Abstract

A technique for treating patients who have advanced tumors of the larynx and pyriform sinus was developed using isocentric anterior and posterior opposed fields with 10 MV X rays. These fields are weighted 4:1 anterior to posterior; the posterior field included a central spinal cord block. This technique can be used to deliver a tumor dose of 45 Gray to the primary site and regional nodes and approximately 40 Gray to the spinal cord. The method eliminates problems of multi-field junctures and lowers the daily spinal cord dose when compared to the standard parallel opposed lateral portals and anterior neck fields. If the patient requires a course of radical radiation therapy, additional treatment is given to small opposed lateral cobalt-60 fields which avoid further treatment of the spinal cord.

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