Exploration of the role of radiotherapy in the management of early glottic cancer with complete carotid artery occlusion.
BACKGROUND
The aim of this study was to compare intensity-modulated radiation therapy (IMRT) vs. 2D and 3D radiotherapy (RT) in the treatment of T1 glottic squamous cell carcinoma in an effort to highlight the advantages of IMRT in this particular clinical situation.


METHODS
We present the case of an 82-year-old female patient with T1 left true vocal cord squamous cell carcinoma and complete occlusion of the left carotid artery resulting in multiple strokes. The patient underwent definitive RT with 63 Gy (28 × 2.25 Gy). 3 plans were generated: 2D RT, 3D RT, and IMRT. The right carotid artery (Rt.CA) mean dose was 865, 2,065, and 4,268 cGy for IMRT, 3D RT, and 2D RT, respectively. The inferior pharyngeal constrictor (IPC) mean dose was 5,341, 6,456, and 6,451 cGy for IMRT, 3D RT, and 2D RT, respectively. IMRT provided the best homogeneity but at a higher cost and with prolonged treatment time.


CONCLUSIONS
IMRT provided the finest planning target volume coverage with minimal Rt.CA and IPC doses. IMRT is recommended in certain clinical scenarios which are not manageable with other techniques.
Department of Radiation Oncology, Beth Israel Medical Center, New York, NY, USA. Waleed246@gmail.com
Waleed F
WF
Mourad
Kenneth S
KS
Hu
Rania A
RA
Shourbaji
James
J
Dolan
Dukagjin M
DM
Blakaj
Daniel
D
Shasha
Louis B
LB
Harrison
D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000532:radiotherapy*; D020266:Radiotherapy, Conformal / Q000379:methods*; D016896:Treatment Outcome