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     <dc:title xml:lang="fr">Modélisation et simulation numérique de croissance tumorale et réponse à la radiothérapie</dc:title>
     <dcterms:alternative xml:lang="en">In silico modelling and simulation of tumour growth and response to radiotherapy</dcterms:alternative>
     <dc:subject xml:lang="fr">Modélisation mécaniste</dc:subject><dc:subject xml:lang="fr">cancer de la prostate</dc:subject><dc:subject xml:lang="fr">radiothérapie</dc:subject><dc:subject xml:lang="fr">analyse de sensibilité</dc:subject><dc:subject xml:lang="fr">récidive biochimique</dc:subject><dc:subject xml:lang="fr">probabilité de contrôle tumoral</dc:subject>
     <dc:subject xml:lang="en">Mechanistic modelling</dc:subject><dc:subject xml:lang="en">prostate cancer</dc:subject><dc:subject xml:lang="en">radiotherapy</dc:subject><dc:subject xml:lang="en">sensitivity analysis</dc:subject><dc:subject xml:lang="en">biochemical recurrence</dc:subject><dc:subject xml:lang="en">tumour control probability</dc:subject><tef:sujetRameau><tef:vedetteRameauNomCommun>
						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="027256898">Prostate</tef:elementdEntree><tef:subdivision autoriteSource="Sudoc" type="subdivisionDeSujet" autoriteExterne="02756763X">Cancer -- Radiothérapie</tef:subdivision>
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     <dcterms:abstract xml:lang="fr">La radiothérapie externe (RTE) est le traitement le plus courant du cancer localisé de la prostate. Une dose totale comprise entre 74 et 80 Gy, délivrée en fractions de 2 Gy, est généralement prescrite. Le contrôle local de la tumeur est atteint dans 60 % à 90 % des cas, selon le groupe de risque. Des thérapies modifiées, telles que des traitements hypofractionnés, qui pourraient augmenter ces pourcentages ont été récemment proposées. Cependant, les connaissances sur la réponse des patients à ces nouveaux schémas sont encore limitées. L'objectif principal de cette thèse est donc de simuler numériquement la réponse tumorale à la RTE dans le contexte du cancer de la prostate. À cette fin, dans un premier temps, un modèle mécaniste existant est adapté et différents schémas d'irradiation sont testés. Ensuite, un modèle original intégrant les principaux mécanismes radiobiologiques est développé. Une analyse de sensibilité exhaustive est réalisée et les courbes de probabilité de contrôle tumoral (TCP) du modèle complet et de 15 versions excluant certains mécanismes sont comparées. Un modèle simplifié, équivalent en termes de TCP et de densité cellulaire tumorale est proposé. Enfin, les prédictions de récidive biochimique utilisant le modèle réduit sont comparées à celles d'une approche radiomique classique. Ces travaux ouvrent la voie à l'optimisation clinique des traitements d'irradiation spécifiques aux patients.</dcterms:abstract>
     <dcterms:abstract xml:lang="en">External beam radiotherapy (EBRT) is the most common treatment for localised prostate cancer. A total dose between 74 and 80 Gy, delivered in 2 Gy fractions, is typically prescribed. Local tumour control is achieved in 60% to 90% of cases, depending on the risk group. Modified therapies, such as hypofractionated treatments, that may increase these percentages have been recently proposed. However, the knowledge about the response of patients to these new schedules is still limited. The main objective of this thesis is thus to simulate \textit{in silico} the tumour response to EBRT in the context of prostate cancer. For this purpose, as a first step, an existing mechanistic model is adapted and different irradiation schedules are tested. Then, an original model integrating the main radiobiological mechanisms is developed. A thorough sensitivity analysis is performed and tumour control probability (TCP) curves of the comprehensive model and 15 versions excluding certain mechanisms are compared. A simplified model, equivalent in terms of TCP and tumour cell density is proposed. Finally, biochemical recurrence predictions using the reduced model are compared with those of a conventional radiomics approach. This work paves the way for the clinical optimisation of patient-specific irradiation treatments.</dcterms:abstract>
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