![\"thérapie](\"https://s3.eu-central-1.amazonaws.com/bookimed/_images_without_dir/68d4e4393b68d.jpeg\")
Shefaa Al Orman International Oncology Hospitals est un centre accrédité par l'ESMO avec des hôpitaux séparés pour adultes et enfants. Il est spécialisé dans le diagnostic oncologique, le traitement et l'oncologie pédiatrique. Il traite environ 6 000 patients par an.
Shefaa Al Orman International Oncology Hospitals est un centre accrédité par l'ESMO avec des hôpitaux séparés pour adultes et enfants. Il est spécialisé dans le diagnostic oncologique, le traitement et l'oncologie pédiatrique. Il traite environ 6 000 patients par an.
Le Dr Mohamed Mahmoud Abdelhakim est professeur de radio-oncologie à l'Institut national du cancer de l'Université du Caire. Il est chef du service de radio-oncologie à l'hôpital Shefa al Orman. Le Dr Abdelhakim traite des cancers complexes, notamment le cancer du sein, les sarcomes des tissus mous et les tumeurs gynécologiques. Il est membre de l'ESTRO et de l'ESMO.
Shefaa Al Orman International Oncology Hospitals est un centre accrédité par l'ESMO avec des hôpitaux séparés pour adultes et enfants. Il est spécialisé dans le diagnostic oncologique, le traitement et l'oncologie pédiatrique. Il traite environ 6 000 patients par an.
Design fourni Freepik
\n\nLa radiothérapie du cancer du col de l’utérus — est l’une des principales méthodes de traitement. Elle est utilisée aux stades précoces (I–II) dans le but d’une guérison complète, et aux stades avancés (III–IV) pour réduire la tumeur, contrôler la maladie et prolonger la vie. La radiothérapie est souvent associée à la chimiothérapie et/ou à la chirurgie. La décision finale concernant la stratégie de traitement est prise lors d’une réunion de concertation médicale, qui tient compte du stade et de la taille de la tumeur, de l’âge de la patiente, de ses projets de procréation et de son état de santé général.
\n\nLe traitement du cancer du col de l’utérus par radiothérapie se divise en irradiation externe (EBRT) et curiethérapie ; elles sont le plus souvent combinées pour une efficacité et une sécurité maximales.
\n\nL’EBRT cible une zone plus large du bassin et les ganglions lymphatiques, permettant d’agir de l’extérieur sur la tumeur et d’éventuelles micrométastases, tandis que la curiethérapie délivre une forte dose ciblée directement au col de l’utérus ou au vagin, en minimisant l’exposition des organes voisins.
\n\nLa radiothérapie du cancer du col de l’utérus peut être réalisée de deux façons principales : externe (EBRT) et interne — la curiethérapie. Les deux méthodes visent à détruire les cellules tumorales, mais diffèrent par leur technique, la localisation de l’irradiation et la dose.
\n\nEBRT cible une zone plus large du bassin et les ganglions lymphatiques, permettant d’agir de l’extérieur sur la tumeur et d’éventuelles micrométastases, tandis que la curiethérapie délivre une forte dose ciblée directement au col de l’utérus ou au vagin, en minimisant l’exposition des organes voisins.
\n\n👉Rétrospective étude de 2024 a montré que l’association de la radiothérapie externe (EBRT) à la curiethérapie constitue le traitement standard du cancer du col de l’utérus localement avancé. Il est rapporté que la survie globale à 5 ans est d’environ 60–67% lorsque les recommandations sont respectées (radiochimiothérapie concomitante + curiethérapie guidée par IRM).
\n\n💡Habituellement, l’EBRT est réalisée en premier, puis la curiethérapie.
\n\nLa radiothérapie peut constituer le traitement principal (stades précoces ou contre-indications à la chirurgie), être associée à une chimiothérapie en cas de maladie localement avancée ou être administrée après une intervention chirurgicale afin de réduire le risque de récidive.
\n\nLa stratégie de traitement du cancer du col de l’utérus dépend largement du stade de la maladie. Aux stades précoces (I–II), l’objectif principal est la guérison complète, tandis que dans les formes plus avancées, il est de contrôler la maladie, de réduire la tumeur et de prolonger la vie.
