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Facteurs pronostiques biologiques des cancers de la vessie. Interactions avec la radiothérapie

Biological prognostic factors in bladder cancer. Interactions with radiotherapy

  • Synthèse / Review Article
  • Published:
Oncologie

Résumé

La radiochimiothérapie exclusive peut constituer une alternative à la cystectomie chez des patients sélectionnés. Les cliniciens utilisent des facteurs pronostiques cliniques (stade TNM, grade histologique, etc.) pour aider à la décision thérapeutique, tandis que les facteurs propres à la biologie tumorale sont mal connus et peu utilisés. L’activation des oncogènes semble caractériser l’initiation des tumeurs papillaires superficielles de bas grade et les mutations prédominantes dans les gènes suppresseurs de tumeurs (PTEN, TP53 et RB), les lésions in situ et infiltrantes. Les expressions de p53, de Rb, de Bcl-2 ont un rôle pronostique indéniable, mais les études publiées sur les facteurs moléculaires prédictifs de radiosensibilité sont hétérogènes.

Abstract

Concomitant chemoradiotherapy can constitute an alternative to surgical approach in selected patients with bladder carcinoma. TNM staging, histological grading, renal and performance status represent the main prognostic factors useful to define the therapeutic strategy. Biological and genetic factors are still controversial in medical practice. The activation of oncogenes seems to characterize the initiation of superficial low-grade tumors and the mutations in the tumor suppressor genes (PTEN, TP53 and RB) appear as the most important biological features in the in situ and invasive tumors. The expression of p53, Rb, Bcl-2 has an obvious prognostic role but the published studies onmolecular factors predictive of radiosensibility are heterogeneous.

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  1. Hôpital européen Georges-Pompidou, 20, rue Le-Blanc, F-75015, Paris, France

    D. Fernandez & C. Durdux

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  1. D. Fernandez
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  2. C. Durdux
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Fernandez, D., Durdux, C. Facteurs pronostiques biologiques des cancers de la vessie. Interactions avec la radiothérapie. Oncologie 12, 389–395 (2010). https://doi.org/10.1007/s10269-010-1903-x

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  • DOI: https://doi.org/10.1007/s10269-010-1903-x

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