of Radiation Oncology, Kangbuk Samsung Hospital, Seoul, Korea.
- 5Department of Radiation Oncology, Interdisciplinary Program in Radiation Applied Life Science, Seoul National University College of Medicine, Seoul, Korea.
- KMID: 2051110
- DOI: http://doi.org/10.3857/roj.2012.30.1.36
Abstract
- PURPOSE
To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers.
MATERIALS AND METHODS
Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified.
RESULTS
The mean radial displacements were 2.26 (+/-1.03) mm in the control group and 3.05 (+/-1.97) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups.
CONCLUSION
This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.
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