title: [Intensity-modulated radiotherapy in head and neck cancer: ethics and methodology].
abstract: Numerous studies have shown that intensity-modulated radiation therapy is the standard technique for the radiation treatment of head and neck cancers. Intensity-modulated radiation therapy reduces side effects (xerostomia, dysphagia, fibrosis, etc.) and improves the results for cancer localizations with highly complex shapes such as the cavum or nasal cavity. Intensity-modulated radiation therapy is also a costly technique that necessitates a numerous staff, highly trained, with regular practice. If this technique cannot be available (understaffing, overwork, etc.) the choice between entrusting the patient to a colleague and treating the patient with a less sophisticated technique such as 3-dimensional conformal radiation therapy depends on different objective and ethical criteria.
authors.affiliation: Département de radiothérapie, centre Jean-Perrin, BP 5026, 58, rue Montalembert, 63011 Clermont-Ferrand cedex 1, France. Electronic address: michel.lapeyre@cjp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Lapeyre
authors.affiliation: Département de radiothérapie, centre Jean-Perrin, BP 5026, 58, rue Montalembert, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Biau
authors.affiliation: Département de radiothérapie, centre Jean-Perrin, BP 5026, 58, rue Montalembert, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Miroir
authors.affiliation: Service de radiothérapie, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon, France.
authors.forename: S
authors.initials: S
authors.lastname: Servagi-Vernat
authors.affiliation: Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Giraud
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005602:France; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D059032:Learning Curve; D058958:Organs at Risk; D010360:Patient Transfer / Q000941:ethics; D017410:Practice Guidelines as Topic; D011832:Radiation Injuries / Q000517:prevention & control; D018787:Radiation Oncology / Q000193:education; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000191:economics / Q000941:ethics / Q000379:methods*; D013675:Technology, High-Cost / Q000941:ethics; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control
chemical_list: D000970:Antineoplastic Agents
keywords: Ethics; Head and neck; IMRT; ORL; RCMI; Radiotherapy; Radiothérapie; Éthique