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Côlon & Rectum

, Volume 10, Issue 1, pp 55–61 | Cite as

Recommandations pour la pratique clinique Cancer du rectum

Question 7 Quelle est la place des traitements adjuvants après chirurgie ?
  • G. ManceauEmail author
  • T. André
  • J. Taieb
  • L. Quero
Dossier Thématique / Thematic File
  • 94 Downloads

Résumé

Le bénéfice de la chimiothérapie adjuvante a été depuis longtemps prouvé dans le cancer du côlon avec envahissement ganglionnaire. Dans le cancer du rectum, l’intérêt d’une chimiothérapie adjuvante fait toujours l’objet de controverses. Mais l’absence de preuve irréfutable pour cette localisation tumorale est plus liée au faible nombre d’études ayant évalué correctement cette question qu’aux résultats des essais publiés. Le but de ce travail était de proposer une actualisation des recommandations concernant les indications de traitement adjuvant après chirurgie pour cancer du rectum non métastatique. Les données les plus récentes de la littérature semblent indiquer que les indications de chimiothérapie ne diffèrent plus selon qu’un traitement néoadjuvant a été réalisé ou non. Celles-ci tendent à rejoindre celles du cancer du côlon, avec notamment des études positives concernant le FOLFOX6 modifié. Les indications de radiochimiothérapie adjuvante sont maintenant très limitées.

Mots clés

Cancer du rectum Chimiothérapie Radiochimiothérapie Traitement adjuvant Oxaliplatine 

Abstract

The benefit of adjuvant chemotherapy has been well established in patients with stage III colon cancer. In rectal cancer, the benefit of adjuvant chemotherapy is still the subject of controversy. But the absence of irrefutable evidence for this tumor location is more related to the small number of studies that have properly assessed this issue than the results of published trials. The aim of this work was to propose an update of recommendations for adjuvant treatment after surgery for nonmetastatic rectal cancer. The most recent data from the literature suggest that the indications for chemotherapy do not differ whether a neoadjuvant treatment was performed or not. These indications tend to be the same as for colon cancer, with positive studies regarding the modified FOLFOX6 regimen. Indications for adjuvant chemoradiotherapy are now very limited.

Keywords

Rectal cancer Chemotherapy Chemoradiotherapy Adjuvant treatment Oxaliplatin 

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Copyright information

© Springer-Verlag France 2015

Authors and Affiliations

  1. 1.Service de chirurgie digestive et hépato-bilio-pancréatique, Assistance Publique Hôpitaux de Paris, CHU Pitié-Salpêtrière, Institut Universitaire de CancérologieUniversité Pierre et Marie Curie (Paris VI)Paris cedex 13France

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