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Роль циторедуктивных операций в лечении распространенного рака яичников (обзор литературы)
Роль циторедуктивных операций в лечении распространенного рака яичников (обзор литературы)
Танделов Р.К., Сельчук В.Ю., Морхов К.Ю. и др. Роль циторедуктивных операций в лечении распространенного рака яичников (обзор литературы). Современная Онкология. 2018; 20 (1): 5–10.
DOI: 10.26442/1815-1434_20.1.5-10
Tandelov R.K., Sel'chuk V.Yu., Morkhov K.Yu. et al. The role of cytoreduction surgery in advanced ovarian cancer (review). Journal of Modern Oncology. 2018; 20 (1): 5–10.DOI: 10.26442/1815-1434_20.1.5-10
DOI: 10.26442/1815-1434_20.1.5-10
________________________________________________
Tandelov R.K., Sel'chuk V.Yu., Morkhov K.Yu. et al. The role of cytoreduction surgery in advanced ovarian cancer (review). Journal of Modern Oncology. 2018; 20 (1): 5–10.DOI: 10.26442/1815-1434_20.1.5-10
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Аннотация
Представлен обзор исследований, посвященных сравнению эффективности первичных и промежуточных циторедуктивных операций при распространенном раке яичников. По данным метаанализов и ретроспективных исследований, наилучшие результаты лечения отмечаются при выполнении операции на I этапе лечения при условии полного удаления визуально определяемой опухоли. Если остаточная опухоль более 1 см, то первичная циторедукция не дает увеличения выживаемости. Данные рандомизированных исследований не подтвердили преимущества первичных циторедуктивных операций.
Ключевые слова: рак яичников, циторедуктивные операции, первичная циторедукция, промежуточная циторедукция, оптимальная циторедукция, полная циторедукция, остаточная опухоль, неоадъювантная химиотерапия
Key words: ovarian cancer, cytoreductive surgery, primary debulking surgery, interval debulking surgery, optimal cytoreduction, residual disease, neoadjuvant chemotherapy.
Ключевые слова: рак яичников, циторедуктивные операции, первичная циторедукция, промежуточная циторедукция, оптимальная циторедукция, полная циторедукция, остаточная опухоль, неоадъювантная химиотерапия
________________________________________________
Key words: ovarian cancer, cytoreductive surgery, primary debulking surgery, interval debulking surgery, optimal cytoreduction, residual disease, neoadjuvant chemotherapy.
Полный текст
Список литературы
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DOI: 10.1111/j.1525-1438.2003.13354.x
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6. Omura G, Blessing JA, Ehrlich CE et al. A randomized trial of cyclophosphamide and doxorubicinum with or without cisplatin in advanced ovarian carcinoma. Cancer 1986; 57 (9): 1725–30. DOI: 10.1002/1097-0142(19860501)57:9
7. Omura GA, Brady MF, Homesley HD et al. Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience. J Clin Oncol 1991; 9 (7): 1138–50. DOI: 10.1200/JCO.1991.9.7.1138
8. Chi DS, Eisenhauer EL, Lang J et al. What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol 2006; 103 (2): 559–64. DOI: 10.1016/j.ygyno.2006.03.051
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10. Eisenkop SM, Spirtos NM. Procedures required to accomplish complete cytoreduction of ovarian cancer: is there a correlation with "biological aggressiveness" and survival? Gynecol Oncol 2001; 82 (3): 435–41. DOI: 10.1006/gyno.2001.6313
11. Bristow RE, Tomacruz RS, Armstrong DK et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002; 20 (5): 1248–59. DOI: 10.1200/jco.2002.20.5.1248
12. Bristow RE, Chi DS. Platinum-based neoadjuvant chemotherapy and interval surgical cytoreduction for advanced ovarian cancer: a meta-analysis. Gynecol Oncol 2006; 103 (3): 1070–6. DOI: 10.1016/j.ygyno.2006.06.025
13. Чубенко ВА. Перспективные методы лечения злокачественных новообразований. Практическая онкология. 2007; 32 (4): 228–35. / Chubenko VA. Perspektivnye metody lecheniia zlokachestvennykh novoobrazovanii. Prakticheskaia onkologiia. 2007; 32 (4): 228–35. [in Russian]
14. Skipper HE. Adjuvant chemotherapy. Cancer 1978; 41 (3): 936–40. DOI: 10.1002/1097-0142(197803)41:3
15. Goldie JH, Coldman AJ. A mathematic model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep 1979; 63 (11–12): 1727–33.
