Radiothérapie externe; Radiothérapie FLASH; Radiobiologie; Distribution de la dose; Optimisation de la dose; External beam radiation therapy; Dose optimization; Dose distribution; Radiobiology; FLASH radiotherapy
Abstract :
[fr] La radiothérapie s’est installée au 20ème siècle comme une modalité incontournable dans la lutte contre le cancer. Les avancées technologiques majeures des dernières décennies ont permis une amélioration considérable de la fenêtre thérapeutique. Elles ont également ouvert la voie à la radiothérapie stéréotaxique et à de nouvelles indications. Cet article a pour objectif de permettre aux lecteurs de comprendre la radiothérapie externe en 2021 et d’en appréhender les enjeux de demain. Trois axes d’amélioration de la discipline seront décrits, l’optimisation de la dose thérapeutique prescrite, l’amélioration de la distribution de cette dose et, finalement, la meilleure compréhension de la radiobiologie. Pour chacun de ces axes, des implications actuelles seront données ainsi que celles qui pourraient/ devraient avoir un impact sur la radiothérapie future. La radiothérapie FLASH sera, par exemple, abordée. [en] Radiotherapy established itself in the 20th century as an essential modality in the fight against cancer. The major technological advances of the last decades have allowed a considerable improvement in the therapeutic window. They have also paved the way for stereotactic radiotherapy and new indications. The aim of this article is to enable readers to understand external radiotherapy in 2021 and to understand the challenges of tomorrow. Three areas of improvement in the discipline will be described, the optimization of the prescribed therapeutic dose, the improvement of the distribution of this dose and, finally, the better understanding of radiobiology. For each of these axes, the current implications will be described as well as those which could/should have a major impact on the radiotherapy. FLASH radiotherapy will also be discussed.
Disciplines :
Oncology
Author, co-author :
Colin, Gilles ; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiothérapie
COUCKE, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiothérapie
Language :
French
Title :
Comment améliorer la radiothérapie ? évolutions teChnologiques et radiothérapie de demain
Alternative titles :
[en] how to improve radiotherapy ? teChnologiCal developments and radiotherapy of tomorrow
Publication date :
2021
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Belgium
Bernier J, Hall EJ, Giaccia A. Radiation oncology: A century of achievements. Nat Rev Cancer 2004;4:737-47.
Thariat J, Hannoun-Levi JM, Sun Myint A, et al. Past, present, and future of radiotherapy for the benefit of patients. Nat Rev Clin Oncol 2013;10:52-60.
Coucke PA, Withofs N, Jansen N, Janvary ZL, Hustinx R. Vers une radiothérapie chirurgicale: nécessité d’une radiothérapie guidée par l’imagerie. Rev Med Liege 2010;65:17-22.
Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy for the comprehensive treatment of oligometastatic cancers: Long-term results of the SABR-COMET Phase II randomized trial. J Clin Oncol 2020;38:2830-8.
Jaffray DA. Image-guided radiotherapy: From current concept to future perspectives. Nat Rev Clin Oncol 2012;9:688-99.
Bolle S, Louis C, Coucke PA. Innovations technologiques en radiothérapie-oncologie. Rev Med Liege 2007;62:399-404.
Coucke P, Martinive P. La radiobiologie pour les néophytes. Rev Med Liege 2014;69:16-9.
Lallemand F, Lakosi F, Hustinx R, Withofs N, Meunier P, Tshibanda L, et al. Utilisation de l’imagerie fonctionnelle en radiothérapie. Rev Med Liege 2014;69:20-8.
Murray Brunt A, Haviland JS, Wheatley DA, et al. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet 2020;395:1613-26.
Goodwin A, Parker S, Ghersi D, Wilcken N. Post-operative radiotherapy for ductal carcinoma in situ of the breast. Cochrane Database Syst Rev 2013;11:CD000563.
Kunkler IH, Williams LJ, Jack WJ, et al. Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): A randomised controlled trial. Lancet Oncol 2015;16:266-73.
Kimple RJ, Smith MA, Blitzer GC, et al. Enhanced radiation sensitivity in HPV-positive head and neck cancer. Cancer Res 2013;73:4791-800.
Baumann M, Krause M, Overgaard J, et al. Radiation oncology in the era of precision medicine. Nat Rev Cancer 2016;16:234-49.
Batista V, Meyer J, Kügele M, Al-Hallaq H. Clinical paradigms and challenges in surface guided radiation therapy: Where do we go from here? Radiother Oncol 2020;153:34-42.
Nutting CM, Morden JP, Harrington KJ, et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): A phase 3 multicentre randomised controlled trial. Lancet Oncol 2011;12:127-36.
Zelefsky MJ, Levin EJ, Hunt M, et al. Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2008;70:1124-9.
Senthi S, Lagerwaard FJ, Haasbeek CJA, et al. Patterns of disease recurrence after stereotactic ablative radiotherapy for early stage non-small-cell lung cancer: A retrospective analysis. Lancet Oncol 2012;13:802-9.
Cao C, Wang D, Chung C, et al. A systematic review and meta-analysis of stereotactic body radiation therapy versus surgery for patients with non-small cell lung cancer. J Thorac Cardiovasc Surg 2019;157:362-73.
Theelen WS, Chen D, Verma V, et al. Pembrolizumab with or without radiotherapy for metastatic non-small-cell lung cancer: a pooled analysis of two randomised trials. Lancet Respir Med 2020;2600:1-9.
Durante M, Orecchia R, Loeffler JS. Charged-particle therapy in cancer: Clinical uses and future perspectives. Nat Rev Clin Oncol 2017;14:483-95.
de Mol van Otterloo SR, Christodouleas JP, Blezer ELA, et al. The MOMENTUM study: an international registry for the evidence-based introduction of MR-guided adaptive therapy. Front Oncol 2020;10:1328.
Cuculich PS, Schill MR, Kashani R, et al. Noninvasive cardiac radiation for ablation of ventricular tachycardia. N Engl J Med 2017;377:2325-36.
Machiels JP, René Leemans C, Golusinski W, et al. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2020;31:1462-75.
Bentzen SM. Preventing or reducing late side effects of radiation therapy: Radiobiology meets molecular pathology. Nat Rev Cancer 2006;6:702-13.
Bonvalot S, Rutkowski PL, Thariat J, et al. NBTXR3, a first-in-class radioenhancer hafnium oxide nanoparticle, plus radiotherapy versus radiotherapy alone in patients with locally advanced soft-tissue sarcoma (Act.In.Sarc): a multicentre, phase 2-3, randomised, controlled trial. Lancet Oncol 2019;20:1148-59.
Alexander MS, Wilkes JG, Schroeder SR, et al. Pharmacologic ascorbate reduces radiation-induced normal tissue toxicity and enhances tumor radiosensitization in pancreatic cancer. Cancer Res 2018;78:6838-51.
Cosset JM, Deutsch E. Low-dose irradiation of non-malignant diseases: Did we throw the baby out with the bathwater ? Cancer Radiother 2021;25(3):279-282.
Hess CB, Buchwald ZS, Stokes W, et al. Low-dose whole-lung radiation for COVID-19 pneumonia: Planned day 7 interim analysis of a registered clinical trial. Cancer 2020;126:5109-13.
Favaudon V, Caplier L, Monceau V, et al. Ultrahigh dose-rate FLASH irradiation increases the differential response between normal and tumor tissue in mice. Sci Transl Med 2014;6:245ra93.
Maxim PG, Tantawi SG, Loo BW. PHASER: A platform for clinical translation of FLASH cancer radiotherapy. Radiother Oncol 2019;139:28-33.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.
