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Background:   This preliminary simulation study aimed to compare the dosimetric outcomes of carotid arteries (CAs) and pharyngeal constrictor muscle (PCM) in patients with T1N0M0 glottic carcinoma undergoing helical tomotherapy-intensity modulated radiotherapy (HT-IMRT) and 3-dimensional conformal radiotherapy (3D-CRT) plans.Methods:   In addition to the clinical target volume (CTV) which was defined as the entire larynx, the CAs and PCM of 11 glottic carcinoma patients were delineated. The CTV was uniformly expanded 5 mm to create a planning target volume (PTV) relative to the PCM and at a distance of 2 mm from the CA. The dosimetric characteristics in HT-IMRT and lateral opposed fields-based 3D-CRT plans were analyzed.Results:   Median D 95% and V 100%  of PTV were significantly higher in HT-IMRT (p &lt; 0.001) compared to 3D-CRT. The right/left CA dosimetric outcomes, including the mean doses (20.7/21.5 Gy versus 48.7/50.5 Gy), D max  (53.6/52.0 Gy versus 67.4/67.7 Gy), V 30  (25.0/27.1% versus 77.6/80.3%), V 40  (8.0/7.9% versus 74.6/71.9%), and V 50  (2.0/1.2% versus 70.0/71.6%) were also significantly lower in HT-IMRT (p &lt; 0.05), similar to the mean PCM doses (49.6 Gy versus 62.6 Gy for 3D-CRT;p &lt; 0.001), respectively.Conclusions:   Our present results demonstrated the feasibility of simultaneous sparing of the CAs and PCM in HT-IMRT- compared to 3D-CRT plans in glottic carcinoma patients undergoing definitive radiotherapy.

Preliminary Simulation Study of Carotid Artery and Pharyngeal Constrictor Muscle Sparing-Radiotherapy in Glottic Carcinoma