Illustration of the potential of Tomotherapy to spare the pharyngeal muscles in a patient with locally advanced base of tongue cancer and right neck nodal metastases treated with definitive concurrent chemoradiation.

<p>Despite the proximity of the gross tumor and neck nodes treated to 70 Gy, mean pharyngeal muscle radiation dose was 22.5 Gy. A split field intensity-modulated radiotherapy technique to shield the larynx and pharyngeal muscles would have underdosed the right neck nodes and gross tumor. The patient is in clinical remission two years following treatment and has no difficulty with swallowing except for xerostomia as the parotid gland could not be spared.</p

Illustrating the potential of Tomotherapy to spare the pharyngeal muscles in a patient who had postoperative chemoradiation for locally advanced base of tongue and bilateral neck metastases.

<p>Even though the right neck was dissected and required radiation of the surgical bed and scars to 63 Gy, the pharyngeal muscles can still be spared from excessive radiation dose. The midline laryngeal block with the split field intensity-modulated radiotherapy technique would have had underdosed the surgical scar and area of the surgical bed located in close proximity to the larynx and the gross lymph nodes on the left side. The patient is in remission 13 month after treatment.</p

Aspiration rate reported in the literature following radiotherapy for non-laryngeal and non-hypopharyngeal head and neck cancer.

<p>C: conventional with two lateral and a supraclavicular field; NS: not specified; IMRT: intensity-modulated radiotherapy; WF: whole-field; SF: split-field; IGRT: image-guided radiotherapy.</p

Patient characteristics.

<p>Patient characteristics.</p

Mean pharyngeal dose (Gy) correlation with dysphagia severity or aspiration reported in the literature.

<p>NA: not assessed; QOL: quality of life.</p