Онкологические заболевания являются второй причиной смертности после сердечно-сосудистых заболеваний. В Российской Федерации в последние годы отмечен неуклонный рост числа больных со злокачественными новообразованиями, что, в первую очередь, связано с увеличением выявляемости и общей выживаемости онкологических больных. Развитие программы по раннему выявлению рака предстательной железы (РПЖ) у мужчин старше 40 лет привело к значительному росту числа выявляемых случаев заболевания на ранних стадиях. Частота обнаружения РПЖ выше у мужчин старше 60 лет, которые чаще имеют интеркуррентные заболевания, осложняющие течение основного заболевания при проведении радикальных методов лечения. Таким пациентам, а также больным с ожидаемой продолжительностью жизни менее 10 лет или отказывающимся от радикального оперативного лечения из-за возможных осложнений предложен ряд малоинвазивных методов лечения: криоаблация, HIFU-терапия, фотодинамическая терапия, лазерная аблация и др. Наиболее изученным из перечисленных методов лечения РПЖ является криоаблация, рекомендованная в качестве альтернативного лечения Американским и Европейским обществами урологов. Существующие литературные данные, оценивающие онкологические результаты криоаблации, показывают высокий уровень безрецидивной выживаемости.
Cancer is the second most common cause of death only to cardiovascular diseases. In Russia, we marked the steady increase in the number of patients with malignant neoplasms last years, which were primarily due to increasing diagnostics and cancer overall survival rates. The development of the programme for the early prostate cancer screening in men older than 40 years lead to a significant incensement in the determination of the diseases at early stages. Prostate cancer (PC) frequency was higher in men over 60 years old, who often had intercurrent diseases, associated with severe course of the main disease during the radical methods of treatment. In such patients as well as in patients with life expectancies of less than 10 years, or in patients who had refused radical surgical treatment because of the possible complications, we had suggested the number of minimally invasive methods of treatment: cryoablation, HIFU treatment, photodynamic therapy, laser ablation, etc. The most studied PC treatment methods was cryoablation, which was recommended by the American and European Association of Urology as an alternative treatment. The received literature data, estimating the results of cryoablation showed the high recurrence-free survival rates.
Key words: prostate cancer, cryoablation, alternative methods of treatment, recurrence-free survival.
1. Каприн А.Д., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2013 году (заболеваемость и смертность). М.: МНИОИ им. П.А.Герцена, 2015. / Kaprin A.D., Starinskii V.V., Petrova G.V. Zlokachestvennye novoobrazovaniia v Rossii v 2013 godu (zabolevaemost' i smertnost'). M.: MNIOI im. P.A.Gertsena, 2015. [in Russian]
2. Dewar J. The Liquefaction of gases. Nature 1985; 51: 365–7.
3. Patel BG, Parsons CL, Bidair M et al. Cryoablation for carcinoma of the prostate. J Surg Oncology 1996; 63: 256–64.
4. Gonder MJ, Soanes Wa, Smith V. Experimental Prostate Cryosurgery. Invest Urol 1964; 14: 610–9. Gonder MJ, Soanes WA, S. Shulman Cryosurgical treatment of the prostate. Invest Urol 1966; 3 (4): 372–8.
5. Фрейдович В.И., Фрейдович А.И. Криодеструкция предстательной железы. Мед. техника. 1970; 2: 55–7. / Freidovich V.I., Freidovich A.I. Kriodestruktsiia predstatel'noi zhelezy. Med. tekhnika. 1970; 2: 55–7. [in Russian]
6. Onik GM, Cohen JK, Reyes GD et al. Transrectal ultrasound-guided percutaneous radical cryosurgical ablation of the prostate. Cancer 1993; 72: 1291–9.
7. Lee F. US-guided percutaneous cryoablation of the prostate cancer. Radiology 1994; 192: 769–6.
8. Cohen JK, Miller RJ, Shuman BA. Urethral warming catheter for use during cryoablation of the prostate. Urology 1995; 45: 861–4.
9. Janzen NK, Han KR, Perry KT et al. Feasibility of nerve-sparing prostate cryosurgery: applications and limitations in a canine model. J Endourol 2005; 19: 520–5.