16. Norton L. Conceptual and practical implications of breast tissue geometry: toward a more effective, less toxic therapy. Oncologist 2005; 10 (6): 370–81. DOI: 10.1634/theoncologist.10-6-370
17. Schorge JO, McCann C, Del Carmen MG. Surgical debulking of ovarian cancer: what difference does it make? Rev Obstet Gynecol 2010; 3 (3): 111–7. DOI: 10.3909/riog0111
18. Chi DS, Eisenhauer EL, Zivanovic O et al. Improved progression-free and overall survival in advanced ovarian cancer as a result of a change in surgical paradigm. Gynecol Oncol 2009; 114 (1): 26–31. DOI: 10.1016/j.ygyno.2009.03.018
19. Vergote I, Tropé CG, Amant F et al; European Organization for Research and Treatment of Cancer-Gynaecological Cancer Group; NCIC Clinical Trials Group. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med 2010; 363 (10): 943–53. DOI: 10.1056/NEJMoa0908806
20. Chi DS, Musa F, Dao F et al. An analysis of patients with bulky advanced stage ovarian, tubal, and peritoneal carcinoma treated with primary debulking surgery (PDS) during an identical time period as the randomized EORTC-NCIC trial of PDS vs neoadjuvant chemotherapy (NACT). Gynecol Oncol 2012; 124 (1): 10–4. DOI: 10.1016/j.ygyno.2011.08.014
21. Морхов К.Ю., Нечушкина В.М., Кузнецов В.В. Хирургическое лечение рака яичников. Практическая онкология. 2014; 60 (4): 153–7. / Morkhov K.Iu., Nechushkina V.M., Kuznetsov V.V. Khirurgicheskoe lechenie raka iaichnikov. Prakticheskaia onkologiia. 2014; 60 (4): 153–7. [in Russian]
22. Kehoe S, Hook J, Nankivell M et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 2015; 386 (9990): 249–57.
DOI: 10.1016/S0140-6736(14)62223-6
2. Baekelandt M. The potential role of neoadjuvant chemotherapy in advanced ovarian cancer. Int J Gynecol Cancer 2003; 13 (Suppl. 2): 163–8.
DOI: 10.1111/j.1525-1438.2003.13354.x
3. Meigs JV. Tumors of the Female Pelvic Organs. New York, NY, Macmillan, 1934.
4. Griffiths CT. Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma. Natl Cancer Inst Monogr 1975; 42: 101–4.
5. Pölcher M, Zivanovic O, Chi DS. Cytoreductive surgery for advanced ovarian cancer. Womens Health (Lond) 2014; 10 (2): 179–90. DOI: 10.2217/whe.14.4
6. Omura G, Blessing JA, Ehrlich CE et al. A randomized trial of cyclophosphamide and doxorubicinum with or without cisplatin in advanced ovarian carcinoma. Cancer 1986; 57 (9): 1725–30. DOI: 10.1002/1097-0142(19860501)57:9
7. Omura GA, Brady MF, Homesley HD et al. Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience. J Clin Oncol 1991; 9 (7): 1138–50. DOI: 10.1200/JCO.1991.9.7.1138
8. Chi DS, Eisenhauer EL, Lang J et al. What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol 2006; 103 (2): 559–64. DOI: 10.1016/j.ygyno.2006.03.051
9. Hoskins WJ, Bundy BN, Thigpen JT, Omura GA. The influence of cytoreductive surgery on recurrence-free interval and survival in small-volume stage III epithelial ovarian cancer: a gynecologic oncology group study. Gynecol Oncol 1992; 47 (2): 159–66. DOI: 10.1016/0090-8258(92)90100-W
10. Eisenkop SM, Spirtos NM. Procedures required to accomplish complete cytoreduction of ovarian cancer: is there a correlation with "biological aggressiveness" and survival? Gynecol Oncol 2001; 82 (3): 435–41. DOI: 10.1006/gyno.2001.6313
11. Bristow RE, Tomacruz RS, Armstrong DK et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002; 20 (5): 1248–59. DOI: 10.1200/jco.2002.20.5.1248
12. Bristow RE, Chi DS. Platinum-based neoadjuvant chemotherapy and interval surgical cytoreduction for advanced ovarian cancer: a meta-analysis. Gynecol Oncol 2006; 103 (3): 1070–6. DOI: 10.1016/j.ygyno.2006.06.025
13. Chubenko VA. Perspektivnye metody lecheniia zlokachestvennykh novoobrazovanii. Prakticheskaia onkologiia. 2007; 32 (4): 228–35. [in Russian]
14. Skipper HE. Adjuvant chemotherapy. Cancer 1978; 41 (3): 936–40. DOI: 10.1002/1097-0142(197803)41:3
15. Goldie JH, Coldman AJ. A mathematic model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep 1979; 63 (11–12): 1727–33.
