Do you routinely use IMRT to spare the carotids for early-stage glottic cancer?

Not only can IMRT spare the carotids here, and as I recall Dr. Fuller and others at MDACC were one of the first to officially publish some results on this, but it also reduces acute skin toxicity. It should be dosimetrically apparent that if you go from an opposed lateral field arrangement to a 3-field (IMRT) arrangement, skin effects/skin dose go down. This is clinically apparent, for sure... to the extent that after you use 3-field for a period of time, you really as a physician grow to appreciate it because the patients seem to do better and complain less (and obviously you see the results in the weekly OTVs). Obviously going from a 2-field to a 3- or 4-field approach to reduce skin toxicity has been seen in a multitude of clinical situa...