[Intensity-modulated radiotherapy of head and neck cancers. Dose constraint for spinal cord and brachial plexus].
Given the ballistic opportunities it offers, intensity-modulated radiotherapy has emerged as the gold standard treatment for head and neck cancers. Protection of organs at risk is one of the objectives of optimization during the planning process. The compliance of dose constraints to the nervous system must be prioritized over all others. To avoid complications, it is recommended to respect a maximum dose of 50Gy to the spinal cord, and 60Gy to the brachial plexus using conventional fractionation of 2Gy per fraction. These constraints can be adapted depending on the clinical situation; they will probably be refocused by the follow-up of the IMRT studies.
Département de radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34298 Montpellier, France. Electronic address: pierre.boisselier@icm.unicancer.fr.
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Boisselier
Département de radiothérapie, centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France.
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Racadot
Département de radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France.
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Thariat
Département de radiothérapie, institut universitaire du cancer de Toulouse Oncopôle, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France.
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Graff
Institut interrégional de cancérologie, centre Jean-Bernard, clinique Victor-Hugo, 9, rue Beauverger, 72000 Le Mans, France.
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Pointreau
D001917:Brachial Plexus / Q000528:radiation effects; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000517:prevention & control; D004307:Dose-Response Relationship, Radiation; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D058958:Organs at Risk; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D013116:Spinal Cord / Q000528:radiation effects; D013118:Spinal Cord Diseases / Q000209:etiology / Q000517:prevention & control
Brachial plexus; Head and neck cancer; Intensity-modulated radiotherapy; Moelle épinière; Organ at risk; Organes à risque; Plexus brachial; Radiothérapie conformationnelle avec modulation d’intensité; Spinal cord; Tumeurs des voies aérodigestives supérieures