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Background/Aims@#We used next-generation sequencing (NGS) to analyze resistance-associated substitutions (RASs) and retreatment outcomes in patients with chronic hepatitis C virus (HCV) infection who failed direct-acting antiviral agent (DAA) treatment in South Korea. @*Methods@#Using prospectively collected data from the Korean HCV cohort study, we recruited 36 patients who failed DAA treatment in 10 centers between 2007 and 2020; 29 blood samples were available from 24 patients. RASs were analyzed using NGS. @*Results@#RASs were analyzed for 13 patients with genotype 1b, 10 with genotype 2, and one with genotype 3a. The unsuccessful DAA regimens were daclatasvir+asunaprevir (n=11), sofosbuvir+ribavirin (n=9), ledipasvir/sofosbuvir (n=3), and glecaprevir/pibrentasvir (n=1). In the patients with genotype 1b, NS3, NS5A, and NS5B RASs were detected in eight, seven, and seven of 10 patients at baseline and in four, six, and two of six patients after DAA failure, respectively. Among the 10 patients with genotype 2, the only baseline RAS was NS3 Y56F, which was detected in one patient. NS5A F28C was detected after DAA failure in a patient with genotype 2 infection who was erroneously treated with daclatasvir+asunaprevir. After retreatment, 16 patients had a 100% sustained virological response rate. @*Conclusions@#NS3 and NS5A RASs were commonly present at baseline, and there was an increasing trend of NS5A RASs after failed DAA treatment in genotype 1b. However, RASs were rarely present in patients with genotype 2 who were treated with sofosbuvir+ribavirin. Despite baseline or treatment-emergent RASs, retreatment with pan-genotypic DAA was highly successful in Korea, so we encourage active retreatment after unsuccessful DAA treatment.
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Spinal epidural abscess (SEA) caused by Escherichia coli is an uncommon condition. It usually occurs secondary to urinary tract infection (UTI), following hematogenous propagation. Disruption of spinal anatomic barriers increases susceptibility to SEA. Although rarely, such disruption can take the form of lumbar spine stress fractures, which can result from even innocuous activity. Here, we describe a case of SEA secondary to UTI in a patient with pre-existing stress fractures of the lumbar spine, following use of an automated massage chair. Successful treatment of SEA consisted of surgical debridement and a six-month course of antibiotic therapy.
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Objectives@#The purpose of this study was to investigate the influence of anxiety, uncertainty, and cancer coping on the quality of life in breast cancer patients receiving neoadjuvant chemotherapy. @*Methods@#The participants of the study were 103 breast cancer patients who were in B Metropolitan City. Data had been collected between August 28 and November 22, 2020. For data analysis, SPSS/WIN 24.0 program was used, and descriptive, independent t-test, ANOVA and Scheffe’s test, and Pearson’s correlation coefficients and multiple regression were used for analysis. @*Results@#The most influencing factor on quality of life was anxiety (β=-.66, p<.001) which was followed by the number of chemotherapy treatments (β=.23, p<.001), interpersonal cancer coping(β=.18, p=.007) and inter-personal cancer coping (β=.18, p=.004). The overall explanatory power was 78.0%. @*Conclusion@#In order to improve the quality of life for breast cancer patients receiving neoadjuvant chemotherapy, it is necessary to develop a nursing program that may reduce their anxiety, promote cancer coping, and consider the number of their chemotherapy treatments.
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Purpose@#This study was conducted to identify the factors influencing the posttraumatic growth (PTG) in patients with lung cancer and to provide basic data for nursing intervention development to improve PTG and adaptation. @*Methods@#The study included 126 non-small cell lung cancer patients initially diagnosed at the Lung Cancer Center, C University Hospital in S city, Gyeonggi-do. Patients were asked to complete a questionnaire consisting of demographic characteristics, disease characteristics, posttraumatic growth, cancer coping, social support, and resilience. Data were analyzed using t-tests, ANOVA, and Pearson's correlation and multiple regression analysis. @*Results@#The mean score for PTG in lung cancer patients was 56.39, cancer coping was 61.31, social support was 61.09, and resilience was 92.77. Significant positive correlations were found for PTG and cancer coping (r=.75, p<.001), social support (r=.52, p<.001) and resilience (r=.63, p<.001). Factors contributing to PTG of lung cancer patients were cancer coping (β=.53 p<.001), perceived health status(β=.20, p=.002), resilience (β=.21, p=.010) and importance of religion (β=.15, p=.013). This model explained about 64.0% of variances of PTG (F=29.58, p<.001). @*Conclusion@#It is necessary to develop new nursing intervention programs to improve PTG for patients with lung cancer based on strategies to enhance coping and resilience to recovery. Longitudinal studies examining temporal changes in PTG among patients with lung cancer are suggested for future studies in this regard.
