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Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study

  • Choi, Hoon Sik (Department of Radiation Oncology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Jeong, Bae Kwon (Department of Radiation Oncology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Jeong, Hojin (Department of Radiation Oncology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Song, Jin Ho (Department of Radiation Oncology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Kim, Jin Pyeong (Institute of Health Science, Gyeongsang National University) ;
  • Park, Jung Je (Institute of Health Science, Gyeongsang National University) ;
  • Woo, Seung Hoon (Institute of Health Science, Gyeongsang National University) ;
  • Kang, Ki Mun (Department of Radiation Oncology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine)
  • Received : 2015.12.24
  • Accepted : 2016.03.03
  • Published : 2016.03.31

Abstract

Purpose: To compare the dose distribution between carotid sparing intensity modulated radiotherapy (IMRT) and opposed lateral field technique (LAFT), and to determine the effects of carotid sparing IMRT in early glottic cancer patients who have risk factors for atherosclerosis. Materials and Methods: Ten early glottic cancer patients were treated with carotid sparing IMRT. For each patient, the conventional LAFT plan was developed for comparison. IMRT and LAFT plans were compared in terms of planning target volume (PTV) coverage, conformity index, homogeneity index, and the doses to planning organ at risk volume (PRV) for carotid arteries, spinal cord and pharyngeal constrictor muscle. Results: Recurrence was not observed in any patients during the follow-up period. $V_{95%}$ for PTV showed no significant difference between IMRT and LAFT plans, while $V_{100%}$ was significantly higher in the IMRT plan (95.5% vs. 94.6%, p = 0.005). The homogeneity index (11.6%) and conformity index (1.4) in the IMRT plan were significantly better than those in the LAFT plans (8.5% and 5.1, respectively) (p = 0.005). The median $V_{5Gy}$ (90.0%), $V_{25Gy}$ (13.5%), and $V_{50Gy}$ (0%) for carotid artery PRV in the IMRT plan were significantly lower than those in the LAFT plan (99.1%, 89.0%, and 77.3%, respectively) (p = 0.005). Conclusion: Our study suggests that carotid sparing IMRT can significantly decrease the dose to carotid arteries compared to LAFT, and it would be considered for early glottic cancer patient with high risk of atherosclerosis.

