Неоадъювантная лучевая терапия в стратегии лечения рака прямой кишки с синхронным метастатическим поражением печени. Обзор литературы
Автор: Почуев Тарас Петрович, Невольских Алексей Алексеевич, Петров Леонид Олегович, Титова Людмила Николаевна, Карпов Александр Анатольевич
Журнал: Сибирский онкологический журнал @siboncoj
Рубрика: Обзоры
Статья в выпуске: 5 т.20, 2021 года.
Бесплатный доступ
Введение. В России примерно у 6 200 больных ежегодно выявляются синхронные отдаленные метастазы и у 4 000 больных - синхронное метастатическое поражение печени. Пациенты с раком прямой кишки с синхронным поражением печени - достаточно многочисленная группа, при планировании лечения которой необходимо учитывать локализацию, распространенность первичной опухоли, осложнения, связанные с ней, а также резектабельность метастатического поражения. В алгоритме лечения этих больных использование лучевой терапии расширяет возможности онкологической помощи и указывает на актуальность и сложность рассматриваемого вопроса. Целью исследования явился анализ результатов исследований, которые были направлены на поиск наиболее эффективных методов лечения больных раком прямой кишки с синхронными метастазами в печень при использовании лучевой терапии на область первичной опухоли. Материал и методы. В обзор включены данные ретроспективных и проспективных исследований, проведен анализ ранее выполненных обзоров, а также отечественных и зарубежных клинических рекомендаций. Результаты. Подавляющее большинство экспертов сходятся во мнении о необходимости предоперационной лучевой терапии на область первичного очага, особенно при локализации опухоли в нижне- и среднеампулярном отделе прямой кишки. Однако рандомизированных исследований с репрезентативным количеством больных, подтверждающих или опровергающих эту точку зрения, еще нет. Увеличение продолжительности жизни больных в связи с совершенствованием лекарственной терапии, внедрением современных малоинвазивных технологий сделало актуальным вопрос о необходимости радикального лечения первичного очага. Таким образом, подходы к лечению первичной опухоли с синхронным метастатическим поражением печени должны быть такими же, как и при II-III стадии заболевания, неоадъювантная лучевая терапия является неотъемлемой частью этой стратегии
Метастатический рак прямой кишки, синхронные метастазы в печень, лучевая терапия, стратегия лечения
Короткий адрес: https://sciup.org/140261330
IDR: 140261330 | DOI: 10.21294/1814-4861-2021-20-5-123-137
Список литературы Неоадъювантная лучевая терапия в стратегии лечения рака прямой кишки с синхронным метастатическим поражением печени. Обзор литературы
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