Dosimetric comparison of the carotid arteries in patients of T1 and T2 N0 M0 carcinoma glottis by three-dimensional conformal radiotherapy versus carotid sparing intensity-modulated radiotherapy technique
Background: Radiotherapy (RT) is a cornerstone in the treatment of early-stage glottic carcinoma (T1 and T2 N0 M0). However, RT can lead to radiation-induced vasculopathy, which increases the risk of cerebrovascular complications. Carotidsparing intensity-modulated RT (Cs-IMRT) has been proposed to...
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Manipal College of Medical Sciences, Pokhara
2025-06-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://ajmsjournal.info/index.php/AJMS/article/view/4546 |
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| author | Sathya SB Sathiyan K Harish Karthick R Vijayasree TN |
| author_facet | Sathya SB Sathiyan K Harish Karthick R Vijayasree TN |
| author_sort | Sathya SB |
| collection | DOAJ |
| description | Background: Radiotherapy (RT) is a cornerstone in the treatment of early-stage glottic carcinoma (T1 and T2 N0 M0). However, RT can lead to radiation-induced vasculopathy, which increases the risk of cerebrovascular complications. Carotidsparing intensity-modulated RT (Cs-IMRT) has been proposed to minimize radiation exposure to the carotid arteries while maintaining effective tumor control.
Aims and Objectives: This study aimed to compare the dosimetric impact of three-dimensional conformal RT (3DCRT) and Cs-IMRT on carotid artery exposure in patients with T1 and T2 N0 M0 carcinoma of the glottis.
Materials and Methods: This prospective comparative study included 30 patients equally divided into 3DCRT and Cs-IMRT treatment arms. Dosimetric parameters, including carotid artery dose exposure (V5Gy, V25Gy, and V50Gy), mean carotid dose, and local control rates, were analyzed.
Results: The mean carotid artery dose was lower in the Cs-IMRT group (43.2±9.7 Gy) than in the 3DCRT group (46.9±5.3 Gy, P=0.004). Cs-IMRT demonstrated a significant reduction in high-dose exposure, with V50Gy being 10.2±5.8% for Cs-IMRT versus 42.7±20.1% for 3DCRT (P<0.001). Similarly, Cs-IMRT achieved dose constraints more effectively, with 73.3% of patients meeting the V50Gy=0 criterion compared with none in the 3DCRT group. Although Cs-IMRT showed a slight improvement in local control rates, the difference was not significant (P=0.382).
Conclusion: Cs-IMRT showed significant dosimetric advantages over 3DCRT by reducing carotid artery radiation exposure, potentially lowering the risk of radiation-induced carotid artery vasculopathy. While both techniques achieved similar local control, the reduced vascular toxicity associated with Cs-IMRT supports its preferential use in early-stage glottic carcinoma. |
| format | Article |
| id | doaj-art-09b41b2dcdba4522a23df04420010c7e |
| institution | Kabale University |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-09b41b2dcdba4522a23df04420010c7e2025-08-20T03:55:22ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-06-01166130135https://doi.org/10.71152/ajms.v16i6.4546Dosimetric comparison of the carotid arteries in patients of T1 and T2 N0 M0 carcinoma glottis by three-dimensional conformal radiotherapy versus carotid sparing intensity-modulated radiotherapy techniqueSathya SB 0https://orcid.org/0009-0005-7269-1386Sathiyan K 1https://orcid.org/0009-0009-8391-7060Harish Karthick R 2https://orcid.org/0009-0005-1211-6144Vijayasree TN 3https://orcid.org/0009-0009-9797-324XSenior Assistant Professor, Department of Radiation Oncology, Madras Medical College, Chennai, Tamil Nadu, India Postgraduate Resident, Department of Radiation Oncology, Madras Medical College, Chennai, Tamil Nadu, India Postgraduate Resident, Department of Radiation Oncology, Madras Medical College, Chennai, Tamil Nadu, India Professor, Department of Radiation Oncology, Madras Medical College, Chennai, Tamil Nadu, India Background: Radiotherapy (RT) is a cornerstone in the treatment