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

doi:10.1016/S1470-2045(25)00326-2

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 WhitleyAnn 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^*

^*Corresponding author for this work

Department of Oncology

8 Citations (Scopus)

Abstract

The Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology jointly developed evidence-based guidelines and a contouring atlas for primary target volume delineation for radiotherapy in nasopharyngeal carcinoma. The guidelines systematically address three crucial challenges: margin design of clinical target volumes; target volume delineation after induction chemotherapy; and low-risk clinical target volume delineation based on local stepwise extension patterns. Based on a comprehensive systematic review and critical appraisal by an international multidisciplinary panel of 50 nasopharyngeal carcinoma specialists from 17 countries and regions, these guidelines are in keeping with advances in nasopharyngeal carcinoma diagnosis and treatment, embodying contemporary treatment concepts, and elaborating on the differences in practice. These guidelines aim to support global clinical practice in radiotherapy target volume delineation, substantially enhancing homogeneity and reducing variability in nasopharyngeal carcinoma target delineation.

Original language	English
Journal	The Lancet Oncology
Volume	26
Issue number	9
Pages (from-to)	e477-e487
ISSN	1470-2045
DOIs	https://doi.org/10.1016/S1470-2045(25)00326-2
Publication status	Published - Sept 2025

Keywords

Humans
Nasopharyngeal Carcinoma/radiotherapy
Nasopharyngeal Neoplasms/radiotherapy
Radiotherapy Planning, Computer-Assisted/standards
Radiation Oncology/standards

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Tang, L.-L., Huang, C.-L., Lin, S.-J., Le, Q.-T., O'Sullivan, B., Yom, S. S., Huang, S. H., Chan, A. W., Lee, N., Pan, J.-J., Mejia, M. B. A., Ahn, Y. C., Wong, K. C. W., McDowell, L., Orlandi, E., Friborg, J., Chen, Y.-P., Yasuda, K., Kodaira, T., ... Ma, J. (2025). Primary target volume delineation for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas. The Lancet Oncology, 26(9), e477-e487. https://doi.org/10.1016/S1470-2045(25)00326-2

Tang, L-L, Huang, C-L, Lin, S-J, Le, Q-T, O'Sullivan, B, Yom, SS, Huang, SH, Chan, AW, Lee, N, Pan, J-J, Mejia, MBA, Ahn, YC, Wong, KCW, McDowell, L, Orlandi, E, Friborg, J, Chen, Y-P, Yasuda, K, Kodaira, T, Whitley, AC, King, AD, Prajogi, GB, Hahn, E, Lin, J-C, Kiyota, N, Lee, V, Ji, P-J, Hitchcock, Y, Hoebers, F, Blanchard, P, Moon, SH, Wan Ishak, WZ, Harrington, KJ, Yang, K-Y, Colevas, AD, Lee, A, Hu, C-S, Rosenthal, D, Siddiqui, F, Langendijk, JA, Lang, J-Y, Yi, J-L, Shen, L-F, Li, J-B, Liu, L-Z, Lee, AWM, Mai, H-Q, Yang, M-K, Sun, Y, Chua, MLK & Ma, J 2025, 'Primary target volume delineation for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas', The Lancet Oncology, vol. 26, no. 9, pp. e477-e487. https://doi.org/10.1016/S1470-2045(25)00326-2

@article{ee4c287ce6a647488825f7beb6f68dd2,

title = "Primary target volume delineation for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas",

abstract = "The Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology jointly developed evidence-based guidelines and a contouring atlas for primary target volume delineation for radiotherapy in nasopharyngeal carcinoma. The guidelines systematically address three crucial challenges: margin design of clinical target volumes; target volume delineation after induction chemotherapy; and low-risk clinical target volume delineation based on local stepwise extension patterns. Based on a comprehensive systematic review and critical appraisal by an international multidisciplinary panel of 50 nasopharyngeal carcinoma specialists from 17 countries and regions, these guidelines are in keeping with advances in nasopharyngeal carcinoma diagnosis and treatment, embodying contemporary treatment concepts, and elaborating on the differences in practice. These guidelines aim to support global clinical practice in radiotherapy target volume delineation, substantially enhancing homogeneity and reducing variability in nasopharyngeal carcinoma target delineation.",

keywords = "Humans, Nasopharyngeal Carcinoma/radiotherapy, Nasopharyngeal Neoplasms/radiotherapy, Radiotherapy Planning, Computer-Assisted/standards, Radiation Oncology/standards",

author = "Ling-Long Tang and Cheng-Long Huang and Shao-Jun Lin and Quynh-Thu Le and Brian O'Sullivan and Yom, \{Sue S\} and Huang, \{Shao Hui\} and Chan, \{Annie W\} and Nancy Lee and Jian-Ji Pan and Mejia, \{Michael Benedict A\} and Ahn, \{Yong Chan\} and Wong, \{Kenneth C W\} and Lachlan McDowell and Ester Orlandi and Jeppe Friborg and Yu-Pei Chen and Koichi Yasuda and Takeshi Kodaira and Whitley, \{Alexander C\} and King, \{Ann D\} and Prajogi, \{Gregorius Ben\} and Ezra Hahn and Jin-Ching Lin and Naomi Kiyota and Victor Lee and Peng-Jie Ji and Ying Hitchcock and Frank Hoebers and Pierre Blanchard and Moon, \{Sung Ho\} and \{Wan Ishak\}, \{Wan Zamaniah\} and Harrington, \{Kevin J\} and Kun-Yu Yang and Colevas, \{A Dimitrios\} and Anna Lee and Chao-Su Hu and David Rosenthal and Farzan Siddiqui and Langendijk, \{Johannes Albertus\} and Jin-Yi Lang and Jun-Lin Yi and Liang-Fang Shen and Ji-Bin Li and Li-Zhi Liu and Lee, \{Anne W M\} and Hai-Qiang Mai and Ming-Kai Yang and Ying Sun and Chua, \{Melvin L K\} and Jun Ma",

