Delineation of the neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines.
Identifieur interne : 003A57 ( Main/Exploration ); précédent : 003A56; suivant : 003A58Delineation of the neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines.
Auteurs : Vincent Grégoire [Belgique] ; Kian Ang [États-Unis] ; Wilfried Budach [Allemagne] ; Cai Grau [Danemark] ; Marc Hamoir [Belgique] ; Johannes A. Langendijk [Pays-Bas] ; Anne Lee [République populaire de Chine] ; Quynh-Thu Le [États-Unis] ; Philippe Maingon [France] ; Chris Nutting [Royaume-Uni] ; Brian O'Sullivan [Canada] ; Sandro V. Porceddu [Australie] ; Benoit Lengele [Belgique]Source :
- Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [ 1879-0887 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Consensus, Cou (anatomie et histologie), Humains, Métastase lymphatique, Noeuds lymphatiques (anatomie et histologie), Noeuds lymphatiques (anatomopathologie), Noeuds lymphatiques (effets des radiations), Radio-oncologie (), Radio-oncologie (normes), Tumeurs de la tête et du cou (anatomopathologie), Tumeurs de la tête et du cou (radiothérapie).
- MESH :
- anatomie et histologie : Cou, Noeuds lymphatiques.
- anatomopathologie : Noeuds lymphatiques, Tumeurs de la tête et du cou.
- effets des radiations : Noeuds lymphatiques.
- normes : Radio-oncologie.
- radiothérapie : Tumeurs de la tête et du cou.
- Adulte, Consensus, Humains, Métastase lymphatique, Radio-oncologie.
English descriptors
- KwdEn :
- Adult, Consensus, Head and Neck Neoplasms (pathology), Head and Neck Neoplasms (radiotherapy), Humans, Lymph Nodes (anatomy & histology), Lymph Nodes (pathology), Lymph Nodes (radiation effects), Lymphatic Metastasis, Neck (anatomy & histology), Radiation Oncology (methods), Radiation Oncology (standards).
- MESH :
- anatomy & histology : Lymph Nodes, Neck.
- methods : Radiation Oncology.
- pathology : Head and Neck Neoplasms, Lymph Nodes.
- radiation effects : Lymph Nodes.
- radiotherapy : Head and Neck Neoplasms.
- standards : Radiation Oncology.
- Adult, Consensus, Humans, Lymphatic Metastasis.
Abstract
In 2003, a panel of experts published a set of consensus guidelines for the delineation of the neck node levels in node negative patients (Radiother Oncol, 69: 227-36, 2003). In 2006, these guidelines were extended to include the characteristics of the node positive and the post-operative neck (Radiother Oncol, 79: 15-20, 2006). These guidelines did not fully address all nodal regions and some of the anatomic descriptions were ambiguous, thereby limiting consistent use of the recommendations. In this framework, a task force comprising opinion leaders in the field of head and neck radiation oncology from European, Asian, Australia/New Zealand and North American clinical research organizations was formed to review and update the previously published guidelines on nodal level delineation. Based on the nomenclature proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery, and in alignment with the TNM atlas for lymph nodes in the neck, 10 node groups (some being divided into several levels) were defined with a concise description of their main anatomic boundaries, the normal structures juxtaposed to these nodes, and the main tumor sites at risk for harboring metastases in those levels. Emphasis was placed on those levels not adequately considered previously (or not addressed at all); these included the lower neck (e.g. supraclavicular nodes), the scalp (e.g. retroauricular and occipital nodes), and the face (e.g. buccal and parotid nodes). Lastly, peculiarities pertaining to the node-positive and the post-operative clinical scenarios were also discussed. In conclusion, implementation of these guidelines in the daily practice of radiation oncology should contribute to the reduction of treatment variations from clinician to clinician and facilitate the conduct of multi-institutional clinical trials.
