Факторы эффективности лечения неоперабельного немелкоклеточного рака легкого III стадии (обзор литературы)

Автор: Соловьева Екатерина Петровна, Вальков Михаил Юрьевич

Журнал: Сибирский онкологический журнал @siboncoj

Статья в выпуске: 2 (74), 2016 года.

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В обзоре представлены современные данные об эффективности консервативного лечения неоперабельного местнораспространенного немелкоклеточного рака легкого и факторах, способных на нее влиять. Совместное использование ЛТ и ХТ в настоящее время является общепризнанным подходом с пятилетней выживаемостью 20-30 % и медианой выживаемости от 17 до 28 мес, при этом, по данным метаанализов, только одновременная ХЛТ дает преимущество в выживаемости перед ЛТ. Однако в практике значительная часть больных не получает химиотерапию даже в последовательном режиме. По данным популяционных исследований, радикальное химиолучевое лечение получают 13-35 % больных. Лучевая терапия совершенствуется, опубликованы перспективные данные о результатах использования методов IMRT, IGRT, изотоксической эскалации дозы, но эти подходы остаются экспериментальными. Риск ускоренной репопуляции клоногенов при НМРЛ диктует необходимость интенсификации лечения, сокращение его общего времени. Схемы ускоренного гиперфракционирования представляются наиболее оптимальным путем к достижению этой цели. Данные ряда экспериментальных и клинических исследований также свидетельствуют о негативной роли задержек во времени начала любого лечения, а особенно лучевого. Оптимальной тактикой лечения НМРЛ III стадии представляется раннее начало ЛТ и короткая ее продолжительность.

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Неоперабельный местнораспространенный немелкоклеточный рак легкого iii стадии, лучевая терапия, химиотерапия

Короткий адрес: https://sciup.org/14056675

IDR: 14056675 | DOI: 10.21294/1814-4861-2016-15-2-76-89

Список литературы Факторы эффективности лечения неоперабельного немелкоклеточного рака легкого III стадии (обзор литературы)

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