Adaptive radiation therapy: When, how and what are the benefits that literature provides?

To identify from the current literature when is the right time to replan and to assign thresholds for the optimum process of replanning. Nowadays, adaptive radiotherapy (ART) for head and neck cancer plays an exceptional role consisting of an evaluation procedure of the prominent anatomical and dosi...

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Bibliographic Details
Published in:Cancer radiothérapie 2022-06, Vol.26 (4), p.622-636
Main Authors: Avgousti, R., Antypas, C., Armpilia, C., Simopoulou, F., Liakouli, Z., Karaiskos, P., Kouloulias, V., Kyrodimos, E., Moulopoulos, L.A., Zygogianni, A.
Format: Article
Language:English
Subjects:
Adaptive radiotherapy
Anatomic changes
Cancer de la tête et du cou
Changements anatomiques
Changements dosimétriques
Dosimetric changes
Head and neck cancer
Head and Neck Neoplasms - radiotherapy
Humans
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - methods
Radiotherapy, Image-Guided - methods
Radiotherapy, Intensity-Modulated - methods
Radiothérapie adaptative
Temps d’adaptation
Time of adaptation
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Summary:To identify from the current literature when is the right time to replan and to assign thresholds for the optimum process of replanning. Nowadays, adaptive radiotherapy (ART) for head and neck cancer plays an exceptional role consisting of an evaluation procedure of the prominent anatomical and dosimetric variations. By performing complex radiotherapy methods, the credibility of the therapeutic result is crucial. Image guided radiotherapy (IGRT) was developed to ensure locoregional control and thus changes that might occur during radiotherapy be dealt with. An electronic research of articles published in PubMed/MEDLINE and Science Direct databases from January 2004 to October 2020 was performed. Among a total of 127 studies assessed for eligibility, 85 articles were ultimately retained for the review. The most noticeable changes have been reported in the middle fraction of the treatment. Therefore, the suggested optimal time to replan is between the third and the fourth week. Anatomical deviations>1cm in the external contour, average weight loss>10%, violation in the dose coverage of the targets>5%, and violation in the dose of the peripherals were some of the thresholds that are currently used, and which lead to replanning. ART may decrease toxicity and improve local-control. Whether it is beneficial or not, depends ultimately on each patient. However, more investigation of the changes should be performed in future prospective studies to obtain more accurate results. L’objectif de cet article est, après une recherche bibliographique approfondie, de déterminer le moment le plus adéquat pour réviser et modifier un plan de traitement et, en même temps, attribuer des seuils au processus de traitement. À nos jours, la radiothérapie adaptative, pour le cancer de la tête et du cou, joue un rôle important qui consiste en une procédure d’évaluation des variations anatomiques et leurs conséquences dosimétriques. En appliquant des méthodes de radiothérapie complexes, la crédibilité du résultat thérapeutique est cruciale. La radiothérapie guidée par l’image (IGRT) a été développée pour assurer un contrôle locorégional et ainsi traiter les changements qui peuvent survenir pendant la radiothérapie. Une recherche électronique des articles, publiés dans les bases de données PubMed/MEDLINE et Science Direct, depuis janvier 2004 jusqu’à octobre 2020, a été effectuée. Sur un total de 127 études évaluées pour l’éligibilité, 85 articles ont finalement été retenus pour la revu
ISSN:1278-3218
1769-6658
DOI:10.1016/j.canrad.2021.08.023