[Intensity-modulated radiotherapy of head and neck cancers. Dose constraint for spinal cord and brachial plexus]

Abstract

Given the ballistic opportunities it offers, intensity-modulated radiotherapy has emerged as the gold standard treatment for head and neck cancers. Protection of organs at risk is one of the objectives of optimization during the planning process. The compliance of dose constraints to the nervous system must be prioritized over all others. To avoid complications, it is recommended to respect a maximum dose of 50Gy to the spinal cord, and 60Gy to the brachial plexus using conventional fractionation of 2Gy per fraction. These constraints can be adapted depending on the clinical situation; they will probably be refocused by the follow-up of the IMRT studies.

Keywords: Brachial plexus; Head and neck cancer; Intensity-modulated radiotherapy; Moelle épinière; Organ at risk; Organes à risque; Plexus brachial; Radiothérapie conformationnelle avec modulation d’intensité; Spinal cord; Tumeurs des voies aérodigestives supérieures.