{"id":16016,"date":"2018-01-30T15:02:22","date_gmt":"2018-01-30T14:02:22","guid":{"rendered":"https:\/\/www.chu-poitiers.fr\/?p=16016"},"modified":"2021-04-20T18:06:10","modified_gmt":"2021-04-20T16:06:10","slug":"cancer-du-pancreas-des-aiguilles-contre-la-tumeur","status":"publish","type":"post","link":"https:\/\/www.chu-poitiers.fr\/en\/cancer-du-pancreas-des-aiguilles-contre-la-tumeur\/","title":{"rendered":"Cancer du pancr\u00e9as : des aiguilles contre la tumeur"},"content":{"rendered":"<p>&#8220;L\u2019incidence des cancers du pancr\u00e9as explose aujourd\u2019hui, avec plus de 1% de nouveaux cas chaque ann\u00e9e, chez des patients de plus en plus jeunes. C\u2019est l\u2019un des cancers solides les plus mauvais en termes de pronostic vital, car il est souvent d\u00e9couvert tard et r\u00e9pond tr\u00e8s mal \u00e0 la chimioth\u00e9rapie&#8221;, rappelle le Pr Jean-Pierre Tasu, chef du <a href=\"https:\/\/www.chu-poitiers.fr\/specialites\/radiologie-medecine-nucleaire-et-biophysique\/\" target=\"_blank\" rel=\"noopener noreferrer\">p\u00f4le imagerie du CHU de Poitiers<\/a>. Face \u00e0 ce constat et fort de l\u2019acquisition d\u2019un Nanoknife<sup>1<\/sup>, le CHU de Poitiers m\u00e8ne une \u00e9tude unique en France. Le protocole d\u2019\u00e9tude Irecap \u2013 \u00e9lectroporation irr\u00e9versible dans le traitement de l\u2019ad\u00e9nocarcinome du pancr\u00e9as localement avanc\u00e9 \u2013, conduit par les professeurs Jean-Pierre Tasu, Michel Carretier et David Tougeron et le Dr Guillaume Vesselle, vise \u00e0 \u00e9valuer la m\u00e9thode d\u2019\u00e9lectroporation dans le traitement de certains types de cancers du pancr\u00e9as.<\/p>\n<p>Quand la chirurgie ou les m\u00e9thodes de thermoablation ne peuvent \u00eatre retenues, l\u2019\u00e9lectroporation peut pr\u00e9senter une nouvelle voie th\u00e9rapeutique et une alternative avantageuse. Le principe ? L\u2019\u00e9lectroporation se caract\u00e9rise par l\u2019utilisation d\u2019un courant de tr\u00e8s fort voltage et de courte dur\u00e9e entra\u00eenant l\u2019ouverture de nanopores membranaires dans la cellule, de fa\u00e7on temporaire ou permanente. L\u2019\u00e9lectroporation irr\u00e9versible permet de cibler et d\u00e9truire les cellules canc\u00e9reuses. Son principal atout : elle respecte les structures nobles (art\u00e8res, veines, nerfs\u2026) et ne d\u00e9truit pas les tissus environnants, un plus par rapport aux m\u00e9thodes de destruction des tumeurs par la chaleur ou le froid comme la radiofr\u00e9quence et la cryoablation. Au niveau du foie, apr\u00e8s l\u2019\u00e9lectroporation irr\u00e9versible, les cellules peuvent se r\u00e9g\u00e9n\u00e9rer en quelques jours et ainsi reformer un tissu normal.<\/p>\n<figure id=\"attachment_16017\" aria-describedby=\"caption-attachment-16017\" style=\"width: 350px\" class=\"wp-caption alignright\"><img decoding=\"async\" class=\"zoom filet wp-image-16017\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2018\/01\/equipe-medicale-nanoknife.jpg\" alt=\"L\u2019\u00e9quipe m\u00e9dicale contr\u00f4le l\u2019\u00e9lectroporation dans le traitement du cancer du pancr\u00e9as avec le Nanoknife.\" width=\"350\" height=\"263\" srcset=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2018\/01\/equipe-medicale-nanoknife.jpg 748w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2018\/01\/equipe-medicale-nanoknife-300x225.jpg 300w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2018\/01\/equipe-medicale-nanoknife-130x98.jpg 130w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2018\/01\/equipe-medicale-nanoknife-550x413.jpg 550w\" sizes=\"(max-width: 350px) 100vw, 350px\" \/><figcaption id=\"caption-attachment-16017\" class=\"wp-caption-text\">L\u2019\u00e9quipe m\u00e9dicale contr\u00f4le l\u2019\u00e9lectroporation dans le traitement du cancer du pancr\u00e9as avec le Nanoknife.<\/figcaption><\/figure>\n<p><strong>Crit\u00e8res d\u2019inclusion stricts<\/strong><br \/>\n Dans le protocole Irecap, les patients inclus viennent de toute la France, Poitiers \u00e9tant le seul centre en France \u00e0 disposer d\u2019un Nanoknife d\u00e9di\u00e9 au pancr\u00e9as. Les crit\u00e8res d\u2019inclusion sont stricts. Sont concern\u00e9s les patients avec des l\u00e9sions localement avanc\u00e9es, non op\u00e9rables et non m\u00e9tastatiques. Il existe plusieurs contre-indications : troubles du rythme cardiaque, \u00e9pilepsie, patient porteur d\u2019un neurostimulateur ou d\u2019un mat\u00e9riel d\u2019\u00e9lectrostimulation et grossesse notamment.