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Table 5 Anatomical landmarks in contouring various oral subsites

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

Sub-site Cranial Caudal Anterior Posterior Lateral Medial
Oral tongue/ Floor of the Mouth (FoM) Superior aspect tongue Hyoid bone Symphysis menti Anterior oropharyngeal mucosa To mandible. Includes ipsilateral parapharyngeal space Ipsilateral tongue/FoM in well lateralized tumours. Contralateral mandible in midline or advanced tumours
Buccal mucosa Inferior aspect zygomatic arch/hard palate Hyoid bone Angle of mouth Oropharyngeal mucosa. To overlying skin Oropharyngeal mucosa. Contralateral parapharyngeal space spared
Infratemporal fossa should be included in HNCPs with involvement or proximity to inferior alveolar nerve
Retromolar Trigone Superior aspect soft palate/hard palate Hyoid bone Junction of posterior third and anterior two thirds of the tongue Oropharyngealmucosa To mandible. Oropharyngeal mucosa
Contralateral parapharyngeal space spared
Includes ipsilateral parapharyngeal space
Hard palate Superior aspect of hard palate +10 mm Hyoid bone 10-15 mm anterior margin on GTV into palate Anterior aspect oropharyngeal mucosa To mandible / medial pterygoid muscle on both sides. Includes both Parapharyngeal spaces. To mandible/medial pterygoid muscle on both sides.
Includes both parapharyngeal spaces.