\n\nÀ ces stades, l’objectif principal est la guérison complète. On utilise habituellement la radiothérapie externe (EBRT) associée à la curiethérapie, avec parfois l’ajout de médicaments de chimiothérapie. Le choix entre la chirurgie et la radiothérapie dépend de la taille de la tumeur, de l’état des ganglions lymphatiques et des projets de préservation de la fertilité.
\n\n👉Dans le groupeayant reçu uniquement une EBRT avec boost concomitant, la survie à 3 ans était de 44 %, le contrôle local de 75 % (jusqu’à 90 % avec boost). Aucun effet indésirable grave n’a été observé. Ce schéma peut être utilisé, si la curiethérapie est impossible, mais n’est pas considéré comme un traitement radical standard.
\n\nAux stades IB2–IVA, l’approche standard est la radiochimiothérapie avec curiethérapie. En présence de métastases, la radiothérapie aide à contrôler les symptômes et les complications, et le plan de traitement est adapté individuellement.
\n\n| Stade | \n\t\t\tObjectif | \n\t\t\tMéthode | \n\t\t\tPrincipal | \n\t\t
| I–II | \n\t\t\tGuérison complète | \n\t\t\tEBRT + curiethérapie (parfois + chimiothérapie) | \n\t\t\tLe choix de la méthode est individuel et dépend de la tumeur, des ganglions lymphatiques et de la fertilité | \n\t\t
| IB2–IVA | \n\t\t\tContrôle de la maladie | \n\t\t\tChimioradiothérapie + curiethérapie | \n\t\t\tLe plan est adapté individuellement ; en cas de métastases, la radiothérapie aide à réduire les symptômes | \n\t\t
Un traitement de radiothérapie consiste en une série de courtes séances (fractions). Si le traitement est indiqué, 1 à 4 séances de curiethérapie sont ajoutées. La dose de rayonnement est répartie entre les séances afin que le traitement soit aussi efficace et sûr que possible.
\n\nLa dose de rayonnement est mesurée en Gray et est divisée en fractions distinctes. La radiothérapie externe (EBRT) délivre une dose de base à la zone touchée, tandis que la curiethérapie « ajoute » une forte dose ciblée directement à la tumeur, en minimisant l’exposition des organes voisins.
\n\nLa plupart des effets secondaires de la radiothérapie sont temporaires et gérables. Après une radiothérapie externe (EBRT), le patient ne présente aucun danger pour ses proches, car il n’« émet » pas de radiations.
\n\nUne sécheresse, des cicatrices et une diminution de l’élasticité des tissus sont possibles. Une partie des effets s’atténue avec le temps. Le médecin aborde à l’avance les questions de contraception et de préservation de la fertilité afin de minimiser les risques.
\n\nAprès une EBRT, la personne ne présente aucun danger pour son entourage. Avec les sources temporaires utilisées en curiethérapie, l’activité cesse immédiatement après la procédure ; les restrictions, si elles sont nécessaires, sont brèves et indiquées dans la notice.
\n\nDes restrictions temporaires sont possibles : éviter provisoirement les contacts étroits avec les enfants et les femmes enceintes, limiter les efforts physiques importants et l’activité intime.
\n\nPendant le traitement de radiothérapie, le patient peut ressentir de la fatigue, une irritation cutanée, des troubles du transit intestinal ou de la miction. En général, ces symptômes diminuent quelques semaines après la fin du traitement.
\n\nRadiothérapie pour le cancer du col de l’utérus — effets secondaires les plus fréquemment observés :
\n\nL’alimentation, l’activité physique et les soins locaux sont convenus avec le médecin. En cas de douleurs, des hydratants ou des dilatateurs sont utilisés sur prescription ;
\n\n| Action | \n\t\t\tRemarque | \n\t\t
| Repos et alimentation | \n\t\t\tRégime alimentaire léger et maintien d'une bonne hydratation pour réduire la fatigue et les nausées | \n\t\t
| Soins de la peau | \n\t\t\tHydratation quotidienne et protection des zones irradiées | \n\t\t
| Retour progressif à l'activité | \n\t\t\tPromenades légères, augmentation progressive des efforts | \n\t\t
| Soins locaux des organes pelviens | \n\t\t\tUtilisation de dilatateurs ou de moyens prescrits en cas de rapports douloureux | \n\t\t
| Surveillance des symptômes | \n\t\t\tEn cas de manifestations sévères ou inhabituelles — contacter d'urgence la clinique | \n\t\t
❗En cas de symptômes sévères ou inhabituels il est nécessaire de contacter d'urgence la clinique.
