2016_Head & Neck COURSE BOOK

Elective neck irradiation

• The risk of initial subclinical spread to neck nodes is  relatively low • Elective neck radiotherapy is recommended for • patients with initial N‐positive disease • if primary tumor invades oral cavity, pharynx or skin • +? (emerging evidence..) • If elective RT is indicated:  • include levels Ib, II, and III (+facial nodes).  • If the nasopharynx is involved, levels I–V should be included • Unilateral neck irradiation can be used for maxillary  tumors not involving the midline