SIMPLE CAROTID-SPARING INTENSITY-MODULATED RADIOTHERAPY TECHNIQUE AND PRELIMINARY EXPERIENCE FOR T1-2 GLOTTIC CANCER INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS Rosenthal, D. I., Fuller, C. D., Barker, J. L., Mason, B., Garcia, J. A., Lewin, J. S., Holsinger, F. C., Stasney, C. R., Frank, S. J., Schwartz, D. L., Morrison, W. H., Garden, A. S., Ang, K. K. 2010; 77 (2): 455-461


To investigate the dosimetry and feasibility of carotid-sparing intensity-modulated radiotherapy (IMRT) for early glottic cancer and to report preliminary clinical experience.Digital Imaging and Communications in Medicine radiotherapy (DICOM-RT) datasets from 6 T1-2 conventionally treated glottic cancer patients were used to create both conventional IMRT plans. We developed a simplified IMRT planning algorithm with three fields and limited segments. Conventional and IMRT plans were compared using generalized equivalent uniform dose and dose-volume parameters for in-field carotid arteries, target volumes, and organs at risk. We have treated 11 patients with this simplified IMRT technique.Intensity-modulated radiotherapy consistently reduced radiation dose to the carotid arteries (p < 0.05) while maintaining the clinical target volume coverage. With conventional planning, median carotid V35, V50, and V63 were 100%, 100%, and 69.0%, respectively. With IMRT planning these decreased to 2%, 0%, and 0%, respectively (p < 0.01). Radiation planning and treatment times were similar for conventional radiotherapy and IMRT. Treatment results have been excellent thus far.Intensity-modulated radiotherapy significantly reduced unnecessary radiation dose to the carotid arteries compared with conventional lateral fields while maintaining clinical target volume coverage. Further experience and longer follow-up will be required to demonstrate outcomes for cancer control and carotid artery effects.

View details for DOI 10.1016/j.ijrobp.2009.04.061

View details for Web of Science ID 000278167500019

View details for PubMedID 19679406