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Отдаленные последствия терапии злокачественных опухолей у детей: 35-летний опыт клинических наблюдений
Отдаленные последствия терапии злокачественных опухолей у детей: 35-летний опыт клинических наблюдений
Заева Г.Е., Валиев Т.Т., Гавриленко Т.Ф. и др. Отдаленные последствия терапии злокачественных опухолей у детей: 35-летний опыт клинических наблюдений. Современная Онкология. 2015; 18 (1): 55–60.
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Аннотация
Успехи современной детской онкологии заставили пересмотреть задачи терапии в пользу не только достижения максимального противоопухолевого эффекта, но и снижения неблагоприятных отдаленных последствий проводимого лечения. Антрациклиновые антибиотики, препараты платины, метотрексат, блеомицин, лучевая терапия – вот лишь немногие агенты, вызывающие серьезные отдаленные осложнения со стороны жизненно важных органов и систем организма ребенка, перенесшего противоопухолевое лечение. В статье представлен мировой и собственный опыт, обобщающий и анализирующий последствия терапии злокачественных опухолей у детей. На большом клиническом материале (873 пациента) авторы демонстрируют широкий спектр нарушений в работе сердечно-сосудистой, дыхательной, пищеварительной, эндокринной, опорно-двигательной, иммунной и других систем. Длительный период наблюдения (с 1979 по 2014 г.) за состоянием здоровья лиц, в детстве излеченных от злокачественных новообразований, позволил охарактеризовать возникающие вторые опухоли у этой категории населения. Особенный интерес представляют данные, полученные при анализе показателей здоровья потомства лиц, в детстве излеченных от онкопатологии. Оказалось, что они вполне сопоставимы с таковыми у детей в семьях без отягощенного онкологического анамнеза родителей.
Ключевые слова: злокачественные новообразования, дети, лечение, отдаленные последствия.
Key words: cancer, children, treatment, long-term effects.
Ключевые слова: злокачественные новообразования, дети, лечение, отдаленные последствия.
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Key words: cancer, children, treatment, long-term effects.
Полный текст
Список литературы
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15. Krischer JP, Epstein S, Cuthbertson DD et al. Clinical cardiotoxicity following anthracycline treatment for childhood cancer: the Pediatric Oncology Group experience. J Clin Oncol 1997; 15: 1544–52.
16. Alvarez J, Scully R, Miller T et al. Long-term effects of treatments for childhood cancers. Curr Opin Pediatr 2007; 19: 23–31.
17. Simbre VC, Duffy SA, Dadlani GH et al. Cardiotoxicity of cancer chemotherapy: implications for children. Paediatr Drugs 2005; 7: 187–202.
18. Barry E, Alvarez JA, Scully RE et al. Anthracycline-induced cardiotoxicity: course, pathophysiology, prevention and management. Exp Opin Pharmacother 2007; 8: 1039–58.
19. Делягин В.М. Пневмотоксические реакции в онкогематологической практике. Практ. медицина. 2014; 9: 28–31. / Deliagin V.M. Pnevmotoksicheskie reaktsii v onkogematologicheskoi praktike. Prakt. meditsina. 2014; 9: 28–31. [in Russian]
20. Kerachian MA, Séguin C, Harvey EJ. Glucocorticoids in osteonecrosis of the femoral head: A new understanding of the mechanisms of action. J Steroid Biochem Mol Biol 2009; 114: 121–8.
21. Powell C, Chang C, Gershwin ME. Current concepts on the pathogenesis and natural history of ster- oid-induced osteonecrosis. Clin Rev Allergy Immunol 2011; 41: 102–13.
22. Chen SH, Chang TY, Jaing TH et al. Incidence, risk factors, and treatment outcome of symptomatic osteonecrosis in Taiwanese children with acute lymphoblastic leukemia: a retrospective cohort study of 245 patients in a single institution. Int J Hematol 2015; 102 (1): 41–7.