DOI: 10.1016/j.radonc.2013.10.010
PubMed: 24183870
Affiliations:
- Allemagne, Australie, Belgique, Canada, Danemark, France, Pays-Bas, Royaume-Uni, République populaire de Chine, États-Unis
- Angleterre, Bourgogne, Bourgogne-Franche-Comté, Grand Londres, Groningue (province), Ontario, Région de Bruxelles-Capitale, Texas
- Bruxelles, Dijon, Groningue (ville), Houston, Londres, Louvain-la-Neuve, Toronto
- Université catholique de Louvain, Université de Groningue, Université de Toronto
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Langendijk</name><affiliation wicri:level="4"><nlm:affiliation>Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Radiation Oncology, University Medical Center Groningen, University of Groningen</wicri:regionArea><placeName><settlement type="city">Groningue (ville)</settlement><region>Groningue (province)</region></placeName><orgName type="university">Université de Groningue</orgName></affiliation></author><author><name sortKey="Lee, Anne" sort="Lee, Anne" uniqKey="Lee A" first="Anne" last="Lee">Anne Lee</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Oncology, The University of Hong Kong (Shenzhen) Hospital, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Clinical Oncology, The University of Hong Kong (Shenzhen) Hospital</wicri:regionArea><wicri:noRegion>The University of Hong Kong (Shenzhen) Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Le, Quynh Thu" sort="Le, Quynh Thu" uniqKey="Le Q" first="Quynh-Thu" last="Le">Quynh-Thu Le</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, Stanford University School of Medicine, Stanford Cancer Center, Stanford, USA; Radiation Therapy Oncology Group (RTOG), USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, Stanford University School of Medicine, Stanford Cancer Center, Stanford, USA; Radiation Therapy Oncology Group (RTOG)</wicri:regionArea><wicri:noRegion>USA; Radiation Therapy Oncology Group (RTOG)</wicri:noRegion></affiliation></author><author><name sortKey="Maingon, Philippe" sort="Maingon, Philippe" uniqKey="Maingon P" first="Philippe" last="Maingon">Philippe Maingon</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiation Oncology, Centre Georges-François Leclerc, Dijon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Radiation Oncology, Centre Georges-François Leclerc, Dijon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Bourgogne</region><settlement type="city">Dijon</settlement></placeName></affiliation></author><author><name sortKey="Nutting, Chris" sort="Nutting, Chris" uniqKey="Nutting C" first="Chris" last="Nutting">Chris Nutting</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiation Oncology, Royal Marsden Hospital and Institute of Cancer Research, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Radiation Oncology, Royal Marsden Hospital and Institute of Cancer Research, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="O Sullivan, Brian" sort="O Sullivan, Brian" uniqKey="O Sullivan B" first="Brian" last="O'Sullivan">Brian O'Sullivan</name><affiliation wicri:level="4"><nlm:affiliation>Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto</wicri:regionArea><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Porceddu, Sandro V" sort="Porceddu, Sandro V" uniqKey="Porceddu S" first="Sandro V" last="Porceddu">Sandro V. Porceddu</name><affiliation wicri:level="1"><nlm:affiliation>Cancer Services, Princess Alexandra Hospital, Brisbane, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Cancer Services, Princess Alexandra Hospital, Brisbane</wicri:regionArea><wicri:noRegion>Brisbane</wicri:noRegion></affiliation></author><author><name sortKey="Lengele, Benoit" sort="Lengele, Benoit" uniqKey="Lengele B" first="Benoit" last="Lengele">Benoit Lengele</name><affiliation wicri:level="4"><nlm:affiliation>Cancer Center and Department of Human Anatomy and Plastic & Reconstructive Surgery, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Cancer Center and Department of Human Anatomy and Plastic & Reconstructive Surgery, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region><settlement type="city">Louvain-la-Neuve</settlement></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="RBID">pubmed:24183870</idno><idno type="pmid">24183870</idno><idno type="doi">10.1016/j.radonc.2013.10.010</idno><idno type="wicri:Area/PubMed/Corpus">003A51</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">003A51</idno><idno type="wicri:Area/PubMed/Curation">003922</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">003922</idno><idno type="wicri:Area/PubMed/Checkpoint">003922</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">003922</idno><idno type="wicri:Area/Ncbi/Merge">001550</idno><idno type="wicri:Area/Ncbi/Curation">001550</idno><idno type="wicri:Area/Ncbi/Checkpoint">001550</idno><idno type="wicri:Area/Main/Merge">003B02</idno><idno type="wicri:Area/Main/Curation">003A57</idno><idno type="wicri:Area/Main/Exploration">003A57</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Delineation of the neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines.