Современные ультразвуковые технологии при мониторинге эффективности химиотерапии рака шейки матки
Современные ультразвуковые технологии при мониторинге эффективности химиотерапии рака шейки матки
Мусаева З.Р.-Б., Чекалова М.А., Мещеряков А.А. Современные ультразвуковые технологии при мониторинге эффективности химиотерапии рака шейки матки. Современная Онкология. 2019; 21 (3): 56–61. DOI: 10.26442/18151434.2019.3.190658
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Musaeva Z.R.-B., Chekalova M.A., Mesheryakov A.A. Modern ultrasound technologies in monitoring the effectiveness of chemotherapy for cervical cancer. Journal of Modern Oncology. 2019; 21 (3): 56–61. DOI: 10.26442/18151434.2019.3.190658
Современные ультразвуковые технологии при мониторинге эффективности химиотерапии рака шейки матки
Мусаева З.Р.-Б., Чекалова М.А., Мещеряков А.А. Современные ультразвуковые технологии при мониторинге эффективности химиотерапии рака шейки матки. Современная Онкология. 2019; 21 (3): 56–61. DOI: 10.26442/18151434.2019.3.190658
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Musaeva Z.R.-B., Chekalova M.A., Mesheryakov A.A. Modern ultrasound technologies in monitoring the effectiveness of chemotherapy for cervical cancer. Journal of Modern Oncology. 2019; 21 (3): 56–61. DOI: 10.26442/18151434.2019.3.190658
Рак шейки матки (РШМ) остается одной из важнейших социальных и медицинских проблем во всем мире в связи с ростом заболеваемости и смертности. Усовершенствование существующих и разработка новых вариантов диагностики и лечения распространенных стадий РШМ являются актуальной задачей современной онкологии. В соответствии со стандартами терапии при распространенном РШМ применяют лекарственную, лучевую терапию и оперативное лечение в различных модификациях. Неоадъювантная химиотерапия позволяет уменьшить объем опухоли, что способствует достижению оптимальной ее резектабельности, повышает абластичность операции. Кроме того, она дает возможность за счет подавления микрометастазирования улучшить выживаемость. Точная оценка эффективности лечения является одним из важных факторов успешного лечения. Комплексная ультразвуковая диагностика остается самым доступным и распространенным методом визуализации, обладая рядом важных технологий, позволяющих максимально объективно визуализировать опухолевый очаг шейки матки, распространенность, особенности кровотока и получить своевременную информацию о регрессе опухоли. В связи с внедрением новых технологий сегодня наблюдается значительное расширение возможностей ультразвуковой диагностики в онкологии в целом. Наиболее перспективными из них считаются ультразвуковая эластография и контрастно-усиленное ультразвуковое исследование. Данный обзор посвящен возможностям методик в оценке эффективности неоадъювантной химиотерапии.
Cervical cancer remains one of the most important social and medical problems worldwide due to the increase in morbidity and mortality. Improvement of existing and development of new options for diagnosis and treatment of common stages of cervical cancer is an urgent problem of modern Oncology. In accordance with the standards of treatment for advanced cervical cancer, drug, radiation therapy and surgical treatment in various modifications are used. Neoadjuvant chemotherapy can reduce the volume of tumors, which helps to achieve optimal resectability of the tumors, increases the ablasticity of the operation. In addition, it improves survival. An accurate assessment of the effectiveness of treatment is one of the important factors in the overall treatment. Complex ultrasound diagnostics is the most affordable and common imaging method, possessing a number of important technologies, allowing you to get the most objectively visualized tumors, uterus, prevalence, blood flow features and to receive timely information about tumor regression. In connection with the introduction of new technologies, a significant expansion of the capabilities of ultrasound diagnostics in oncology as a whole is observed today. The most promising of them are ultrasound elastography and contrast-enhanced ultrasound. The review is devoted to the possibilities of these methods in assessing the effectiveness of neoadjuvant chemotherapy.
