Abstract
BackgroundTo evaluate the feasibility of image-guided radiotherapy based on helical Tomotherapy to spare the contralateral parotid gland in head and neck cancer patients with unilateral or no neck node metastases.MethodsA retrospective review of 52 patients undergoing radiotherapy for head and neck cancers with image guidance based on daily megavoltage CT imaging with helical tomotherapy was performed.ResultsMean contralateral parotid dose and the volume of the contralateral parotid receiving 40 Gy or more were compared between radiotherapy plans with significant constraint (SC) of less than 20 Gy on parotid dose (23 patients) and the conventional constraint (CC) of 26 Gy (29 patients). All patients had PTV coverage of at least 95% to the contralateral elective neck nodes. Mean contralateral parotid dose was, respectively, 14.1 Gy and 24.7 Gy for the SC and CC plans (p < 0.0001). The volume of contralateral parotid receiving 40 Gy or more was respectively 5.3% and 18.2% (p < 0.0001)ConclusionTomotherapy for head and neck cancer minimized radiotherapy dose to the contralateral parotid gland in patients undergoing elective node irradiation without sacrificing target coverage.
Highlights
To evaluate the feasibility of image-guided radiotherapy based on helical Tomotherapy to spare the contralateral parotid gland in head and neck cancer patients with unilateral or no neck node metastases
Effectiveness of Tomotherapy-based Image-guided radiotherapy (IGRT) has been proven to be superior to conventional intensity-modulated radiotherapy (IMRT) for larynx and pharyngeal muscles sparing in patients with non-laryngeal and hypopharyngeal cancers even in the presence of neck node metastases [17]
We investigate in this report the feasibility of Tomotherapy to reduce parotid gland irradiation in head and neck cancer patients undergoing elective neck node irradiation
Summary
To evaluate the feasibility of image-guided radiotherapy based on helical Tomotherapy to spare the contralateral parotid gland in head and neck cancer patients with unilateral or no neck node metastases. Introduction of intensity-modulated radiotherapy (IMRT) leads to significant sparing of the parotid glands in patients with clinically negative neck nodes because lymph node metastases, the ipsilateral parotid gland is not spared from radiation because of the risk of underdosing level II lymph node and to prevent recurrence in the peri-parotid lymph node [13,14]. A radiotherapy technique that can achieve adequate coverage of the regional lymph nodes at risk while minimizing contralateral parotid gland irradiation will lead to significant improvement in patients’ quality of life as well as effective regional control in the neck. We investigate in this report the feasibility of Tomotherapy to reduce parotid gland irradiation in head and neck cancer patients undergoing elective neck node irradiation
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