Skip to main content
SpringerLink
Log in

Radiothérapie par modulation d’intensité

Intensity modulated radiation therapy

  • Original
  • Published:
Oncologie

Résumé

La radiothérapie par modulation d’intensité permet d’augmenter la dose au volume cible en respectant l’irradiation des organes critiques et des tissus sains. La technique s’est particulièrement développée dans les indications des cancers prostatiques, des cancers de la tète et du cou et des tumeurs gynécologiques pelviennes. Les différentes étapes de la mise en œuvre de ces traitements nécessitent des programmes d’assurance de qualité rigoureux permettant de valider les indications, la définition des volumes à traiter et respectant les contraintes des organes sensibles. Son efficacité et ses résultats sont désormais bien établis pour les irradiations à dose élevée des cancers prostatiques et pour la préservation salivaire des malades irradiés pour les cancers de la tête et du cou. La formation des personnes impliquées dans la mise en œuvre de ces traitements est indispensable à sa généralisation afin de permettre à un nombre plus important de patients de bénéficier de cette amélioration technologique en radiothérapie.

Abstract

Intensity modulated radiation therapy makes it possible to increase the dose delivered to the target volume while avoiding the irradiation of at-risk organs and normal tissue. This technique is mainly indicated in the treatment of prostate carcinoma, head and neck cancer and pelvic gynaecological malignancies. The different steps in the use of this treatment require thorough quality assurance programmes that confirm the indications, target volumes and constraints with regard to normal tissue. The efficacy and outcomes of the high-dose irradiation of prostate tumours and its effectiveness in preventing xerostomia in patients treated for head and neck cancers have been well established. The key to increasing the number of patients who will benefit from this technological advancement is the systematic training of the medical professionals involved in its implementation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. Ahamad A, D’souza W, Salehpour M, et al. (2005) Intensity-modulated radiation therapy after hysterectomy: comparison with conventional treatment and sensitivity of the normal-tissue-sparing effect to margin size. Int J Radiat Oncol Biol Phys 62(4): 1117–24

    Article  PubMed  Google Scholar 

  2. Ailleres N, Azria D, Thezenas S, et al. (2004) Étude de faisabilité de radiothérapie de conformation avec modulation d’intensité dans les cancers localisés de la prostate. Cancer/Radiother 8: 59–69

    Article  CAS  Google Scholar 

  3. Aydogan B, Mundt AJ, Smith B, et al. (2006) A dosimetric analysis of intensity-modulated radiation therapy (IMRT) as an alternative to adjuvant high-dose-rate (HDR) brachytherapy in early endometrial cancer patients. Int J Radiat Oncol Biol Phys 65(1): 266–73

    Article  PubMed  Google Scholar 

  4. Boehmer D, Bohsung J, Eichwurzel I, et al. (2004) Clinical and physical quality assurance for intensity modulated radiotherapy of prostate cancer. Radiother Oncol 71: 319–25

    Article  PubMed  Google Scholar 

  5. Brahme A (1988) Optimization of stationary and moving beam radiation therapy techniques, Radiother Oncol 12: 129–40

    Article  PubMed  CAS  Google Scholar 

  6. Brixey CJ, Roeske JC, Lujan AE, et al. (2002) Impact of intensity-modulated radiotherapy on acute hematologic toxicity in women with gynecologic malignancies. Int J Radiat Oncol Biol Phys 54(5): 1388–96

    Article  PubMed  Google Scholar 

  7. Butler EB, Teh BS, Grant WH, et al. (1999) SMART (simultaneous modulated accelerated radiation therapy) boost: a new accelerated fractionation. Int J Radiat Oncol Biol Phys 45: 21–32

    Article  PubMed  CAS  Google Scholar 

  8. Chapet O, Fraas BA, Ten Haken RA (2006) Multiple fields may offer better esophagus sparing without increased probability of lung toxicity in optimized IMRT of lung tumors. Int J Radiat Oncol Biol Phys 65:1, 255–65

    Article  PubMed  Google Scholar 

  9. Chao CK, Ozyigit G, Blanco AL, et al. (2004) Intensity-modulated radiation therapy for oropharyngeal carcinoma: impact of tumor volume. Int J Radiat Oncol Biol Phys 59(1): 43–50

    Article  PubMed  Google Scholar 

  10. De Arruda FF, Puri DR, Zhung J, et al. (2006) Intensity-modulated radiation therapy for the treatment of oropharyngeal carcinoma: the Memorial Sloan-Kettering Cancer Center experience. Int J Radiat Oncol Biol Phys 64(2): 363–73

    Article  PubMed  Google Scholar 

  11. Deamaley DP, Hall E, Lawrence D, et al. (2005) Phase III pilot study of dose escalation using conformal radiotherapy in prostate cancer: PSA control and side effects. Br J Cancer 92(3): 488–98