of early-stage glottic carcinoma (T1 and T2 N0 M0). However, RT can lead to radiation-induced vasculopathy, which increases the risk of cerebrovascular complications. Carotidsparing intensity-modulated RT (Cs-IMRT) has been proposed to minimize radiation exposure to the carotid arteries while maintaining effective tumor control. Aims and Objectives: This study aimed to compare the dosimetric impact of three-dimensional conformal RT (3DCRT) and Cs-IMRT on carotid artery exposure in patients with T1 and T2 N0 M0 carcinoma of the glottis. Materials and Methods: This prospective comparative study included 30 patients equally divided into 3DCRT and Cs-IMRT treatment arms. Dosimetric parameters, including carotid artery dose exposure (V5Gy, V25Gy, and V50Gy), mean carotid dose, and local control rates, were analyzed. Results: The mean carotid artery dose was lower in the Cs-IMRT group (43.2±9.7 Gy) than in the 3DCRT group (46.9±5.3 Gy, P=0.004). Cs-IMRT demonstrated a significant reduction in high-dose exposure, with V50Gy being 10.2±5.8% for Cs-IMRT versus 42.7±20.1% for 3DCRT (P<0.001). Similarly, Cs-IMRT achieved dose constraints more effectively, with 73.3% of patients meeting the V50Gy=0 criterion compared with none in the 3DCRT group. Although Cs-IMRT showed a slight improvement in local control rates, the difference was not significant (P=0.382). Conclusion: Cs-IMRT showed significant dosimetric advantages over 3DCRT by reducing carotid artery radiation exposure, potentially lowering the risk of radiation-induced carotid artery vasculopathy. While both techniques achieved similar local control, the reduced vascular toxicity associated with Cs-IMRT supports its preferential use in early-stage glottic carcinoma.https://ajmsjournal.info/index.php/AJMS/article/view/4546glottic carcinoma; radiation therapy; 3d conformal radiotherapy; carotid-sparing intensity-modulated radiotherapy technique; dosimetric |
| spellingShingle | Sathya SB Sathiyan K Harish Karthick R Vijayasree TN Dosimetric comparison of the carotid arteries in patients of T1 and T2 N0 M0 carcinoma glottis by three-dimensional conformal radiotherapy versus carotid sparing intensity-modulated radiotherapy technique Asian Journal of Medical Sciences glottic carcinoma; radiation therapy; 3d conformal radiotherapy; carotid-sparing intensity-modulated radiotherapy technique; dosimetric |
| title | Dosimetric comparison of the carotid arteries in patients of T1 and T2 N0 M0 carcinoma glottis by three-dimensional conformal radiotherapy versus carotid sparing intensity-modulated radiotherapy technique |
| title_full | Dosimetric comparison of the carotid arteries in patients of T1 and T2 N0 M0 carcinoma glottis by three-dimensional conformal radiotherapy versus carotid sparing intensity-modulated radiotherapy technique |
| title_fullStr | Dosimetric comparison of the carotid arteries in patients of T1 and T2 N0 M0 carcinoma glottis by three-dimensional conformal radiotherapy versus carotid sparing intensity-modulated radiotherapy technique |
| title_full_unstemmed | Dosimetric comparison of the carotid arteries in patients of T1 and T2 N0 M0 carcinoma glottis by three-dimensional conformal radiotherapy versus carotid sparing intensity-modulated radiotherapy technique |
| title_short | Dosimetric comparison of the carotid arteries in patients of T1 and T2 N0 M0 carcinoma glottis by three-dimensional conformal radiotherapy versus carotid sparing intensity-modulated radiotherapy technique |
| title_sort | dosimetric comparison of the carotid arteries in patients of t1 and t2 n0 m0 carcinoma glottis by three dimensional conformal radiotherapy versus carotid sparing intensity modulated radiotherapy technique |
| topic | glottic carcinoma; radiation therapy; 3d conformal radiotherapy; carotid-sparing intensity-modulated radiotherapy technique; dosimetric |
| url | https://ajmsjournal.info/index.php/AJMS/article/view/4546 |
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