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Selection and Delineation of Lymph Node Target Volumes in Head and Neck Conformal and Intensity-Modulated Radiation Therapy

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Clinical Target Volumes in Conformal and Intensity Modulated Radiation Therapy

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

Abstract

The use of conformal and intensity-modulated radiation therapy to deliver the dose more precisely to the target volumes while protecting the normal tissues at risk obviously requires a proper knowledge of the volumes to be irradiated and an accurate delineation of these volumes on a 3D basis. These requirements have always existed, but were greatly simplified in 2D planning in the sense that one dimension was evidently missing or greatly minimized. For instance, in head and neck tumors irradiated, as still suggested in all major textbooks, by two opposed lateral fields, there was no need to define the tumor or lymph node extension in the medio-lateral direction. In some ways, conformal and intensity-modulated radiation therapy requires the radiation oncologist to approach this issue in the spirit of a surgeon planning and performing an operation. The surgical field is replaced by a computed tomography (CT) scan or a magnetic resonance (MR) image and the scalpel by a mouse or an electronic pencil. Without any doubt, this represents a new challenge for the radiation oncology community. Such a procedure requires a precise knowledge of CT- or MRI-based anatomy, as well as microscopic extension of the tumors and/or nodes in the fatty tissues, along the aponeurotic fascia and muscles, or around the blood vessels and nerves.

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Authors and Affiliations

  1. Radiation Oncology Department, Université Catholique de Louvain, St-Luc University Hospital, 10 Ave Hippocrate, 1200, Brussels, Belgium

    V. Grégoire MD, PhD (Associate Professor)

  2. Radiology Department, Université Catholique de Louvain, St-Luc University Hospital, 10 Ave Hippocrate, 1200, Brussels, Belgium

    E. Coche MD (Assistant Professor)

  3. Radiology Department, Université Catholique de Louvain, St-Luc University Hospital, 10 Ave Hippocrate, 1200, Brussels, Belgium

    G. Cosnard MD (Professor)

  4. ENT and Head and Neck Surgery Department, Université Catholique de Louvain, St-Luc University Hospital, 10 Ave Hippocrate, 1200, Brussels, Belgium

    M. Hamoir MD (Professor)

  5. Oral and Maxillo-Facial Surgery Department, Université Catholique de Louvain, St-Luc University Hospital, 10 Ave Hippocrate, 1200, Brussels, Belgium

    H. Reychler MD, DMD (Professor)

Authors
  1. V. Grégoire MD, PhD
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  2. E. Coche MD
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  3. G. Cosnard MD
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  4. M. Hamoir MD
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  5. H. Reychler MD, DMD
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Editors and Affiliations

  1. Department of Radiation Oncology, Université Catholique de Louvain Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, UCL 10/4752, 1200, Bruxelles, Belgium

    Vincent Grégoire MD, PhD  & Pierre Scalliet MD, PhD  & 

  2. Department of Radiation Oncology, UT MD Anderson Cancer Center, 77030, Houston, TX, USA

    K. Kian Ang MD, PhD

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© 2004 Springer-Verlag Berlin Heidelberg

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Grégoire, V., Coche, E., Cosnard, G., Hamoir, M., Reychler, H. (2004). Selection and Delineation of Lymph Node Target Volumes in Head and Neck Conformal and Intensity-Modulated Radiation Therapy. In: Grégoire, V., Scalliet, P., Ang, K.K. (eds) Clinical Target Volumes in Conformal and Intensity Modulated Radiation Therapy. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-06270-8_3

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  • DOI: https://doi.org/10.1007/978-3-662-06270-8_3

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-07463-9

  • Online ISBN: 978-3-662-06270-8

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