{"id":154,"date":"2020-12-14T13:37:06","date_gmt":"2020-12-14T12:37:06","guid":{"rendered":"https:\/\/onetech.dev\/covid\/?page_id=154"},"modified":"2026-04-22T15:31:56","modified_gmt":"2026-04-22T14:31:56","slug":"les-sarcomes","status":"publish","type":"page","link":"https:\/\/onetech.dev\/covid\/les-sarcomes","title":{"rendered":"Les Sarcomes"},"content":{"rendered":"<section class=\"l-section wpb_row height_small\"><div class=\"l-section-h i-cf\"><div class=\"g-cols vc_row via_grid cols_1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\"><div class=\"wpb_column vc_column_container type_sticky\"><div class=\"vc_column-inner\" style=\"top:180px\"><div class=\"w-image us_custom_fb33871a us_animate_this has_height align_center\"><div class=\"w-image-h\"><img decoding=\"async\" width=\"900\" height=\"127\" src=\"https:\/\/onetech.dev\/covid\/data\/irc_logo.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/onetech.dev\/covid\/data\/irc_logo.png 900w, https:\/\/onetech.dev\/covid\/data\/irc_logo-300x42.png 300w, https:\/\/onetech.dev\/covid\/data\/irc_logo-150x21.png 150w\" sizes=\"auto, (max-width: 900px) 100vw, 900px\" \/><\/div><\/div><div class=\"ult-spacer spacer-69f4102dbd99b\" data-id=\"69f4102dbd99b\" data-height=\"35\" data-height-mobile=\"35\" data-height-tab=\"35\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><h3 class=\"w-text us_custom_7ccf62ca has_text_color\"><span class=\"w-text-h\"><span class=\"w-text-value\">RECOMMANDATIONS G\u00c9N\u00c9RALES<\/span><\/span><\/h3><\/div><\/div><\/div><\/div><\/section><section class=\"l-section wpb_row height_small\"><div class=\"l-section-h i-cf\"><div class=\"g-cols vc_row via_grid cols_1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\"><div class=\"wpb_column vc_column_container\"><div class=\"vc_column-inner\"><div class=\"g-cols wpb_row via_grid cols_2-1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\" style=\"--columns-gap:3rem;\"><div class=\"wpb_column vc_column_container\"><div class=\"vc_column-inner\"><div class=\"aio-icon-component    style_2\"><a class=\"aio-icon-box-link\" ><div id=\"Info-box-wrap-3829\" class=\"aio-icon-box left-icon\" style=\"\"  ><div class=\"aio-icon-left\"><div class=\"ult-just-icon-wrapper  \"><div class=\"align-icon\" style=\"text-align:center;\">\n<div class=\"aio-icon-img \" style=\"font-size:50px;background:#03254C;border-style:solid;border-color:#03254C;border-width:1px;padding:20px;border-radius:500px;display:inline-block;\" >\n\t<img decoding=\"async\" class=\"img-icon\" alt=\"null\" src=\"https:\/\/onetech.dev\/covid\/data\/intestine.png\"\/>\n<\/div><\/div><\/div><\/div><div class=\"aio-ibd-block\"><div class=\"aio-icon-header\" ><h6 class=\"aio-icon-title ult-responsive\"  data-ultimate-target='#Info-box-wrap-3829 .aio-icon-title'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:bold;color:#03254C;\">Les Sarcomes<\/h6><\/div> <!-- header --><\/div> <!-- aio-ibd-block --><\/div> <!-- aio-icon-box --><\/a><\/div> <!-- aio-icon-component --><\/div><\/div><div class=\"wpb_column vc_column_container\"><div class=\"vc_column-inner\"><div class=\"w-btn-wrapper align_right\"><a class=\"w-btn us-btn-style_1 icon_atleft\" href=\"https:\/\/onetech.dev\/covid\/\"><i class=\"far fa-backward\"><\/i><span class=\"w-btn-label\">Retour<\/span><\/a><\/div><\/div><\/div><\/div><div class=\"ult-spacer spacer-69f4102dbe7ed\" data-id=\"69f4102dbe7ed\" data-height=\"25\" data-height-mobile=\"25\" data-height-tab=\"25\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><div