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Radiotherapie du cancer bronchique non a petites cellules: Definitions des volumes, selection des patients. Recommandations de l'International Association for the Study of Lung Cancer (IASLC) workshop, Annecy 1998

par Mornex, Françoise;Van Houtte, Paul ;Scalliet, Pierre;Loubeyre, P.
Référence Cancer radiothérapie, 2, 5, page (579-589)
Publication Publié, 1998-09

Article révisé par les pairs

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Résumé :

Chemoradiation is the standard treatment of unresectable, locally advanced non-small cell lung cancer, with a mean dose of 60-66 Gy, excluding escalation dose schemes. The standard treated volume includes primary tumor, ipsilateral hilar and mediastinal nodes, supraclavicular and contralateral nodes as well, regardless of the node status. This work tries to answer the question of the optimal volume to be treated. Drainage routes analysis is in favor of large volumes, while toxicity analysis favors small volumes. Combined modality treatment may increase the observed toxicity. The optimal volume definition is difficult, and requires available conformal therapy tools. Patients selection is another important issue. A volume definition is then attempted, based on the IASLC (International Association for the Study of Lung Cancer) Annecy workshop experience, highlighting the interobservers discrepancies, and suggests basic recommendations to harmonize volume definition.