ADEQUATE IRRADIATION OF THE INTERNAL JUGULAR LYMPH-NODE CHAIN - TECHNICAL CONSIDERATIONS

Purpose: This research aimed to study the anatomic relationship betwee n the internal jugular vein with the surrounding internal jugular lymp h node chain and the underlying bony anatomical structures which are c ommonly used as landmarks for radiation therapy planning. Methods and Materials: Twelve patients with carcinoma of the head and neck region were studied prospectively, Using our three dimensional planning syste m, a beam's-eye view of the internal jugular vein was projected onto a lateral and anterior simulation film, Quantitative measurements were made in every case of the anatomic relationship between the internal j ugular vein and the posterior border of the cervical vertebrae and sag ittal midline. Results: The distance between the posterior border of t he internal jugular vein and the posterior border of the cervical vert ebrae ranged between 0 and 2.5 cm, The distances between the sagittal midline and the medial border of the internal jugular veins ranged bet ween 2 and 4 cm. Conclusion: To ensure adequate irradiation of the int ernal jugular lymph nodes, the posterior border of the lateral radiati on therapy upper-neck fields should be placed at least 1 cm posterior to the posterior aspect of the cervical vertebrae, The midline block u sed in the lower neck anterior field should not exceed 2 cm in width. (C) 1997 Elsevier Science Inc.