An approach to contouring the dorsal vagal complex for radiotherapy planning

Multiple studies suggest that radiation dose to the area of the brainstem called the "dorsal vagal complex (DVC)" influences the frequency of nausea and vomiting during radiotherapy. The purpose of this didactic article is to describe the step-by-step process that we use to contour the general area of the DVC on axial computed tomography (CT) images as would be done for radiotherapy planning. The contouring procedure that we describe for contouring the area of the DVC is useful to medical dosimetrists and radiation oncologists.