Boisselier P, Racadot S, Thariat J, Graff P, Pointreau Y
Département de radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34298 Montpellier, France.
Département de radiothérapie, centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France.
Cancer Radiother. 2016 Oct;20(6-7):459-66. doi: 10.1016/j.canrad.2016.08.124. Epub 2016 Sep 7.
Given the ballistic opportunities it offers, intensity-modulated radiotherapy has emerged as the gold standard treatment for head and neck cancers. Protection of organs at risk is one of the objectives of optimization during the planning process. The compliance of dose constraints to the nervous system must be prioritized over all others. To avoid complications, it is recommended to respect a maximum dose of 50Gy to the spinal cord, and 60Gy to the brachial plexus using conventional fractionation of 2Gy per fraction. These constraints can be adapted depending on the clinical situation; they will probably be refocused by the follow-up of the IMRT studies.
鉴于调强放射治疗所提供的精确放疗机会，它已成为头颈部癌症的金标准治疗方法。在计划过程中，保护危及器官是优化的目标之一。对神经系统的剂量限制的遵守必须优先于所有其他方面。为避免并发症，建议采用每次分割2Gy的常规分割方式时，脊髓的最大剂量为50Gy，臂丛神经的最大剂量为60Gy。这些限制可根据临床情况进行调整；它们可能会在调强放射治疗研究的随访中重新聚焦。
