PMID- 19577862
OWN - NLM
STAT- MEDLINE
DCOM- 20100524
LR  - 20100511
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 77
IP  - 2
DP  - 2010 Jun 1
TI  - Comparison of methods to reduce dose to swallowing-related structures in head and 
      neck cancer.
PG  - 462-7
LID - 10.1016/j.ijrobp.2009.05.020 [doi]
AB  - 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.
CI  - Published by Elsevier Inc.
FAU - Caudell, Jimmy J
AU  - Caudell JJ
AD  - Department of Radiation Oncology, University of Alabama at Birmingham, USA. 
      jjcaudell@gmail.com
FAU - Burnett, Omer L 3rd
AU  - Burnett OL 3rd
FAU - Schaner, Philip E
AU  - Schaner PE
FAU - Bonner, James A
AU  - Bonner JA
FAU - Duan, Jun
AU  - Duan J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20090704
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Carcinoma, Squamous Cell/pathology/*radiotherapy
MH  - Deglutition/*radiation effects
MH  - Head and Neck Neoplasms/pathology/*radiotherapy
MH  - Humans
MH  - Larynx/radiation effects
MH  - Mouth Neoplasms/radiotherapy
MH  - Oropharyngeal Neoplasms/radiotherapy
MH  - Parotid Gland/radiation effects
MH  - Pharyngeal Muscles/radiation effects
MH  - Radiation Injuries/*prevention & control
MH  - Radiotherapy Dosage
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Spinal Cord/radiation effects
MH  - Tonsillar Neoplasms/radiotherapy
EDAT- 2009/07/07 09:00
MHDA- 2010/05/25 06:00
CRDT- 2009/07/07 09:00
PHST- 2009/02/13 00:00 [received]
PHST- 2009/05/01 00:00 [revised]
PHST- 2009/05/02 00:00 [accepted]
PHST- 2009/07/07 09:00 [entrez]
PHST- 2009/07/07 09:00 [pubmed]
PHST- 2010/05/25 06:00 [medline]
AID - S0360-3016(09)00760-3 [pii]
AID - 10.1016/j.ijrobp.2009.05.020 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2010 Jun 1;77(2):462-7. doi: 
      10.1016/j.ijrobp.2009.05.020. Epub 2009 Jul 4.