A recent case study questioned the trade-off of less radiation dose to the carotid arteries coming with less radiation dose, albeit unintentional, to larynx-adjacent lymph nodes when employing carotid-sparing IMRT for early glottic cancer. This response argues, even generously granting the supposition that a traditional 3D-approach would have prevented the case’s isolated nodal failure, reverting to a “happy dosimetric accident” isn’t the ideal solution. We first need to consciously decide whether or not to treat adjacent nodal regions and, if so, include them in the target volume while maintaining a carotid artery dose as low as reasonably achievable. | Chin, Pract Radiat Oncol 2023
