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Prise en charge oncologique du patient opéré: chimiothérapie adjuvante, surveillance, traitement des rechutes

Oncological management of the operated patient: adjuvant chemotherapy, surveillance, treatment of recurrences

  • Synthèse / Review Article
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Oncologie

Abstract

Despite recent progress obtained from perioperative chemotherapy and particularly, that demonstrated by the clinical trials on adjuvant chemotherapy, recurrences remain frequent after surgery for non-small cell lung cancer. Research on adjuvant treatments is ongoing, focused on targeted therapies or personalised therapeutic strategies. Other questions remain unanswered and are still investigated in clinical trials by the French Cancer Institute, such as thoracic radiotherapy for N2 disease, surveillance and treatment of recurrences. Although post-surgical surveillance, with or without chemotherapy, may theoretically increase survival by an earlier detection of recurrences, there are no evidence-based data. With the wide use of adjuvant chemotherapy, the profile of recurrences is likely to change and the best chemotherapy for metastatic recurrences remains to be defined.

Résumé

Malgré les progrès thérapeutiques récents, obtenus avec la chimiothérapie périopératoire, en particulier démontrés par les essais de chimiothérapie adjuvante, les rechutes après chirurgie d’un carcinome bronchique non à petites cellules restent fréquentes. Les efforts de recherche se pousuivent dans le cadre des traitements adjuvants, avec des essais intégrant les thérapeutiques ciblées et évaluant des stratégies thérapeutiques personnalisées. D’autres questions n’ont actuellement aucune réponse et font l’objet d’essais cliniques conduits sous l’égide de l’IFCT, tels que la radiothérapie postopératoire des N2, la surveillance et le traitement des rechutes. La surveillance après chirurgie ± chimiothérapie, bien que théoriquement susceptible d’améliorer la survie par une détection plus précoce des rechutes, ne repose actuellement sur aucune donnée scientifique solide. Avec l’avènement des chimiothérapies périopératoires, le profil des rechutes est susceptible de se modifier, et la meilleure chimiothérapie à délivrer lors de rechutes métastatiques reste à définir.

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Authors and Affiliations

  1. Service de pneumologie, université de Franche-Comté, CHU, hôpital Jean-Minjoz, boulevard Fleming, F-25000, Besançon, France

    V. Westeel

  2. PMAC oncologie thoracique, centre hospitalier universitaire de Grenoble, BP 217X, F-38043, Grenoble cedex, France

    Denis Moro-Sibilot

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  1. V. Westeel
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  2. Denis Moro-Sibilot
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Correspondence to V. Westeel or Denis Moro-Sibilot.

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Westeel, V., Moro-Sibilot, D. Prise en charge oncologique du patient opéré: chimiothérapie adjuvante, surveillance, traitement des rechutes. Oncologie 10, 525–528 (2008). https://doi.org/10.1007/s10269-008-0953-9

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  • DOI: https://doi.org/10.1007/s10269-008-0953-9

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