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Purpose@#The objective of this study was to analyze the effects of non-pharmacological interventions on cancer patients with sleep disorder. @*Methods@#A total of 4,246 studies published between 2000 and 2018 were identified by searching NDSL, RISS, Koreamed, PubMed, EMBASE, Cochrane Library, and CINAHL. Seventeen of these studies were selected for inclusion in the meta-analysis.Data were analyzed using the Comprehensive Meta-Analysis (CMA) Ver. 3.4.1 program, and the effect sizes were shown using Hedges’ g score. @*Results@#Intervention studies included 8 studies on exercise, 4 studies on cognitive-behavioral therapy, 2 studies on music, and 1 study each on aromatherapy, massage, and mindfulness-based stress reduction. The overall controlled effect size was .78 (95% Confidence Interval=.40, 1.16, Z=4.02, p<.001), using a random effects model. @*Conclusion@#Through this study, it was found that the effects of exercise (walking), aromatherapy, massage, and music intervention were all statistically significant. As such, the findings of this study provide evidence supporting the incorporation of various non-pharmacological interventions into nursing practice to improve sleep quality in patients with sleep disorder.
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Purpose@#This study was conducted to identify the factors influencing the posttraumatic growth (PTG) in patients with lung cancer and to provide basic data for nursing intervention development to improve PTG and adaptation. @*Methods@#The study included 126 non-small cell lung cancer patients initially diagnosed at the Lung Cancer Center, C University Hospital in S city, Gyeonggi-do. Patients were asked to complete a questionnaire consisting of demographic characteristics, disease characteristics, posttraumatic growth, cancer coping, social support, and resilience. Data were analyzed using t-tests, ANOVA, and Pearson's correlation and multiple regression analysis. @*Results@#The mean score for PTG in lung cancer patients was 56.39, cancer coping was 61.31, social support was 61.09, and resilience was 92.77. Significant positive correlations were found for PTG and cancer coping (r=.75, p<.001), social support (r=.52, p<.001) and resilience (r=.63, p<.001). Factors contributing to PTG of lung cancer patients were cancer coping (β=.53 p<.001), perceived health status(β=.20, p=.002), resilience (β=.21, p=.010) and importance of religion (β=.15, p=.013). This model explained about 64.0% of variances of PTG (F=29.58, p<.001). @*Conclusion@#It is necessary to develop new nursing intervention programs to improve PTG for patients with lung cancer based on strategies to enhance coping and resilience to recovery. Longitudinal studies examining temporal changes in PTG among patients with lung cancer are suggested for future studies in this regard.
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Purpose@#The objective of this study was to analyze the effects of non-pharmacological interventions on cancer patients with sleep disorder. @*Methods@#A total of 4,246 studies published between 2000 and 2018 were identified by searching NDSL, RISS, Koreamed, PubMed, EMBASE, Cochrane Library, and CINAHL. Seventeen of these studies were selected for inclusion in the meta-analysis.Data were analyzed using the Comprehensive Meta-Analysis (CMA) Ver. 3.4.1 program, and the effect sizes were shown using Hedges’ g score. @*Results@#Intervention studies included 8 studies on exercise, 4 studies on cognitive-behavioral therapy, 2 studies on music, and 1 study each on aromatherapy, massage, and mindfulness-based stress reduction. The overall controlled effect size was .78 (95% Confidence Interval=.40, 1.16, Z=4.02, p<.001), using a random effects model. @*Conclusion@#Through this study, it was found that the effects of exercise (walking), aromatherapy, massage, and music intervention were all statistically significant. As such, the findings of this study provide evidence supporting the incorporation of various non-pharmacological interventions into nursing practice to improve sleep quality in patients with sleep disorder.