10. Clarke DM, Baust JM, Van Buskirk RG et al. Chemo-cryo combination therapy: an adjunctive model for the treatment of prostate cancer. Cryobiology 2001; 42: 274–85.
11. Wang H, Tu HJ, Qin J et al. Effect of cryotherapy and 5-fluorouracil on apoptosis of G422 glioma cells. Ai Zheng 2004; 23: 412–5.
12. Jiang J, Goel R, Iftekhar MA et al. Tumor necrosis factor-alpha-induced accentuation in cryoinjury: mechanisms in vitro and in vivo. Mol Cancer Ther 2008; 7: 2547–5.
13. Baust JM, Klossner DP, Robilotto A et al. Vitamin D3 cryosensitization increases prostate cancer susceptibility to cryoablation via mitochondrial-mediated apoptosis and necrosis. BJU Int 2012; 109 (6): 949–58.
14. Muldrew K, Rewcastle J, Donnelly BJ et al. Flounder antifreeze peptides increase the efficacy of cryosurgery. Cryobiology 2001; 42: 182–9.
15. Burton SA, Paljug WR, Kalnicki S et al. Hypothermia-enhanced human tumor cell radiosensitivity. Cryobiology 1997; 35: 70–8.
16. Говоров А.В., Васильев А.О., Пушкарь Д.Ю. Особенности криодеструкции предстательной железы. Мед. техника. 2015; 1: 40–5. / Govorov A.V., Vasil'ev A.O., Pushkar' D.Iu. Osobennosti kriodestruktsii predstatel'noi zhelezy. Med. tekhnika. 2015; 1: 40–5. [in Russian]
17. Govorov AV, Vasilyev AO, Pushkar DU. Specifics of Prostate Cryoablation. Biomedical Engineering 2015; 49 (1): 54–9.
18. Говоров А.В., Васильев А.О., Иванов В.Ю. и др. Лечение рака предстательной железы при помощи криоаблации: проспективное исследование. Урология. 2014; 6: 69–74.
19. Mottet N, Bastian PJ, Bellmunt J et al. Prostate cancer: guidelines. Netherlands: European Association of Urology, 2015.
20. Koppie TM, Shinohara K, Grossfeld GD et al. The efficacy of cryosurgical ablation of the prostate cancer: the University of Carolina, San Francisco experience. J Urol 1999; 162 (2): 427–32.
21. Long JP, Bahn D, Lee F et al. Five-year retrospective, multi-institutional pooled analysis of cancer-related outcomes after cryosurgical ablation of the prostate. Urology 2001; 57 (3): 518–23.
22. Donnelly BJ, Saliken JC, Ernst DS et al. Prospective trial of cryosurgical ablation of the prostate: five-year results. Urology 2002; 60 (4): 645–9.
23. Jones JS, Rewcastle JC, Donnelly BJ et al. Whole gland primary prostate cryoablation: initial results from the Cryo On-line Data Registry. J Urol 2008; 180: 554–8.
24. Cohen JK, Miller RJ, Ahmed S et al. Ten-year biochemical disease control for patients with prostate cancer treated with cryosurgery as primary therapy. Urology 2008; 71: 515–8.
25. Bahn DK, Lee F, Badalament R et al. Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer. Urology 2002; 60 (2A): 3–11.
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1. Kaprin A.D., Starinskii V.V., Petrova G.V. Zlokachestvennye novoobrazovaniia v Rossii v 2013 godu (zabolevaemost' i smertnost'). M.: MNIOI im. P.A.Gertsena, 2015. [in Russian]
2. Dewar J. The Liquefaction of gases. Nature 1985; 51: 365–7.
3. Patel BG, Parsons CL, Bidair M et al. Cryoablation for carcinoma of the prostate. J Surg Oncology 1996; 63: 256–64.
4. Gonder MJ, Soanes Wa, Smith V. Experimental Prostate Cryosurgery. Invest Urol 1964; 14: 610–9. Gonder MJ, Soanes WA, S. Shulman Cryosurgical treatment of the prostate. Invest Urol 1966; 3 (4): 372–8.
