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Topics:
Head and Neck Cancers • Radiation Oncology
When do you spare constrictors in head and neck treatment planning?
In contouring base of tongue, tonsil, larynx and other H+N tumors, the CTV and PTV will frequently encroach on the posterior pharyngeal wall. I'd appreciate any comments or references as to when one can reasonably spare the pharyngeal constrictors without compromising appropriate target dosimetry, and if so, where does one begin to contour them and what are DVH/dose limits?
What dose limits do the experts use in the field for sup/mid/inferior constrictors?
Answer from: Radiation Oncologist at Academic Institution
The best data is from Eisbruch and colleagues at Michigan. I spare them when possible but it is often not feasible without compromising target coverage. That is the case for any OAR, including the optic chiasm, in which case I exceed the OAR thresholds to adequately irradiate the tumor.
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