{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T15:00:06Z","timestamp":1785596406000,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,5,30]],"date-time":"2017-05-30T00:00:00Z","timestamp":1496102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>To assess laryngeal motion in early glottic cancer in order to determine safe margins for partial larynx volumetric modulated arc therapy (PL\u2010VMAT), and to quantify dosimetric advantages of PL\u2010VMAT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study included T1\u20102N0 glottic cancers treated with whole larynx VMAT (WL\u2010VMAT). Pre\u2010 and mid\u2010treatment 4D\u2010computed tomography (4D\u2010CT) and dynamic magnetic resonance imaging (MRI) allowed for assessment of larynx swallowing and respiratory motion. For 10 patients with lateralized lesions, PL\u2010VMAT plans were calculated using margins derived from 4D\u2010CT analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty patients were accrued from 2014 to 2016. Mean amplitude of larynx swallowing excursion was 23\u00a0mm and 6\u00a0mm in the superior and anterior directions, respectively. Mean respiratory motion reached 4\u00a0mm and 2\u00a0mm in superior\u2010inferior and antero\u2010posterior directions, respectively. Pre\u2010treatment 4D\u2010CT analysis identified one patient with planning CT acquired during swallowing. Mid\u2010treatment 4D\u2010CT revealed larynx shift relative to vertebrae in 30% of cases. PL\u2010VMAT allowed for significant reduction of mean doses to ipsilateral carotid, contralateral carotid, thyroid gland, contralateral arytenoid and larynx. Using 8\u00a0mm internal margin for PL\u2010VMAT, swallowing resulted in clinical target volume excursion beyond 95% isodose line during \u22641.5% of total treatment time in all patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although swallowing motion is rare, rapid and easily suppressed by patients, there is a risk of systematic miss\u2010targeting if planning CT is acquired during swallowing. Larynx position shift relative to vertebrae occurs in 1\/3 of patients over the course of radiotherapy. With soft\u2010tissue image guidance and margins accounting for respiratory motion, PL\u2010VMAT allows safe reduction of dose to organs at risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.12612","type":"journal-article","created":{"date-parts":[[2017,5,30]],"date-time":"2017-05-30T05:46:44Z","timestamp":1496123204000},"page":"666-673","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Larynx motion considerations in partial larynx volumetric modulated arc therapy for early glottic cancer"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9508-0602","authenticated-orcid":false,"given":"Houda","family":"Bahig","sequence":"first","affiliation":[{"name":"Radiation Oncology Department Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al Montreal Quebec Canada"},{"name":"CHUM Research Center Montreal Quebec 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