</title><author><name sortKey="Gregoire, Vincent" sort="Gregoire, Vincent" uniqKey="Gregoire V" first="Vincent" last="Grégoire">Vincent Grégoire</name><affiliation wicri:level="4"><nlm:affiliation>Cancer Center and Department of Radiation Oncology, Clinical and Experimental Research Institute, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels, Belgium. Electronic address: vincent.gregoire@uclouvain.be.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Cancer Center and Department of Radiation Oncology, Clinical and Experimental Research Institute, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region><settlement type="city">Louvain-la-Neuve</settlement></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation></author><author><name sortKey="Ang, Kian" sort="Ang, Kian" uniqKey="Ang K" first="Kian" last="Ang">Kian Ang</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston</wicri:regionArea><placeName><settlement type="city">Houston</settlement><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Budach, Wilfried" sort="Budach, Wilfried" uniqKey="Budach W" first="Wilfried" last="Budach">Wilfried Budach</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University Hospital Düsseldorf, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Radiation Oncology, University Hospital Düsseldorf</wicri:regionArea><wicri:noRegion>University Hospital Düsseldorf</wicri:noRegion><wicri:noRegion>University Hospital Düsseldorf</wicri:noRegion><wicri:noRegion>University Hospital Düsseldorf</wicri:noRegion></affiliation></author><author><name sortKey="Grau, Cai" sort="Grau, Cai" uniqKey="Grau C" first="Cai" last="Grau">Cai Grau</name><affiliation wicri:level="1"><nlm:affiliation>Department of Oncology, Aarhus University Hospital, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Oncology, Aarhus University Hospital</wicri:regionArea><wicri:noRegion>Aarhus University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Hamoir, Marc" sort="Hamoir, Marc" uniqKey="Hamoir M" first="Marc" last="Hamoir">Marc Hamoir</name><affiliation wicri:level="4"><nlm:affiliation>Cancer Center and Department of Otorhinolaryngology, Head and Neck Surgery, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Cancer Center and Department of Otorhinolaryngology, Head and Neck Surgery, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region><settlement type="city">Louvain-la-Neuve</settlement></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation></author><author><name sortKey="Langendijk, Johannes A" sort="Langendijk, Johannes A" uniqKey="Langendijk J" first="Johannes A" last="Langendijk">Johannes A. Langendijk</name><affiliation wicri:level="4"><nlm:affiliation>Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Radiation Oncology, University Medical Center Groningen, University of Groningen</wicri:regionArea><placeName><settlement type="city">Groningue (ville)</settlement><region>Groningue (province)</region></placeName><orgName type="university">Université de Groningue</orgName></affiliation></author><author><name sortKey="Lee, Anne" sort="Lee, Anne" uniqKey="Lee A" first="Anne" last="Lee">Anne Lee</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Oncology, The University of Hong Kong (Shenzhen) Hospital, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Clinical Oncology, The University of Hong Kong (Shenzhen) Hospital</wicri:regionArea><wicri:noRegion>The University of Hong Kong (Shenzhen) Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Le, Quynh Thu" sort="Le, Quynh Thu" uniqKey="Le Q" first="Quynh-Thu" last="Le">Quynh-Thu Le</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, Stanford University School of Medicine, Stanford Cancer Center, Stanford, USA; Radiation Therapy Oncology Group (RTOG), USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, Stanford University School of Medicine, Stanford Cancer Center, Stanford, USA; Radiation Therapy Oncology Group (RTOG)</wicri:regionArea><wicri:noRegion>USA; Radiation Therapy Oncology Group (RTOG)</wicri:noRegion></affiliation></author><author><name sortKey="Maingon, Philippe" sort="Maingon, Philippe" uniqKey="Maingon P" first="Philippe" last="Maingon">Philippe