class=\"g-cols wpb_row via_grid cols_1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\" style=\"--columns-gap:3rem;\"><div class=\"wpb_column vc_column_container us_custom_7e20fa79 us_animate_this\"><div class=\"vc_column-inner\"><div class=\"w-tabs us_custom_064d3121 style_default switch_click accordion has_scrolling\" style=\"--sections-title-size:18px\"><div class=\"w-tabs-sections titles-align_none icon_chevron cpos_right\"><div class=\"w-tabs-section active\" id=\"d1e2\"><button class=\"w-tabs-section-header active\" aria-controls=\"content-d1e2\" aria-expanded=\"true\"><div class=\"w-tabs-section-title\">1) Aucune modification de pratique ne doit s\u2019appliquer dans les situations suivantes:<\/div><div class=\"w-tabs-section-control\"><\/div><\/button><div  class=\"w-tabs-section-content us_custom_ea76afbe\" id=\"content-d1e2\"><div class=\"w-tabs-section-content-h i-cf\"><div class=\"wpb_text_column\"><div class=\"wpb_wrapper\"><ul>\n<li style=\"text-align: justify;\">La chimioth\u00e9rapie n\u00e9o-adjuvante et adjuvante des sarcomes d\u2019Ewing, des ost\u00e9osarcomes, et des rhabdomyosarcomes alv\u00e9olaires et embryonnaires.<\/li>\n<li style=\"text-align: justify;\">La chirurgie curative des formes localis\u00e9es des ost\u00e9osarcomes et des sarcomes d\u2019Ewing.<\/li>\n<li style=\"text-align: justify;\">Le traitement par chimioth\u00e9rapie en phase m\u00e9tastatique des ost\u00e9osarcomes, et des sarcomes d\u2019Ewing (premi\u00e8re ligne).<\/li>\n<li style=\"text-align: justify;\">La chirurgie des sarcomes des parties molles (tronc\/extr\u00e9mit\u00e9s) op\u00e9rables de grade 2-3.<\/li>\n<li style=\"text-align: justify;\">La chirurgie des sarcomes visc\u00e9raux.<\/li>\n<li style=\"text-align: justify;\">La radioth\u00e9rapie adjuvante des sarcomes des tissus mous ne doit pas \u00eatre retard\u00e9e.<\/li>\n<li style=\"text-align: justify;\">La chimioth\u00e9rapie n\u00e9o-adjuvante cytor\u00e9ductrice pour les sarcomes des parties molles non r\u00e9secables ou chez qui la seule intervention possible est mutilante.<\/li>\n<li style=\"text-align: justify;\">Le traitement adjuvant par Imatinib pour les GISTs \u00e0 haut risque de rechute.<\/li>\n<li style=\"text-align: justify;\">Le traitement des GISTs en phase m\u00e9tastatique par Imatinib, Sunitinib, R\u00e9goraf\u00e9nib en 1\u00e8re, 2\u00e8me, et 3\u00e8me ligne respective, s\u2019applique sans modification.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div><div class=\"w-tabs-section\" id=\"i573\"><button class=\"w-tabs-section-header\" aria-controls=\"content-i573\" aria-expanded=\"false\"><div class=\"w-tabs-section-title\">2) Des adaptations de pratique sont \u00e0 envisager dans les situations suivantes:<\/div><div class=\"w-tabs-section-control\"><\/div><\/button><div  class=\"w-tabs-section-content us_custom_71d3e3d1\" id=\"content-i573\"><div class=\"w-tabs-section-content-h i-cf\"><div class=\"wpb_text_column\"><div class=\"wpb_wrapper\"><ul>\n<li style=\"text-align: justify;\">Pour les chirurgies lourdes (exp: sarcomes r\u00e9tro-p\u00e9riton\u00e9aux), s\u2019assurer de la capacit\u00e9 de la r\u00e9animation post-op\u00e9ratoire.<\/li>\n<li style=\"text-align: justify;\">En cas de capacit\u00e9 op\u00e9ratoire limit\u00e9e en temps de pand\u00e9mie, consid\u00e9rer le report de la chirurgie dans les situation suivantes:<\/li>\n<li style=\"text-align: justify;\">En absence de sympt\u00f4mes, la chirurgie des sarcomes de bas grade \u00e0 comportement indolent (liposarcome r\u00e9tro-p\u00e9riton\u00e9al bien diff\u00e9renci\u00e9) et \u00e0 faible risque m\u00e9tastatique (liposarcome myxoide, tumeur fibro-myxoide de bas grade) peut \u00eatre d\u00e9cal\u00e9e.