23. te Winkel ML, Pieters R, Hop WC et al. Bone mineral density at diagnosis determines fracture rate in children with acute lymphoblastic leukemia treated according to the DCOG-ALL9 protocol. Bone 2014; 59: 223–8.
24. Румянцев А.Г., Масчан А.А., Самочатова Е.В. Сопроводительная терапия и контроль инфекции при гематологических и онкологических заболеваниях. М.: Медпрактика-М, 2006. / Rumiantsev A.G., Maschan A.A., Samochatova E.V. Soprovoditel'naia terapiia i kontrol' infektsii pri gematologicheskikh i onkologicheskikh zabolevaniiakh. M.: Medpraktika-M, 2006. [in Russian]
25. Prasad PK, Hardy KK, Zhang N et al. Psychosocial and Neurocognitive Outcomes in Adult Survivors of Adolescent and Early Young Adult Cancer: A Report From the Childhood Cancer Survivor Study. J Clin Oncol 2015; 33 (23): 2545–52.
26. Мазеркина Н.А. Эндокринные нарушения после комплексного лечения злокачественных опухолей хиазмально-селлярной области и задней черепной ямки у детей: Автореф. дис. ... д-ра мед. наук. М., 2007. / Mazerkina N.A. Endokrinnye narusheniia posle kompleksnogo lecheniia zlokachestvennykh opukholei khiazmal'no-selliarnoi oblasti i zadnei cherepnoi iamki u detei: Avtoref. dis. ... d-ra med. nauk. M., 2007. [in Russian]
2. Valiev T.T., Bariakh E.A., Zeinalova P.A. i dr. Optimizatsiia diagnostiki i lecheniia limfomy Berkitta u detei, podrostkov i molodykh vzroslykh. Klin. onkogematologiia. 2014; 7 (2): 175–83. [in Russian]
3. Rukovodstvo po khimioterapii opukholevykh zabolevanii. Pod red. N.I.Perevodchikovoi, V.A.Gorbunovoi. M.: Prakticheskaia meditsina, 2015. [in Russian]
4. Batista A, Riedemann L, Vardam T et al. Targeting the Tumor Microenvironment to Enhance Pediatric Brain Cancer Treatment. Cancer J 2015; 21 (4): 307–13.
5. Bariakh E.A., Valiev T.T., Zvonkov E.E. i dr. Intensivnaia terapiia limfomy Berkitta: opisanie dvukh klinicheskikh sluchaev. Gematologiia i transfuziologiia. 2007; 1: 41–3. [in Russian]
6. Mertens AC, Yasui Y, Neglia JP et al. Late mortality experience in five-year survivors of childhood and adolescent cancer: the Childhood Cancer Survivor Study. J Clin Oncol 2001; 19: 3163–72.
7. Hudson MM, Mertens AC, Yasui Y et al. Health status of adult long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. JAMA 2003; 290: 1583–92.
8. Winther JF, Kenborg L, Byrne J et al. Childhood cancer survivor cohorts in Europe. Acta Oncol 2015; 54 (5): 655–68.
9. Rudneva A.E., Il'ina E.E. Nabliudenie za patsientkmi s gemoblastozami posle okonchaniia protivoopukholevoi terapii. Onkogematologiia. 2014; 4: 46–53. [in Russian]
10. Robison LL, Armstrong GT, Boice JD et al. The Childhood Cancer Survivor Study: a National Cancer Institute-supported resource for outcome and intervention research. J Clin Oncol 2009; 27 (14): 2308–18.
