Comparison of Methods to Reduce Dose to Swallowing-Related Structures in Head and Neck Cancer
- Department of Radiation Oncology, University of Alabama at Birmingham (United States)
Introduction: Emerging data suggest that reduction of dose to the larynx and pharyngeal constrictor may lower the risk of swallowing complications such as long-term gastrostomy dependence and aspiration. Organ avoidance becomes difficult when the primary tumor or involved nodes are present at the level of the larynx. Materials and Methods: Fifteen patients with Stage III-IV squamous cell carcinoma of the head and neck with high-dose target volume at the level of the larynx (but not involving the glottic larynx) were planned with whole-field IMRT (WF-IMRT), as well as a low anterior neck field dynamically matched to an IMRT plan (D-SCLV). Plans were compared with respect to coverage of targets and sparing of normal tissues including the larynx, inferior pharyngeal constrictor (IPC), parotid, and cord. Results: There was no significant difference between the two techniques in coverage of the high- or intermediate-dose planning target volumes (PTVs). Coverage of the elective nodal PTV was inferior with the D-SCLV technique, with a mean of 96.5% vs. 86.3% of the volume receiving the prescription dose (p = 0.001) compared with WF-IMRT plans. However, the D-SCLV technique significantly reduced mean dose to the larynx (43.7 vs. 46.7 Gy, p = 0.05) and IPC (39.1 vs. 46.1 Gy, p = 0.002). There was no significant difference in dose to the parotid or cord. Conclusion: Given the steep dose responses seen in studies examining the association between swallowing toxicity and dose to the larynx and IPC, dose reductions using the D-SCLV technique may be clinically significant.
- OSTI ID:
- 21372294
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 77, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2009.05.020; PII: S0360-3016(09)00760-3; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
Similar Records
Chemo-IMRT of Oropharyngeal Cancer Aiming to Reduce Dysphagia: Swallowing Organs Late Complication Probabilities and Dosimetric Correlates
Methods for Reducing Normal Tissue Complication Probabilities in Oropharyngeal Cancer: Dose Reduction or Planning Target Volume Elimination