<\/li>\n<li style=\"text-align: justify;\">Un report de chirurgie de 3 mois ou plus peut \u00eatre discut\u00e9 dans les DFSP sans d\u00e9g\u00e9n\u00e9rescence fibrosarcomateuse, tumeurs desmoides, tumeur lipomateuse atypique (ALT), tumeurs t\u00e9nosynoviales \u00e0 cellules g\u00e9antes (TSGC), et tumeurs osseuses \u00e0 cellules g\u00e9antes.<\/li>\n<li style=\"text-align: justify;\">La reprise des r\u00e9sections R1 pour les sarcomes des parties molles des extr\u00e9mit\u00e9s\/tronc en absence de maladie r\u00e9siduelle sur l\u2019imagerie.<\/li>\n<li style=\"text-align: justify;\">Une courte p\u00e9riode de surveillance active pourrait \u00eatre envisag\u00e9e en cas de rechute oligo-m\u00e9tastatique (\u00e0 discuter au cas par cas) avant une r\u00e9section chirurgicale ou st\u00e9r\u00e9otaxique.<\/li>\n<li style=\"text-align: justify;\">En cas capacit\u00e9 op\u00e9ratoire limit\u00e9e, des traitements d\u2019attente peuvent \u00eatre discut\u00e9s:<\/li>\n<li style=\"text-align: justify;\">Une radioth\u00e9rapie pr\u00e9-op\u00e9ratoire peut \u00eatre discut\u00e9e selon la localisation, le type histologique et l\u2019exp\u00e9rience des \u00e9quipes.<\/li>\n<li style=\"text-align: justify;\">Consid\u00e9rer l\u2019utilisation de l\u2019imatinib en n\u00e9o-adjuvant pour les GISTs avec une anomalie mol\u00e9culaire sensible<\/li>\n<li style=\"text-align: justify;\">Une chimioth\u00e9rapie n\u00e9o-adjuvante \u00e0 base d&rsquo;anthracycline peut \u00eatre envisag\u00e9e pour les sarcomes des partie molles (tronc\/extr\u00e9mit\u00e9s) \u00e0 haut risque, mais doit \u00eatre balanc\u00e9e au risque de mortalit\u00e9 en cas d\u2019infection li\u00e9e au COVID-19.<\/li>\n<li style=\"text-align: justify;\">Pour la radioth\u00e9rapie n\u00e9oadjuvante \/ adjuvante, l\u2019utilisation de sch\u00e9mas hypofractionn\u00e9s doivent \u00eatre envisag\u00e9<\/li>\n<li style=\"text-align: justify;\">En situation m\u00e9tastatique, pour le traitement de premi\u00e8re ligne des sarcomes des parties molles, associer syst\u00e9matiquement des facteurs de croissance (GCSF) \u00e0 la doxorubicine monoth\u00e9rapie (risque de neutrop\u00e9nie f\u00e9brile interm\u00e9diaire 13%) (2).<\/li>\n<li style=\"text-align: justify;\">R\u00e9server la poly-chimioth\u00e9rapie en premi\u00e8re ligne pour les formes avec m\u00e9tastases pulmonaires sans extension extra-thoraciques et accessibles \u00e0 une chirurgie thoracique.<\/li>\n<li style=\"text-align: justify;\">Pour les traitement de deuxi\u00e8me ligne et au-del\u00e0 des sarcomes des parties molles, privil\u00e9gier la voie orale; pazopanib pour les sarcomes non adipocytaires.<\/li>\n<li style=\"text-align: justify;\">Pour les fibromtatose desmo\u00efde \u00e9volutives, privil\u00e9gier des options th\u00e9rapeutiques sans anti-inflammatoires non stero\u00efdiens (AINS)<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong><u>R\u00e9f\u00e9rence:<\/u><\/strong><\/p>\n<ul>\n<li style=\"text-align: justify;\">Penel N, Bonvalot S, Minard V, Orbach D, Gouin F, Corradini N, Brahmi M, Marec-B\u00e9rard P, Briand S, Gaspar N, Llacer C, Carr\u00e8re S, Dufresne A, Le Cesne A, Blay JY.French Sarcoma Group proposals for management of sarcoma patients during the COVID-19 outbreak. Ann Oncol. 2020 Apr 9. pii: S0923-7534(20)36413-9. doi: 10.1016\/j.annonc.2020.03.308.