DOI: https://doi.org/10.22263/2312-4156.2018.5.80
Суконко О.Г., Поляков С.Л., Ролевич А.И., Жегалик А.Г.
Лечение мышечно-инвазивного рака мочевого пузыря с неблагоприятным прогнозом: актуальность проблемы
Республиканский научно-практический центр онкологии и медицинской радиологии им. Н.Н. Александрова, г. Минск, Республика Беларусь
Вестник ВГМУ. – 2018. – Том 17, №5. – С. 80-93.
Резюме.
Мышечно-инвазивный рак мочевого пузыря (МИРМП) с неблагоприятным прогнозом (категории рТ3-4N0 либо pN+) характеризуется высокой агрессивностью течения опухолевого процесса и смертностью. В настоящее время в рамках комплексного лечения данной патологии наряду с радикальной цистэктомией (ЦЭ) используется неоадъювантная (НХТ) либо адъювантная химиотерапия (АХТ), главным образом, на основе цисплатина, характеризующаяся высокой токсичностью и умеренной эффективностью. У пациентов с МИРМП с неблагоприятным прогнозом, которым не проводилась НХТ, после радикальной ЦЭ предлагается применять режимы M-VAC (цисплатин, адриамицин, метотрексат и винбластин), GC (гемцитабин, цисплатин) или CMV (цисплатин, метотрексат и винбластин). Данные исследований, в том числе и проспективного рандомизированного исследования, проведенного в Республиканском научно-практическом центре онкологии и медицинской радиологии им. Н.Н. Александрова, показали, что наибольшая эффективность АХТ отмечается в подгруппе пациентов без метастатического поражения регионарных лимфоузлов.
Ключевые слова: мышечно-инвазивный рак мочевого пузыря, цистэктомия, адъювантная химиотерапия, неоадъювантная химиотерапия, выживаемость.
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Сведения об авторах:
Суконко О.Г. – д.м.н., профессор, директор Республиканского научно-практического центра онкологии и медицинской радиологии им. Н.Н. Александрова;
Поляков С.Л. – д.м.н., заведующий лабораторией онкоурологической патологии, Республиканский научно-практический центр онкологии и медицинской радиологии им. Н.Н. Александрова;
Ролевич А.И. – д.м.н., ведущий научный сотрудник лаборатории онкоурологической патологии, Республиканский научно-практический центр онкологии и медицинской радиологии им. Н.Н. Александрова;
Жегалик А.Г. – врач-онколог-уролог онкологического урологического отделения, Республиканский научно-практический центр онкологии и медицинской радиологии им. Н.Н. Александрова.
Адрес для корреспонденции: Республика Беларусь, 223040, агрогородок Лесной, Минский район, Республиканский научно-практический центр онкологии и медицинской радиологии им. Н.Н. Александрова, отдел абдоминальной онкопатологии, онкологическое отделение гепатопанкреатобилиарной патологии. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Жегалик Александр Георгиевич.
