Le traitement non coplanaire apporte-t-il des améliorations significatives par rapport à l’arc-thérapie coplanaire ?

Question

Le traitement non coplanaire apporte-t-il des améliorations significatives par rapport à l’arc-thérapie coplanaire ?

Accepted Answer

Les preuves publiées suggèrent que même si les traitements VMAT donnent une bonne dosimétrie, les traitements VMAT non coplanaires peuvent donner des résultats encore meilleurs, par exemple dans le cancer du poumon^1,2,3 le cancer du sein ^4,5,6 et les cancers ORL^7,8,9.

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[5] Xu, Y., Ma, P., Hu, Z., Tian, Y., Men, K., Wang, S., Xu, Y. and Dai, J. (2021). Non-coplanar volumetric modulated arc therapy for locoregional radiotherapy of left-sided breast cancer including internal mammary nodes. Radiology and Oncology, 55(4), pp.499–507. doi:https://doi.org/10.2478/raon-2021-0045.

[6] A, B., et al. (2023). Dosimetric Comparision of Coplanar versus Noncoplanar Volumetric Modulated Arc Therapy for Treatment of Bilateral Breast Cancers. Journal of medical physics, [online] 48(3). doi:https://doi.org/10.4103/jmp.jmp_36_23.

[7] Biau J, Lopez L, Thivat E, Casile M, Millardet C, Saroul N, Pham-Dang N, Molnar I, Bourhis J, Lapeyre M. Postoperative SBRT in the treatment of early-stage oropharyngeal and oral cavity cancers with high-risk margins: A dosimetric comparison of volumetric modulated arc therapy with or without non-coplanar arcs and acute toxicity outcomes from the STEREOPOSTOP GORTEC 2017-03 phase 2 trial. Clin Transl Radiat Oncol. 2022 Nov 14;38:169-174. doi: 10.1016/j.ctro.2022.11.007. PMID: 36466746; PMCID: PMC9712819.

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[9] Gayen S, Kombathula SH, Manna S, Varshney S, Pareek P. Dosimetric comparison of coplanar and non-coplanar volumetric-modulated arc therapy in head and neck cancer treated with radiotherapy. Radiat Oncol J. 2020 Jun;38(2):138-147. doi: 10.3857/roj.2020.00143. Epub 2020 May 26. PMID: 33012157; PMCID: PMC7533406.