\n\nPropagation de la maladie et pronostic
\n\nLe pronostic du cancer du col de l'utérus dépend du stade de la maladie, de la taille de la tumeur, de l'atteinte des ganglions lymphatiques et de la réponse au traitement. Aux stades précoces (I–II), les chances de guérison complète atteignent 80–90 %, tandis qu'en cas de maladie localement avancée (IB2–IVA), la combinaison EBRT + chimiothérapie + curiethérapie permet de contrôler la maladie dans 60–70 % des cas.
\n\nEn présence de métastases dans les ganglions lymphatiques pelviens ou para-aortiques, les poumons, le foie ou les os, la radiothérapie est utilisée pour contrôler les symptômes, réduire la douleur et les complications locales, et les zones d'irradiation ainsi que le plan de traitement sont élargis individuellement.
\n\nLe cancer du col de l'utérus peut se propager à différents organes, ce qui influence le choix des zones d'irradiation et la nécessité d'un traitement systémique :
\n\n![\"vie](\"https://s3.eu-central-1.amazonaws.com/bookimed/_images_without_dir/68d4e446b4ab7.jpeg\")
Après l’achèvement du traitement de radiothérapie, l’issue et l’espérance de vie dépendent du stade de la maladie et de la réponse au traitement. Sur cette base, les médecins déterminent la suite du contrôle de la maladie et la stratégie de suivi :
\n\n👉L’association de la chimiothérapie et de l’irradiation offre un avantage en termes de survie par rapport à l’irradiation seule, avec une amélioration absolue d’environ 10 % de la survie à 5 ans aux stades IB3–IVA lors de l’utilisation d’une chimiothérapie concomitante à base de platine.
\n\n💡 Après le traitement, un dépistage oncologique régulier est nécessaire pour détecter précocement une récidive.
\n\n*Sur Bookimed, des avis de vrais patients sont disponibles ; ils partagent leur expérience de traitement et confirment la qualité des services médicaux fournis.
\n\nDes réponses courtes permettent de s’orienter rapidement ; les détails figurent dans les sections ci-dessus.
\n\n"},"guide_mc":{"text":"
Jour 1
Jour 2
Jour 3
Jour 4
Jour 5
Semaine 1 à 4
Semaine 5
Semaine 6
Veuillez noter que le processus de rétablissement de chaque patient varie en fonction de son état de santé.
"}}},"relations":{"countries":[{"name":"Allemagne","alias":"germany","iso_code":"DE"},{"name":"Autriche","alias":"austria","iso_code":"AT"},{"name":"Chine","alias":"china","iso_code":"CN"},{"name":"Egypte","alias":"egypt","iso_code":"EG"},{"name":"Espagne","alias":"spain","iso_code":"ES"},{"name":"Grèce","alias":"greece","iso_code":"GR"},{"name":"Inde","alias":"india","iso_code":"IN"},{"name":"Israël","alias":"israel","iso_code":"IL"},{"name":"Malaisie","alias":"malaysia","iso_code":"MY"},{"name":"République de Corée","alias":"republic-of-korea","iso_code":"KR"},{"name":"République dominicaine","alias":"dominican-republic","iso_code":"DO"},{"name":"Suisse","alias":"switzerland","iso_code":"CH"},{"name":"Thaïlande","alias":"thailand","iso_code":"TH"},{"name":"Turquie","alias":"turkey","iso_code":"TR"},{"name":"Ukraine","alias":"ukraine","iso_code":"UA"}],"cities":[{"name":"Caire","alias":"cairo"}],"operations":[{"name":"Immunothérapie","alias":"immunotherapy"},{"name":"Immunothérapie avec Keytruda (Pembolizumab)","alias":"keytruda"},{"name":"Chimiothérapie","alias":"chemotherapy"},{"name":"Une greffe de moelle osseuse","alias":"bone-marrow-transplantation"},{"name":"Ablation