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Tongue‐out versus tongue‐in position during intensity‐modulated radiotherapy for base of tongue cancer: Clinical implications for minimizing post‐radiotherapy swallowing dysfunction
Author(s) -
Kil Whoon Jong,
Kulasekere Christina,
Hatch Craig,
Bugno Jacob,
Derrwaldt Ronald
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24809
Subject(s) - tongue , medicine , swallowing , larynx , pharynx , radiation therapy , cancer , head and neck cancer , oral cavity , radiology , nuclear medicine , anatomy , dentistry , pathology
Background The purpose of this study was to assess whether different tongue positions change the radiation doses to swallowing organs at risks: the pharyngeal constrictor, oral cavity, and larynx during intensity‐modulated radiotherapy (IMRT) for base of tongue (BOT) cancer. Methods IMRT plans with Tongue‐out (IMRT‐TO) and tongue‐in position (IMRT‐TI) was compared in 3 cases. Results Distance from BOT to pharyngeal constrictor was increased to 1.8 ± 0.8 cm with IMRT‐TO from 0.9 ± 0.6 cm with IMRT‐TI ( P < .01). Compared to IMRT‐TI, IMRT‐TO significantly decreased the radiation dose to the anterior oral cavity, oral tongue, superior pharyngeal constrictor, middle pharyngeal constrictor, and supraglottic larynx (all P ≤ .04). IMRT‐TO also had a smaller volume irradiated than IMRT‐TI to the anterior oral cavity and the oral tongue receiving ≥30 Gy (V30) and V35, and superior pharyngeal constrictor and middle pharyngeal constrictor for V55 and V65 (all P ≤ .04). Conclusion Dosimetric advantage with IMRT‐TO over IMRT‐TI may potentially reduce post‐IMRT swallowing dysfunction in selected patients with BOT cancer.