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Irradiation locorégionale des cancers du sein d’emblée métastatiques

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Book cover Cancer du sein en situation métastatique

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Résumé

L’incidence des cancers du sein avec métastases synchrones au diagnostic (stade IV) est relativement rare, représentant moins de 5 % de l’ensemble des cancers du sein (1–4). Leur pronostic est effroyable avec une survie médiane de 18–24 mois (5, 6). L’avènement de nouvelles molécules systémiques, telles que vinorelbine, paclitaxel, docétaxel, dérivés oraux du 5-fluorouracil (capécitabine), létrozole, anastrozole, exemestane et thérapies ciblées (trastuzumab), a probablement amélioré la survie de ces patientes atteintes d’un cancer de stade IV. Entre 1987 et 1993, la survie globale à 3 ans était estimée à 27 %, puis après l’utilisation des taxanes et des inhibiteurs de l’aromatase (entre 1994 et 2000), la survie globale à 3 ans de ces patientes est de 44 % (p < 0,001) (7). Malgré les progrès des traitements systémiques, la place des traitements locorégionaux était souvent restreinte à celle du traitement palliatif, soit à visée antalgique, soit à visée hémostatique.

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Références

  1. Rao R, Feng L, Kuerer HM et al. (2008) Timing of surgical intervention for the intact primary in stage IV breast cancer patients. Ann Surg Oncol 15: 1696–1702

    Article  PubMed  Google Scholar 

  2. Blanchard DK, Shetty PB, Hilsenbeck SG, Elledge RM (2008) Association of surgery with improved survival in stage IV breast cancer patients. Ann Surg 247: 732–738

    Article  PubMed  Google Scholar 

  3. Babiera GV, Rao R, Feng L et al. (2006) Effect of primary tumor extirpation in breast cancer patients who present with stage IV disease and an intact primary tumor. Ann Surg Oncol 13: 776–782

    Article  PubMed  Google Scholar 

  4. Gnerlich J, Jeffe DB, Deshpande AD, Beers C, Zander C, Margenthaler JA (2007) Surgical removal of the primary tumor increases overall survival in patients with metastatic breast cancer: analysis of the 1988–2003 SEER data. Ann Surg Oncol 14: 2187–2194

    Article  PubMed  Google Scholar 

  5. Muss HB, Case LD, Richards F, 2nd et al. (1991) Interrupted versus continuous chemotherapy in patients with metastatic breast cancer. The Piedmont Oncology Association. N Engl J Med 325: 1342–1348

    Article  PubMed  CAS  Google Scholar 

  6. Norton L (1991) Metastatic breast cancer. Length and quality of life. N Engl J Med 325: 1370–1371

    CAS  Google Scholar 

  7. Andre F, Slimane K, Bachelot T et al. (2004) Breast cancer with synchronous metastases: trends in survival during a 14-year period. J Clin Oncol 22: 3302–3308

    Article  PubMed  Google Scholar 

  8. Hortobagyi NG (2001) Can We Cure Limited Metastatic Breast Cancer? J Clin Oncol 20: 620–623

    Google Scholar 

  9. Carmichael AR, Anderson ED, Chetty U, Dixon JM (2003) Does local surgery have a role in the management of stage IV breast cancer? Eur J Surg Oncol 29: 17–19

    Article  PubMed  CAS  Google Scholar 

  10. Khan SA, Stewart AK, Morrow M (2002) Does aggressive local therapy improve survival in metastatic breast cancer? Surgery 132: 620–626; discussion 626–7

    Article  PubMed  Google Scholar 

  11. Griffiths CT, Parker LM, Lee S, Finkler NJ (2002) The effect of residual mass size on response to chemotherapy after surgical cytoreduction for advanced ovarian cancer: long-term results. Int J Gynecol Cancer 12: 323–331

    Article  PubMed  CAS  Google Scholar 

  12. Martin R, Paty P, Fong Y et al. (2003) Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastasis. J Am Coll Surg 197: 233–2341; discussion 232–41

    Article  PubMed  Google Scholar 

  13. Rosen SA, Buell JF, Yoshida A et al. (2000) Initial presentation with stage IV colorectal cancer: how aggressive should we be? Arch Surg 135: 530–534; discussion 534–5

    Article  PubMed  CAS  Google Scholar 

  14. Tanaka K, Shimada H, Matsuo K et al. (2004) Outcome after simultaneous colorectal and hepatic resection for colorectal cancer with synchronous metastases. Surgery 136: 650–659

    Article  PubMed  Google Scholar 

  15. Cristofanilli M, Budd GT, Ellis MJ et al. Circulating tumor cells, disease progression, and survival in metastatic breast cancer. N Engl J Med 2004;351: 781–791