11. Meditsinskaia, psikhologicheskaia i sotsial'naia adaptatsiia detei, izlechennykh ot onkologicheskikh zabolevanii. Pod red. M.D.Alieva. M.: Prakticheskaia meditsina, 2012. [in Russian]
12. Dietz JH, Jr. Adaptive rehabilitation of the cancer patient. Curr Probl Cancer 1980; 5: 1–56.
13. Yoshioka H. Rehabilitation for the terminal cancer patient. Am J Phys Med Rehabil 1994; 73: 199–206.
14. Giantris A, Abdurrahman L, Hinkle A et al. Anthracycline-induced cardiotoxicity in children and young adults. Crit Rev Oncol Hematol 1998; 27: 53–68.
15. Krischer JP, Epstein S, Cuthbertson DD et al. Clinical cardiotoxicity following anthracycline treatment for childhood cancer: the Pediatric Oncology Group experience. J Clin Oncol 1997; 15: 1544–52.
16. Alvarez J, Scully R, Miller T et al. Long-term effects of treatments for childhood cancers. Curr Opin Pediatr 2007; 19: 23–31.
17. Simbre VC, Duffy SA, Dadlani GH et al. Cardiotoxicity of cancer chemotherapy: implications for children. Paediatr Drugs 2005; 7: 187–202.
18. Barry E, Alvarez JA, Scully RE et al. Anthracycline-induced cardiotoxicity: course, pathophysiology, prevention and management. Exp Opin Pharmacother 2007; 8: 1039–58.
19. Deliagin V.M. Pnevmotoksicheskie reaktsii v onkogematologicheskoi praktike. Prakt. meditsina. 2014; 9: 28–31. [in Russian]
20. Kerachian MA, Séguin C, Harvey EJ. Glucocorticoids in osteonecrosis of the femoral head: A new understanding of the mechanisms of action. J Steroid Biochem Mol Biol 2009; 114: 121–8.
21. Powell C, Chang C, Gershwin ME. Current concepts on the pathogenesis and natural history of ster- oid-induced osteonecrosis. Clin Rev Allergy Immunol 2011; 41: 102–13.
22. Chen SH, Chang TY, Jaing TH et al. Incidence, risk factors, and treatment outcome of symptomatic osteonecrosis in Taiwanese children with acute lymphoblastic leukemia: a retrospective cohort study of 245 patients in a single institution. Int J Hematol 2015; 102 (1): 41–7.
23. te Winkel ML, Pieters R, Hop WC et al. Bone mineral density at diagnosis determines fracture rate in children with acute lymphoblastic leukemia treated according to the DCOG-ALL9 protocol. Bone 2014; 59: 223–8.
24. Rumiantsev A.G., Maschan A.A., Samochatova E.V. Soprovoditel'naia terapiia i kontrol' infektsii pri gematologicheskikh i onkologicheskikh zabolevaniiakh. M.: Medpraktika-M, 2006. [in Russian]
25. Prasad PK, Hardy KK, Zhang N et al. Psychosocial and Neurocognitive Outcomes in Adult Survivors of Adolescent and Early Young Adult Cancer: A Report From the Childhood Cancer Survivor Study. J Clin Oncol 2015; 33 (23): 2545–52.
26. Mazerkina N.A. Endokrinnye narusheniia posle kompleksnogo lecheniia zlokachestvennykh opukholei khiazmal'no-selliarnoi oblasti i zadnei cherepnoi iamki u detei: Avtoref. dis. ... d-ra med. nauk. M., 2007. [in Russian]
2. Валиев Т.Т., Барях Е.А., Зейналова П.А. и др. Оптимизация диагностики и лечения лимфомы Беркитта у детей, подростков и молодых взрослых. Клин. онкогематология. 2014; 7 (2): 175–83. / Valiev T.T., Bariakh E.A., Zeinalova P.A. i dr. Optimizatsiia diagnostiki i lecheniia limfomy Berkitta u detei, podrostkov i molodykh vzroslykh. Klin. onkogematologiia. 2014; 7 (2): 175–83. [in Russian]
3. Руководство по химиотерапии опухолевых заболеваний. Под ред. Н.И.Переводчиковой, В.А.Горбуновой. М.: Практическая медицина, 2015. / Rukovodstvo po khimioterapii opukholevykh zabolevanii. Pod red. N.I.Perevodchikovoi, V.A.Gorbunovoi. M.: Prakticheskaia meditsina, 2015. [in Russian]
4. Batista A, Riedemann L, Vardam T et al. Targeting the Tumor Microenvironment to Enhance Pediatric Brain Cancer Treatment. Cancer J 2015; 21 (4): 307–13.
