Благодаря улучшению результатов комбинированного лечения злокачественных новообразований выживаемость онкологических пациентов растет. Все более актуальным становится вопрос об улучшении качества жизни как на фоне лечения, так и после его завершения. Индивидуально подобранный комплекс восстановительного лечения, проводимый мультидисциплинарной командой, направленный на коррекцию не только медицинских проблем, но и социальных возможностей пациента, учитывающий персональный опыт пациента, его психологические черты, привычки и т.д., помогает значительно снизить количество осложнений, улучшить качество жизни больных. В статье рассматриваются этапы, методы реабилитации, нутритивная поддержка онкологических пациентов.
Ключевые слова: злокачественные новообразования, комплексная реабилитация, нутритивная поддержка онкологических пациентов, методы медицинской реабилитации, качество жизни
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Due to the improvement of the results of combined treatment of malignant tumors the survival rate of cancer patients is increasing. The issue of improving the quality of life, both during treatment and after its completion, is becoming more and more urgent. Conducting an individually selected comprehensive rehabilitation treatment conducted by a multidisciplinary team aimed at correcting not only medical problems but also the social capabilities of the patient taking into account the personal experience of the patient, his psychological traits, habits, etc., helps reduce the number of complications significantly, improve the quality of life of patients. The article discusses the stages, methods of rehabilitation, nutritional support for cancer patients.
Keywords: malignant neoplasms, complex rehabilitation, nutritional support for cancer patients, methods of medical rehabilitation, quality of life
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2. Antonio M, Saldaña J, Carmona-Bayonas A, et al. Geriatric Assessment Predicts Survival and Competing Mortality in Elderly Patients with Early Colorectal Cancer: Can It Help in Adjuvant Therapy Decision-Making? Oncologist. 2017;22(8):934-43. DOI:10.1634/theoncologist.2016-0462; PMID: 28487465; PMCID: PMC5553962
3. Presley CJ, Han L, Leo-Summers L, et al. Functional trajectories before and after a new cancer diagnosis among community-dwelling older adults. J Geriatr Oncol. 2019;10(1):60-7. DOI:10.1016/j.jgo.2018.05.017; PMID: 29937422; PMCID: PMC6526705
4. Gegechkori N, Haines L, Lin JJ. Long-Term and Latent Side Effects of Specific Cancer Types. Med Сlin North Am. 2017;101(6):1053-73. DOI:10.1016/j.mcna.2017.06.003
5. Smith SR, Zheng JY, Silver J, et al. Cancer rehabilitation as an essential component of quality care and survivorship from an international perspective. Disabil Rehabil. 2020;42:8‐13.
6. Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021;40(5):2898-913.
DOI:10.1016/j.clnu.2021.02.005; PMID: 33946039
7. Singh B, Hayes SC, Spence RR, et al. Exercise and colorectal cancer: a systematic review and meta-analysis of exercise safety, feasibility and effectiveness. Int J Behav Nutr Phys Act. 2020;17(1):122. DOI:10.1186/s12966-020-01021-7; PMID: 32972439; PMCID: PMC7513291
8. Shpata V, Prendushi X, Kreke M, et al. Malnutrition at the time of surgery affects negatively the clinical outcome of critically ill patients with gastrointestinal cancer. Med Arch. 2014;68(4):263-7.
9. Kabata P, Jastrzębski T, Kąkol M, et al. Preoperative nutritional support in cancer patients with no clinical signs of malnutrition – prospective randomized controlled trial. Support Care Cancer. 2015;23:365-37.
10. Trépanier M, Minnella EM, Paradis T, et al. Improved Disease-free Survival After Prehabilitation for Colorectal Cancer Surgery. Ann Surg. 2019;270(3):493-501. DOI:10.1097/SLA.0000000000003465; PMID: 31318793
11. Lee Y, Yu J, Doumouras AG, et al. Enhanced recovery after surgery (ERAS) versus standard recovery for elective gastric cancer surgery: A meta-analysis of randomized controlled trials. Surg Oncol. 2020;32:75-87. DOI:10.1016/j.suronc.2019.11.004; PMID: 31786352
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19. Greenlee H, Balneaves LG, Carlson LE, et al. Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr. 2014;346-58.
20. Alhamdoun A, Alomari K, Qadire MA. The Effects of Massage Therapy on Symptom Management among Patients with Cancer: A Systematic Review. Int Res J Oncol. 2020;3(2):38-45.