par radiofréquence","alias":"radiofrequency-ablation"},{"name":"Thérapie hormonale","alias":"hormonal-therapy"},{"name":"Hystérectomie (ablation de l’utérus)","alias":"hysterectomy"},{"name":"Prothèse testiculaire","alias":"testicular-prosthesis"},{"name":"Radiothérapie","alias":"radiotherapy"},{"name":"Ablation d'une tumeur cérébrale","alias":"removal-of-the-brain-tumor"},{"name":"Thérapie ciblée","alias":"targeted-therapy"},{"name":"Thérapie à l'iode radioactif","alias":"radioiodine-therapy"},{"name":"Mastectomie","alias":"mastectomy"},{"name":"Néphrectomie","alias":"nephrectomy"},{"name":"Thyroïdectomie","alias":"thyroidectomy"},{"name":"Orchidectomie","alias":"orchiectomy"},{"name":"Prostatectomie","alias":"prostatectomy"},{"name":"Chirurgie du cancer du sein","alias":"operation-on-breast-cancer"},{"name":"Chirurgie d'une tumeur cérébrale","alias":"brain-tumor-surgery"},{"name":"Chirurgie au laser","alias":"laser-surgery"},{"name":"Microchirurgie de Mohs","alias":"mohs-surgery"},{"name":"NanoCouteau","alias":"nanoknife"},{"name":"Chirurgie du cancer du pancréas","alias":"pancreatic-cancer-surgery"},{"name":"Ablation d'une tumeur de la moelle épinière","alias":"removal-of-spinal-cord-tumor"},{"name":"Chirurgie des tumeurs hypophysaires","alias":"pituitary-tumor-surgery"},{"name":"Chirurgie de Whipple","alias":"whipple-surgery"},{"name":"Chirurgie du cancer du poumon","alias":"lung-cancer-surgery"},{"name":"Hystérectomie laparoscopique","alias":"laparoscopic-hysterectomy"},{"name":"Curiethérapie","alias":"brachytherapy"},{"name":"Résection thyroïdienne","alias":"thyroid-resection"},{"name":"Élimination du cancer du côlon","alias":"removal-of-colon-cancer"},{"name":"Chirurgie du cancer de l'estomac","alias":"gastrectomy"},{"name":"Ablation du méningiome","alias":"removal-of-meningioma"},{"name":"Ablation des polypes gastriques","alias":"polypectomy"},{"name":"Colectomie (résection du gros intestin)","alias":"colectomy-large-bowel-resection"},{"name":"Résection transurétrale de la prostate (TURP)","alias":"transurethral-resection-of-the-prostate-turp"},{"name":"Ablation de la vessie","alias":"rezekcia-mocevogo-puzyra"},{"name":"Résection rectale","alias":"rectal-resection"},{"name":"Lumpectomie","alias":"lumpectomy"},{"name":"Curiethérapie pour le cancer de la prostate","alias":"brachytherapy-for-prostate-cancer"},{"name":"Chimioembolisation du foie","alias":"chemoembolization-of-the-liver"},{"name":"Ablation par radiofréquence du foie","alias":"radiofrequency-ablation-of-the-liver"},{"name":"Gastroectomie","alias":"gastroectomy"},{"name":"Élimination du cancer du foie","alias":"removal-of-liver-cancer"},{"name":"Greffe de moelle osseuse autologue","alias":"autologous-bone-marrow-transplantation"},{"name":"Chimiothérapie du lymphome","alias":"lymphoma-chemotherapy"},{"name":"Œsophagectomie","alias":"esophagectomy"},{"name":"Chimiothérapie pour le cancer du sein","alias":"chemotherapy-for-breast-cancer"},{"name":"Ablation d'une tumeur testiculaire","alias":"removal-of-tumor-of-testicle"},{"name":"Néphrectomie laparoscopique","alias":"laparoscopic-nephrectomy"},{"name":"Chirurgie du cancer de la langue","alias":"tongue-cancer-surgery"},{"name":"Radiothérapie pour le cancer du sein","alias":"radiotherapy-for-breast-cancer"},{"name":"Radiothérapie pour le cancer de la