{"id":1781,"date":"2004-10-01T01:00:00","date_gmt":"2004-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/phototherapie-dynamique-dans-le-cancer-de-loesophage-resultats-de-5-ans-de-pratique-en-hopital-general\/"},"modified":"2018-10-20T18:39:34","modified_gmt":"2018-10-20T16:39:34","slug":"phototherapie-dynamique-dans-le-cancer-de-loesophage-resultats-de-5-ans-de-pratique-en-hopital-general","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/phototherapie-dynamique-dans-le-cancer-de-loesophage-resultats-de-5-ans-de-pratique-en-hopital-general\/","title":{"rendered":"PHOTOTHERAPIE DYNAMIQUE DANS LE CANCER DE L’\u0152SOPHAGE : RESULTATS DE 5 ANS DE PRATIQUE EN HOPITAL GENERAL."},"content":{"rendered":"

2004<\/strong><\/p>\n

Isabelle Rosa, Herv\u00e9 Hag\u00e8ge, Thierry Lons, Violaine Ozenne, Ga\u00eblle Pileire,
\nMichel Chousterman.
\nCentre Hospitalier Intercommunal de Cr\u00e9teil, 40 av de Verdun, 94010 Cr\u00e9teil.<\/em><\/p>\n

Endoscopie <\/strong>– \u00a00000-00-00 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Isabelle Rosa, Herv\u00e9 Hag\u00e8ge, Thierry Lons, Violaine Ozenne, Ga\u00eblle Pileire,
\nMichel Chousterman.
\nCentre Hospitalier Intercommunal de Cr\u00e9teil, 40 av de Verdun, 94010 Cr\u00e9teil.<\/p>\n

La phototh\u00e9rapie dynamique (PDT) est une technique endoscopique utilis\u00e9e dans le traitement des cancers de l’\u0153sophage. Le principe de la PDT est de provoquer la n\u00e9crose d’une l\u00e9sion tissulaire, apr\u00e8s avoir inject\u00e9 un agent photosensibilisant, inactif \u00e0 l’\u00e9tat basal, activ\u00e9 gr\u00e2ce \u00e0 un rayonnement lumineux d’une longueur d’ondes sp\u00e9cifique.
\nLe but de l’\u00e9tude \u00e9tait d’\u00e9valuer les r\u00e9sultats de la PDT dans le cancer de l’\u0153sophage chez des malades non s\u00e9lectionn\u00e9s. De 1999 \u00e0 2004, nous avons trait\u00e9 13 malades atteints de cancers de l’\u0153sophage par cette technique. Il s’agissait dans 8 cas d’un carcinome \u00e9pidermo\u00efde et dans 5 cas d’un ad\u00e9nocarcinome sur \u0153sophage de Barrett. L’\u00e2ge moyen \u00e9tait de 66 ans (de 48 \u00e0 84 ans). Le suivi moyen des malades \u00e9tait de 15 mois. Tous les malades ont b\u00e9n\u00e9fici\u00e9 en pr\u00e9-th\u00e9rapeutique d’une \u00e9cho-endoscopie (dans un cas par mini-sonde), d’un scanner thoracique et d’une \u00e9chographie abdominale. Il s’agissait d’une l\u00e9sion in situ dans 9 cas et dans 4 cas d’une l\u00e9sion T1N0. Dans 3 cas, il s’agissait d’une r\u00e9cidive apr\u00e8s radioth\u00e9rapie (curieth\u00e9rapie dans 2 cas). Dans 7 cas, il existait une contre-indication \u00e0 la chirurgie du fait de co-morbidit\u00e9s (cirrhose avec hypertension portale: 2 cas, insuffisance cardio-respiratoire: 2 cas; \u00e2ge >80 ans: 3 cas). Chez un malade, il s’agissait d’une r\u00e9cidive anastomotique post-op\u00e9ratoire apr\u00e8s gastrectomie polaire sup\u00e9rieure et \u0153sophagectomie partielle inf\u00e9rieure. Enfin, 2 malades avaient refus\u00e9 la chirurgie en premi\u00e8re intention. Les malades ont re\u00e7u une injection intra-veineuse de porphym\u00e8re disodique (Photofrin) \u00e0 la dose de 2 mg\/kg 48 h avant la fibroscopie. Lors de l’examen endoscopique, il \u00e9tait d\u00e9livr\u00e9 \u00e0 l’aide d’un diffuseur de lumi\u00e8re cylindrique 750 Joules, avec un rayonnement lumineux de 630 nm.
\nR\u00e9sultats: Les donn\u00e9es de 10 malades ont pu \u00eatre analys\u00e9es (8 cancers in situ et 2 T1) : 2 malades ont \u00e9t\u00e9 perdus de vue, un malade est d\u00e9c\u00e9d\u00e9. Le traitement a permis une \u00e9radication compl\u00e8te des l\u00e9sions chez 6 malades (60%), avec un recul de 16 mois (de 3 \u00e0 36 mois). Parmi ces malades, une 2\u00e8me l\u00e9sion m\u00e9tachrone \u0153sophagienne \u00e0 distance de la premi\u00e8re l\u00e9sion a \u00e9t\u00e9 diagnostiqu\u00e9e au cours de la surveillance endoscopique en moyenne 18 mois apr\u00e8s la PDT. Parmi les 8 malades ayant un carcinome in situ, 6 ont eu une \u00e9radication compl\u00e8te (75%). En revanche, le traitement a \u00e9t\u00e9 un \u00e9chec chez les 2 malades ayant une tumeur T1.
\nConclusion : Dans notre exp\u00e9rience, la PDT dans le cancer de l’\u0153sophage est une technique int\u00e9ressante et efficace, principalement chez les malades ayant un carcinome in situ. Elle permet d’obtenir une r\u00e9ponse tumorale compl\u00e8te satisfaisante chez des malades pour qui l’\u0153sophagectomie n’est pas r\u00e9alisable. La place de cette technique par rapport \u00e0 la chirurgie et aux autres techniques endoscopiques reste \u00e0 \u00e9valuer.<\/p>\n","protected":false},"excerpt":{"rendered":"

2004 Isabelle Rosa, Herv\u00e9 Hag\u00e8ge, Thierry Lons, Violaine Ozenne, Ga\u00eblle Pileire, Michel Chousterman. Centre Hospitalier Intercommunal de Cr\u00e9teil, 40 av de Verdun, 94010 Cr\u00e9teil. Endoscopie – \u00a00000-00-00 –\u00a0CO – ________________________________ Isabelle Rosa, Herv\u00e9 Hag\u00e8ge, Thierry Lons, Violaine Ozenne, Ga\u00eblle Pileire, Michel Chousterman. Centre Hospitalier Intercommunal de Cr\u00e9teil, 40 av de Verdun, 94010 Cr\u00e9teil. La phototh\u00e9rapie […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[6],"tags":[15],"class_list":["post-1781","post","type-post","status-publish","format-standard","hentry","category-endoscopie","tag-15"],"yoast_head":"\nPHOTOTHERAPIE DYNAMIQUE DANS LE CANCER DE L'\u0152SOPHAGE : RESULTATS DE 5 ANS DE PRATIQUE EN HOPITAL GENERAL. - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/phototherapie-dynamique-dans-le-cancer-de-loesophage-resultats-de-5-ans-de-pratique-en-hopital-general\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"PHOTOTHERAPIE DYNAMIQUE DANS LE CANCER DE L'\u0152SOPHAGE : RESULTATS DE 5 ANS DE PRATIQUE EN HOPITAL GENERAL. - 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