Clinical and dosimetric implications of intensity-modulated radiotherapy for early-stage glottic carcinoma.

Clinical and dosimetric implications of intensity-modulated radiotherapy for early-stage glottic carcinoma.

Med Dosim. 2015 Nov 6;

Authors: Ward MC, Pham YD, Kotecha R, Zakem SJ, Murray E, Greskovich JF

Abstract
Conventional parallel-opposed radiotherapy (PORT) is the established standard technique for early-stage glottic carcinoma. However, case reports have reported the utility of intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) with or without image guidance (image-guided radiotherapy, IGRT) in select patients. The proposed advantages of IMRT/VMAT include sparing of the carotid artery, thyroid gland, and the remaining functional larynx, although these benefits remain unclear. The following case study presents a patient with multiple vascular comorbidities treated with VMAT for early-stage glottic carcinoma. A detailed explanation of the corresponding treatment details, dose-volume histogram (DVH) analysis, and a review of the relevant literature are provided. Conventional PORT remains the standard of care for early-stage glottic carcinoma. IMRT or VMAT may be beneficial for select patients, although great care is necessary to avoid a geographical miss. Clinical data supporting the benefit of CRT are lacking. Therefore, these techniques should be used with caution and only in selected patients.

PMID: 26553472 [PubMed - as supplied by publisher]

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