    Google Scholar 

  12. Duthoy W, Boterberg T, Claus F, et al. (2005) Postoperative intensity-modulated radiotherapy in sinonasal carcinoma: clinical results in 39 patients. Cancer 104(1): 71–82

    Article  PubMed  Google Scholar 

  13. Fowler J, Chappell R, Ritter M (2001) Is alpha/beta for prostate cancer really low? Int J Radiat Oncol Biol Phys 50: 1021–31

    Article  PubMed  CAS  Google Scholar 

  14. Graff P, Lapeyre M, Desandes E, et al. (2007) Impact of intensity-modulated radiotherapy on health-related quality of life for head and neck cancer patients: matched-pair comparison with conventional radiotherapy. Int J Radiat Oncol Biol Phys 67: 1309–17

    PubMed  Google Scholar 

  15. Krengli M, Ballare A, Cannillo B, et al. (2006) Potential advantage of studying the lymphatic drainage by sentinel node technique and SPECT-CT image fusion for pelvic irradiation of prostate cancer. Int J Radiat Oncol Biol Phys 66(4): 1100–4

    PubMed  Google Scholar 

  16. Lee N, Xia P, Quivey JM, et al. (2002) Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys 53(1): 12–22

    Article  PubMed  Google Scholar 

  17. Li XA, Wang JZ, Jursinic PA, et al. (2005) Dosimetric advantages of IMRT simultaneous integrated boost for high-risk prostate cancer. Int J Radiat Oncol Biol Phys 61(4): 1251–7

    Article  PubMed  Google Scholar 

  18. Mohan R, Wu Q, Manning M, et al. (2000) Radiobiological considerations in the design of fractionation strategies for intensity modulated radiation therapy of head and neck cancers. Int J Radiat Oncol Biol Phys 46: 619–30, 44

    Article  PubMed  CAS  Google Scholar 

  19. Mundt AJ, Lujan AE, Rotmensch J, et al. (2002) Intensity-modulated whole pelvic radiotherapy in women with gynecologic malignancies. Int J Radiat Oncol Biol Phys 52(5): 1330–7

    Article  PubMed  Google Scholar 

  20. Peeters ST, Heemsbergen WD, Koper PC, et al. (2006) Dose-response in radiotherapy for localized prostate cancer: results of the Dutch multicenter randomized phase III trial comparing 68 Gy of radiotherapy with 78 Gy. J Clin Oncol 24(13): 1990–6

    Article  PubMed  Google Scholar 

  21. Pollack A, Zagars GK, Starkschall G, et al. (2002) Prostate cancer radiation dose response: results of the M. D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys 53(5): 1097–105

    Article  PubMed  Google Scholar 

  22. Portelance L, Chao KS, Grigsby PW, et al. (2001) Intensity-modulated radiation therapy (IMRT) reduces small bowel, rectum, and bladder doses in patients with cervical cancer receiving pelvic and para-aortic irradiation. Int J Radiat Oncol Biol Phys 51(1): 261–6

    Article  PubMed  CAS  Google Scholar 

  23. Rosenwald JC, Papatheodorou S, Gaboriaud G, et al. (1999) La modulation d’intensité, pourquoi et comment? Cancer/Radiothérapie 3(Suppl 1): 150–9

    Article  Google Scholar 

  24. Sanguineti G, Cavey ML, Endres EJ, et al. (2006) Is IMRT needed to spare the rectum when pelvic lymph nodes are part of the initial treatment volume for prostate cancer? Int J Radiat Oncol Biol Phys 64(1): 151–60

    Article  PubMed  Google Scholar 

  25. Wolden SL, Chen WC, Pfister DG, et al. (2006) Intensity-modulated radiation therapy (IMRT) for nasopharynx cancer: update of the Memorial Sloan-Kettering experience. Int J Radiat Oncol Biol Phys 64(1): 57–62

    Article  PubMed  Google Scholar 

  26. Yao MIN, Dornfeld KJ, Buati JM, et al. (2005) Intensity-modulated radiation theray for head- and neck squamous cell carcinoma-The Iowa experience. Int J Radiat Oncol Biol Phys 63: 410–21

    Article  PubMed  Google Scholar 

  27. Zelefsky MJ, Chan H, Hunt M, et al. (2006) Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol 176(4 Pt 1): 1415–9

    Article  PubMed  Google Scholar 

  28. Zietman AL, Desilvio ML, Slater JD, et al. (2005) Comparison of conventional-dose vs. high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA 294(10): 1233–9

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, F-21079, Dijon Cedex, France

    P. Maingon, G. Truc, K. Peignaux, G. Créhange & E. Lagneau

Authors
  1. P. Maingon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Truc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Peignaux
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Créhange
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E. Lagneau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Maingon.

About this article

Cite this article

Maingon, P., Truc, G., Peignaux, K. et al. Radiothérapie par modulation d’intensité. Oncologie 9, 417–421 (2007). https://doi.org/10.1007/s10269-007-0653-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10269-007-0653-x

Mots clés

Keywords

Search

Navigation