year = "2025",

month = sep,

doi = "10.1016/S1470-2045(25)00326-2",

language = "English",

volume = "26",

pages = "e477--e487",

journal = "The Lancet Oncology",

issn = "1470-2045",

publisher = "Elsevier Limited",

number = "9",

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TY - JOUR

T1 - Primary target volume delineation for radiotherapy in nasopharyngeal carcinoma

T2 - CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas

AU - Tang, Ling-Long

AU - Huang, Cheng-Long

AU - Lin, Shao-Jun

AU - Le, Quynh-Thu

AU - O'Sullivan, Brian

AU - Yom, Sue S

AU - Huang, Shao Hui

AU - Chan, Annie W

AU - Lee, Nancy

AU - Pan, Jian-Ji

AU - Mejia, Michael Benedict A

AU - Ahn, Yong Chan

AU - Wong, Kenneth C W

AU - McDowell, Lachlan

AU - Orlandi, Ester

AU - Friborg, Jeppe

AU - Chen, Yu-Pei

AU - Yasuda, Koichi

AU - Kodaira, Takeshi

AU - Whitley, Alexander C

AU - King, Ann D

AU - Prajogi, Gregorius Ben

AU - Hahn, Ezra

AU - Lin, Jin-Ching

AU - Kiyota, Naomi

AU - Lee, Victor

AU - Ji, Peng-Jie

AU - Hitchcock, Ying

AU - Hoebers, Frank

AU - Blanchard, Pierre

AU - Moon, Sung Ho

AU - Wan Ishak, Wan Zamaniah

AU - Harrington, Kevin J

AU - Yang, Kun-Yu

AU - Colevas, A Dimitrios

AU - Lee, Anna

AU - Hu, Chao-Su

AU - Rosenthal, David

AU - Siddiqui, Farzan

AU - Langendijk, Johannes Albertus

AU - Lang, Jin-Yi

AU - Yi, Jun-Lin

AU - Shen, Liang-Fang

AU - Li, Ji-Bin

AU - Liu, Li-Zhi

AU - Lee, Anne W M

AU - Mai, Hai-Qiang

AU - Yang, Ming-Kai

AU - Sun, Ying

AU - Chua, Melvin L K

AU - Ma, Jun

PY - 2025/9

Y1 - 2025/9

N2 - The Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology jointly developed evidence-based guidelines and a contouring atlas for primary target volume delineation for radiotherapy in nasopharyngeal carcinoma. The guidelines systematically address three crucial challenges: margin design of clinical target volumes; target volume delineation after induction chemotherapy; and low-risk clinical target volume delineation based on local stepwise extension patterns. Based on a comprehensive systematic review and critical appraisal by an international multidisciplinary panel of 50 nasopharyngeal carcinoma specialists from 17 countries and regions, these guidelines are in keeping with advances in nasopharyngeal carcinoma diagnosis and treatment, embodying contemporary treatment concepts, and elaborating on the differences in practice. These guidelines aim to support global clinical practice in radiotherapy target volume delineation, substantially enhancing homogeneity and reducing variability in nasopharyngeal carcinoma target delineation.

AB - The Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology jointly developed evidence-based guidelines and a contouring atlas for primary target volume delineation for radiotherapy in nasopharyngeal carcinoma. The guidelines systematically address three crucial challenges: margin design of clinical target volumes; target volume delineation after induction chemotherapy; and low-risk clinical target volume delineation based on local stepwise extension patterns. Based on a comprehensive systematic review and critical appraisal by an international multidisciplinary panel of 50 nasopharyngeal carcinoma specialists from 17 countries and regions, these guidelines are in keeping with advances in nasopharyngeal carcinoma diagnosis and treatment, embodying contemporary treatment concepts, and elaborating on the differences in practice. These guidelines aim to support global clinical practice in radiotherapy target volume delineation, substantially enhancing homogeneity and reducing variability in nasopharyngeal carcinoma target delineation.

KW - Humans

KW - Nasopharyngeal Carcinoma/radiotherapy

KW - Nasopharyngeal Neoplasms/radiotherapy

KW - Radiotherapy Planning, Computer-Assisted/standards

KW - Radiation Oncology/standards

U2 - 10.1016/S1470-2045(25)00326-2

DO - 10.1016/S1470-2045(25)00326-2

M3 - Review

C2 - 40907526

SN - 1470-2045

VL - 26

SP - e477-e487

JO - The Lancet Oncology

JF - The Lancet Oncology

IS - 9

ER -

Primary target volume delineation for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas

Abstract

Keywords

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