{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T08:39:02Z","timestamp":1775032742748,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T00:00:00Z","timestamp":1607126400000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T00:00:00Z","timestamp":1607126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012287","name":"Andrew Sabin Family Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012287","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1R25EB025787\u201001"],"award-info":[{"award-number":["1R25EB025787\u201001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000070","name":"National Institute of Biomedical Imaging and Bioengineering","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000070","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["BD2K"],"award-info":[{"award-number":["BD2K"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["1R01CA214825\u201001"],"award-info":[{"award-number":["1R01CA214825\u201001"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["1R01CA218148\u201001"],"award-info":[{"award-number":["1R01CA218148\u201001"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["P30CA016672"],"award-info":[{"award-number":["P30CA016672"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine the optimal dose\u2010volume constraint for laryngeal sparing using three commonly employed intensity modulated radiation therapy (IMRT) approaches in patients with oropharyngeal cancer treated to the bilateral neck.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Thirty patients with stage II\u2010IVA oropharynx cancers received definitive radiotherapy with split\u2010field IMRT (SF\u2010IMRT) to the bilateral neck between 2008 and 2013. Each case was re\u2010planned using whole\u2010field IMRT (WF\u2010IMRT) and volumetric modulated arc therapy (VMAT) and plan quality metrics and dose to laryngeal structures was evaluated. Two larynx volumes were defined and compared on the current study: the Radiation Therapy Oncology Group (RTOG) larynx as defined per the RTOG 1016 protocol and the MDACC larynx defined as the components of the larynx bounded by the superior and inferior extent of the thyroid cartilage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Target coverage, conformity, and heterogeneity indices were similar in all techniques. The RTOG larynx mean dose was lower with WF\u2010IMRT than SF\u2010IMRT (22.1 vs 25.8\u00a0Gy; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). The MDACC larynx mean dose was 17.5\u00a0Gy\u00a0\u00b1\u00a05.4\u00a0Gy with no differences between the 3 techniques. WF\u2010IMRT and VMAT plans were associated with lower mean doses to the supraglottic larynx (42.1 vs 41.2 vs 54.8\u00a0Gy; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) and esophagus (18.1 vs 18.2 vs 36\u00a0Gy; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Modern whole field techniques can provide effective laryngeal sparing in patients receiving radiotherapy to the bilateral neck for advanced oropharyngeal cancers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Summary<\/jats:title><jats:p>We evaluated laryngeal dose in patients with locally advanced oropharyngeal cancer treated to the bilateral neck using split\u2010field IMRT (SF\u2010IMRT), whole\u2010field IMRT (WF\u2010IMRT) and volumetric arc therapy (VMAT). All three techniques provided good sparing of laryngeal structures and were able to achieve a mean larynx dose\u00a0&lt;\u00a033\u00a0Gy. There were no significant differences in dose to target structures or non\u2010laryngeal organs at risk among techniques.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.13009","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T11:58:28Z","timestamp":1607169508000},"page":"37-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Defining the dose\u2010volume criteria for laryngeal sparing in locally advanced oropharyngeal cancer utilizing split\u2010field IMRT, whole\u2010field IMRT and VMAT"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4147-6040","authenticated-orcid":false,"given":"Christopher","family":"Wilke","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston TX 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Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean R.","family":"Quinlan\u2010Davidson","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam S.","family":"Garden","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David I.","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clifton D.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston TX 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