<\/li>\n<li style=\"text-align: justify;\">ESMO-EURACAN Management And Treatment Adapted Recommendations In The Covid-19 Era: Sarcomas. https:\/\/www.esmo.org\/guidelines\/cancer-patient-management-during-the-covid-19-pandemic\/sarcomas-in-the-covid-19-era<\/li>\n<li style=\"text-align: justify;\">Society of Surgical Oncology. Resource for management options of sarcoma during COVID19 available at: https:\/\/www.surgonc.org\/wp-content\/uploads\/2020\/03\/Sarcoma-Resource-during-COVID-19-3.30.20.pdf (14th April 2020, date last accessed).<\/li>\n<li style=\"text-align: justify;\">Judson I, Verweij J, Gelderblom H et al. Doxorubicin alone versus inten- sified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma: a randomised controlled phase 3 trial. Lancet Oncol 2014; 15: 415\u2013423.<\/li>\n<li style=\"text-align: justify;\">https:\/\/www.ema.europa.eu\/en\/news\/ema-gives-advice-use-non-steroidal-anti-inflammatories-covid-19<\/li>\n<li style=\"text-align: justify;\">Capuano A, Scavone C, Racagni G, Scaglione F; Italian Society of Pharmacology. NSAIDs in patients with viral infections, including Covid-19: victims or perpetrators? Pharmacol Res. 2020 Apr 29:104849. doi: 10.1016\/j.phrs.2020.104849<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"ult-spacer spacer-69f4102dbf931\" data-id=\"69f4102dbf931\" data-height=\"35\" data-height-mobile=\"35\" data-height-tab=\"35\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><div class=\"g-cols wpb_row us_custom_60e9caca us_animate_this via_grid cols_1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\" style=\"--columns-gap:3rem;\"><div class=\"wpb_column vc_column_container\"><div class=\"vc_column-inner\"><div class=\"w-text us_custom_7ccf62ca has_text_color\"><span class=\"w-text-h\"><span class=\"w-text-value\">PARTENAIRES<\/span><\/span><\/div><\/div><\/div><\/div><div class=\"w-image align_center\"><div class=\"w-image-h\"><img decoding=\"async\" width=\"1300\" height=\"231\" src=\"https:\/\/onetech.dev\/covid\/data\/partenaire.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/onetech.dev\/covid\/data\/partenaire.png 1300w, https:\/\/onetech.dev\/covid\/data\/partenaire-300x53.png 300w, https:\/\/onetech.dev\/covid\/data\/partenaire-1024x182.png 1024w, https:\/\/onetech.dev\/covid\/data\/partenaire-150x27.png 150w\" sizes=\"auto, (max-width: 1300px) 100vw, 1300px\" \/><\/div><\/div><\/div><\/div><\/div><\/div><\/section>\n","protected":false},"excerpt":{"rendered":"RECOMMANDATIONS G\u00c9N\u00c9RALES Les Sarcomes Retour1) Aucune modification de pratique ne doit s\u2019appliquer dans les situations suivantes: La chimioth\u00e9rapie n\u00e9o-adjuvante et adjuvante des sarcomes d\u2019Ewing, des ost\u00e9osarcomes, et des rhabdomyosarcomes alv\u00e9olaires et embryonnaires. La chirurgie curative des formes localis\u00e9es des ost\u00e9osarcomes et des sarcomes d\u2019Ewing. Le traitement par chimioth\u00e9rapie en phase m\u00e9tastatique des ost\u00e9osarcomes, et des...","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-154","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/pages\/154","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/comments?post=154"}],"version-history":[{"count":1,"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/pages\/154\/revisions"}],"predecessor-version":[{"id":155,"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/pages\/154\/revisions\/155"}],"wp:attachment":[{"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/media?parent=154"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}