16. Norton L. Conceptual and practical implications of breast tissue geometry: toward a more effective, less toxic therapy. Oncologist 2005; 10 (6): 370–81. DOI: 10.1634/theoncologist.10-6-370
17. Schorge JO, McCann C, Del Carmen MG. Surgical debulking of ovarian cancer: what difference does it make? Rev Obstet Gynecol 2010; 3 (3): 111–7. DOI: 10.3909/riog0111
18. Chi DS, Eisenhauer EL, Zivanovic O et al. Improved progression-free and overall survival in advanced ovarian cancer as a result of a change in surgical paradigm. Gynecol Oncol 2009; 114 (1): 26–31. DOI: 10.1016/j.ygyno.2009.03.018
19. Vergote I, Tropé CG, Amant F et al; European Organization for Research and Treatment of Cancer-Gynaecological Cancer Group; NCIC Clinical Trials Group. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med 2010; 363 (10): 943–53. DOI: 10.1056/NEJMoa0908806
20. Chi DS, Musa F, Dao F et al. An analysis of patients with bulky advanced stage ovarian, tubal, and peritoneal carcinoma treated with primary debulking surgery (PDS) during an identical time period as the randomized EORTC-NCIC trial of PDS vs neoadjuvant chemotherapy (NACT). Gynecol Oncol 2012; 124 (1): 10–4. DOI: 10.1016/j.ygyno.2011.08.014
21. Morkhov K.Iu., Nechushkina V.M., Kuznetsov V.V. Khirurgicheskoe lechenie raka iaichnikov. Prakticheskaia onkologiia. 2014; 60 (4): 153–7. [in Russian]
22. Kehoe S, Hook J, Nankivell M et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 2015; 386 (9990): 249–57.
DOI: 10.1016/S0140-6736(14)62223-6
2. Baekelandt M. The potential role of neoadjuvant chemotherapy in advanced ovarian cancer. Int J Gynecol Cancer 2003; 13 (Suppl. 2): 163–8.
DOI: 10.1111/j.1525-1438.2003.13354.x
3. Meigs JV. Tumors of the Female Pelvic Organs. New York, NY, Macmillan, 1934.
4. Griffiths CT. Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma. Natl Cancer Inst Monogr 1975; 42: 101–4.
5. Pölcher M, Zivanovic O, Chi DS. Cytoreductive surgery for advanced ovarian cancer. Womens Health (Lond) 2014; 10 (2): 179–90. DOI: 10.2217/whe.14.4
6. Omura G, Blessing JA, Ehrlich CE et al. A randomized trial of cyclophosphamide and doxorubicinum with or without cisplatin in advanced ovarian carcinoma. Cancer 1986; 57 (9): 1725–30. DOI: 10.1002/1097-0142(19860501)57:9
7. Omura GA, Brady MF, Homesley HD et al. Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience. J Clin Oncol 1991; 9 (7): 1138–50. DOI: 10.1200/JCO.1991.9.7.1138
8. Chi DS, Eisenhauer EL, Lang J et al. What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol 2006; 103 (2): 559–64. DOI: 10.1016/j.ygyno.2006.03.051
9. Hoskins WJ, Bundy BN, Thigpen JT, Omura GA. The influence of cytoreductive surgery on recurrence-free interval and survival in small-volume stage III epithelial ovarian cancer: a gynecologic oncology group study. Gynecol Oncol 1992; 47 (2): 159–66. DOI: 10.1016/0090-8258(92)90100-W
10. Eisenkop SM, Spirtos NM. Procedures required to accomplish complete cytoreduction of ovarian cancer: is there a correlation with "biological aggressiveness" and survival? Gynecol Oncol 2001; 82 (3): 435–41. DOI: 10.1006/gyno.2001.6313
11. Bristow RE, Tomacruz RS, Armstrong DK et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002; 20 (5): 1248–59. DOI: 10.1200/jco.2002.20.5.1248
12. Bristow RE, Chi DS. Platinum-based neoadjuvant chemotherapy and interval surgical cytoreduction for advanced ovarian cancer: a meta-analysis. Gynecol Oncol 2006; 103 (3): 1070–6. DOI: 10.1016/j.ygyno.2006.06.025
13. Чубенко ВА. Перспективные методы лечения злокачественных новообразований. Практическая онкология. 2007; 32 (4): 228–35. / Chubenko VA. Perspektivnye metody lecheniia zlokachestvennykh novoobrazovanii. Prakticheskaia onkologiia. 2007; 32 (4): 228–35. [in Russian]
14. Skipper HE. Adjuvant chemotherapy. Cancer 1978; 41 (3): 936–40. DOI: 10.1002/1097-0142(197803)41:3
15. Goldie JH, Coldman AJ. A mathematic model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep 1979; 63 (11–12): 1727–33.