Maingon</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiation Oncology, Centre Georges-François Leclerc, Dijon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Radiation Oncology, Centre Georges-François Leclerc, Dijon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Bourgogne</region><settlement type="city">Dijon</settlement></placeName></affiliation></author><author><name sortKey="Nutting, Chris" sort="Nutting, Chris" uniqKey="Nutting C" first="Chris" last="Nutting">Chris Nutting</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiation Oncology, Royal Marsden Hospital and Institute of Cancer Research, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Radiation Oncology, Royal Marsden Hospital and Institute of Cancer Research, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="O Sullivan, Brian" sort="O Sullivan, Brian" uniqKey="O Sullivan B" first="Brian" last="O'Sullivan">Brian O'Sullivan</name><affiliation wicri:level="4"><nlm:affiliation>Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto</wicri:regionArea><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Porceddu, Sandro V" sort="Porceddu, Sandro V" uniqKey="Porceddu S" first="Sandro V" last="Porceddu">Sandro V. Porceddu</name><affiliation wicri:level="1"><nlm:affiliation>Cancer Services, Princess Alexandra Hospital, Brisbane, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Cancer Services, Princess Alexandra Hospital, Brisbane</wicri:regionArea><wicri:noRegion>Brisbane</wicri:noRegion></affiliation></author><author><name sortKey="Lengele, Benoit" sort="Lengele, Benoit" uniqKey="Lengele B" first="Benoit" last="Lengele">Benoit Lengele</name><affiliation wicri:level="4"><nlm:affiliation>Cancer Center and Department of Human Anatomy and Plastic & Reconstructive Surgery, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Cancer Center and Department of Human Anatomy and Plastic & Reconstructive Surgery, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region><settlement type="city">Louvain-la-Neuve</settlement></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation></author></analytic><series><title level="j">Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology</title><idno type="eISSN">1879-0887</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Consensus</term><term>Head and Neck Neoplasms (pathology)</term><term>Head and Neck Neoplasms (radiotherapy)</term><term>Humans</term><term>Lymph Nodes (anatomy & histology)</term><term>Lymph Nodes (pathology)</term><term>Lymph Nodes (radiation effects)</term><term>Lymphatic Metastasis</term><term>Neck (anatomy & histology)</term><term>Radiation Oncology (methods)</term><term>Radiation Oncology (standards)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Consensus</term><term>Cou (anatomie et histologie)</term><term>Humains</term><term>Métastase lymphatique</term><term>Noeuds lymphatiques (anatomie et histologie)</term><term>Noeuds lymphatiques (anatomopathologie)</term><term>Noeuds lymphatiques (effets des radiations)</term><term>Radio-oncologie ()</term><term>Radio-oncologie (normes)</term><term>Tumeurs de la tête et du cou (anatomopathologie)</term><term>Tumeurs de la tête et du cou (radiothérapie)</term></keywords><keywords scheme="MESH" qualifier="anatomie et histologie" xml:lang="fr"><term>Cou</term><term>Noeuds lymphatiques</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Noeuds lymphatiques</term><term>Tumeurs de la tête et du cou</term></keywords><keywords scheme="MESH" qualifier="anatomy & histology" xml:lang="en"><term>Lymph Nodes</term><term>Neck</term></keywords><keywords scheme="MESH" qualifier="effets des radiations" xml:lang="fr"><term>Noeuds lymphatiques</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Radiation Oncology</term></keywords><keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Radio-oncologie</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Head and Neck Neoplasms</term><term>Lymph Nodes</term></keywords><keywords scheme="MESH" qualifier="radiation effects" xml:lang="en"><term>Lymph Nodes</term></keywords><keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Head and Neck Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Tumeurs de la tête et du cou</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Radiation Oncology</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Consensus</term><term>Humans</term><term>Lymphatic Metastasis</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Consensus</term><term>Humains</term><term>Métastase lymphatique</term><term>Radio-oncologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In 2003, a panel of experts published a set of consensus