title: [Metabolic tailoring in radiotherapy for head and neck cancer].
abstract: Radiotherapy based on functional imaging consists to deliver a heterogeneity dose based on biological proprieties. This approach is termed biologically conformal radiotherapy or dose painting with biological target volume inside the gross tumor volume. Diffusion-weighted magnetic resonance imaging (MRI) and dynamic contrast-enhanced MRI can also be used to define a specific biological target volume. Three main tracers are used: ((18)F)-fluorodeoxyglucose to target the hypermetabolism, ((18)F)-fluoromizonidazole and ((18)F)- fluoroazomycin arabinoside to target areas of hypoxia. In this review, we give a practical approach to achieving a treatment-guided radiotherapy molecular and the main issues raised by this imaging technique. Despite the provision of all the technological tools to the radiotherapist, this new therapeutic approach is still evaluated in clinical studies to demonstrate a real clinical benefit compared to radiotherapy based on anatomic imaging.
authors.affiliation: Service de radiothérapie, hôpital Jean-Minjoz, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France. Electronic address: stephanie.servagi@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Servagi-Vernat
authors.affiliation: Service d'oncologie radiothérapie, hôpital européen George-Pompidou, université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Giraud
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000378:metabolism / Q000532:radiotherapy; D015687:Cell Hypoxia; D002986:Clinical Trials as Topic; D038524:Diffusion Magnetic Resonance Imaging; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000532:radiotherapy*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008920:Misonidazole / Q000031:analogs & derivatives; D064847:Multimodal Imaging; D009593:Nitroimidazoles; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D047368:Tumor Burden
chemical_list: D005462:Fluorine Radioisotopes; D009593:Nitroimidazoles; D019275:Radiopharmaceuticals; C031843:fluoromisonidazole; D019788:Fluorodeoxyglucose F18; C498052:fluoroazomycin arabinoside; D008920:Misonidazole
keywords: Dose painting; Hypermetabolism; Hypoxia; Hypoxie; IRM; Imagerie moléculaire; MRI; Positron emission tomography; Radiothérapie guidée par l’imagerie fonctionnelle; Tomographie par émission de positons (TEP)