16. Norton L. Conceptual and practical implications of breast tissue geometry: toward a more effective, less toxic therapy. Oncologist 2005; 10 (6): 370–81. DOI: 10.1634/theoncologist.10-6-370
17. Schorge JO, McCann C, Del Carmen MG. Surgical debulking of ovarian cancer: what difference does it make? Rev Obstet Gynecol 2010; 3 (3): 111–7. DOI: 10.3909/riog0111
18. Chi DS, Eisenhauer EL, Zivanovic O et al. Improved progression-free and overall survival in advanced ovarian cancer as a result of a change in surgical paradigm. Gynecol Oncol 2009; 114 (1): 26–31. DOI: 10.1016/j.ygyno.2009.03.018
19. Vergote I, Tropé CG, Amant F et al; European Organization for Research and Treatment of Cancer-Gynaecological Cancer Group; NCIC Clinical Trials Group. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med 2010; 363 (10): 943–53. DOI: 10.1056/NEJMoa0908806
20. Chi DS, Musa F, Dao F et al. An analysis of patients with bulky advanced stage ovarian, tubal, and peritoneal carcinoma treated with primary debulking surgery (PDS) during an identical time period as the randomized EORTC-NCIC trial of PDS vs neoadjuvant chemotherapy (NACT). Gynecol Oncol 2012; 124 (1): 10–4. DOI: 10.1016/j.ygyno.2011.08.014
21. Морхов К.Ю., Нечушкина В.М., Кузнецов В.В. Хирургическое лечение рака яичников. Практическая онкология. 2014; 60 (4): 153–7. / Morkhov K.Iu., Nechushkina V.M., Kuznetsov V.V. Khirurgicheskoe lechenie raka iaichnikov. Prakticheskaia onkologiia. 2014; 60 (4): 153–7. [in Russian]
22. Kehoe S, Hook J, Nankivell M et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 2015; 386 (9990): 249–57.
DOI: 10.1016/S0140-6736(14)62223-6
________________________________________________
2. Baekelandt M. The potential role of neoadjuvant chemotherapy in advanced ovarian cancer. Int J Gynecol Cancer 2003; 13 (Suppl. 2): 163–8.
