Radiotherapy technique for maxillary carcinoma with paraorbital involvement

The treatment volume for maxillary carcinoma with parorbital involvement must include the entire maxilla, adjacent nasal cavity, ethmoid sinuses, orbital apex, inferomedial part of orbit, homolateral retropharyngeal nodes, pterygopalatine fossa and infratemporal fossa. The eye and lacrimal gland must be protected by lead block, provided there is no gross involvement of orbit. Anterior and lateral wedged fields of 3:1 weighting are used, and lateral field angled 10 deg posteriorly to avoid contralateral eye. Anterior margin of lateral field is just posteriorly of lateral bony margin of the orbit to spare homolateral cornea, lens and others. (author)