5. Барях Е.А., Валиев Т.Т., Звонков Е.Е. и др. Интенсивная терапия лимфомы Беркитта: описание двух клинических случаев. Гематология и трансфузиология. 2007; 1: 41–3. / Bariakh E.A., Valiev T.T., Zvonkov E.E. i dr. Intensivnaia terapiia limfomy Berkitta: opisanie dvukh klinicheskikh sluchaev. Gematologiia i transfuziologiia. 2007; 1: 41–3. [in Russian]
6. Mertens AC, Yasui Y, Neglia JP et al. Late mortality experience in five-year survivors of childhood and adolescent cancer: the Childhood Cancer Survivor Study. J Clin Oncol 2001; 19: 3163–72.
7. Hudson MM, Mertens AC, Yasui Y et al. Health status of adult long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. JAMA 2003; 290: 1583–92.
8. Winther JF, Kenborg L, Byrne J et al. Childhood cancer survivor cohorts in Europe. Acta Oncol 2015; 54 (5): 655–68.
9. Руднева А.Е., Ильина Е.Е. Наблюдение за пациентами с гемобластозами после окончания противоопухолевой терапии. Онкогематология. 2014; 4: 46–53. / Rudneva A.E., Il'ina E.E. Nabliudenie za patsientkmi s gemoblastozami posle okonchaniia protivoopukholevoi terapii. Onkogematologiia. 2014; 4: 46–53. [in Russian]
10. Robison LL, Armstrong GT, Boice JD et al. The Childhood Cancer Survivor Study: a National Cancer Institute-supported resource for outcome and intervention research. J Clin Oncol 2009; 27 (14): 2308–18.
11. Медицинская, психологическая и социальная адаптация детей, излеченных от онкологических заболеваний. Под ред. М.Д.Алиева. М.: Практическая медицина, 2012. / Meditsinskaia, psikhologicheskaia i sotsial'naia adaptatsiia detei, izlechennykh ot onkologicheskikh zabolevanii. Pod red. M.D.Alieva. M.: Prakticheskaia meditsina, 2012. [in Russian]
12. Dietz JH, Jr. Adaptive rehabilitation of the cancer patient. Curr Probl Cancer 1980; 5: 1–56.
13. Yoshioka H. Rehabilitation for the terminal cancer patient. Am J Phys Med Rehabil 1994; 73: 199–206.
14. Giantris A, Abdurrahman L, Hinkle A et al. Anthracycline-induced cardiotoxicity in children and young adults. Crit Rev Oncol Hematol 1998; 27: 53–68.
15. Krischer JP, Epstein S, Cuthbertson DD et al. Clinical cardiotoxicity following anthracycline treatment for childhood cancer: the Pediatric Oncology Group experience. J Clin Oncol 1997; 15: 1544–52.
16. Alvarez J, Scully R, Miller T et al. Long-term effects of treatments for childhood cancers. Curr Opin Pediatr 2007; 19: 23–31.
17. Simbre VC, Duffy SA, Dadlani GH et al. Cardiotoxicity of cancer chemotherapy: implications for children. Paediatr Drugs 2005; 7: 187–202.
18. Barry E, Alvarez JA, Scully RE et al. Anthracycline-induced cardiotoxicity: course, pathophysiology, prevention and management. Exp Opin Pharmacother 2007; 8: 1039–58.
