Delineation of the neck node levels for head and neck tumors: A 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines

Grégoire, Vincent; Ang, K. Kian; Budach, Wilfried; Grau, Cai; Hamoir, Marc; Langendijk, Johannes A.; Lee, Anne; Le, Quynh Thu; Maingon, P.; Nutting, Chris; O’Sullivan, Brian; Porceddu, Sandro; Lengelé, Benoît

doi:10.1016/j.radonc.2013.10.010

Cited by 602 publications

(329 citation statements)

References 16 publications

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“…As poorly implemented, it harbors an increased risk of missing the target volume [66,67]. Internationally endorsed delineation guidelines are of paramount importance to reduce inter-observer and inter-patient treatment variations and have proven essential in the conduction of multi-institutional clinical trials [68-70]. A recent analysis of the Surveillance, Epidemiology, and End Results (SEER) database demonstrated that the use of IMRT was associated with a significant improvement in cause-specific survival compared with non-IMRT techniques [71].…”

Section: Challenges and Perspectives In (Chemo)radiationmentioning

confidence: 99%

Advances in the management of squamous cell carcinoma of the head and neck

Machiels¹,

Lambrecht²,

Hanin³

et al. 2014

F1000Prime Rep

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Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common cancer worldwide. The main risk factors for cancers of the oral cavity, larynx, oropharynx, and hypopharynx are alcohol and tobacco use. In addition, the human papillomavirus (HPV) is an established cause of oropharyngeal cancer. An experienced multidisciplinary team is necessary for adequate management and optimal outcome. The treatment of locally advanced disease generally requires various combinations of radiotherapy, surgery, and systemic therapy, but despite this aggressive multimodal treatment, 40% to 60% of the patients will relapse. In this report, we will discuss recent advances in the management of SCCHN, including new developments in molecular biology, imaging, and treatment.

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Section: Challenges and Perspectives In (Chemo)radiationmentioning

confidence: 99%

Advances in the management of squamous cell carcinoma of the head and neck

Machiels¹,

Lambrecht²,

Hanin³

et al. 2014

F1000Prime Rep

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“…In 2013, DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines regarding the delineation of the neck node levels for head and neck tumors has defined the parotid lymph node group as level VIII, which included the subcutaneous pre-auricular nodes, the superficial and deep intraparotid nodes, and the subparotid nodes [2]. In anatomy, parotid lymph node receive efferent lymphatic from the frontal and temporal skin, the eyelids, the conjunctiva, the external auditory canal, the tympanum, the nasal cavities, the root of the nose, the nasopharynx, and the Eustachian tube.…”

Section: Introductionmentioning

confidence: 99%

High-risk factors of parotid lymph node metastasis in nasopharyngeal carcinoma: a case-control study

et al. 2016

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BackgroundAlthough parotid-sparing IMRT decreased the dose distribution of parotid, parotid region recurrence has been reported. Prophylactic irradiation in parotid area would be necessary in patients with high risk of parotid lymph node metastasis (PLNM). This study was to detect the high-risk factors of PLNM in nasopharyngeal carcinoma.MethodsThis was a 1:2 case-control study. All patients in this study were newly diagnosed NPC with N2-3 classification from January 2005 to December 2012. Cases were 22 sides with ipsilateral PLNM. Controls were 44 patients who were randomly selected from N2-3 disease in database.Results20/1096 (1.82 %) NPC patients were found PLNM. Sum of the longest diameter for multiple lymph nodes (SLD) in level II was larger in case group than that in control group (6.0 cm vs. 3.6 cm, p = 0.003). Level II lymph node necrosis, level Va/b involvement, and rare neck areas involvement were more common in case group (p = 0.016, p = 0.034, and p < 0.001, respectively). RPN, level III, and level IV metastases showed no significant difference between the two groups. Multivariate analysis in logistic regression showed that only SLD ≥5 cm in II area (OR = 4.11, p = 0.030) and rare neck areas involvement (OR = 3.95, p = 0.045) were associated with PLNM in NPC patients.ConclusionsPLNM was an uncommon event in NPC patients. SLD ≥5 cm in level II and involvement in rare-neck areas may be potentially high-risk factors for PLNM. Sparing parotid in IMRT was not recommended for NPC patients with high risks of PLNM.

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“…These have been developed and published for several common cancers such as lung (23–24), prostate (25–26), breast (27), rectum (28), pancreas (29) anus (30), cervical and endometrial cancer (31–32) and head and neck cancer (33). These atlases are typically assembled via consensus after target volumes and organs at risk are delineated by several established specialists for standardized test cases.…”

Section: Discussionmentioning

confidence: 99%

Quantitative assessment of target delineation variability for thymic cancers: agreement evaluation of a prospective segmentation challenge

et al. 2015

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Objectives We sought to quantitatively determine the inter-observer variability of expert radiotherapy target-volume delineation for thymic cancers, as part of a larger effort to develop an expert-consensus contouring atlas. Methods A pilot dataset was created consisting of a standardized case presentation with pre- and post-operative DICOM CT image sets from a single patient with Masaoka-Koga Stage III thymoma. Expert thoracic radiation oncologists delineated tumor targets on the pre- and post-operative scans as they would for a definitive and adjuvant case, respectively. Respondents completed a survey including recommended dose prescription and target volume margins for definitive and post-operative scenarios. Inter-observer variability was analyzed quantitatively with Warfield's simultaneous truth, performance level estimation (STAPLE) algorithm and Dice similarity coefficient (DSC). Results Seven users completed contouring for definitive and adjuvant cases; of these, 5 completed online surveys. Segmentation performance was assessed, with high mean±SD STAPLE-estimated segmentation sensitivity for definitive case GTV and CTV at 0.77 and 0.80, respectively, and post-operative CTV sensitivity of 0.55; all volumes had specificity of ≥0.99. Inter-observer agreement was markedly higher for the definitive target volumes, with mean±SD DSC of 0.88±0.03 and 0.89±0.04 for GTV and CTV respectively, compared to post-op CTV DSC of 0.69±0.06 (Kruskal-Wallis p<0.01. Conclusion Expert agreement for definitive case volumes was exceptionally high, though significantly lower agreement was noted post-operatively. Technique and dose prescription between experts was substantively consistent, and these preliminary results will be utilized to create an expert-consensus contouring atlas to aid the non-expert radiation oncologist in the planning of these challenging, rare tumors.

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Delineation of the neck node levels for head and neck tumors: A 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines

Cited by 602 publications

References 16 publications

Advances in the management of squamous cell carcinoma of the head and neck

Advances in the management of squamous cell carcinoma of the head and neck

High-risk factors of parotid lymph node metastasis in nasopharyngeal carcinoma: a case-control study

Quantitative assessment of target delineation variability for thymic cancers: agreement evaluation of a prospective segmentation challenge

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