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Dosimétrie Basée Sur L'imagerie Pour L'optimisation De La Thérapie Photodynamique Pour Le Mésothéliome Pleural Malin

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Dosimétrie Basée Sur L'imagerie Pour L'optimisation De La Thérapie Photodynamique Pour Le Mésothéliome Pleural Malin Dosimétrie basée sur l’imagerie pour l’optimisation de la thérapie photodynamique pour le mésothéliome pleural malin Camille Munck To cite this version: Camille Munck. Dosimétrie basée sur l’imagerie pour l’optimisation de la thérapie photodynamique pour le mésothéliome pleural malin. Médecine humaine et pathologie. Université du Droit et de la Santé - Lille II, 2017. Français. NNT : 2017LIL2S050. tel-01967622 HAL Id: tel-01967622 https://tel.archives-ouvertes.fr/tel-01967622 Submitted on 1 Jan 2019 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. UNIVERSITE LILLE 2 DROIT ET SANTE ECOLDE DOCTORALE BIOLOGIE SANTE DE LILLE Année : 2017 THESE D'UNIVERSITE Dosimétrie basée sur l'imagerie pour l'optimisation de la thérapie photodynamique pour le mésothéliome pleural malin Discipline : Physique CNU : Cancérologie ; Radiothérapie Présentée et soutenue publiquement le 5 Décembre 2017 par Camille MUNCK Thèse dirigée par Monsieur le Professeur Serge MORDON et Monsieur le Professeur Arnaud SCHERPEREEL JURY Rapporteurs : Madame le Docteur Geneviève BOURG-HECKLY Monsieur le Professeur Fabrice BARLESI Membres du Jury : Madame le Professeur Françoise LE PIMPEC-BARTHES Monsieur le Professeur Arnaud SCHERPEREEL Monsieur le Professeur Serge MORDON Camille MUNCK - Thèse de sciences Camille MUNCK - Thèse de sciences Camille MUNCK - Thèse de sciences Camille MUNCK - Thèse de sciences A mes Directeurs de Thèse Pr Serge MORDON Pr Arnaud SCHERPEREEL Je vous remercie d’avoir accepté de « co-diriger » ma thèse. Tout commença un jour, il y’a quelques années, à partir de votre rencontre dans un avion au retour d’un congrès, et voici aujourd’hui un magnifique projet mené à terme, et à poursuivre ! Merci pour votre investissement. Camille MUNCK - Thèse de sciences Camille MUNCK - Thèse de sciences Aux Rapporteurs et Membres du Jury Dr Geneviève BOURG-HECKLY Pr Fabrice BARLESI Pr Françoise LE PIMPEC-BARTHES Je vous remercie d’avoir accepté de suivre ce projet et d’en être les juges. Camille MUNCK - Thèse de sciences Camille MUNCK - Thèse de sciences A tous ceux qui m’ont accompagnée pendant ce travail Nacim Je te remercie de m’avoir accompagnée et encouragée depuis le Master 2 jusqu’à la thèse. C’est certainement toi qui m’a transmis ta passion pour la recherche et qui a donné tous les reliefs à ce projet. Merci pour ton amitié et ta confiance. Anne-Sophie, Greg, Maximilien, Jean-Claude, Pascal, Bertrand Merci pour votre accueil au sein de l’unité, votre bonne humeur et pour votre aide au projet. Clément, Elise, Laura, Claire et tous les masters 2 rencontrés au fil des années Merci pour tous ces bons moments passés ensemble à l’unité et en terrasse, qui ont contribué à l’aboutissement de cette thèse. Wael Merci d’avoir rejoint ce projet en cours de route et pour ton aide. A tous mes confrères pneumologues Merci pour votre soutien. A mes confrères chirurgiens thoraciques Merci d’avoir rendu ce projet clinique possible. Camille MUNCK - Thèse de sciences Camille MUNCK - Thèse de sciences Antoine Merci pour ta patience et ton soutien. Ma famille Merci pour vos encouragements. Camille MUNCK - Thèse de sciences Camille MUNCK - Thèse de sciences Table des matières Résumé .................................................................................................................................................... 1 Préambule ............................................................................................................................................... 5 Abréviations ............................................................................................................................................ 6 Introduction générale ............................................................................................................................. 7 Dosimétrie de lumière : rappels et définitions...................................................................................... 10 Modélisation de l'interaction de la lumière avec un milieu .................................................................. 11 PARTIE I La thérapie photodynamique pour le mésothéliome pleural malin: d’hier à aujourd'hui et vers un essai clinique Introduction de la partie I ..................................................................................................................... 16 Chapitre 1 : Place de la thérapie photodynamique dans le traitement du mésothéliome pleural malin ...................................................................................................................................................... 17 1. Introduction ................................................................................................................................... 17 2. Présentation du mésothéliome pleural malin ............................................................................... 18 2.1. Epidémiologie et présentation clinique ................................................................................. 18 2.2. Prise en charge thérapeutique ............................................................................................... 21 3. Thérapie photodynamique intrapleurale ...................................................................................... 25 3.1. Principes de la thérapie photodynamique ............................................................................. 25 3.2. La thérapie photodynamique intrapleurale en pratique ....................................................... 27 4. Thérapie photodynamique et mésothéliome pleural malin : Etat de l'art .................................... 31 4.1. Présentation des articles sélectionnés ................................................................................... 31 4.2. Toxicité ................................................................................................................................... 33 4.3. Evolution technique de la PDT intrapleurale .......................................................................... 35 4.4. Etude de la survie ................................................................................................................... 36 4.5. Autres études ......................................................................................................................... 38 5. Conclusion ..................................................................................................................................... 40 Camille MUNCK - Thèse de sciences Chapitre 2 : Essai clinique "MesoPDT" ................................................................................................. 41 1. Introduction ................................................................................................................................... 41 2. Présentation de l'essai clinique ..................................................................................................... 43 3. Contribution à la mise en place de l'essai clinique ........................................................................ 48 3.1. Préparation à l'essai clinique et information ......................................................................... 48 3.2. Gestion du matériel et des dispositifs médicaux ................................................................... 49 3.3. Réalisation de la procédure .................................................................................................... 50 4. Illumination et dosimétrie pour l'essai clinique ............................................................................ 52 4.1. Dispositif lumineux ................................................................................................................. 52 4.2. Système de dosimétrie avec les sept capteurs isotropes ....................................................... 54 5. Déroulement de l’essai clinique .................................................................................................... 58 6. Difficultés rencontrées .................................................................................................................. 64 7. Conclusion ..................................................................................................................................... 67 PARTIE II Nouvelle approche de la dosimétrie basée sur l'imagerie pour la thérapie photodynamique intrapleurale Introduction de la partie II .................................................................................................................... 70 Chapitre 1 : Dosimétrie pré-opératoire et planification thérapeutique ............................................. 71 1. Introduction ................................................................................................................................... 71 2. Méthode de segmentation de la cavité pleurale .......................................................................... 73 3. Planification dosimétrique ............................................................................................................ 75 4. Discussion et conclusion
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