Simple Carotid-Sparing Intensity-Modulated Radiotherapy Technique and Preliminary Experience for T1-2 Glottic Cancer

Journal Article · Tue Jun 01 04:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.04.061· OSTI ID:21372293

Fuller, Clifton D ^[1]; Barker, Jerry L ^[2]; Mason, Bryan M.S.; Garcia, John A. C. ^[3]; Lewin, Jan S; Holsinger, F Christopher ^[4]; Stasney, C Richard ^[5]; Frank, Steven J ^[3]; Schwartz, David L ^[3]; Morrison, William H; Garden, Adam S; Ang, K Kian ^[3]

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1. Department of Radiation Oncology, and Division of Radiological Sciences, Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (United States)
2. Texas Oncology, P.A., Fort Worth, TX (United States)
3. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
4. Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
5. Texas Voice Center and the University of Texas Health Science Center, Houston, TX (United States)

Purpose: To investigate the dosimetry and feasibility of carotid-sparing intensity-modulated radiotherapy (IMRT) for early glottic cancer and to report preliminary clinical experience. Methods and Materials: 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. Results: 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. Conclusions: 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.

• OSTI ID: 21372293
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 77; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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