title: Reduction of clinical target volume in patients with lateralized cancer of the nasopharynx and without contralateral lymph node metastasis receiving intensity-modulated radiotherapy.
abstract: This study investigated lymph node distribution in patients with lateralized cancer of the nasopharynx to identify areas suitable for clinical target volume (CTV) reduction.
  
  
  
  A total of 1680 patients with nasopharyngeal carcinoma (NPC) whose tumor involvement was assessed by MRI were reviewed retrospectively.
  
  
  
  One hundred and twelve patients (7%) had a lateralized primary lesion. Of these, 9 patients (8%) had contralateral lymph nodes including 4 (4%) who had contralateral cervical lymph nodes (CLNs). The rates of contralateral level III/Va metastasis were <1% (1 of 104) and 12.5% (1 of 8) in patients without and with contralateral retropharynx/level II involvement, respectively. No known risk factors were significantly associated with contralateral lymph node metastasis.
  
  
  
  Reduced cervical CTV coverage, including the contralateral level II, is feasible in patients with lateralized primary NPC, which may help to better protect the cervical OAR, including the thyroid, larynx, and esophagus. © 2015 Wiley Periodicals, Inc. Head Neck 38: E468-E472, 2016.
authors: State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors: Ying
authors: Y
authors: Sun
authors: Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors: Xiao-Li
authors: XL
authors: Yu
authors: State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors: Guang-Shun
authors: GS
authors: Zhang
authors: Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors: Yi-Min
authors: YM
authors: Liu
authors: State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors: Chang-Juan
authors: CJ
authors: Tao
authors: State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors: Rui
authors: R
authors: Guo
authors: State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors: Ling-Long
authors: LL
authors: Tang
authors: Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors: Rong
authors: R
authors: Zhang
authors: Department of Medical Statistics and Epidemiology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors: Ying
authors: Y
authors: Guo
authors: State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors: Jun
authors: J
authors: Ma
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D009305:Nasopharynx / Q000473:pathology; D009367:Neoplasm Staging; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D047368:Tumor Burden
keywords: clinical target volume; intensity-modulated radiotherapy; lateralized cancer; nasopharyngeal carcinoma; organs at risk