21. Sanal-Toprak C, Ozsoy-Unubol T, Bahar-Ozdemir Y, et al. The efficacy of intermittent pneumatic compression as a substitute for manual lymphatic drainage in complete decongestive therapy in the treatment of breast cancer related lymphedema. Lymphology. 2019;52(2):82-91. PMID: 31525829
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26. Kilmartin L, Denham T, Fu MR, et al. Complementary low-level laser therapy for breast cancer-related lymphedema: a pilot, double-blind, randomized, placebo-controlled study. Lasers Med Sci. 2020;35(1):95-105. DOI:10.1007/s10103-019-02798-1; PMID: 31079232
27. Strouthos I, Chatzikonstantinou G, Tselis N, et al. Photobiomodulation therapy for the management of radiation-induced dermatitis: A single-institution experience of adjuvant radiotherapy in breast cancer patients after breast conserving surgery. Strahlenther Onkol. 2017;193(6):491-8.
DOI:10.1007/s00066-017-1117-x; PMID: 28243723
28. Franklin AE, Lovell MR. Pain and pain management. In: Textbook of palliative care. Eds. RD MacLeod, L van den Block. Cham: Springer International Publishing, 2019.
29. Gewandter JS, Chaudari J, Ibegbu C, et al. Wireless transcutaneous electrical nerve stimulation device for chemotherapy-induced peripheral neuropathy: an open-label feasibility study. Support Care Cancer. 2018;27(5):1765-74.
30. Carvalho A, Mendonca R, Tirolli M, et al. TENS effects on dysesthesia and quality of life after breast can-cer surgery with axilectomy: randomized contro-lled trial. Fisioter Mov. 2017;30(1):S285-95.
31. Angeles MM, Larios PBL, Martinez GMI. Effectiveness of transcutaneous electrical nerve stimulation associated to acetaminophen in the reduction of postmastectomy pain related to neoplasm in female patients at ISSSTE. Investigaciуn en Discapacidad. 2018;7(3):91-9.
32. Sakr A, Sauri FAM, Zakarnah E, et al. Assessment and management of low anterior resection syndrome after sphincter preserving surgery for rectal cancer. Chin Med J. 2020;133(15):1824-33. DOI:10.1097/CM9.0000000000000852
33. Rick O, von Hehn U, Mikus E, et al. Magnetic Field Therapy in Patients With Cytostatics-Induced Polyneuropathy: A Prospective Randomized Placebo-Controlled Phase-III Study. Bioelectromagnetics. 2017;38(2):85-94.
34. Delbrück H. Rehabilitation and palliation of cancer patients (Patient care). Paris, 2007.
35. Catarino R, Correia T, Cardoso A, et al. Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up. Actas Urológicas Españolas. 2020;44:561-7.
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DOI:10.1097/DCR.0000000000001209; PMID: 30192320
37. Wei J, Meng L, Hou X, et al. Radiation-induced skin reactions: mechanism and treatment. Cancer Manag Res. 2018;11:167-77.
38. Watanabe T, Asai K, Fukuhara S, et al. Effectiveness of surgery and hyperbaric oxygen for antiresorptive agent-related osteonecrosis of the jaw: A subgroup analysis by disease stage. PloS One. 2021;16(1):e0244859.
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________________________________________________
1. Kumar A, Langstraat CL, DeJong SR, et al. Functional not chronologic age: Frailty index predicts outcomes in advanced ovarian cancer. Gynecol Oncol. 2017;147(1):104-9. DOI:10.1016/j.ygyno.2017.07.126; PMID: 28734497
2. Antonio M, Saldaña J, Carmona-Bayonas A, et al. Geriatric Assessment Predicts Survival and Competing Mortality in Elderly Patients with Early Colorectal Cancer: Can It Help in Adjuvant Therapy Decision-Making? Oncologist. 2017;22(8):934-43. DOI:10.1634/theoncologist.2016-0462; PMID: 28487465; PMCID: PMC5553962
3. Presley CJ, Han L, Leo-Summers L, et al. Functional trajectories before and after a new cancer diagnosis among community-dwelling older adults. J Geriatr Oncol. 2019;10(1):60-7. DOI:10.1016/j.jgo.2018.05.017; PMID: 29937422; PMCID: PMC6526705
4. Gegechkori N, Haines L, Lin JJ. Long-Term and Latent Side Effects of Specific Cancer Types. Med Сlin North Am. 2017;101(6):1053-73. DOI:10.1016/j.mcna.2017.06.003
5. Smith SR, Zheng JY, Silver J, et al. Cancer rehabilitation as an essential component of quality care and survivorship from an international perspective. Disabil Rehabil. 2020;42:8‐13.
6. Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021;40(5):2898-913.