    Article  PubMed  CAS  Google Scholar 

  16. Dauplat J, Le Bouedec G, Pomel C, Scherer C (2000) Cytoreductive surgery for advanced stages of ovarian cancer. Semin Surg Oncol 19: 42–48

    Article  PubMed  CAS  Google Scholar 

  17. Danna EA, Sinha P, Gilbert M, Clements VK, Pulaski BA, Ostrand-Rosenberg S (2004) Surgical removal of primary tumor reverses tumor-induced immunosuppression despite the presence of metastatic disease. Cancer Res 64: 2205–2211

    Article  PubMed  CAS  Google Scholar 

  18. Dooley WC (2006) A surgical indication in incurable breast cancer. Ann Surg Oncol 13: 759–760

    Article  PubMed  Google Scholar 

  19. Le Scodan R, Stevens D, Brain E et al. (2009) Breast cancer with synchronous metastases: survival impact of exclusive locoregional radiotherapy. J Clin Oncol 27: 1375–1381

    Article  PubMed  Google Scholar 

  20. Bourgier C, Khodari W, Vataire AL et al. Breast radiotherapy as part of locoregional treatments in stage IV breast cancer patients with oligometastatic disease. Submitted 2009.

    Google Scholar 

  21. Khodari W, Vataire AL, Delaloge S et al. (2008) The role of radiation therapy as part of loco-regional treatment in breast cancer patients with metastatic disease at diagnosis. J Clin Oncol 26: 1085

    Google Scholar 

  22. Overgaard M, Hansen PS, Overgaard J et al. (1997) Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial. N Engl J Med 337: 949–955

    Article  PubMed  CAS  Google Scholar 

  23. Overgaard M, Jensen MB, Overgaard J et al. (1999) Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomised trial. Lancet 353: 1641–1648

    Article  PubMed  CAS  Google Scholar 

  24. Ragaz J, Jackson SM, Le N et al. (1997) Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N Engl J Med 337: 956–962

    Article  PubMed  CAS  Google Scholar 

  25. Ragaz J, Olivotto IA, Spinelli JJ et al. (2005) Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J Natl Cancer Inst 97: 116–126

    Article  PubMed  Google Scholar 

  26. Kyndi M, Sorensen FB, Knudsen H, Overgaard M, Nielsen HM, Overgaard J (2008) Estrogen receptor, progesterone receptor, HER-2, and response to postmastectomy radiotherapy in high-risk breast cancer: the Danish Breast Cancer Cooperative Group. J Clin Oncol 26: 1419–1426

    Article  PubMed  CAS  Google Scholar 

  27. Arriagada R, Mouriesse H, Sarrazin D, Clark RM, Deboer G (1985) Radiotherapy alone in breast cancer. I. Analysis of tumor parameters, tumor dose and local control: the experience of the Gustave-Roussy Institute and the Princess Margaret Hospital. Int J Radiat Oncol Biol Phys 11: 1751–1757

    Article  PubMed  CAS  Google Scholar 

  28. Courdi A, Ortholan C, Hannoun-Levi JM et al. (2006) Long-term results of hypofractionated radiotherapy and hormonal therapy without surgery for breast cancer in elderly patients. Radiother Oncol 79: 156–161

    Article  PubMed  Google Scholar 

  29. Fourquet A, Campana F, Mosseri V et al. (1995) Iridium-192 versus cobalt-60 boost in 3-7 cm breast cancer treated by irradiation alone: final results of a randomized trial. Radiother Oncol 34: 114–120

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Département de cancérologie radiothérapie, Institut Gustave Roussy, 39, rue Camille-Desmoulins, 94805, Villejuif

    C. Bourgier

  2. Département de radiothérapie, Unité fonctionnelle de sénologie, Institut Gustave Roussy, 39, rue Camille-Desmoulins, 94805, Villejuif

    W. Khodari

  3. Département de cancérologie radiothérapie, CRLC Val d’Aurelle, 31, rue Croix-Verte, 34000, Montpellier

    D. Azria

Authors
  1. C. Bourgier
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  2. W. Khodari
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  3. D. Azria
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© 2010 Springer-Verlag France

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Bourgier, C., Khodari, W., Azria, D. (2010). Irradiation locorégionale des cancers du sein d’emblée métastatiques. In: Cancer du sein en situation métastatique. Springer, Paris. https://doi.org/10.1007/978-2-8178-0076-9_14

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  • DOI: https://doi.org/10.1007/978-2-8178-0076-9_14

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0075-2

  • Online ISBN: 978-2-8178-0076-9

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