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Objectives@#This study was conducted to analyze dental caries and periodontal diseases in Korean adults depending on types of national health insurance, using data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES Ⅶ). @*Methods@#From 2016 to 2018, the final analysis included a total of 12,601 adults over 19 years of age, who had undergone dental inspections for dental caries and periodontitis, and whose national health insurance was verified. @*Results@#Among all the subjects, the ratio of employees was highest (67.4%), followed by the self-employed (39.4%), and then medical care recipients (3.3%). The prevalence of dental caries and periodontitis was 93.0% and 30.5%, respectively, among all subjects. The former was highest for medical aid recipients (95.9%), followed by employees (93.1%), and was lowest for the self-employed (92.2%) (P<0.001). The latter was highest for medical aid recipients (40.7%), followed by the self-employed (35.9%), and was lowest for employees (27.7%) (P<0.001). The prevalence of dental caries in the self-employed group was significantly lower (0.52 times) than that of medical care recipients (95% CI: 0.28-0.94), while no significant difference was seen between the latter and employees. There were also no significant differences among them, depending on the types of national health insurance and periodontitis. @*Conclusions@#It is necessary to develop oral health promotion programs that are not biased toward specific types of health insurance subscriptions, and to establish a business plan for oral prevention of subscribers of medical benefits.
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Background@#There are various Helicobacter species colonizing the stomachs of animals. Although Helicobacter species usually cause asymptomatic infection in the hosts, clinical signs can occur due to gastritis associated with Helicobacter in animals. Among them, Helicobacter pylori is strongly associated with chronic gastritis, gastric ulcers, and gastric cancers. As the standard therapies used to treat H. pylori have proven insufficient, alternative options are needed to prevent and eradicate the diseases associated with this bacterium. Cheonwangbosim-dan (CBD), a traditional herbal formula that is popular in East Asia, has been commonly used for arterial or auricular flutter, neurosis, insomnia, and cardiac malfunction-induced disease. @*Objectives@#The present study investigated the antimicrobial effect of CBD on H. pylori-infected human gastric carcinoma AGS cells and model mice. @*Methods@#AGS cells were infected with H. pylori and treated with a variety of concentrations of CBD or antibiotics. Mice were given 3 oral inoculations with H. pylori and then dosed with CBD (100 or 500 mg/kg) for 4 weeks or with standard antibiotics for 1 week. One week after the last treatment, gastric samples were collected and examined by histopathological analysis, real-time quantitative polymerase chain reaction, and immunoblotting. @*Results@#Our results showed that CBD treatment of AGS cells significantly reduced the H. pylori-induced elevations of interleukin-8, inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2). In the animal model, CBD treatment inhibited the colonization of H. pylori and the levels of malondialdehyde, inflammation, proinflammatory cytokines, iNOS, and COX-2 in gastric tissues. CBD also decreased the phosphorylation levels of p38 mitogen-activated protein kinase family. @*Conclusions@#This study suggests that CBD might be a prospective candidate for treatingH. pylori-induced gastric injury.
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PURPOSE: The purpose of this qualitative research is to explore the background of occurrence of perceived incivility by nursing students in clinical practice.METHOD: Data were collected through focus interviews and individual interviews were analysed using qualitative content analysis.RESULT: The results showed that three categories that represented the background of occurrence of incivility were scheme which is not cleared, position which is not settled and unequal relationship.CONCLUSION: Since the background of occurrence of perceived incivility is complex, So it is required to macroscopic approach to reduce the perceived incivility of the students in the clinical practice.
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Humans , Methods , Nursing , Qualitative Research , Students, NursingABSTRACT
PURPOSE: External beam radiotherapy (EBRT) is a useful option to treat head and neck skin cancer patients who are not indicated for surgery. In this study, we evaluated the treatment outcomes of EBRT in an Asian population.MATERIALS AND METHODS: The records from 19 head and neck skin cancer patients (10 with squamous cell carcinoma and 9 with basal cell carcinoma) who were treated with definitive or adjuvant EBRT from 2009 to 2017 were retrospectively reviewed. The radiotherapy doses administered ranged from 50 to 66 Gy (median, 55 Gy) with 2.0–2.75 Gy per daily fraction (median, 2.5 Gy). The T stage at presentation was as follows: Tis (1 patient), T1 (11 patients), T2 (6 patients), and T3 (1 patient). None had regional lymph node disease or distant metastasis at presentation. The local failure-free survival (LFFS) rates, toxicity, and cosmetic results were analyzed.RESULTS: The median age was 75.5 years (range, 52.6 to 92.5 years). The median follow-up duration from the completion of radiotherapy was 44.9 months (range, 5.8 to 82.6 months). One local failure occurred in a patient with a 2.1-cm posterior neck squamous cell carcinoma at 32.5 months after radiotherapy (1/19, 5.3%). The 3-year LFFS rate was 91.7%. No patients died from skin cancer during follow-up, and no grade 3 complications occurred. The cosmetic outcomes were excellent for 16 (84.2%) and good for 3 (15.8%) of the 19 patients.CONCLUSION: EBRT offers good local control and cosmetic outcomes in patients with head and neck skin cancer, with no grade 3 complications.
