Department of Radiotherapy, Jean-Perrin Centre, 58, rue Montalembert, 63011 Clermont-Ferrand, France.
Department of ENT Surgery, Centre Hospitalier Universitaire Hôpital Gabriel Montpied, 58, rue Montalembert, 63003 Clermont Ferrand, France.
Cancer Radiother. 2021 Jul;25(5):502-506. doi: 10.1016/j.canrad.2020.05.021. Epub 2021 Mar 21.
Intensity modulated radiation therapy for head and neck is a complex technique. Inappropriate delineation and/or dose distribution can lead to recurrences. Analysis of these recurrences should lead to improve clinical practice. For several years, different methods of analysis have been described. The purpose of this review is to describe these different methods and to discuss their advantages and limitations. The first published methods used a volume-based approach studying the entire volume of recurrence according to initial target volumes, or dose distribution. The main limitation of these methods was that the volume of recurrence studied was dependent on the delay in diagnosis of that recurrence. Subsequently, other methods used point-based approaches, conceptualizing recurrence either as a spherical expansion from a core of radioresistant cells (center of mass of recurrence volume) or using a more clinical approach, taking into account tumor expansion pathways. More recently, more precise combined methods have been described, combining the different approaches. The choice of method is decisive for conclusions on the origin of recurrence.
头颈部调强放疗是一种复杂的技术。不适当的勾画和/或剂量分布可能导致复发。对这些复发的分析应导致临床实践的改进。多年来，已经描述了不同的分析方法。本综述的目的是描述这些不同的方法，并讨论它们的优点和局限性。最早发表的方法使用基于体积的方法，根据初始靶区或剂量分布，研究整个复发体积。这些方法的主要局限性是所研究的复发体积取决于复发的诊断延迟。随后，其他方法使用基于点的方法，将复发概念化为从抗辐射细胞核心（复发体积的质心）的球形扩展，或采用更具临床意义的方法，考虑肿瘤扩展途径。最近，更精确的综合方法已经被描述，结合了不同的方法。方法的选择对复发起源的结论至关重要。
