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Table 3 Specific RT volume definition volumes for Arm 2 (Primary TOS) if adjuvant RT is required

From: Treatment de-escalation for HPV-associated oropharyngeal squamous cell carcinoma with radiotherapy vs. trans-oral surgery (ORATOR2): study protocol for a randomized phase II trial

Radiotherapy VolumeDefinition
With ENE or positive margins (30 fractions over 6 weeks)Without ENE or positive margins (25 fractions over 5 weeks)
CTV60 Areas of positive margins and/or ENE
CTV54CTV50Entire tumor bed and any dissected neck nodal levels
CTV48CTV45Undissected nodal areas that must be treated based on pathological results.
Treatment volumes must include nodal levels adjacent to areas containing involved nodes (eg. if there is a level II node positive, levels Ib and V must be included)
 – All patients with N1 (ipsilateral) nodal disease:
  ◦Ipsilateral: Ib, II-V, RP
  ◦Contralaterala: II-IV, RP only if extension to posterior pharyngeal wall or soft palate
 – All patients with N2 disease:
  ◦Ipsilateral and contralateral: Ib, II-V, RP
  1. aIf treating the contralateral neck