Brachial Plexus Contouring with CT and MR Imaging in Radiation Therapy Planning for Head and Neck Cancer

摘要: With the increasing use of intensity-modulated radiation therapy (IMRT) for treatment head and neck cancer, oncologists are expected to have an in-depth knowledge computed tomographic (CT) magnetic resonance (MR) imaging anatomy this region be able accurately characterize tumor extent define organs at risk potential injury. The brachial plexus is a complex anatomic structure in adjacent diseased nodes elective nodal volumes (ie, areas that prophylactically treated because they high micrometastatic disease) should, therefore, carefully identified contoured CT prior IMRT planning. A number multi-institutional protocols mandate contouring as "avoidance structure" or volume complications therapy) planning therapy, and, although little information exists on best method doing so consistently, may facilitated with fusion CT-MR software. three-dimensional conformal not routinely contoured; its dose limits evaluated In contrast, IMRT, tolerance doses can set limit maximum 60 Gy most protocols, true patients cancer has been mentioned only sporadically literature. Additional studies will required determine if identification avoidance improves outcome reduces long-term toxicity structure.