Keywords

References

  1. Mendenhall WM, Mancuso AA, Amdur RJ, Werning JW. Laryngeal cancer. In: Halperin EC, Brady LW, Perez CA, et al., editors. Perez and Brady's principles and practice of radiation oncology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. p. 850-68.
  2. Petrakos I, Kontzoglou K, Nikolopoulos TP, Papadopoulos O, Kostakis A. Glottic and supraglottic laryngeal cancer: epidemiology, treatment patterns and survival in 164 patients. J BUON 2012;17:700-5.
  3. Teshima T, Chatani M, Hata K, Inoue T. Radiation therapy of early glottic cancer (T1N0M0); retrospective review of historical control. Rinsho Hoshasen 1989;34:1603-6.
  4. Gujral DM, Shah BN, Chahal NS, Senior R, Harrington KJ, Nutting CM. Clinical features of radiation-induced carotid atherosclerosis. Clin Oncol (R Coll Radiol) 2014;26:94-102. https://doi.org/10.1016/j.clon.2013.10.002
  5. Chatterjee S, Guha S, Prasath S, Mallick I, Achari R. Carotid sparing hypofractionated tomotherapy in early glottic cancers: refining image guided IMRT to improve morbidity. J Cancer Res Ther 2013;9:452-5. https://doi.org/10.4103/0973-1482.119349
  6. Lauve A, Morris M, Schmidt-Ullrich R, et al. Simultaneous integrated boost intensity-modulated radiotherapy for locally advanced head-and-neck squamous cell carcinomas: II. clinical results. Int J Radiat Oncol Biol Phys 2004;60:374-87. https://doi.org/10.1016/j.ijrobp.2004.03.010
  7. Chen AP, Setser A, Anadkat MJ, et al. Grading dermatologic adverse events of cancer treatments: the Common Terminology Criteria for Adverse Events Version 4.0. J Am Acad Dermatol 2012;67:1025-39. https://doi.org/10.1016/j.jaad.2012.02.010
  8. Brown PD, Foote RL, McLaughlin MP, et al. A historical prospective cohort study of carotid artery stenosis after radiotherapy for head and neck malignancies. Int J Radiat Oncol Biol Phys 2005;63:1361-7. https://doi.org/10.1016/j.ijrobp.2005.05.046
  9. Cheng SW, Ting AC, Lam LK, Wei WI. Carotid stenosis after radiotherapy for nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 2000;126:517-21. https://doi.org/10.1001/archotol.126.4.517
  10. Smith GL, Smith BD, Buchholz TA, et al. Cerebrovascular disease risk in older head and neck cancer patients after radiotherapy. J Clin Oncol 2008;26:5119-25. https://doi.org/10.1200/JCO.2008.16.6546
  11. Dorresteijn LD, Kappelle AC, Boogerd W, et al. Increased risk of ischemic stroke after radiotherapy on the neck in patients younger than 60 years. J Clin Oncol 2002;20:282-8. https://doi.org/10.1200/JCO.2002.20.1.282
  12. Cheung K. Intensity modulated radiotherapy: advantages, limitations and future developments. Biomed Imaging Interv J 2006;2:e19.
  13. Hong CS, Oh D, Ju SG, et al. Carotid-sparing tomohelical 3-dimensional conformal radiotherapy for early glottic cancer. Cancer Res Treat 2016;48:63-70. https://doi.org/10.4143/crt.2014.265
  14. Kim ES, Yeo SG. Volumetric modulated arc radiotherapy sparing the thyroid gland for early-stage glottic cancer: a dosimetrical analysis. Oncol Lett 2014;7:1987-91. https://doi.org/10.3892/ol.2014.2039
  15. Ki YK, Kim WT, Nam JH, et al. Treatment planning for minimizing carotid artery dose in the radiotherapy of early glottic cancer. J Korean Soc Ther Radiol Oncol 2011;29:115-20. https://doi.org/10.3857/jkstro.2011.29.2.115
  16. Rosenthal DI, Fuller CD, Barker JL Jr, et al. Simple carotid-sparing intensity-modulated radiotherapy technique and preliminary experience for T1-2 glottic cancer. Int J Radiat Oncol Biol Phys 2010;77:455-61. https://doi.org/10.1016/j.ijrobp.2009.04.061
  17. Chera BS, Amdur RJ, Morris CG, Mendenhall WM. Carotidsparing intensity-modulated radiotherapy for early-stage squamous cell carcinoma of the true vocal cord. Int J Radiat Oncol Biol Phys 2010;77:1380-5. https://doi.org/10.1016/j.ijrobp.2009.07.1687
  18. Zumsteg ZS, Riaz N, Jaffery S, et al. Carotid sparing intensitymodulated radiation therapy achieves comparable locoregional control to conventional radiotherapy in T1-2N0 laryngeal carcinoma. Oral Oncol 2015;51:716-23. https://doi.org/10.1016/j.oraloncology.2015.02.003
  19. Osman SO, Astreinidou E, de Boer HC, et al. IMRT for imageguided single vocal cord irradiation. Int J Radiat Oncol Biol Phys 2012;82:989-97. https://doi.org/10.1016/j.ijrobp.2010.12.022
  20. van Asselen B, Raaijmakers CP, Lagendijk JJ, Terhaard CH. Intrafraction motions of the larynx during radiotherapy. Int J Radiat Oncol Biol Phys 2003;56:384-90. https://doi.org/10.1016/S0360-3016(02)04572-8
  21. Kwa SL, Al-Mamgani A, Osman SO, Gangsaas A, Levendag PC, Heijmen BJ. Inter- and intrafraction target motion in highly focused single vocal cord irradiation of t1a larynx cancer patients. Int J Radiat Oncol Biol Phys 2015;93:190-5. https://doi.org/10.1016/j.ijrobp.2015.04.049
  22. Baron CA, Awan MJ, Mohamed AS, et al. Estimation of daily interfractional larynx residual setup error after isocentric alignment for head and neck radiotherapy: quality assurance implications for target volume and organs-at-risk margination using daily CT on- rails imaging. J Appl Clin Med Phys 2014;16:5108.
  23. Teshima T, Chatani M, Inoue T. Radiation therapy for early glottic cancer (T1N0M0): I. results of conventional open field technique. Int J Radiat Oncol Biol Phys 1989;17:1199-202. https://doi.org/10.1016/0360-3016(89)90526-9
  24. Teshima T, Chatani M, Inoue T. Radiation therapy for early glottic cancer (T1N0M0): II. prospective randomized study concerning radiation field. Int J Radiat Oncol Biol Phys 1990;18:119-23. https://doi.org/10.1016/0360-3016(90)90275-O

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