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Int J Radiat Oncol Biol Phys. 2010 Jun 1;77(2):455-61. doi: 10.1016/j.ijrobp.2009.04.061. Epub 2009 Aug 11.

Simple carotid-sparing intensity-modulated radiotherapy technique and preliminary experience for T1-2 glottic cancer.

Author information

  • 1Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. dirosenthal@mdanderson.org

Abstract

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.

Copyright 2010 Elsevier Inc. All rights reserved.

PMID:
19679406
[PubMed - indexed for MEDLINE]
PMCID:
PMC3307784
Free PMC Article
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