Henriques de Figueiredo B, Petit A, Sargos P, Kantor G, Pouypoudat C, Saut O, Zacharatou C, Antoine M
Département de radiothérapie, institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
Département de radiothérapie, institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
Cancer Radiother. 2015 Oct;19(6-7):446-9. doi: 10.1016/j.canrad.2015.06.016. Epub 2015 Sep 1.
Adaptive radiotherapy is defined as all processes leading to the modification of a treatment plan on the basis of patient-specific variations observed during the course of a treatment. This concept is currently of particular relevance due to the development of onboard volumetric imaging systems, which allow for daily viewing of variations in both tumour and organs at risk in terms of position, shape or volume. However, its application in routine clinical practice is limited due to the demanding nature of the processes involved (re-delineation and replanning) and increased dependence on available human resources. Even if "online" strategies, based on deformable image registration (DIR) algorithms, could lead to a reduction in both work and calculation time, for the moment their use is limited to the research field due to uncertainties surrounding the validity of results gathered. Other strategies without DIR can be used as "offline" or "hybrid offline-online" strategies that seem to offer a compromise between time consumption and therapeutic gain for the patient.
自适应放射治疗被定义为基于在治疗过程中观察到的患者特定变化对治疗计划进行修改的所有过程。由于机载容积成像系统的发展，这一概念目前具有特别的相关性，该系统允许每日观察肿瘤和危及器官在位置、形状或体积方面的变化。然而，由于所涉及过程（重新勾画轮廓和重新计划）的高要求性质以及对可用人力资源的依赖性增加，其在常规临床实践中的应用受到限制。即使基于可变形图像配准（DIR）算法的“在线”策略可能会减少工作量和计算时间，但目前由于所收集结果有效性的不确定性，其应用仅限于研究领域。其他不使用DIR的策略可作为“离线”或“混合离线 - 在线”策略，这些策略似乎在时间消耗和患者治疗获益之间提供了一种折衷方案。
