{"id":15645,"date":"2021-12-14T07:00:01","date_gmt":"2021-12-14T06:00:01","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=15645"},"modified":"2024-12-11T14:16:04","modified_gmt":"2024-12-11T13:16:04","slug":"interet-de-la-radiotherapie-tres-faible-dose-dans-le-lymphome-b-indolent","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/interet-de-la-radiotherapie-tres-faible-dose-dans-le-lymphome-b-indolent\/","title":{"rendered":"Int\u00e9r\u00eat de la radioth\u00e9rapie tr\u00e8s faible dose dans le lymphome B indolent"},"content":{"rendered":"

R\u00e9f. : HematoStat.net ; 2 (4) : R31<\/p>\n

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

Imber BS et al. Excellent response to very-low-dose radiation (4 Gy) for indolent B-cell lymphomas: is 4 Gy suitable for curable patients? Blood Adv. 22 oct 2021;5(20):4185<\/em>\u2011<\/em>97.<\/em><\/p>\n

<\/em><\/p>\n

R\u00e9sum\u00e9 de l’article<\/strong><\/p>\n

Les lymphomes non-hodgkinien B indolents (LNHi) localis\u00e9s peuvent \u00eatre trait\u00e9 par radioth\u00e9rapie : le standard est de 24 Gy. Une alternative d\u00e9livrant une tr\u00e8s faible dose 2 x 2 Gy (VLDRT) a \u00e9t\u00e9 propos\u00e9e mais son utilisation hors contexte palliatif, demeure controvers\u00e9e. Les auteurs rapportent leur exp\u00e9rience d\u2019un traitement VLDRT chez 250 patients (299 l\u00e9sions trait\u00e9es). Le taux de r\u00e9ponse globale \u00e9tait de 90 % dont 68 % de r\u00e9ponses compl\u00e8tes.<\/p>\n

Dans nos pratiques<\/strong><\/p>\n

Une \u00e9tude qui rappelle la tr\u00e8s grande sensibilit\u00e9 des LNHi \u00e0 la radioth\u00e9rapie et son utilit\u00e9 th\u00e9rapeutique, y compris depuis l\u2019av\u00e8nement de nouvelles th\u00e9rapeutiques. Les auteurs proposent ici une approche originale o\u00f9 des patients en situation curative se voient proposer un traitement VLDRT. Une r\u00e9\u00e9valuation pr\u00e9coce par PET scanner \u00e9tait effectu\u00e9e entre 8 et 12 semaines et un traitement compl\u00e9mentaire pouvait \u00eatre r\u00e9alis\u00e9 si n\u00e9cessaire.<\/p>\n

Le regard du statisticien<\/strong><\/p>\n

Sans \u00eatre parfaite sur le plan de la rigueur m\u00e9thodologique, cette \u00e9tude a un int\u00e9r\u00eat statistique particulier, celui d\u2019avoir compar\u00e9 deux types de mod\u00e9lisations d\u2019analyses d\u2019\u00e9v\u00e9nements (progressions) au cours du temps : des mod\u00e8les de Cox cause-sp\u00e9cifiques et repr\u00e9sentations de Kaplan-Meier versus <\/em>des mod\u00e8les de risques comp\u00e9titifs (incluant notamment les d\u00e9c\u00e8s) et courbes d\u2019incidence cumulatives. Le c\u00f4t\u00e9 imparfait r\u00e9side dans les mod\u00e8les multivari\u00e9s qui int\u00e8grent une variable temps-d\u00e9pendante (la r\u00e9ponse au traitement) et des donn\u00e9es manquantes pour certains param\u00e8tres diminuant de facto <\/em>le nombre de sites \u00e9tudi\u00e9s. Au del\u00e0 des r\u00e9sultats cliniques, cela reste une approche int\u00e9ressante.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":16,"featured_media":15646,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[209,210,192,87],"ppma_author":[456],"class_list":["post-15645","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-lymphome-b-indolent","tag-modeles-de-cox","tag-radiotherapie","tag-risques-competitifs","author-alexis-genthon"],"aioseo_notices":[],"authors":[{"term_id":456,"user_id":16,"is_guest":0,"slug":"alexis-genthon","display_name":"Alexis GENTHON","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue.\r\nCorrespondance : H\u00f4pital Saint-Antoine \r\nService h\u00e9matologie clinique\r\n184 rue du Faubourg Saint-Antoine 75012 Paris."}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15645","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=15645"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15645\/revisions"}],"predecessor-version":[{"id":18199,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15645\/revisions\/18199"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=15645"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=15645"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=15645"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=15645"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}