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Book written in french.
In the course of the last 10 years, radiation therapy for cancer has undergone major changes.
In addition to the considerable technical advances obtained in the precision of treatment and the better understanding of the biological mechanisms causing radiosensitivity, recent incidents and accidents have highlighted the importance of keeping our focus on the patient and of the clinical reality of the disease.
There have been major changes in our environment in recent times, in response to the desire expressed by patients to have easier access to information and to the need for stringent application of safety precautions. In addition, because of the increase in the incidence of cancer, often in an elderly population, we will have to adapt our clinical practices for prostate cancers, breast and lung cancers in women and also for brain, ENT and gastrointestinal disease, as these are conditions in which we continue to play a major role.
These strategic aspects combined with the need to justify, optimize and evaluate our practices and treatment choices will bring us to change the way we are organised and force us to become more effective. At the same time, we also have to deal with the increasing lack of availability of both medical and support staff (physicists, operators, etc.).
This book does not claim to cover the entire field of radiotherapy in 2009. However, it provides the basis for further thought and elucidates what is at stake from a biological, technical, organisational and, above all, clinical standpoint in cancer radiotherapy.