Tomothérapie des cancers ORL : évaluation scintigraphique prospective de la préservation des glandes salivaires

Cost-effectiveness landscape analysis of treatments addressing xerostomia in patients receiving head and neck radiation therapy

“…A study is ongoing combining the surgical submandibular gland transfer technique (see later description of the Seikaly-Jha procedure for submandibular salivary gland transfer) with tomotherapy-based IMRT, 55 a very promising solution, which might provide a better sparing of the submandibular glands, but remains invasive, time-consuming, and very costly. Newer rotational IMRT techniques, such as volumetric modulated arc therapy and helical tomotherapy, can improve delivered radiation dose, reduce radiation delivery time, and carry potential for a better conformation to the salivary glands: preliminary results in terms of salivary function seem encouraging, 56,57 but there is still a debate as to whether the dosimetric improvements translate into clinical outcome, as compared with standard step-and-shoot IMRT. 58 As a consequence, IMRT certainly reduces xerostomia as per patient survey—from 80% down to 25%–40% incidence, according to 3 recent prospective randomized studies conducted in the UK and in Hong Kong.…”

Innovations en radiothérapie

“…Chaque dosimé-trie est basée sur une planification inverse (RCMI). Les résultats dosimétriques mettent en évidence un gradient de dose plus élevé, une couverture homogène des volumes cibles avec une épargne des tissus sains[1]. La technique permet de réaliser durant une même séance des niveaux de dose différents selon la cible : boost intégré.…”