Target volume delineation of the neck for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas - 02/09/25
Doi : 10.1016/S1470-2045(25)00327-4
Ling-Long Tang, ProfMD a, *, Cheng-Long Huang, MD a, *, Shao-Jun Lin, ProfMD b, *, Quynh-Thu Le, ProfMD c, *, Brian O’Sullivan, ProfMD d, e, *, Sue S Yom, ProfMD PhD f, *, Shao Hui Huang, MD d, e, *, Annie W Chan, ProfMD g, *, Nancy Lee, ProfMD h, *, Jian-Ji Pan, ProfMD b, *, Michael Benedict A Mejia, MD i, Yong Chan Ahn, ProfMD PhD j, k, Kenneth C W Wong, FRCR l, Lachlan McDowell, ProfPhD m, Ester Orlandi, MD n, Jeppe Friborg, MD PhD o, Yu-Pei Chen, MD a, Koichi Yasuda, MD PhD p, Takeshi Kodaira, ProfMD PhD q, Alexander C Whitley, MD PhD r, Ann D King, ProfMD s, Gregorius Ben Prajogi, MD t, Ezra Hahn, MD d, e, Jin-Ching Lin, ProfMD PhD u, Naomi Kiyota, MD v, Victor Lee, ProfMD w, Peng-Jie Ji, MD a, Ying Hitchcock, ProfMD x, Frank Hoebers, MD PhD y, Pierre Blanchard, ProfMD z, Sung Ho Moon, ProfMD aa, Wan Zamaniah Wan Ishak, MD ab, Kevin J Harrington, ProfPhD ac, Kun-Yu Yang, ProfMD ad, A Dimitrios Colevas, ProfMD ae, Anna Lee, MD af, Chao-Su Hu, ProfMD ag, David Rosenthal, ProfMD af, Farzan Siddiqui, ProfMD ah, Johannes Albertus Langendijk, ProfMD PhD ai, Jin-Yi Lang, ProfMD aj, Jun-Lin Yi, MD ak, Liang-Fang Shen, ProfMD al, Ji-Bin Li, PhD am, Li-Zhi Liu, ProfMD an, Anne W M Lee, ProfMD ao, Hai-Qiang Mai, ProfMD ap, Ming-Kai Yang, BS aq, Ying Sun, ProfMD a, †, Melvin L K Chua, ProfMD ar, †, Jun Ma, ProfMD a, †, ⁎ 
a Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
b Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, China
c Department of Radiation Oncology, Stanford University, Stanford, CA, USA
d Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
e Department of Otolaryngology–Head & Neck Surgery, the Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
f Department of Radiation Oncology, and Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, CA, USA
g Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
h Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
i Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
j Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
k Department of Radiation Oncology, CHA Ilsan Medical Center, CHA University, Pocheon, South Korea
l State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
m Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, QLD, Australia
n Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
o Department of Oncology, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
p Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
q Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
r Central Alabama Radiation Oncology, Montgomery, AL, USA
s Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
t Department of Radiation Oncology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
u Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
v Kobe University Hospital, Cancer Center, Kobe, Japan
w Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
x University of Utah Huntsman Cancer Institute, Greg Stoddard, University of Utah, Salt Lake City, UT, USA
y Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
z Department of Radiation Oncology, Université Paris-Saclay, INSERM U1018 Oncostat, Gustave-Roussy, Villejuif, France
aa Proton Therapy Center, National Cancer Center, Goyang-si, South Korea
ab Department of Clinical Oncology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
ac The Institute of Cancer Research, Royal Marsden Hospital, London, UK
ad Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
ae Department of Medicine (Oncology), Stanford University, Stanford, CA, USA
af Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
ag Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
ah Department of Radiation Oncology, Henry Ford Cancer Institute and Hospital, Detroit, MI, USA
ai Department of Radiation Oncology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
aj Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
ak Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
al Department of Radiation Oncology, Xiangya Hospital of Central South University, Changsha, China
am Clinical Trials Center, Sun Yat-sen University Cancer Center, Guangzhou, China
an Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China
ao Clinical Oncology Centre, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
ap Department of Nasopharyngeal Carcinoma, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
aq Changsha, China
ar Division of Radiation Oncology, National Cancer Centre, Singapore
* Correspondence to: Prof Jun Ma, Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China Department of Radiation Oncology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat-sen University Cancer Center Guangzhou China
Summary |
The Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, the Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology collaboratively developed evidence-based guidelines and a comprehensive contouring atlas for neck target volume delineation in nasopharyngeal carcinoma. These guidelines address five key challenges in modern radiotherapy practice: margin design of clinical target volume; nodal target volume delineation after induction chemotherapy; delineation of equivocal nodes evident on imaging; low-risk clinical target volume delineation based on regional stepwise extension patterns; and modifications for anatomical boundaries of lymphatic areas. Developed through a rigorous systematic review and expert appraisal process by a panel of 50 international, multidisciplinary members from 17 countries and regions, these guidelines incorporate the latest advances in nasopharyngeal carcinoma diagnosis and treatment. They reflect contemporary therapeutic concepts and elaborate on current practice variations. These guidelines aim to standardise global practice, substantially improving consistency and reducing variability in nasopharyngeal carcinoma radiotherapy target delineation.
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Vol 26 - N° 9
P. e488-e498 - septembre 2025 Retour au numéro
Article précédent
- Primary target volume delineation for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas
- Ling-Long Tang, Cheng-Long Huang, Shao-Jun Lin, Quynh-Thu Le, Brian O’Sullivan, Sue S Yom, Shao Hui Huang, Annie W Chan, Nancy Lee, Jian-Ji Pan, Michael Benedict A Mejia, Yong Chan Ahn, Kenneth C W Wong, Lachlan McDowell, Ester Orlandi, Jeppe Friborg, Yu-Pei Chen, Koichi Yasuda, Takeshi Kodaira, Alexander C Whitley, Ann D King, Gregorius Ben Prajogi, Ezra Hahn, Jin-Ching Lin, Naomi Kiyota, Victor Lee, Peng-Jie Ji, Ying Hitchcock, Frank Hoebers, Pierre Blanchard, Sung Ho Moon, Wan Zamaniah Wan Ishak, Kevin J Harrington, Kun-Yu Yang, A Dimitrios Colevas, Anna Lee, Chao-Su Hu, David Rosenthal, Farzan Siddiqui, Johannes Albertus Langendijk, Jin-Yi Lang, Jun-Lin Yi, Liang-Fang Shen, Ji-Bin Li, Li-Zhi Liu, Anne W M Lee, Hai-Qiang Mai, Ming-Kai Yang, Ying Sun, Melvin L K Chua, Jun Ma
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