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Master Thesis

Irradiation de métastases cérébrales en conditions stéréotaxiques par rayonnement synchrotron : évaluation dosimétrique d'une technique innovante

Abstract : BACKGROUND: In recent years, innovative radiation techniques have emerged with RC3D, STEREO and IMRT. ESRF has an X-ray source for delivering medical radiation of interest, the SSRT. OBJECTIVES: Perform a dosimetric comparison between these techniques and the SSRT in the absence and in the presence of iodinated contrast agent for stereotactic irradiation of brain metastasis. Perform a dosimetric comparison between STEREO and SSRT / PdCl for 5 patients with brain metastases and evaluate the impact of changes related injuries. PATIENTS AND METHODS: This study is based on five patients aged 34 to 70 years. Prescribing a dose of 23.1 Gy was performed on the 70% isodose with a dose of 33 Gy to the isocenter. The comparison is focused on the shape of the dose and the evaluation of doses to organs at risk. RESULTS: The most optimal treatment for stereotactic irradiation of a single brain metastasis appears to be STEREO. The SSRT / PdCI is very close to the STEREO with coverage of target volumes and preservation of SRO adapted. The observed differences in dose are correlated with the heterogeneity of the tumor contrast enhancement. The disadvantage of the SSRT remains overdose delivered to the bone. CONCLUSION: STEREO must remain the main treatment for single brain metastases. The SSRT in the presence of heavy elements appears to be a promising technique for the treatment of small lesions, with a homogeneous enhancement, a intra-parenchymal central location, away from the bone structures and great vessels.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00877496
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Submitted on : Monday, October 28, 2013 - 4:17:15 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
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  • HAL Id : dumas-00877496, version 1

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Alexandre Tessier. Irradiation de métastases cérébrales en conditions stéréotaxiques par rayonnement synchrotron : évaluation dosimétrique d'une technique innovante. Médecine humaine et pathologie. 2013. ⟨dumas-00877496⟩

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