19. Делягин В.М. Пневмотоксические реакции в онкогематологической практике. Практ. медицина. 2014; 9: 28–31. / Deliagin V.M. Pnevmotoksicheskie reaktsii v onkogematologicheskoi praktike. Prakt. meditsina. 2014; 9: 28–31. [in Russian]
20. Kerachian MA, Séguin C, Harvey EJ. Glucocorticoids in osteonecrosis of the femoral head: A new understanding of the mechanisms of action. J Steroid Biochem Mol Biol 2009; 114: 121–8.
21. Powell C, Chang C, Gershwin ME. Current concepts on the pathogenesis and natural history of ster- oid-induced osteonecrosis. Clin Rev Allergy Immunol 2011; 41: 102–13.
22. Chen SH, Chang TY, Jaing TH et al. Incidence, risk factors, and treatment outcome of symptomatic osteonecrosis in Taiwanese children with acute lymphoblastic leukemia: a retrospective cohort study of 245 patients in a single institution. Int J Hematol 2015; 102 (1): 41–7.
23. te Winkel ML, Pieters R, Hop WC et al. Bone mineral density at diagnosis determines fracture rate in children with acute lymphoblastic leukemia treated according to the DCOG-ALL9 protocol. Bone 2014; 59: 223–8.
24. Румянцев А.Г., Масчан А.А., Самочатова Е.В. Сопроводительная терапия и контроль инфекции при гематологических и онкологических заболеваниях. М.: Медпрактика-М, 2006. / Rumiantsev A.G., Maschan A.A., Samochatova E.V. Soprovoditel'naia terapiia i kontrol' infektsii pri gematologicheskikh i onkologicheskikh zabolevaniiakh. M.: Medpraktika-M, 2006. [in Russian]
25. Prasad PK, Hardy KK, Zhang N et al. Psychosocial and Neurocognitive Outcomes in Adult Survivors of Adolescent and Early Young Adult Cancer: A Report From the Childhood Cancer Survivor Study. J Clin Oncol 2015; 33 (23): 2545–52.
26. Мазеркина Н.А. Эндокринные нарушения после комплексного лечения злокачественных опухолей хиазмально-селлярной области и задней черепной ямки у детей: Автореф. дис. ... д-ра мед. наук. М., 2007. / Mazerkina N.A. Endokrinnye narusheniia posle kompleksnogo lecheniia zlokachestvennykh opukholei khiazmal'no-selliarnoi oblasti i zadnei cherepnoi iamki u detei: Avtoref. dis. ... d-ra med. nauk. M., 2007. [in Russian]
________________________________________________
2. Valiev T.T., Bariakh E.A., Zeinalova P.A. i dr. Optimizatsiia diagnostiki i lecheniia limfomy Berkitta u detei, podrostkov i molodykh vzroslykh. Klin. onkogematologiia. 2014; 7 (2): 175–83. [in Russian]
3. Rukovodstvo po khimioterapii opukholevykh zabolevanii. Pod red. N.I.Perevodchikovoi, V.A.Gorbunovoi. M.: Prakticheskaia meditsina, 2015. [in Russian]
4. Batista A, Riedemann L, Vardam T et al. Targeting the Tumor Microenvironment to Enhance Pediatric Brain Cancer Treatment. Cancer J 2015; 21 (4): 307–13.
5. Bariakh E.A., Valiev T.T., Zvonkov E.E. i dr. Intensivnaia terapiia limfomy Berkitta: opisanie dvukh klinicheskikh sluchaev. Gematologiia i transfuziologiia. 2007; 1: 41–3. [in Russian]
6. Mertens AC, Yasui Y, Neglia JP et al. Late mortality experience in five-year survivors of childhood and adolescent cancer: the Childhood Cancer Survivor Study. J Clin Oncol 2001; 19: 3163–72.
7. Hudson MM, Mertens AC, Yasui Y et al. Health status of adult long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. JAMA 2003; 290: 1583–92.
