Delineation of neck clinical target volume specific to nasopharyngeal carcinoma based on lymph node distribution and the international consensus guidelines

Neck node distribution probability maps and curves for NPC were established based on 10651 nodes from 956 patients. Relationships between node distribution and international consensus guidelines for delineation of neck node levels were analyzed. Our findings demonstrate that the majority of node levels in the 2013 updated consensus guidelines are comprehensive and applicable for NPC. We propose a new level VIIc to include medial group of retropharyngeal LNs, recommend moderate extended boundaries for levels Vb and VIIa, and suggest that boundaries for levels Ib, II, IV and Vc might be reduced.

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