[Practical recommendations for breathing-adapted radiotherapy]. / Bonnes pratiques pour la radiothérapie asservie à la respiration.

Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumor sites affected by respiratory motion such as lung, breast and liver tumors. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart...) is expected. Respiratory gating is in line with the need for improved precision required by radiotherapy techniques such as 3D conformal radiotherapy or intensity modulated radiotherapy. Reduction of respiratory motion can be achieved by using either breath-hold techniques or respiration synchronized gating techniques. Breath-hold techniques can be achieved with active techniques, in which airflow of the patient is temporarily blocked by a valve, or passive techniques, in which the patient voluntarily holds his/her breath. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. This work summarizes the different experiences of the centers of the STIC 2003 project. It describes the different techniques, gives an overview of the literature and proposes a practice based on our experience.

New beam monitoring tool for radiobiology experiments at the cyclotron ARRONAX.

The ARRONAX cyclotron is able to deliver alpha particles at 68 MeV. In the frame of radiological research, a new method is studied to infer in situ the deposited dose: it is based on the online measurement of the bremsstrahlung (>1 keV) produced by the interaction of the incident particle with the medium. Experiments are made using bombarded poly(methyl methacrylate) (PMMA)-equivalent water targets in order to characterise this continuous X-ray spectrum. The intensity of the bremsstrahlung spectrum allows for the beam monitoring. A simulation code of the bremsstrahlung has been built, and a good agreement is found with the experimental spectra. With this simulation, it is possible to predict the sensibility of this method: it varies with the target thickness, showing a good sensibility for thin target (<1000 µm) and saturation for thicker ones. Bremsstrahlung spectrum also shows a sensibility on the target's chemical composition.

[Quality control during radiation therapy]. / Le contrôle de qualité en cours d'irradiation.

The aim of quality control procedures during radiation therapy is to check the consistency between actual and prescribed treatments. Given the technical complexity of modern radiotherapy, stricter policies are necessary to meet increasing requirements for quality and safety. Among the various tools available, electronic imaging systems play an increasing role in patient-beam position checking and in vivo dose measurements. Written procedures will have to be established in order to describe the control modalities and frequency, as well as the rules for error corrections according to the treatment intent. Non medical staff will be devoted to new tasks, under the radiation oncologist's responsibility. A special attention should be directed at electronic archives, since the present technology is unlikely to meet the legal requirement to keep medical records accessible for at least 30 years.

EBT2 films response to alpha radiation at 48.3 MeV.

To advance the development of a radiobiological experimental set-up for alpha particle irradiations at the Arronax cyclotron, experiments were performed to get the dose response of Gafchomic EBT2 films for alpha particles at 48.3 MeV. A system has been developed using a thin monitor copper foil and an X-ray spectrometer to measure the beam intensity and to calculate the delivered dose. On the other hand, the authors have irradiated EBT2 films, with 6-MV X rays, to get the dose response of EBT2 films for photons. The dose response curve for alpha particles shows an effect of polymerisation saturation compared with the dose response curve for photons.