Unraveling the patterns and pathways of local recurrence of nasopharyngeal carcinoma: evidence for individualized clinical target volume delineation

Ou, Xiaomin; Yan, Wenbin; Huang, Yangle; He, Xiayun; Ying, Hongmei; Lu, Xueguan; Zhu, Hui; Wu, Bin; Wang, Jiazhou; Hu, Chaosu

doi:10.1186/s13014-023-02199-3

Table 2 Risk classification of local recurrence at various anatomic sites and recommended delineation of clinical target volume

From: Unraveling the patterns and pathways of local recurrence of nasopharyngeal carcinoma: evidence for individualized clinical target volume delineation

T1-2(N = 33)				T3-4(N = 19)
Anatomic sites	No	Percentage	Risk of recurrence	Anatomic sites	No	Percentage	Risk of recurrence
Levator veli palatine muscle	26	78.8%	High	Levator veli palatine muscle	14	73.7%	High
Nasopharynx	25	75.8%		Nasopharynx	14	73.7%
Prevertebral muscle	24	72.7%		Prevertebral muscle	11	57.9%
Tensor veli palatine muscle	20	60.6%		Tensor veli palatine muscle	11	57.9%
Retropharyngeal lymph node	20	60.6%		Foramen lacerum	11	57.9%
Foramen lacerum	17	51.5%		Posterior Nasal cavity	10	52.6%
Bottom of sphenoid sinus	17	51.5%		Great wing of sphenoid bone	9	47.4%
Pterygoid process	14	42.4%		Bottom of sphenoid sinus	9	47.4%
Great wing of sphenoid bone	11	33.3%		Pterygoid process	8	42.1%
Parapharyngeal space	11	33.3%		Petrous apex	8	42.1%
Sphenoid sinus	10	30.3%		Clivus	8	42.1%
Petrous apex	8	24.2%	Median	Retropharyngeal lymph node	7	36.8%
Posterior Nasal cavity	7	21.2%		Pterygopalatine fossa	7	36.8%
Jugular Foramen	7	21.2%		Parapharyngeal Space	6	31.6%
Clivus	6	18.2%		Sphenoid sinus	6	31.6%
Pterygopalatine fossa	6	18.2%		Jugular Foramen	5	26.3%	Median
Medial pterygoid muscle	6	18.2%		Posterior ethmoid sinus^a	4	21.1%
Foramen ovale	6	18.2%		Hypoglossal canal^a	4	21.1%
Foramen rotundum	4	12.1%	Low	Lateral pterygoid muscle^a	4	21.1%
Posterior ethmoid sinus	3	9.1%		Foramen rotundum^a	3	15.8%
Inferior orbital fissure	3	9.1%		Inferior orbital fissure^a	3	15.8%
Anterior ethmoid sinus	3	9.1%		Cavernous sinus^a	3	15.8%
Oropharynx	2	6.1%		Medial pterygoid muscle^b	2	10.5%	Low
Anterior Nasal cavity	2	6.1%		Orbit	2	10.5%
Frontal sinus	2	6.1%		Foramen ovale^b	1	5.3%
Hypoglossal canal	1	3.0%		Anterior ethmoid sinus	1	5.3%
Lateral pterygoid muscle	1	3.0%		Oropharynx	1	5.3%
Cavernous sinus	1	3.0%		Anterior Nasal cavity	1	5.3%
Orbit	1	3.0%		Maxillary sinus	1	5.3%
Maxillary sinus	1	3.0%		Cervical vertebrae	1	5.3%
Cervical vertebrae	0	0.0%		Frontal sinus	0	0.0%
Infratemporal fossa	0	0.0%		Infratemporal fossa	0	0.0%
Hypopharynx	0	0.0%		Hypopharynx	0	0.0%

The anatomic sties with median or high risk should be included in the contouring of CTV
^aThe possibility of invasion of these structures was higher in cases with T3-4 (≥ 15%) than cases with T1-2 (< 15%). These anatomic structures were recommended to be included in CTV in locally advanced cases (T3-4)
^bAlthough the possibility of invasion of these structures was low in T3-4 cases (< 15%), they were recommended to be included due to median risk of involvement in early-stage diseases (T1-2)

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