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• W2923149456 abstract "La radiothérapie adjuvante mammaire s’est imposée comme un standard de prise en charge des cancers du sein, soit en situation post-chirurgicale, soit dans les cancers avec envahissement ganglionnaire. La chaîne mammaire interne est de plus en plus incluse dans les volumes-cibles, du fait d’un gain en survie. Ce gain en survie est cependant à mettre en balance avec les complications cardiaques dans les cancers du sein gauche. La radiothérapie conformationnelle en modulation d’intensité (RCMI) est volontiers employée dans cette indication, de manière à mieux couvrir les volumes-cibles, mais elle tend à majorer les volumes sains irradiés, notamment cardiaques. La dose moyenne cardiaque est plus élevée avec RCMI, alors qu’elle est par ailleurs prédictive d’événements cardiovasculaires chez les patientes traitées en 3D. Cet article a pour but de faire un état des lieux des irradiations de la CMI, ainsi qu’une revue des mécanismes de toxicité cardiaque radio-induite et des moyens de la diagnostiquer précocement. Une coopération entre oncologues médicaux, oncologues radiothérapeutes, et cardiologues est nécessaire de manière à mieux prendre en charge les patientes. Adjuvant radiation therapy in breast cancer is a standard of care, either post-lumpectomy or in case of lymph node involvement. Internal mammary chain (IMC) is more and more included in the clinical target volume, because it increases overall survival. This increase must be weighed against cardiac complications in left breast cancer. Intensity modulated radiation therapy (IMRT) is used in this indication in order to better cover target volumes, but tends to increase irradiated healthy volumes, including the heart. The average cardiac dose is higher with IMRT, while it is also predictive of cardiovascular events in patients treated in 3D. This article aims to make an inventory of the IMC irradiations, as well as a review of the mechanisms of radiation-induced cardiac toxicity and ways to diagnose it early. Cooperation between medical oncologists, radiotherapy oncologists and cardiologists is needed to better support patients." @default.
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• W2923149456 date "2019-04-01" @default.
• W2923149456 modified "2023-10-14" @default.
• W2923149456 title "Complications cardiaques de la radiothérapie mammaire" @default.
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• W2923149456 doi "https://doi.org/10.1016/j.bulcan.2019.01.020" @default.
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