Objective: To investigate the protective value of equivalent uniform dose（EUD） combined with dose-volume（DV） optimization for organs at risk in intensity-modulated radiotherapy for cervical and upper-thoracic esophageal cancer. Methods: Twelve patients with cervical and upper-thoracic esophageal cancer were randomly selected from the Department of Oncology

the Affiliated Hospital of Southwest Medical University. A 7-field intensity-modulated radiotherapy（IMRT） plan was designed using the Pinnacle39.10 treatment planning system. A dose-volume histogram was used to analyze the dose-volume parameters of the target

both lungs

the spinal cord

and normal tissues

as well as target homogeneity index（HI）

conformity index（CI）

and total monitor units（MU）.Results: Compared with the DV group

the DV combined with EUD group showed significant reductions in V5

V10

V20

V30

and the mean dose of both lungs by 3.2%

2.1%

2.4%

1.3%

and 122 cGy

respectively（all P < 0.05）

as well as significant decreases in Dmean（mean dose） and D1 cc（dose to 1 cm3） of the spinal cord by 46 cGy and 98 cGy

respectively（both P < 0.05）. Conclusion: Equivalent uniform dose combined with dose-volume optimization can reduce the dose to and volume of the lung and spinal cord irradiated in IMRT for cervical and upper-thoracic esophageal cancer

and it is worthy of clinical application.