Table 1 Target volumes and normal tissues: objectives and constraints
From: Quality assurance for the EORTC 22071–26071 study: dummy run prospective analysis
Protocol compliant | Minor deviation | Major deviation | ||
|---|---|---|---|---|
Target structure | ||||
CTV52.8 Gy | • Bilateral neck irradiation to include levels IB, II, III and IV | • Level IA or V included | • Unilateral irradiation | |
• Complete levels IB, II, III or IV not included | ||||
• Preoperative extent of primary tumour +15 mm | • Preoperative extent of tumour or LN with ECE outside of CTV | |||
• Reconstructed LN with ECE +10 mm | ||||
CTV59.4 Gy | • Preoperative extent of primary tumour +10 mm | -- | • Preoperative extent of tumour or LN with ECE outside of CTV | |
• Reconstructed LN with ECE +10 mm | ||||
CTV66 Gy | • Preoperative extent of primary tumour +10 mm | -- | • Preoperative extent of tumour or LN with ECE outside of CTV | |
• Reconstructed LN with ECE +5 mm | ||||
Volume objective | Dose | |||
PTV52.8 Gy-Exact | D98% | ≥47.52 Gy | 46.57-47.52 Gy | <46.57 Gy |
D95% | ≥50.16 Gy | 49.16-50.16 Gy | <49.16 Gy | |
PTV59.4 Gy-Exact | D98% | ≥53.46 Gy | 52.93-53.46 Gy | <52.93 Gy |
D95% | ≥56.43 Gy | 55.30-56.43 Gy | <55.30 Gy | |
PTV66 Gy-Exact | D98% | ≥59.4 Gy | 58.21-59.40 Gy | <58.21 Gy |
D95% | ≥62.7 Gy | 61.45-62.70 Gy | <61.45 Gy | |
D5% | ≤72.6 Gy | -- | >72.6 Gy | |
Normal tissue | Dose constraint | |||
Outside of PTV3* | Max dose 72.6 Gy to a volume >1.8 cc | >72.6 Gy to >1.8-2.0 cc | >72.6 Gy to >2.0 cc | |
Spinal cord* | D2% | <50 Gy | -- | ≥50 Gy |
Brainstem* | D2% | <52 Gy | -- | ≥52 Gy |
Parotid glands** | ||||
• Either gland | Mean dose | <26 Gy | -- | ≥26 Gy |
• Either gland | ≥50% | <30 Gy | -- | ≥30 Gy |
• Both glands combined | ≥20 cc | <20 Gy | -- | ≥20 Gy |
Submandibular gland | Mean dose | <52 Gy | -- | ≥52 Gy |
Oral cavity | Max dose outside PTV 50 Gy | -- | ≥50 Gy | |
Larynx | Max dose outside PTV 50 Gy | -- | ≥50 Gy | |
Other^ | As low as possible | -- | -- | |