Étude microdosimétrique de l'influence des matériaux sur l'efficacité biologique d'une source d'iode-125

Abstract

Cette thèse concerne les implants permanents pour la prostate. Les isotopes employés, le ¹⁰³Pd et l'¹²⁵I, semblent produire les mêmes résultats cliniques: le premier à cause d'une radiation plus efficace et le second à cause de sa demi-vie plus longue. La recherche utilise le cadre théorique de la microdosimétrie et des simulations Monte Carlo. Elle propose d'employer le spectre d'éjection dans le calcul de l'efficacité; ce changement fait passer l'efficacité relative du ¹⁰³Pd de 10% à 5%. Elle montre ensuite qu'il est possible d'améliorer l'efficacité de la radiation de ¹²⁵I par l'exploitation des rayons X caractéristiques de la capsule. Une source améliorée faite de molybdène et d'yttrium est donnée en exemple. Elle procure une radiation de 5–7% plus efficace, ce qui surclasse les deux sources existantes. Les applications ne se limitent pas au traitement de la prostate; le traitement du mélanome oculaire et la curiethérapie endovasculaire pourraient en bénéficier.

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This thesis concerns permanent implants for the prostate. The isotopes used, ¹⁰³Pd and, seem to produce the same clinical results: the first because of a more effective radiation and the second because of its longer half-life. The research uses the theoretical framework of microdosimetry and Monte Carlo simulations. It proposes to use the ejection spectrum in the calculation of efficiency; this change increases the relative efficiency of ¹⁰³Pd from 10% to 5%. It then shows that it is possible to improve the efficiency of radiation by exploiting the capsule's characteristic X-rays. An improved source made of molybdenum and yttrium is given as an example. It provides 5–7% more effective radiation, which outperforms the two existing sources. Applications are not limited to prostate treatment; treatment of ocular melanoma and endovascular brachytherapy could benefit.