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1. Aksel' E.M., Vinogradova N.N. Statistika zlokachestvennykh novoobrazovanii zhenskikh reproduktivnykh organov. Onkoginekologiia. 2018; 3: 64–78 (in Russian).
2. Kaprin A.D, Starinskii V.V., Petrova G.V. Malignant neoplasms in Russia in 2017 (morbidity and mortality). Moscow: MNIOI im. P.A.Gertsena – filial FGBU "NMITs radiologii" Minzdrava Rossii, 2018 (in Russian).
3. Sushinskaia T.V., Zhordania K.I., Paianidi Iu.G. Analiticheskie aspekty onkologicheskikh zabolevanii zhenskogo naseleniia Rossii. Onkoginekologiia. 2015; 3: 40–3 (in Russian).
4. Kaprin A.D., Starinskii V.V., Petrova G.V. The status of cancer care for the population of Russia in 2018. Moscow: MNIOI im. P.A.Gertsena – filial FGBU "NMITs radiologii" Minzdrava Rossii, 2019 (in Russian).
5. Rerberg A.G., Kaprin A.D., Kostin A.A et al. Neoad"iuvantnaia kombinirovannaia khimioterapiia mestno-rasprostranennogo raka sheiki matki. Onkologiia. Zhurnal im. P.A.Gertsena. 2017; 6 (6): 32–7. https://doi.org/10.17116/onkolog20176632-37 (in Russian).
6. Ashrafian L.A., Aleshikova O.I., Babaeva N.A. et al. Otsenka rezul'tatov neoad"iuvantnoi khimioterapii mestno-rasprostranennogo raka sheiki matki IIB–IIIB stadii pri kompleksnoi ul'trazvukovoi diagnostike. Opukholi zhenskoi reproduktivnoi sistemy. 2015; 2: 76–81 (in Russian).
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8. Rose PG. Locally advanced cervical carcinoma: the role of chemoradiathion. Semin Oncol. 1994; 21: 47–53. PMID: 8310309.
9. Ermakova N.A. The role of chemotherapy at various stages of cervical cancer treatment. Practical Oncology. 2002; 3 (3): 211–9 (in Russian).
10. Zola R, Tripodi E, Zanfagnin V et al. Per. T.A.Ivanovoi, pod red. L.A.Kolomiets, S.G.Afanas'eva. Lechenie rannego raka sheiki matki: vyzhivaemost', oslozhneniia i ekonomicheskie aspekty. Sib. onkologicheskii zhurn. 2012; 3 (51): 14–21 (in Russian).
11. Verscharageen C. Gematology/Oncоlоgy Clinics of North America 1999; 13 (1): 290–303.
12. Ashrafjan L. A, Antonova I.B., Ivashina S.V. et al. Molecular biological and ultrasound methods in assessing the effectiveness of drug therapy in patients with cervical cancer and ovarian cancer. Tumors of the female reproductive system. 2012; 3–4: 120–5 (in Russian).
13. Guseinov K.D. Otsenka effektivnosti ispol'zovaniia lekarstvennoi terapii v kombinirovannom lechenii bol'nykh rakom sheiki matki Ib2–III stadii. Dis. … kand. med. nauk. SPb., 2003; s. 116 (in Russian).
14. Vorgova D.N. Vozmozhnosti kompleksnogo ul'trazvukovogo monitoringa v optimizatsii lecheniia bol'nykh rakom sheiki matki. Dis… kand. med. nauk. Ufa, 2009 (in Russian).
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1 ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России, Москва, Россия;
2 ГБУ «Республиканский онкологический диспансер», Грозный, Россия
*zalina_9373.doctor@mail.ru
________________________________________________
Zalina R.-B. Musaeva*1,2, Marina A. Chekalova1, Andrei A. Mesheryakov1
1 Blokhin National Medical Research Center of Oncology, Moscow, Russia;
2 Republican Oncology Center, Groznyi, Russia
*zalina_9373.doctor@mail.ru