Pointreau Y, Lizée T, Bensadoun R-J, Boisselier P, Racadot S, Thariat J, Graff P
Institut interrégional de cancérologie, centre Jean-Bernard, clinique Victor-Hugo, 9, rue Beauverger, 72000 Le Mans, France.
Institut interrégional de cancérologie, centre Jean-Bernard, clinique Victor-Hugo, 9, rue Beauverger, 72000 Le Mans, France; Institut de cancérologie de l'Ouest Paul-Papin, 15, rue André-Boquel, 49055 Angers cedex 02, France.
Cancer Radiother. 2016 Oct;20(6-7):445-51. doi: 10.1016/j.canrad.2016.07.066. Epub 2016 Sep 7.
Intensity-modulated radiation therapy (IMRT) is the gold standard for head and neck irradiation. It allows better protection to the organs at risk such as salivary glands and mandible, and can reduce the frequency of xerostomia, trismus and osteoradionecrosis. At the time of treatment planning, the mean dose to a single parotid gland should be kept below 26Gy, the mean dose to a single submandibular gland below 39Gy, the mean dose to the mandible below 60 to 65Gy and the D2% to a single temporomandibular joint below 65Gy. These dose constraints could be further improved with data extracted from cohorts of patients receiving IMRT exclusively. The dose administered to the target volumes should not be lessened to spare the salivary glands or mandible.
调强放射治疗（IMRT）是头颈部放疗的金标准。它能更好地保护腮腺和下颌骨等危及器官，并可降低口干、牙关紧闭和放射性骨坏死的发生率。在治疗计划制定时，单个腮腺的平均剂量应保持在26Gy以下，单个下颌下腺的平均剂量在39Gy以下，下颌骨的平均剂量在60至65Gy以下，单个颞下颌关节的D2%在65Gy以下。通过专门接受IMRT治疗的患者队列提取的数据，这些剂量限制可以进一步优化。给予靶区的剂量不应为了保护唾液腺或下颌骨而减少。