Subject(s)
Humans , Asian People , Carcinoma, Squamous Cell , Follow-Up Studies , Head , Lymph Nodes , Neck , Neoplasm Metastasis , Radiotherapy , Retrospective Studies , Skin Neoplasms , Skin , Treatment OutcomeABSTRACT
No abstract available.
Subject(s)
Aged , Humans , Enterococcus , Hyperplasia , Prostate , Urinary Tract Infections , Urinary TractABSTRACT
PURPOSE: Lung Cancer Subcommittee of Korean Radiation Oncology Group (KROG) has recently launched a prospective clinical trial (KROG 17-06) of hippocampus-sparing whole brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in treating multiple brain metastases from non-small cell lung cancer. In order to improve trial quality, dummy run studies among the participating institutions were designed. This work reported the results of two-step dummy run procedures of the KROG 17-06 study. MATERIALS AND METHODS: Two steps tested hippocampus contouring variability and radiation therapy planning compliance. In the first step, the variation of the hippocampus delineation was investigated for two representative cases using the Dice similarity coefficients. In the second step, the participating institutions were requested to generate a HS-WBRT with SIB treatment plan for another representative case. The compliance of the treatment plans to the planning protocol was evaluated. RESULTS: In the first step, the median Dice similarity coefficients of the hippocampus contours for two other dummy run cases changed from 0.669 (range, 0.073 to 0.712) to 0.690 (range, 0.522 to 0.750) and from 0.291 (range, 0.219 to 0.522) to 0.412 (range, 0.264 to 0.598) after providing the hippocampus contouring feedback. In the second step, with providing additional plan priority and extended dose constraints to the target volumes and normal structures, we observed the improved compliance of the treatment plans to the planning protocol. CONCLUSION: The dummy run studies demonstrated the notable inter-institutional variability in delineating the hippocampus and treatment plan generation, which could be decreased through feedback from the trial center.
Subject(s)
Brain , Carcinoma, Non-Small-Cell Lung , Compliance , Hippocampus , Lung Neoplasms , Neoplasm Metastasis , Prospective Studies , Radiation Oncology , RadiotherapyABSTRACT
Parry-Romberg syndrome is a rare neurocutaneous syndrome characterized by progressive shrinkage and degeneration of the tissues usually on only one side of the face. It is usually difficult to restore the facial contour due to skin tightness. In this case report, we report a forehead reconstruction with custom-made three-dimensional (3D) titanium implant of a Parry-Romberg syndrome patient who was treated with multiple fat grafts but had limited effect. A 36-year-old man presented with hemifacial atrophy. The disease progressed from 5 to 16 years old. The patient had alopecia on frontal scalp and received a surgery using tissue expander. The alopecia lesion was covered by expanded scalp flap done 22 years ago. Also, he was treated with fat grafts on depressed forehead 17 years ago. However, it did not work sufficiently, and there was noted depressed forehead. We planned to make 3D titanium implant to cover the depressed area (from the superior orbital rim to the vertex). During the operation, we confirmed that the custom-made 3D implant accurately fit for the depressed area without any dead spaces. Previously depressed forehead and glabella were elevated, and the forehead contour was improved cosmetically. A custom-made 3D titanium implant is widely used for skull reconstruction and bring good results. In our case, the depressed forehead of a Parry-Romberg syndrome patient was improved by a 3D titanium implant.
