Appréciation de la réponse : évolution des concepts

Evaluation of tumoral response has evolved these last years. The bi-dimensional approach, with WHO criterions, is currently substituted by a one-dimensional approach, with RECIST (Response Evaluation Criteria in Solid Tumors). These criterions are simple, but have some limits, delaying notably the diagnostic of progression in comparison with WHO criterions. Some advances concerning nodes evaluation, measure of mesothelioma's lesions, or excavated tumors under anti-angiogenics, have been made and published recently. The choice of time criterion in randomized trials for response evaluation is of paramount importance, being time to progression or progression free survival, with an evaluation timing that needs to be the same in the two arms. Promising results exist also with positon emission tomography (PET) for metabolic response estimation, notably after induction treatment in locally advanced tumors. New standards are needed for a better definition of this metabolic response, before we can use routinely this.