Technical guidelines for head and neck cancer IMRT on behalf of the Italian association of radiation oncology - head and neck working group

Table 11 guidelines for contouring ipsilateral and contralateral neck levels negative at imaging

Side	Level	Risk		Remarks
Ipsilateral	Ib	Low	CTV3	Higher risk for soft palate/oral cavity involvement or multiple positive neck levels-CTV2
	II-III	High	CTV2	Lower risk when the whole neck is negative (cN0)-CTV3
	IV	Low	CTV3	Higher risk when level III is clinically involved- CTV2
	V	Very low	CTV3 or omit
Contralateral	IB	Very low	Omit	Higher if the contralateral II-III lymph node level is clinically positive or the soft palate is involved
	II-III	Low	CTV3	Higher risk if the contralateral level IB is clinically positive
	IV	Low	CTV3	Higher risk when level III is clinically involved
	V	Very low	Omit	Omit unless suspicious nodes are found

ISSN: 1748-717X