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Adult , Humans , Alopecia , Facial Hemiatrophy , Forehead , Neurocutaneous Syndromes , Orbit , Scalp , Skin , Skull , Tissue Expansion Devices , Titanium , TransplantsABSTRACT
The purpose of this study was to investigate the diet tendencies of human and companion animals using big data analysis. The keyword data of human diet and companion animals' diet were collected from the portal site Naver from January 1, 2016 until December 31, 2016 and collected data were analyzed by simple frequency analysis, N-gram analysis, keyword network analysis and seasonality analysis. In terms of human, the word exercise had the highest frequency through simple frequency analysis, whereas diet menu most frequently appeared in the N-gram analysis. companion animals, the term dog had the highest frequency in simple frequency analysis, whereas diet method was most frequent through N-gram analysis. Keyword network analysis for human indicated 4 groups: diet group, exercise group, commercial diet food group, and commercial diet program group. However, the keyword network analysis for companion animals indicated 3 groups: diet group, exercise group, and professional medical help group. The analysis of seasonality showed that the interest in diet for both human and companion animals increased steadily since February of 2016 and reached its peak in July. In conclusion, diets of human and companion animals showed similar tendencies, particularly having higher preference for dietary control over other methods. The diets of companion animals are determined by the choice of their owners as effective diet method for owners are usually applied to the companion animals. Therefore, it is necessary to have empirical demonstration of whether correlation of obesity between human being and the companion animals exist.
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Animals , Cats , Dogs , Humans , Diet , Friends , Methods , Obesity , Pets , Seasons , Statistics as TopicABSTRACT
PURPOSE: To evaluate the effect of adjuvant external beam radiation therapy (EBRT) on local failure-free survival rate (LFFS) for papillary thyroid cancer (PTC) invading the trachea. MATERIALS AND METHODS: Fifty-six patients with locally advanced PTC invading the trachea were treated with surgical resection. After surgery, 21 patients received adjuvant EBRT and radioactive iodine therapy (EBRT group) and 35 patients were treated with radioactive iodine therapy (control group). RESULTS: The age range was 26–87 years (median, 56 years). The median follow-up period was 43 months (range, 4 to 145 months). EBRT doses ranged from 50.4 to 66 Gy (median, 60 Gy). Esophagus invasion and gross residual disease was more frequent in the EBRT group. In the control group, local recurrence developed in 9 (9/35, 26%) and new distant metastasis in 2 (2/35, 6%) patients, occurring 4 to 68 months (median, 37 months) and 53 to 68 months (median, 60 months) after surgery, respectively. Two patients had simultaneous local recurrence and new distant metastasis. There was one local failure in the EBRT group at 18 months after surgery (1/21, 5%). The 5-year LFFS was 95% in the EBRT group and 63% in the control group (p = 0.103). In the EBRT group, one late grade 2 xerostomia was developed. CONCLUSION: Although, EBRT group had a higher incidence of esophagus invasion and gross residual disease, EBRT group showed a better 5-year LFFS. Adjuvant EBRT may have contributed to the better LFFS in these patients.
Subject(s)
Humans , Esophagus , Follow-Up Studies , Incidence , Iodine , Neoplasm Metastasis , Radiotherapy , Recurrence , Survival Rate , Thyroid Gland , Thyroid Neoplasms , Trachea , XerostomiaABSTRACT
Sorafenib is widely used for unresectable and metastatic hepatocellular carcinomas. Radiation recall dermatitis (RRD) is an acute inflammatory reaction confined to previously irradiated skin that occurs after the administration of certain drugs. RRD after sorafenib treatment is rare; five cases have been reported thus far. We describe a 44-year-old man irradiated for chest wall bone metastasis from hepatocellular carcinoma. Eight days after radiotherapy completion, systemic therapy for metastatic hepatocellular carcinoma was initiated with sorafenib treatment. Eleven days after starting sorafenib, the patient complained of erythematous rash with pruritus in the chest wall, in a location consistent with the previous radiation field. Sorafenib was continued at the same dose, despite the RRD. The skin reaction subsided over the next 2 weeks without any medical intervention.
