Can the elective target volume in nasopharyngeal cancer, as specified in RTOG 0615, be reduced if OARs do not meet constraints?

Always protect the brainstem, spinal cord, and chiasm and by that, there will be some compromise of the target. One should not change the target.

No. I do not reduce the PTVs. I exceed the OAR dose constraints if necessary.

I agree with with @Dr. First Last.