Target Volume Determination 2015

Can we improve the results of elective neck irradiation?

De-intensification of elective neck irradiation

• Decrease in target volume: – Disphagia-sparing IMRT:

Feng et al. JCO 2010;28:2731-8.

• Decrease in dose: – Dose de-escalation:

Phase II RCT NCT01812486; Phase III RTC RTOG 1016. • Decrease in target volume & dose: – Omitting elective neck at lower risk of occult metastases from irradiation to NID2Gy 40 Gy: Phase II RCT NCT01287390. – Irradiation of sentinel lymph nodes in T1-2N0 cancer of oral cavity?