title: [Radiotherapy promises: focus on lung cancer].
abstract: Radiotherapy is a key cancer treatment, which greatly modified its practice in recent years thanks to medical imaging and technical improvements. The systematic use of computed tomography (CT) for treatment planning, the imaging fusion/co-registration between CT/magnetic resonance imaging (MRI) or CT/positron emission tomography (PET) improve target identification/selection and delineation. New irradiation techniques such as image-guided radiotherapy (IGRT), stereotactic radiotherapy or hadron therapy offer a more diverse therapeutic armamentarium to patients together with lower toxicity. Radiotherapy, as well as medical oncology, tends to offer a personalized treatment to patients thanks to the IGRT, which takes into account the inter- or intra-fraction anatomic variations. IGRT leads to adaptive radiotherapy (ART) with a new planification in the treatment course in order to decrease toxicity and improve tumor control. The use of systemic therapies with radiations needs to be studied in order to improve efficiency without increasing toxicities from these multimodal approaches. Finally, radiotherapy advances were impacted by radiotherapy accidents like Epinal. They led to an increased quality control with the intensification of identity control, the emergence of in vivo dosimetry or the experience feedback committee in radiotherapy. We will illustrate through the example of lung cancer.
authors.affiliation: Centre Oscar-Lambret, université Lille 2, département universitaire de radiothérapie, 3, rue Frédéric-Combemale, 59000 Lille, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Jouin
authors.forename: Jérôme
authors.initials: J
authors.lastname: Durand-Labrunie
authors.forename: Thomas
authors.initials: T
authors.lastname: Leroy
authors.forename: Diane
authors.initials: D
authors.lastname: Pannier
authors.forename: Antoine
authors.initials: A
authors.lastname: Wagner
authors.forename: Erwan
authors.initials: E
authors.lastname: Rault
authors.forename: Eric
authors.initials: E
authors.lastname: Lartigau
mesh_terms: D059248:Chemoradiotherapy; D056973:Four-Dimensional Computed Tomography; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D058990:Molecular Targeted Therapy; D049268:Positron-Emission Tomography / Q000379:methods; D061766:Proton Therapy; D011786:Quality Control; D016634:Radiosurgery / Q000379:methods; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods
keywords: image-guided radiotherapy; lung cancer; multimodal treatment; quality control; stereotactic radiotherapy