<\/p>\n<p>Une fois le patient inclus dans Irecap, le protocole est le suivant : apr\u00e8s une chimioth\u00e9rapie de trois mois, un bilan d\u2019imagerie complet est r\u00e9alis\u00e9. &#8220;Si la maladie est stable et sans progression m\u00e9tastatique, alors la termoporation est effectu\u00e9e. &#8221; L\u2019objectif de cette \u00e9tude de phase II est d\u2019\u00e9valuer le taux de r\u00e9section compl\u00e8te apr\u00e8s \u00e9lectroporation de malades qui \u00e9taient non op\u00e9rables. En effet, \u00e0 ce jour, le seul traitement de l\u2019ad\u00e9nocarninome du pancr\u00e9as reste la chirurgie.<\/p>\n<p><strong>Une m\u00e9thode porteuse d\u2019espoir<\/strong><br \/>\n &#8220;C\u2019est une technique assez difficile \u00e0 mettre en oeuvre, explique le Pr Tasu. Le placement des aiguilles (six au maximum) se fait sous contr\u00f4le par scanner. Toutes doivent avoir la m\u00eame profondeur et la m\u00eame distance entre elles, le placement se fait au millim\u00e8tre. Les aiguilles entourent la cible tumorale, d\u00e9finissant la zone de traitement. L\u2019anesth\u00e9sie doit \u00eatre tr\u00e8s profonde, avec une curarisation compl\u00e8te du patient afin qu\u2019il n\u2019y ait aucune contraction musculaire. La dur\u00e9e totale d\u2019une \u00e9lectroporation, anesth\u00e9sie incluse, peut atteindre quatre heures.&#8221;<\/p>\n<p>Des effets secondaires de l\u2019\u00e9lectroporation sont possibles : douleurs abdominales et dorsales, pancr\u00e9atite biologique, troubles du transit essentiellement mais des complications plus graves ont \u00e9t\u00e9 observ\u00e9es (pancr\u00e9atite n\u00e9crosante, perforation d\u2019organes digestifs par exemple).<\/p>\n<p>A ce jour, treize patients, d\u2019une moyenne d\u2019\u00e2ge de 59 ans, ont \u00e9t\u00e9 inclus dans le protocole d\u2019\u00e9tude Irecap. Le taux d\u2019\u00e9chec technique est nul. &#8220;Les premiers r\u00e9sultats semblent encourageants. Nous allons peut-\u00eatre avoir un gain en termes de survie sur une population s\u00e9lectionn\u00e9e, m\u00eame si les r\u00e9sultats d\u00e9finitifs ne sont pas encore connus. Cette m\u00e9thode, en association avec d\u2019autres en cours d\u2019\u00e9laboration comme l\u2019immunoth\u00e9rapie, est porteuse d\u2019espoir&#8221;, pointe le Pr Tasu.<\/p>\n<p>1 Gr\u00e2ce au soutien de l\u2019association <a href=\"http:\/\/www.sportetcollection.info\/\" target=\"_blank\" rel=\"noopener noreferrer\">Sport et collection<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Le CHU de Poitiers s\u2019est dot\u00e9 en 2012, gr\u00e2ce au soutien de Sport et collection, d\u2019un \u00e9quipement d\u2019exception : le Nanoknife, utilisant l\u2019\u00e9lectroporation\u2026","protected":false},"author":1,"featured_media":16018,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[33,42],"tags":[],"class_list":["post-16016","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cancerologie","category-chirurgie-viscerale"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cancer du pancr\u00e9as : des aiguilles contre la tumeur - Site du CHU de Poitiers<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.chu-poitiers.fr\/cancer-du-pancreas-des-aiguilles-contre-la-tumeur\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cancer du pancr\u00e9as : des aiguilles contre la tumeur - Site du CHU de Poitiers\" \/>\n<meta property=\"og:description\" content=\"Le CHU de Poitiers s\u2019est dot\u00e9 en 2012, gr\u00e2ce au soutien de Sport et collection, d\u2019un \u00e9quipement d\u2019exception : le Nanoknife, utilisant l\u2019\u00e9lectroporation pour d\u00e9truire les tumeurs. Irecap \u2013 \u00e9lectroporation irr\u00e9versible dans le traitement de l\u2019ad\u00e9nocarcinome du pancr\u00e9as localement avanc\u00e9 \u2013 est une \u00e9tude, unique en France, men\u00e9e au CHU aupr\u00e8s de patients atteints de cancer du pancr\u00e9as. 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Irecap \u2013 \u00e9lectroporation irr\u00e9versible dans le traitement de l\u2019ad\u00e9nocarcinome du pancr\u00e9as localement avanc\u00e9 \u2013 est une \u00e9tude, unique en France, men\u00e9e au CHU aupr\u00e8s de patients atteints de cancer du pancr\u00e9as. 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