Protonthérapie des carcinomes épidermoïdes des voies aérodigestives supérieures : de la physique à la clinique [Proton therapy for head and neck squamous cell carcinomas: From physics to clinic]

Details

Serval ID
serval:BIB_08B31DBDDDBD
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Protonthérapie des carcinomes épidermoïdes des voies aérodigestives supérieures : de la physique à la clinique [Proton therapy for head and neck squamous cell carcinomas: From physics to clinic]
Journal
Cancer radiotherapie
Author(s)
Beddok A., Vela A., Calugaru V., Tessonnier T., Kubes J., Dutheil P., Gérard A., Vidal M., Goudjil F., Florescu C., Kammerer E., Bénézery K., Hérault J., Bourhis J., Thariat J.
Working group(s)
Gortec et de trois centres français
ISSN
1769-6658 (Electronic)
ISSN-L
1278-3218
Publication state
Published
Issued date
09/2019
Peer-reviewed
Oui
Volume
23
Number
5
Pages
439-448
Language
french
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Intensity-modulated radiation therapy (IMRT) is presently the recommended technique for the treatment of locally advanced head and neck carcinomas. Proton therapy would allow to reduce the volume of irradiated normal tissue and, thus, to decrease the risk of late dysphagia, xerostomia, dysgeusia and hypothyroidism. An exhaustive research was performed with the search engine PubMed by focusing on the papers about the physical difficulties that slow down use of proton therapy for head and neck carcinomas. Range uncertainties in proton therapy (±3 %) paradoxically limit the use of the steep dose gradient in distality. Calibration uncertainties can be important in the treatment of head and neck cancer in the presence of materials of uncertain stoichiometric composition (such as with metal implants, dental filling, etc.) and complex heterogeneities. Dental management for example may be different with IMRT or proton therapy. Some uncertainties can be somewhat minimized at the time of optimization. Inter- and intrafractional variations and uncertainties in Hounsfield units/stopping power can be integrated in a robust optimization process. Additional changes in patient's anatomy (tumour shrinkage, changes in skin folds in the beam patch, large weight loss or gain) require rescanning. Dosimetric and small clinical studies comparing photon and proton therapy have well shown the interest of proton therapy for head and neck cancers. Intensity-modulated proton therapy is a promising treatment as it can reduce the substantial toxicity burden of patients with head and neck squamous cell carcinoma compared to IMRT. Robust optimization will allow to perform an optimal treatment and to use proton therapy in current clinical practice.
Keywords
Deglutition Disorders/etiology, Deglutition Disorders/prevention & control, Dysgeusia/etiology, Dysgeusia/prevention & control, Head and Neck Neoplasms/radiotherapy, Health Physics, Humans, Hypothyroidism/etiology, Hypothyroidism/prevention & control, Models, Theoretical, Organs at Risk, Proton Therapy, Radiation Injuries/etiology, Radiation Injuries/prevention & control, Radiation Oncology, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Image-Guided, Radiotherapy, Intensity-Modulated/adverse effects, Squamous Cell Carcinoma of Head and Neck/radiotherapy, Translational Medical Research, Uncertainty, Xerostomia/etiology, Xerostomia/prevention & control, Cancers de la tête et du cou, Image-guided, Proton therapy, Protonthérapie, Radiotherapy, Radiothérapie guidée par l’image, Squamous cell carcinoma of head and neck
Pubmed
Web of science
Create date
06/08/2019 16:18
Last modification date
14/10/2019 5:09
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