The Eugène Marquis Centre supports patients throughout their treatment. Your care will be carried out across various stages. You will be given a lot of information — please feel free to ask questions. The medical and paramedical team are on hand to respond to all your questions and needs.
More than half of all cancer patients receive radiotherapy at some stage during their care. Each year in France, more than 175,000 patients receive radiotherapy.
Just like surgery, radiotherapy is a local therapy for cancer, meaning that it targets the cancerous cells in the affected organ and/or lymph nodes. It uses ionising rays to destroy the cancer cells and prevent them from multiplying. The rays are directed precisely onto the treatment zone, which helps protect the surrounding healthy tissue (the organs at risk). The radiotherapy team works closely with the medical physics team to manage the dose and ensure that you and staff are protected against harmful radiation exposure.
In 2016, the department treated:
2,200 patients with external radiotherapy, across 35,998 sessions
2,018 patients received treatment in 2016, compared with 1,613 in 2013
Over that period, the medical team conducted 8,270 consultations (with new and existing patients).
There are two types of radiotherapy:
During the first stage, you will have a consultation with your radiotherapist, an assessment will be performed and your case will be discussed at the multidisciplinary team meeting (RCP) [Réunion de Concertation Pluridisciplinaire].
Your doctor does not decide on their own what treatment to give you. Your file will be discussed at a multidisciplinary team meeting. The meeting is attended by doctors from at least three different specialist areas (surgeon, medical oncologist, oncological radiotherapist, specialist on the affected organ, pathologist, etc.). Drawing on previous experience, the attendees will design a treatment plan suited to your particular case.
Your doctor will tell you about how the irradiation will be carried out and what the possible side effects are. They will also give you a Personalised Care Plan [Plan Personnalisé de Soins].
TBI involves radiotherapy of the entire body. It is used to treat blood diseases, in combination with chemotherapy, followed by a graft. This technique is used as a preparatory treatment before a bone marrow transplant.
The organs in the thorax move when you breathe. The greater the movement during a breath, the bigger the area that is exposed to radiation and the larger the volume of healthy tissue that is irradiated. Respiratory-gated radiotherapy is primarily used in patients with cancer in the left breast to ensure that the heart is kept away from the tumour during irradiation.
This technique allows the target area to be more accurately pinpointed by the beams of radiation, thereby protecting the healthy organs.
The tumour is irradiated only during pauses in the patient’s breathing. With training, the patient is therefore able to play a role in their treatment.
There are two forms of stereotactic radiotherapy: intracranial and extracranial.
Stereotactic radiotherapy involves the delivery of very high doses of precisely-targeted radiation using microbeams that converge on the tumour. It allows high doses to be delivered in very small volumes. It is combined with highly precise imaging systems.
It is used primarily to treat certain types of brain, lung and liver cancer.
The radiation can be delivered in a single session or across multiple sessions (usually three to six).
At the Eugène Marquis Centre, stereotactic techniques are used with two pieces of equipment: the CyberKnife® and the Versa HD®.
The radiotherapy department at the Eugène Marquis Centre is the leading centre in the region for the irradiation of tumours in children.
Paediatric radiotherapy is coordinated by the regional paediatric oncology network based in the oncology and haematology department of Rennes Southern Hospital [Hôpital Sud à Rennes].
Between 35 and 40 children are treated every year in the Centre’s radiotherapy department. The department receives patients aged between 1 and 17 years, with an average age of 11. Brain cancer, leukaemia, bone cancer, sarcoma and Hodgkin’s lymphoma represent 80% of the paediatric cancers that are treated with radiotherapy in the department.
Treatment decisions are made following consultation between regional experts via a weekly videoconference.
Radiotherapy is rarely prescribed for children; only 800 to 900 children are given radiotherapy in France each year. Paediatric radiotherapy requires special equipment, facilities, time and training. In 2015, there were 17 centres in France qualified to deliver paediatric radiotherapy.
Since 2003, the Eugène Marquis Centre has offered a treatment known as conformal intensity-modulated radiation therapy (IMRT). This technique allows the radiation to be precisely adapted to the shape of the tumour. The dose delivered to the tumour can therefore be increased in order to improve localised control over the tumour, while reducing the dose delivered to surrounding healthy tissue, thereby lessening any side effects.
Since 2009, the Centre has also used volumetric arc therapy. This is a more advanced form of IMRT which combines:
Continual rotation of the accelerator arm around the patient;
Real-time changes in the intensity of the radiation;
Real-time changes in the shape of the beam to take account of the organs in the beam path.
The main advantage of this technique over IMRT is that irradiation is quicker, thereby reducing the risk of the patient or their internal structures moving.
Image-guided radiotherapy involves the acquisition of images during irradiation, which allows the tumour to be precisely targeted during treatment. The target is adjusted to match the body and the position of the tumour during irradiation.
An imaging system is built into the accelerator which monitors the position of the target.
In clinical situations, three methods may be used to pinpoint the area to be treated:
Radiological images can be taken to identify the bone structures around the target.
Fiducial markers can be placed on the target (the prostate, liver, lung, etc.)
Cone beam computed tomography (CBCT) imaging can be added to the accelerator to image the target in 3D, like a CT scan.
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