Commentary on "A pilot study of a digital workflow for navigated tumor bed marking to reduce clinical target volume during adjuvant radiotherapy for oral squamous cell carcinoma".

The accurate identification of the Clinical Target Volume (CTV) remains a challenge in providing postoperative adjuvant radiation therapy for patients with OSCC, due to postoperative changes in anatomy, along with the inability to define the exact location of the CTV during surgery. Holdorf et al. report on a pilot study assessing the utility of a digital navigation intraoperatively to identify and outline the tumor bed to improve planning of postoperative radiation therapy. Using navigated margins traced on imaging postoperatively, the authors demonstrate a reduction in CTV volume compared with traditional planning. They noted a mean reduction in CTV of 25.71%. Most importantly, the navigated method preserved the anatomic integrity of the CTV. This commentary discusses defining the CTV, including reducing the risk of irradiating healthy tissue while maintaining oncologic safety. This study supports integrating surgical navigation into approach for cancer care and provides evidence for further studies evaluating the long-term oncologic and radiation-related side effects. These data mark progress toward providing individualized adjuvant radiation therapy for patients with head and neck cancer.