Irradiation corporelle totale : présent et avenir [Total body irradiation: present and future]

Détails

ID Serval
serval:BIB_47B085C31ED5
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Irradiation corporelle totale : présent et avenir [Total body irradiation: present and future]
Périodique
Cancer Radiothérapie
Auteur(s)
Zilli T., Miralbell R., Ozsahin M.
ISSN
1769-6658[electronic]
Statut éditorial
Publié
Date de publication
2009
Volume
13
Numéro
5
Pages
428-433
Langue
français
Résumé
Total body irradiation (TBI) has an established role as preparative regimen for bone-marrow transplantation in the treatment of hematological malignancies. Many randomized trials demonstrated that the clinical outcomes obtained from the association of TBI and cyclophosphamide are equivalent, or, sometimes, better than those based on chemotherapeutic agents. Despite the therapeutic progress of the last years, and the consequent improvement in the overall survival, this preparative regimen remains always associated with a relatively high rate of acute and late toxicity. In this article, we review the actual indications of TBI in clinical practice, and analyze the technological progress in this domain. We focus on the hypothesis that a selective irradiation of the hematopoietic or lymphoid organs is actually possible with intensity-modulated radiotherapy. Technical limits and preliminary results in terms of acute and late toxicities of intensity-modulated TBI are analyzed. With these new technologies, treatment-related toxicity is not anymore a major limiting factor in the preparative regimens for bone-marrow transplantation, allowing for a larger spectrum of TBI indications, a possible extension to patients older than 50 years, or a dose escalation. Preliminary results warrant, however, further evaluation in clinical trials to better assess the impact of this new approach on disease control and the long-term toxicity.
Mots-clé
Bone Marrow Transplantation, Cyclophosphamide/therapeutic use, Forecasting, Humans, Immunosuppressive Agents/therapeutic use, Radiotherapy, Intensity-Modulated/adverse effects, Radiotherapy, Intensity-Modulated/methods, Transplantation Conditioning/adverse effects, Transplantation Conditioning/methods, Whole-Body Irradiation/adverse effects, Whole-Body Irradiation/methods
Pubmed
Web of science
Création de la notice
09/02/2010 17:41
Dernière modification de la notice
03/03/2018 16:50
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