DOI: 10.1111/j.1525-1438.2003.13354.x
3. Meigs JV. Tumors of the Female Pelvic Organs. New York, NY, Macmillan, 1934.
4. Griffiths CT. Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma. Natl Cancer Inst Monogr 1975; 42: 101–4.
5. Pölcher M, Zivanovic O, Chi DS. Cytoreductive surgery for advanced ovarian cancer. Womens Health (Lond) 2014; 10 (2): 179–90. DOI: 10.2217/whe.14.4
6. Omura G, Blessing JA, Ehrlich CE et al. A randomized trial of cyclophosphamide and doxorubicinum with or without cisplatin in advanced ovarian carcinoma. Cancer 1986; 57 (9): 1725–30. DOI: 10.1002/1097-0142(19860501)57:9
7. Omura GA, Brady MF, Homesley HD et al. Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience. J Clin Oncol 1991; 9 (7): 1138–50. DOI: 10.1200/JCO.1991.9.7.1138
8. Chi DS, Eisenhauer EL, Lang J et al. What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol 2006; 103 (2): 559–64. DOI: 10.1016/j.ygyno.2006.03.051
9. Hoskins WJ, Bundy BN, Thigpen JT, Omura GA. The influence of cytoreductive surgery on recurrence-free interval and survival in small-volume stage III epithelial ovarian cancer: a gynecologic oncology group study. Gynecol Oncol 1992; 47 (2): 159–66. DOI: 10.1016/0090-8258(92)90100-W
10. Eisenkop SM, Spirtos NM. Procedures required to accomplish complete cytoreduction of ovarian cancer: is there a correlation with "biological aggressiveness" and survival? Gynecol Oncol 2001; 82 (3): 435–41. DOI: 10.1006/gyno.2001.6313
11. Bristow RE, Tomacruz RS, Armstrong DK et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002; 20 (5): 1248–59. DOI: 10.1200/jco.2002.20.5.1248
12. Bristow RE, Chi DS. Platinum-based neoadjuvant chemotherapy and interval surgical cytoreduction for advanced ovarian cancer: a meta-analysis. Gynecol Oncol 2006; 103 (3): 1070–6. DOI: 10.1016/j.ygyno.2006.06.025
13. Chubenko VA. Perspektivnye metody lecheniia zlokachestvennykh novoobrazovanii. Prakticheskaia onkologiia. 2007; 32 (4): 228–35. [in Russian]
14. Skipper HE. Adjuvant chemotherapy. Cancer 1978; 41 (3): 936–40. DOI: 10.1002/1097-0142(197803)41:3
15. Goldie JH, Coldman AJ. A mathematic model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep 1979; 63 (11–12): 1727–33.
16. Norton L. Conceptual and practical implications of breast tissue geometry: toward a more effective, less toxic therapy. Oncologist 2005; 10 (6): 370–81. DOI: 10.1634/theoncologist.10-6-370
17. Schorge JO, McCann C, Del Carmen MG. Surgical debulking of ovarian cancer: what difference does it make? Rev Obstet Gynecol 2010; 3 (3): 111–7. DOI: 10.3909/riog0111
18. Chi DS, Eisenhauer EL, Zivanovic O et al. Improved progression-free and overall survival in advanced ovarian cancer as a result of a change in surgical paradigm. Gynecol Oncol 2009; 114 (1): 26–31. DOI: 10.1016/j.ygyno.2009.03.018
19. Vergote I, Tropé CG, Amant F et al; European Organization for Research and Treatment of Cancer-Gynaecological Cancer Group; NCIC Clinical Trials Group. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med 2010; 363 (10): 943–53. DOI: 10.1056/NEJMoa0908806
20. Chi DS, Musa F, Dao F et al. An analysis of patients with bulky advanced stage ovarian, tubal, and peritoneal carcinoma treated with primary debulking surgery (PDS) during an identical time period as the randomized EORTC-NCIC trial of PDS vs neoadjuvant chemotherapy (NACT). Gynecol Oncol 2012; 124 (1): 10–4. DOI: 10.1016/j.ygyno.2011.08.014
21. Morkhov K.Iu., Nechushkina V.M., Kuznetsov V.V. Khirurgicheskoe lechenie raka iaichnikov. Prakticheskaia onkologiia. 2014; 60 (4): 153–7. [in Russian]
22. Kehoe S, Hook J, Nankivell M et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 2015; 386 (9990): 249–57.
DOI: 10.1016/S0140-6736(14)62223-6
Авторы
Р.К.Танделов*1,2, В.Ю.Сельчук1,2, К.Ю.Морхов2, В.М.Нечушкина2,3, В.В.Кузнецов2
1 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И.Евдокимова» Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н.Блохина» Минздрава России.
115478, Россия, Москва, Каширское ш., д. 23;
3 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*romanyh@yandex.ru
1 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 N.N.Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 23;
3 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*romanyh@yandex.ru
1 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И.Евдокимова» Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н.Блохина» Минздрава России.
115478, Россия, Москва, Каширское ш., д. 23;
3 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*romanyh@yandex.ru
________________________________________________
1 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 N.N.Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 23;
3 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*romanyh@yandex.ru
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