5. Freidovich V.I., Freidovich A.I. Kriodestruktsiia predstatel'noi zhelezy. Med. tekhnika. 1970; 2: 55–7. [in Russian]
6. Onik GM, Cohen JK, Reyes GD et al. Transrectal ultrasound-guided percutaneous radical cryosurgical ablation of the prostate. Cancer 1993; 72: 1291–9.
7. Lee F. US-guided percutaneous cryoablation of the prostate cancer. Radiology 1994; 192: 769–6.
8. Cohen JK, Miller RJ, Shuman BA. Urethral warming catheter for use during cryoablation of the prostate. Urology 1995; 45: 861–4.
9. Janzen NK, Han KR, Perry KT et al. Feasibility of nerve-sparing prostate cryosurgery: applications and limitations in a canine model. J Endourol 2005; 19: 520–5.
10. Clarke DM, Baust JM, Van Buskirk RG et al. Chemo-cryo combination therapy: an adjunctive model for the treatment of prostate cancer. Cryobiology 2001; 42: 274–85.
11. Wang H, Tu HJ, Qin J et al. Effect of cryotherapy and 5-fluorouracil on apoptosis of G422 glioma cells. Ai Zheng 2004; 23: 412–5.
12. Jiang J, Goel R, Iftekhar MA et al. Tumor necrosis factor-alpha-induced accentuation in cryoinjury: mechanisms in vitro and in vivo. Mol Cancer Ther 2008; 7: 2547–5.
13. Baust JM, Klossner DP, Robilotto A et al. Vitamin D3 cryosensitization increases prostate cancer susceptibility to cryoablation via mitochondrial-mediated apoptosis and necrosis. BJU Int 2012; 109 (6): 949–58.
14. Muldrew K, Rewcastle J, Donnelly BJ et al. Flounder antifreeze peptides increase the efficacy of cryosurgery. Cryobiology 2001; 42: 182–9.
15. Burton SA, Paljug WR, Kalnicki S et al. Hypothermia-enhanced human tumor cell radiosensitivity. Cryobiology 1997; 35: 70–8.
16. Govorov A.V., Vasil'ev A.O., Pushkar' D.Iu. Osobennosti kriodestruktsii predstatel'noi zhelezy. Med. tekhnika. 2015; 1: 40–5. [in Russian]
17. Govorov AV, Vasilyev AO, Pushkar DU. Specifics of Prostate Cryoablation. Biomedical Engineering 2015; 49 (1): 54–9.
18. Говоров А.В., Васильев А.О., Иванов В.Ю. и др. Лечение рака предстательной железы при помощи криоаблации: проспективное исследование. Урология. 2014; 6: 69–74.
19. Mottet N, Bastian PJ, Bellmunt J et al. Prostate cancer: guidelines. Netherlands: European Association of Urology, 2015.
20. Koppie TM, Shinohara K, Grossfeld GD et al. The efficacy of cryosurgical ablation of the prostate cancer: the University of Carolina, San Francisco experience. J Urol 1999; 162 (2): 427–32.
21. Long JP, Bahn D, Lee F et al. Five-year retrospective, multi-institutional pooled analysis of cancer-related outcomes after cryosurgical ablation of the prostate. Urology 2001; 57 (3): 518–23.
22. Donnelly BJ, Saliken JC, Ernst DS et al. Prospective trial of cryosurgical ablation of the prostate: five-year results. Urology 2002; 60 (4): 645–9.
23. Jones JS, Rewcastle JC, Donnelly BJ et al. Whole gland primary prostate cryoablation: initial results from the Cryo On-line Data Registry. J Urol 2008; 180: 554–8.
24. Cohen JK, Miller RJ, Ahmed S et al. Ten-year biochemical disease control for patients with prostate cancer treated with cryosurgery as primary therapy. Urology 2008; 71: 515–8.
25. Bahn DK, Lee F, Badalament R et al. Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer. Urology 2002; 60 (2A): 3–11.
Авторы
А.В.Говоров*, А.О.Васильев, Д.Ю.Пушкарь
ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1
*alexgovorov@newmail.ru
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A.V.Govorov*, S.O.Vasilyev, D.Yu.Pushkar
A.I.Evdokimov Moscow State Medical and Dental University of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1
*alexgovorov@newmail.ru