Subject(s)
Adult , Humans , Carcinoma, Hepatocellular , Exanthema , Neoplasm Metastasis , Pruritus , Radiodermatitis , Radiotherapy , Skin , Thoracic WallABSTRACT
Sorafenib is widely used for unresectable and metastatic hepatocellular carcinomas. Radiation recall dermatitis (RRD) is an acute inflammatory reaction confined to previously irradiated skin that occurs after the administration of certain drugs. RRD after sorafenib treatment is rare; five cases have been reported thus far. We describe a 44-year-old man irradiated for chest wall bone metastasis from hepatocellular carcinoma. Eight days after radiotherapy completion, systemic therapy for metastatic hepatocellular carcinoma was initiated with sorafenib treatment. Eleven days after starting sorafenib, the patient complained of erythematous rash with pruritus in the chest wall, in a location consistent with the previous radiation field. Sorafenib was continued at the same dose, despite the RRD. The skin reaction subsided over the next 2 weeks without any medical intervention.
Subject(s)
Adult , Humans , Carcinoma, Hepatocellular , Exanthema , Neoplasm Metastasis , Pruritus , Radiodermatitis , Radiotherapy , Skin , Thoracic WallABSTRACT
BACKGROUND/AIMS: It remains to be determined whether switching from adefovir (ADV) to tenofovir (TDF) provides better virological outcomes in patients exhibiting suboptimal responses to ADV plus nucleoside analogue (ADV+NA) therapy for NA-resistant chronic hepatitis B (CHB). METHODS: In this prospective trial, patients who showed partial responses (defined as serum hepatitis B virus [HBV] DNA >60 IU/mL) to ADV+NA therapy for NA resistance were randomly allocated to receive TDF plus NA (TDF+NA group, n=16) or to continue their current therapy (ADV+NA group, n=16). The primary end point was the proportion of patients with complete virological response (CVR, defined as serum HBV DNA 2log10 IU/mL was more likely in the TDF+NA group at both 24 and 48 weeks (68.8% vs. 56.3%, P=0.014 vs. 81.3% vs. 56.3%, P=0.001, respectively). During the follow-up, the rate of HBeAg seroconversion was higher in the TDF+NA group than the ADV+NA group (12.5% vs. 6.25%, P=0.640), as was that for the hepatitis B surface antigen (6.25% vs. 0%, P=0.080). No serious adverse events due to antiviral agents occurred. CONCLUSIONS: In patients exhibiting suboptimal responses to ADV+NA therapy for NA-resistant CHB, switching from ADV to TDF might provide better virological outcomes.
Subject(s)
Female , Humans , Male , Middle Aged , Adenine/analogs & derivatives , Alanine Transaminase/blood , Antiviral Agents/therapeutic use , DNA, Viral/blood , Drug Resistance, Viral , Drug Therapy, Combination , Genotype , Hepatitis B e Antigens/blood , Hepatitis B virus/genetics , Hepatitis B, Chronic/drug therapy , Lamivudine/therapeutic use , Organophosphonates/therapeutic use , Prospective Studies , Tenofovir/therapeutic use , Treatment OutcomeABSTRACT
PURPOSE: Radiotherapy of the neck is known to cause carotid artery stenosis. We compared the carotid artery dose received between volumetric modulated arc therapy (VMAT) and conventional fixed-field intensity-modulated radiotherapy (IMRT) plans in patients with early glottic cancer. MATERIALS AND METHODS: Twenty-one early glottic cancer patients who previously underwent definitive radiotherapy were selected for this study. For each patient, double arc VMAT, 8-field IMRT, 3-dimensional conformal radiotherapy (3DCRT), and lateral parallel-opposed photon field radiotherapy (LPRT) plans were created. The 3DCRT plan was generated using lateral parallel-opposed photon fields plus an anterior photon field. VMAT and IMRT treatment plan optimization was performed under standardized conditions to obtain adequate target volume coverage and spare the carotid artery. Dose-volume specifications for the VMAT, IMRT, 3DCRT, and LPRT plans were calculated with radiotherapy planning system. Monitor units (MUs) and delivery time were measured to evaluate treatment efficiency. RESULTS: Target volume coverage and homogeneity results were comparable between VMAT and IMRT; however, VMAT was superior to IMRT for carotid artery dose sparing. The mean dose to the carotid arteries in double arc VMAT was reduced by 6.8% compared to fixed-field IMRT (p < 0.001). The MUs for VMAT and IMRT were not significantly different (p = 0.089). VMAT allowed an approximately two-fold reduction in treatment delivery time in comparison to IMRT (3 to 5 minutes vs. 5 to 10 minutes). CONCLUSION: VMAT resulted in a lower carotid artery dose compared to conventional fixed-field IMRT, and maintained good target coverage in patients with early glottic cancer.