Вторые опухоли у лиц, подвергавшихся противоопухолевой терапии в детском возрасте. Статистика, этиология, пути профилактики
Автор: Щербенко Олег Ильич
Журнал: Вестник Российского научного центра рентгенорадиологии Минздрава России @vestnik-rncrr
Рубрика: Обзоры
Статья в выпуске: 3 т.13, 2013 года.
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Проведен анализ литературы, посвященной отдаленным последствиям противоопухолевого лечения у детей и подростков. Констатировано, что в отдаленные сроки после излечения первичной опухоли основными проблемами становятся вторые опухоли и сердечно-сосудистая патология. Основным фактором индукции вторых опухолей является лучевая терапия. Вероятность развития последствий терапии находится в прямой корреляции с величиной дозы облучения и временем, прошедшим после лечения. Результаты анализа свидетельствуют о целесообразности пересмотра показаний к проведению консолидирующей лучевой терапии, с отказом от нее в случаях благоприятного прогноза и полной регрессии опухоли в результате операции или химиотерапии. При наличии необходимости в лучевой терапии лечение должно проводиться в максимально щадящем режиме с применением стереотаксических методик, современной радиотерапевтической аппаратуры и в минимально возможных дозах. Больные, получавшие противоопухолевую терапию в юном возрасте, должны находиться пожизненно под диспансерным наблюдением онкологов с особым вниманием к зонам, подвергавшимся облучению.
Опухоли у детей, отдаленные последствия, лучевая терапия, радиационный канцерогенез
Короткий адрес: https://sciup.org/14955408
IDR: 14955408
Second tumors in patients after cancer therapy in childhood. Statistics, etiology, ways of prevention
The analysis of the literature is devoted to the late consequences of antineoplastic treatment in children and adolescents. In the late periods after the treatment of primary tumors the main problems are the second tumors and cardiovascular diseases. The main factor of the induction of secondary tumors is radiotherapy. The likelihood and severity of the late effects of therapy are in direct correlation with the radiation dose and the time elapsed after the treatment. Results of the analysis indicate the advisability of revising the indications for consolidation radiotherapy with the refraining from it in the cases of a favorable prognosis and complete tumor regression as a result of surgery or chemotherapy. In those cases when radiation therapy is indicated the modern techniques and equipment should be used with the lowest possible doses of irradiation. Patients treated with anti-tumor therapy at a young age should be under lifelong medical supervision by oncologists with special attention to areas exposed to radiation.
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