guidelines for the delineation of the neck node levels in node negative patients (Radiother Oncol, 69: 227-36, 2003). In 2006, these guidelines were extended to include the characteristics of the node positive and the post-operative neck (Radiother Oncol, 79: 15-20, 2006). These guidelines did not fully address all nodal regions and some of the anatomic descriptions were ambiguous, thereby limiting consistent use of the recommendations. In this framework, a task force comprising opinion leaders in the field of head and neck radiation oncology from European, Asian, Australia/New Zealand and North American clinical research organizations was formed to review and update the previously published guidelines on nodal level delineation. Based on the nomenclature proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery, and in alignment with the TNM atlas for lymph nodes in the neck, 10 node groups (some being divided into several levels) were defined with a concise description of their main anatomic boundaries, the normal structures juxtaposed to these nodes, and the main tumor sites at risk for harboring metastases in those levels. Emphasis was placed on those levels not adequately considered previously (or not addressed at all); these included the lower neck (e.g. supraclavicular nodes), the scalp (e.g. retroauricular and occipital nodes), and the face (e.g. buccal and parotid nodes). Lastly, peculiarities pertaining to the node-positive and the post-operative clinical scenarios were also discussed. In conclusion, implementation of these guidelines in the daily practice of radiation oncology should contribute to the reduction of treatment variations from clinician to clinician and facilitate the conduct of multi-institutional clinical trials.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>Canada</li><li>Danemark</li><li>France</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Bourgogne</li><li>Bourgogne-Franche-Comté</li><li>Grand Londres</li><li>Groningue (province)</li><li>Ontario</li><li>Région de Bruxelles-Capitale</li><li>Texas</li></region><settlement><li>Bruxelles</li><li>Dijon</li><li>Groningue (ville)</li><li>Houston</li><li>Londres</li><li>Louvain-la-Neuve</li><li>Toronto</li></settlement><orgName><li>Université catholique de Louvain</li><li>Université de Groningue</li><li>Université de Toronto</li></orgName></list><tree><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Gregoire, Vincent" sort="Gregoire, Vincent" uniqKey="Gregoire V" first="Vincent" last="Grégoire">Vincent Grégoire</name></region><name sortKey="Hamoir, Marc" sort="Hamoir, Marc" uniqKey="Hamoir M" first="Marc" last="Hamoir">Marc Hamoir</name><name sortKey="Lengele, Benoit" sort="Lengele, Benoit" uniqKey="Lengele B" first="Benoit" last="Lengele">Benoit Lengele</name></country><country name="États-Unis"><region name="Texas"><name sortKey="Ang, Kian" sort="Ang, Kian" uniqKey="Ang K" first="Kian" last="Ang">Kian Ang</name></region><name sortKey="Le, Quynh Thu" sort="Le, Quynh Thu" uniqKey="Le Q" first="Quynh-Thu" last="Le">Quynh-Thu Le</name></country><country name="Allemagne"><noRegion><name sortKey="Budach, Wilfried" sort="Budach, Wilfried" uniqKey="Budach W" first="Wilfried" last="Budach">Wilfried Budach</name></noRegion></country><country name="Danemark"><noRegion><name sortKey="Grau, Cai" sort="Grau, Cai" uniqKey="Grau C" first="Cai" last="Grau">Cai Grau</name></noRegion></country><country name="Pays-Bas"><region name="Groningue (province)"><name sortKey="Langendijk, Johannes A" sort="Langendijk, Johannes A" uniqKey="Langendijk J" first="Johannes A" last="Langendijk">Johannes A. Langendijk</name></region></country><country name="République populaire de Chine"><noRegion><name sortKey="Lee, Anne" sort="Lee, Anne" uniqKey="Lee A" first="Anne" last="Lee">Anne Lee</name></noRegion></country><country name="France"><region name="Bourgogne-Franche-Comté"><name sortKey="Maingon, Philippe" sort="Maingon, Philippe" uniqKey="Maingon P" first="Philippe" last="Maingon">Philippe Maingon</name></region></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Nutting, Chris" sort="Nutting, Chris" uniqKey="Nutting C" first="Chris" last="Nutting">Chris Nutting</name></region></country><country name="Canada"><region name="Ontario"><name sortKey="O Sullivan, Brian" sort="O Sullivan, Brian" uniqKey="O Sullivan B" first="Brian" last="O'Sullivan">Brian O'Sullivan</name></region></country><country name="Australie"><noRegion><name sortKey="Porceddu, Sandro V" sort="Porceddu, Sandro V" uniqKey="Porceddu S" first="Sandro V" last="Porceddu">Sandro V. 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