Fiche publication
Date publication
novembre 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Pr PEIFFERT Didier
Tous les auteurs :
Renard-Oldrini S, Guinement L, Salleron J, Brunaud C, Huger S, Grandgirard N, Villani N, Marchesi V, Oldrini G, Peiffert D
Lien Pubmed
Résumé
PURPOSE: Intensity-modulated radiotherapy (IMRT) has proven its dosimetric superiority over conformational radiotherapy for cervix cancers in terms of digestive toxicity. Volumetric modulated arctherapy (VMAT) has shown its dosimetric interest when compared to IMRT with static beams. The purpose of our study was to compare conformational radiotherapy, VMAT and tomotherapy for cervical cancers with para-aortic lymph nodes irradiation. PATIENTS AND METHODS: The dosimetric data from ten patients were compared between the three techniques, with collection of the dose received by the planning target volume, kidneys, bowel, rectum, bladder, bone marrow and spinal cord, as well as the complete dose. RESULTS: There was a significant difference in favour of VMAT and tomotherapy when compared with conformational radiotherapy for the organs at risk: intestines (V20 Gy, V30 Gy and V45 Gy), rectum (V30 Gy and V45 Gy), bladder (V30 Gy and V45 Gy) and kidneys (V12 Gy, Daverage, V20 Gy). Volumes receiving 20, 30 and 45Gy were significantly higher in conformational radiotherapy than in VMAT and tomotherapy. There was a significant difference in favour of tomotherapy when compared with VMAT for V12 Gy in kidneys and V45 Gy in the bladder. CONCLUSION: This study confirms the interest of VMAT and tomotherapy for pelvic and para-aortic lymph nodes irradiation of cervix cancer when compared with conformational radiotherapy. There was little difference between VMAT and tomotherapy, except for kidney sparing, which was better with tomotherapy and thus may be interesting for patients receiving nephrotoxic chemotherapy.
Référence
Cancer Radiother. 2015 Nov 4. pii: S1278-3218(15)00373-X