prostate","alias":"radiotherapy-for-prostate-cancer"},{"name":"Résection transnasale de la tumeur","alias":"transnasal-resection-of-tumor"},{"name":"Pneumonectomie","alias":"pneumonectomy"},{"name":"Ablation de la vessie avec reconstruction","alias":"bladder-removal-with-reconstruction"},{"name":"Résection de l'intestin grêle","alias":"small-intestine-surgery"},{"name":"Chirurgie du mélanome","alias":"melanoma-surgery"},{"name":"Opération du cancer de la gorge","alias":"throat-cancer-operation"},{"name":"Radiochirurgie stéréotaxique","alias":"stereotaxic-surgery"},{"name":"Chimiothérapie pour le cancer du poumon","alias":"chemotherapy-for-lung-cancer"},{"name":"Chirurgie du cancer de l'ovaire","alias":"ovarian-cancer-surgery"},{"name":"Transplantation allogénique de moelle osseuse provenant d'un donneur non apparenté","alias":"allogenic-bone-marrow-transplantation-from-an-unrelated-donor"},{"name":"Thymectomie","alias":"thymectomy"},{"name":"Dissection des ganglions lymphatiques","alias":"lymph-node-dissection"},{"name":"Ovariectomie laparoscopique (chirurgie d'ablation des ovaires)","alias":"laparoscopic-oophorectomy-ovary-removal-surgery"},{"name":"Ablation d'une partie de la tumeur et du nerf de l'œil","alias":"removal-of-part-of-tumor-and-nerve-of-eye"},{"name":"Thérapie à l'iode radioactif dans le cancer de la thyroïde","alias":"treatment-of-thyroid-cancer-with-radioactive-iodine"},{"name":"Radiothérapie pour une tumeur cérébrale","alias":"radiation-therapy-for-brain-tumor"},{"name":"Radiothérapie pour le cancer du col de l'utérus","alias":"radiotherapy-for-cervical-cancer"},{"name":"Radioembolisation pour le cancer du foie","alias":"radioembolization-for-liver-cancer"},{"name":"Immunothérapie contre le sarcome","alias":"sarcoma-immunotherapy"},{"name":"Transplantation allogénique de moelle osseuse d'un donneur apparenté","alias":"allogenic-bone-marrow-transplantation-from-a-related-donor"},{"name":"Prostatectomie laparoscopique","alias":"laparoscopic-prostatectomy"},{"name":"Résection osseuse","alias":"resection-of-the-bone"},{"name":"Radiothérapie pour le cancer colorectal","alias":"radiation-therapy-for-colorectal-cancer"},{"name":"Chimiothérapie pour le cancer du foie","alias":"chemotherapy-for-liver-cancer"},{"name":"Curiethérapie pour le cancer de 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l'oesophage","alias":"esophageal-cancer"},{"name":"Cancer du larynx","alias":"larynx-cancer"},{"name":"Cancer du sein","alias":"breast-cancer"},{"name":"Cancer du poumon","alias":"lung-cancer"},{"name":"Cancer des ovaires","alias":"ovarian-cancer"},{"name":"Cancer du pancréas","alias":"pancreatic-cancer"},{"name":"Cancer du foie","alias":"liver-cancer"},{"name":"Cancer du col de l'utérus","alias":"cervical-cancer"},{"name":"Cancer de l'estomac","alias":"stomach-cancer"},{"name":"Mélanome","alias":"melanoma"},{"name":"Astrocytome","alias":"astrocytoma"},{"name":"Cancer de la vésicule biliaire","alias":"gallbladder-cancer"},{"name":"Cancer de la langue","alias":"cancer-of-the-tongue"},{"name":"Cancer de la thyroïde","alias":"thyroid-cancer"},{"name":"Cancer de la prostate","alias":"prostate-cancer"},{"name":"Cancer des os","alias":"bone-cancer"},{"name":"Cancer de la vessie","alias":"bladder-cancer"},{"name":"Cancer du cerveau","alias":"brain-cancer"},{"name":"Cancer de 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