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Table 9 Guidelines for contouring bilateral neck levels (negative on imaging)

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

Side Level Risk Remarks
Bilateral Retropharyngeal, II, III, Va High  
  IV, Vb Low Higher risk when level III is clinically involved
  IB Very Low Omit or include only in case of neck node positivity