74 yo F with Stage IE NK/T Cell Lymphoma with involvement of the nasal cavity and paranasal sinuses presenting for radiation following 2 cycles of p-GEMOX/pembrolizumab, with planned adjuvant chemo following RT.
Technique: VMAT based planning with daily IGRT using CBCT.
Dose: 50.4 Gy in 28 fractions.
Case contributed by UCSD
Contours based on the 2021 ILROG Risk-Adapted Guidelines for NK/T-Cell Lymphoma (Qi IJROBP 2021).
GTV: The sum of involvement on clinical exam, endoscopy and imaging (CT, PET/CT) before treatment.
CTV: GTV + 5 mm + entirety of involved structures + high risk structures. Prophylactic nodal irradiation is not necessary for Stage I and IE NKTCL.
PTV: CTV + 3 mm, cropped off skin except in areas of CTV extention to or within 3mm of skin.
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