Лекарственное лечение первичных злокачественных опухолей кости. Достижения и перспективы развития
- Авторы: Мачак Г.Н.1
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Учреждения:
- Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова
- Выпуск: Том 31, № 2 (2024)
- Страницы: 229-249
- Раздел: Обзоры
- URL: https://journal-vniispk.ru/0869-8678/article/view/265254
- DOI: https://doi.org/10.17816/vto624147
- ID: 265254
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Аннотация
Химиотерапия в сочетании с радикальным хирургическим вмешательством является золотым стандартом лечения сарком кости высокой степени злокачественности. Число излечиваемых пациентов за последние десятилетия не изменилось. Около 30% больных со IIB стадией, 70% — с IIIB стадией и более 80% больных с рецидивирующими саркомами кости резистентны к современным схемам химиотерапии и в конечном счёте умирают от прогрессирования заболевания. Доступные в настоящее время таргетные препараты, преимущественно ингибиторы нескольких тирозинкиназ (мультитаргетные препараты), не излечивают пациента, однако у значительной части больных с генерализованными саркомами достигается стабилизация. Это открывает возможность комбинирования местного и системного лечения для консолидации клинического ответа, снижения опухолевой нагрузки и продления периода без прогрессирования. Оптимальное сочетание системных и местных методов (хирургия, лучевая терапия, радиохирургия) позволяет в ряде случаев эффективно воздействовать на метастатические очаги, переводя распространённый опухолевый процесс из прогрессирующего заболевания в хроническое. Раннее выявление рецидива может оказать положительное влияние на результаты системного лечения за счёт низкой опухолевой нагрузки и менее развитых механизмов резистентности. Перспективы улучшения результатов лечения распространённых сарком кости связаны с разработкой персонализированных подходов и дальнейшим изучением биологии этих новообразований с использованием омиксных технологий.
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Геннадий Николаевич Мачак
Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова
Автор, ответственный за переписку.
Email: machak.gennady@mail.ru
ORCID iD: 0000-0003-1222-5066
SPIN-код: 4020-1743
д-р мед. наук
Россия, 127299, Москва, ул. Приорова, 10Список литературы
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