Oncologie

, Volume 10, Issue 1, pp 16–21

Irradiation partielle et accélérée du sein: une réelle perspective thérapeutique pour le cancer du sein de bon pronostic

  • Y. Belkacémi
  • H. Marsiglia
  • J. -M. Hannoun-Levi
  • R. Orecchia
  • A. Kuten
  • J. -B. Dubois
  • E. Lartigau
Original

Résumé

Après une chirurgie conservatrice, la radiothérapie adjuvante de la totalité de la glande mammaire reste le standard thérapeutique. L’irradiation partielle accélérée du sein (IPAS) et focalisée au lit opératoire, délivrée en quelques jours, constitue, dans le contexte de l’individualisation des traitements, une vraie option thérapeutique et un domaine de recherche prometteur qui permettrait une évolution historique de la radiothérapie mammaire. La durée plus courte du traitement (et la possibilité d’instituer rapidement les traitements médicaux), une meilleure observance thérapeutique et l’absence de recours à la mastectomie totale ont été considérées comme des arguments importants pour légitimer l’option de l’IPAS outre-Atlantique. Même si le profil de patientes idéal pour une IPAS n’est pas encore clairement défini, la tentation d’élargir les indications est grande chez les défenseurs du concept. Ce profil sera certainement basé sur un faisceau d’arguments qui seront discutés dans cet article.

Motsclés

Radiothérapie Cancers du sein Irradiation partielle du sein 

Accelerated partial breast irradiation: a true therapeutic option for breast cancer patients who have good prognoses

Abstract

After conservative surgery, whole-breast radiation therapy remains the standard of care. Accelerated partial breast irradiation (APBI) delivered for one week is a new research avenue in individualized treatment and may lead to historic change in adjuvant breast radiation therapy. In North America, several factors, such as the duration of irradiation allowing early medical treatment, better treatment compliance and the decrease in total mastectomies, allowed the development of APBI. Although the ideal candidate for APBI has not been determined, several teams are advocating increased use of the procedure in a higher proportion of patients. Defining the appropriate selection criteria is crucial for future trials. In this paper, we discuss these selection criteria for better treatment individualization.

Keywords

Radiotherapy Breast cancer Partial breast irradiation 

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Copyright information

© Springer Verlag France 2008

Authors and Affiliations

  • Y. Belkacémi
    • 1
    • 7
  • H. Marsiglia
    • 2
    • 8
  • J. -M. Hannoun-Levi
    • 3
  • R. Orecchia
    • 4
  • A. Kuten
    • 5
  • J. -B. Dubois
    • 6
    • 9
  • E. Lartigau
    • 1
    • 7
  1. 1.département universitaire d’oncologie-radiothérapieCLCC Oscar-LambretLilleFrance
  2. 2.Institut Gustave-RoussyVillejuifFrance
  3. 3.Centre Antoine-LacassagneNiceFrance
  4. 4.Institut d’oncologieMilanItalie
  5. 5.Centre RambamHaïfaIsraël
  6. 6.CLCC Val-d’Aurelle-Paul-LamarqueParc EuromédecineMontpellier cedex 5France
  7. 7.Université de Lille-IILilleFrance
  8. 8.Université de FlorenceFlorenceItalie
  9. 9.Faculté de médecineuniversité de MontpellierMontpellierFrance

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