[Adaptive radiotherapy in routine: The radiation oncologist's point of view].
Adaptive radiotherapy is defined as all processes leading to the modification of a treatment plan on the basis of patient-specific variations observed during the course of a treatment. This concept is currently of particular relevance due to the development of onboard volumetric imaging systems, which allow for daily viewing of variations in both tumour and organs at risk in terms of position, shape or volume. However, its application in routine clinical practice is limited due to the demanding nature of the processes involved (re-delineation and replanning) and increased dependence on available human resources. Even if "online" strategies, based on deformable image registration (DIR) algorithms, could lead to a reduction in both work and calculation time, for the moment their use is limited to the research field due to uncertainties surrounding the validity of results gathered. Other strategies without DIR can be used as "offline" or "hybrid offline-online" strategies that seem to offer a compromise between time consumption and therapeutic gain for the patient.
Département de radiothérapie, institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux cedex, France. Electronic address: b.henriques@bordeaux.unicancer.fr.
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Henriques de Figueiredo
Département de radiothérapie, institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
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Petit
Département de radiothérapie, institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
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Sargos
Département de radiothérapie, institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
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Kantor
Département de radiothérapie, institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
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Pouypoudat
Institut de mathématiques de Bordeaux, 351, cours de la Libération, 33400 Talence, France; CNRS-UMR 5251, 351, cours de la Libération, 33400 Talence, France; UMR 5251, université de Bordeaux 1, 351, cours de la Libération, 33400 Talence, France.
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Saut
Département de radiothérapie, institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
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Zacharatou
Département de radiothérapie, institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
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Antoine
D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy; D018787:Radiation Oncology; D011880:Radiotherapy Planning, Computer-Assisted
Adaptive radiotherapy; Deformation image registration; Dose cumulée; Dose summation; Radiothérapie adaptative; Recalage déformable