Feasibility of image-guided radiotherapy based on helical tomotherapy to reduce contralateral parotid dose in head and neck cancer

A retrospective review of 52 patients undergoing radiotherapy for head and neck cancers with image guidance based on daily megavoltage CT imaging with helical tomotherapy was performed.Mean contralateral parotid dose and the volume of the contralateral parotid receiving 40？Gy or more were compared between radiotherapy plans with significant constraint (SC) of less than 20？Gy on parotid dose (23 patients) and the conventional constraint (CC) of 26？Gy (29 patients). All patients had PTV coverage of at least 95% to the contralateral elective neck nodes. Mean contralateral parotid dose was, respectively, 14.1？Gy and 24.7？Gy for the SC and CC plans (p？<？0.0001). The volume of contralateral parotid receiving 40？Gy or more was respectively 5.3% and 18.2% (p？<？0.0001)Tomotherapy for head and neck cancer minimized radiotherapy dose to the contralateral parotid gland in patients undergoing elective node irradiation without sacrificing target coverage.