Standardisation of Target Volume Delineation for Carotid-sparing Intensity-modulated Radiotherapy in Early Glottis Cancer.
MetadataShow full item record
AIMS: Recently, carotid-sparing intensity-modulated radiotherapy (IMRT) for early laryngeal glottis (T1/T2N0M0) cancer has generated interest in the hope of avoiding long-term carotid toxicity, as well as concerns relating to geographical misses and long-term normal tissue toxicity. The aim of this review was to summarise the current literature on carotid-sparing IMRT for early glottis cancer, with particular focus on definitions of target volumes and the carotid arteries as organs at risk. In addition, we make suggestions for standardisation of these structures, dose constraints and dose reporting. MATERIALS AND METHODS: From 73 references, 16 articles met the criteria for inclusion in this systematic review. These papers described two case reports, 11 planning studies and three prospective studies. RESULTS: There was variation in all target volume definitions with no clear consensus. The greatest variability was in clinical target volume definition. Carotid artery and spinal cord delineation were not always defined and most studies did not use a carotid artery constraint. Of the eight studies that reported carotid artery delineation, no two studies delineated the same length of carotid artery, yet most studies reported mean doses. Most studies used IMRT with three to seven fields. Five studies used arc therapy and two studies used tomotherapy. CONCLUSION: This review highlights a lack of consensus in target volume definitions in carotid-sparing IMRT. Ultimately, long-term prospective data are required to show the benefit of carotid-sparing IMRT. Pooled data will prove useful as most studies will report on small numbers of patients. Therefore, adopting a consensus now on target volume definition, dose constraints and dose reporting will be crucial.
Version of record
Radiotherapy Planning, Computer-Assisted
License start date
Clin Oncol (R Coll Radiol), 2017, 29 (1), pp. 42 - 50
Showing items related by title, author, creator and subject.
LAUNCH OF THE BREAST SCREENING AFTER RADIOTHERAPY DATASET - AN ENGLAND WIDE INITIATIVE TO IMPROVE SCREENING FOR BREAST CANCER IN 9,000 WOMEN AT HIGH RISK FOLLOWING RADIOTHERAPY TO BREAST TISSUE UNDER AGE 36 Radford, J; Howell, S; Vaughan, K; Goode, V; Worthington, D; Yates-Bolton, N; Payne, E; Jenkins, J; Sibbering, M; Swerdlow, A; Cowan, R (2016-10)
Results of a multicentre randomised controlled trial of cochlear-sparing intensity-modulated radiotherapy versus conventional radiotherapy in patients with parotid cancer (COSTAR; CRUK/08/004). Nutting, CM; Morden, JP; Beasley, M; Bhide, S; Cook, A; De Winton, E; Emson, M; Evans, M; Fresco, L; Gollins, S; Gujral, D; Harrington, K; Joseph, M; Lemon, C; Luxon, L; van den Blink, Q; Mendes, R; Miah, A; Newbold, K; Prestwich, R; Robinson, M; Sanghera, P; Simpson, J; Sivaramalingam, M; Srihari, NN; Sydenham, M; Wells, E; Witts, S; Hall, E; COSTAR Investigators (2018-11)PURPOSE: About 40-60% of patients treated with post-operative radiotherapy for parotid cancer experience ipsilateral sensorineural hearing loss. Intensity-modulated radiotherapy (IMRT) can reduce radiation dose to the ...