8. Winther JF, Kenborg L, Byrne J et al. Childhood cancer survivor cohorts in Europe. Acta Oncol 2015; 54 (5): 655–68.
9. Rudneva A.E., Il'ina E.E. Nabliudenie za patsientkmi s gemoblastozami posle okonchaniia protivoopukholevoi terapii. Onkogematologiia. 2014; 4: 46–53. [in Russian]
10. Robison LL, Armstrong GT, Boice JD et al. The Childhood Cancer Survivor Study: a National Cancer Institute-supported resource for outcome and intervention research. J Clin Oncol 2009; 27 (14): 2308–18.
11. Meditsinskaia, psikhologicheskaia i sotsial'naia adaptatsiia detei, izlechennykh ot onkologicheskikh zabolevanii. Pod red. M.D.Alieva. M.: Prakticheskaia meditsina, 2012. [in Russian]
12. Dietz JH, Jr. Adaptive rehabilitation of the cancer patient. Curr Probl Cancer 1980; 5: 1–56.
13. Yoshioka H. Rehabilitation for the terminal cancer patient. Am J Phys Med Rehabil 1994; 73: 199–206.
14. Giantris A, Abdurrahman L, Hinkle A et al. Anthracycline-induced cardiotoxicity in children and young adults. Crit Rev Oncol Hematol 1998; 27: 53–68.
15. Krischer JP, Epstein S, Cuthbertson DD et al. Clinical cardiotoxicity following anthracycline treatment for childhood cancer: the Pediatric Oncology Group experience. J Clin Oncol 1997; 15: 1544–52.
16. Alvarez J, Scully R, Miller T et al. Long-term effects of treatments for childhood cancers. Curr Opin Pediatr 2007; 19: 23–31.
17. Simbre VC, Duffy SA, Dadlani GH et al. Cardiotoxicity of cancer chemotherapy: implications for children. Paediatr Drugs 2005; 7: 187–202.
18. Barry E, Alvarez JA, Scully RE et al. Anthracycline-induced cardiotoxicity: course, pathophysiology, prevention and management. Exp Opin Pharmacother 2007; 8: 1039–58.
19. Deliagin V.M. Pnevmotoksicheskie reaktsii v onkogematologicheskoi praktike. Prakt. meditsina. 2014; 9: 28–31. [in Russian]
20. Kerachian MA, Séguin C, Harvey EJ. Glucocorticoids in osteonecrosis of the femoral head: A new understanding of the mechanisms of action. J Steroid Biochem Mol Biol 2009; 114: 121–8.
21. Powell C, Chang C, Gershwin ME. Current concepts on the pathogenesis and natural history of ster- oid-induced osteonecrosis. Clin Rev Allergy Immunol 2011; 41: 102–13.
22. Chen SH, Chang TY, Jaing TH et al. Incidence, risk factors, and treatment outcome of symptomatic osteonecrosis in Taiwanese children with acute lymphoblastic leukemia: a retrospective cohort study of 245 patients in a single institution. Int J Hematol 2015; 102 (1): 41–7.
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Авторы
Г.Е.Заева, Т.Т.Валиев*, Т.Ф.Гавриленко, Е.И.Моисеенко, Е.Г.Медведовская, С.Н.Михайлова, Ю.В.Синягина
ФГБУ Российский онкологический научный центр им. Н.Н.Блохина Минздрава России.
115478, Россия, Москва, Каширское ш., д. 23
*timurvaliev@mail.ru
N.N.Blokhin Russian Cancer Research Center of the Ministry of Health of the Russian Federation. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 23
*timurvaliev@mail.ru
ФГБУ Российский онкологический научный центр им. Н.Н.Блохина Минздрава России.
115478, Россия, Москва, Каширское ш., д. 23
*timurvaliev@mail.ru
________________________________________________
N.N.Blokhin Russian Cancer Research Center of the Ministry of Health of the Russian Federation. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 23
*timurvaliev@mail.ru
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