DOI:10.1016/j.clnu.2021.02.005; PMID: 33946039
7. Singh B, Hayes SC, Spence RR, et al. Exercise and colorectal cancer: a systematic review and meta-analysis of exercise safety, feasibility and effectiveness. Int J Behav Nutr Phys Act. 2020;17(1):122. DOI:10.1186/s12966-020-01021-7; PMID: 32972439; PMCID: PMC7513291
8. Shpata V, Prendushi X, Kreke M, et al. Malnutrition at the time of surgery affects negatively the clinical outcome of critically ill patients with gastrointestinal cancer. Med Arch. 2014;68(4):263-7.
9. Kabata P, Jastrzębski T, Kąkol M, et al. Preoperative nutritional support in cancer patients with no clinical signs of malnutrition – prospective randomized controlled trial. Support Care Cancer. 2015;23:365-37.
10. Trépanier M, Minnella EM, Paradis T, et al. Improved Disease-free Survival After Prehabilitation for Colorectal Cancer Surgery. Ann Surg. 2019;270(3):493-501. DOI:10.1097/SLA.0000000000003465; PMID: 31318793
11. Lee Y, Yu J, Doumouras AG, et al. Enhanced recovery after surgery (ERAS) versus standard recovery for elective gastric cancer surgery: A meta-analysis of randomized controlled trials. Surg Oncol. 2020;32:75-87. DOI:10.1016/j.suronc.2019.11.004; PMID: 31786352
12. Zhang D, Sun K, Wang T, et al. Systematic Review and Meta-Analysis of the Efficacy and Safety of Enhanced Recovery After Surgery vs. Conventional Recovery After Surgery on Perioperative Outcomes of Radical Cystectomy. Front Oncol. 2020;10:541390. DOI:10.3389/fonc.2020.541390; PMID: 33072572; PMCID: PMC7538712
13. Noba L, Rodgers S, Chandler C, et al. Enhanced Recovery After Surgery (ERAS) Reduces Hospital Costs and Improve Clinical Outcomes in Liver Surgery: a Systematic Review and Meta-Analysis. J Gastrointest Surg. 2020;24(4):918-32. DOI:10.1007/s11605-019-04499-0; PMID: 31900738; PMCID: PMC7165160
14. Hébuterne X, Lemarié E, Michallet M, et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014;38:196-204.
15. Sytov AV, Guzov SA, Kukosh My, et al. Practical recommendations for nutritional support of cancer patients. Malignant tumors. Practical recommendations of RUSSCO #3s2. 2021;11(43) (in Russian).
16. Piraux E, Caty G, Aboubakar N, et al. Effects of exercise therapy in cancer patients undergoing radiotherapy treatment: a narrative review. SAGE Open Med. 2020;8:2050312120922657. DOI:10.1177/2050312120922657
17. Guercio BJ, Zhang S, Ou FS, et al. Associations of Physical Activity With Survival and Progression in Metastatic Colorectal Cancer: Results From Cancer and Leukemia Group B (Alliance)/SWOG 80405. J Clin Oncol. 2019;37(29):2620-31. DOI:10.1200/JCO.19.01019; PMID: 31408415; PMCID: PMC6900834
18. National Comprehensive Cancer Network (NCCN): 2018 NCCN Clinical Practice Guidelines in Oncology, Supportive Care: Cancer-Related Fatigue. version 2.2018. Available at: https://www.nccn.org/professionals/physician_gls/pdf/fatigue.pdf. Accessed: 29.03.2018.
19. Greenlee H, Balneaves LG, Carlson LE, et al. Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr. 2014;346-58.
20. Alhamdoun A, Alomari K, Qadire MA. The Effects of Massage Therapy on Symptom Management among Patients with Cancer: A Systematic Review. Int Res J Oncol. 2020;3(2):38-45.
21. Sanal-Toprak C, Ozsoy-Unubol T, Bahar-Ozdemir Y, et al. The efficacy of intermittent pneumatic compression as a substitute for manual lymphatic drainage in complete decongestive therapy in the treatment of breast cancer related lymphedema. Lymphology. 2019;52(2):82-91. PMID: 31525829
22. Belmonte R, Tejero M, Ferrer M, et al. Efficacy of low-frequency low-intensity electrotherapy in the treatment of breast cancer-related lymphoedema: a cross-over randomized trial. Clin Rehabil. 2012;26(7):607-18. DOI:10.1177/0269215511427414; PMID: 22172923; PMCID: PMC3573682
23. Jadaud E, Bensadoun R. Low-level laser therapy: a standard of supportive care for cancer therapy-induced oral mucositis in head and neck cancer patients? Laser therapy. 2012;21(4):297-303. DOI:10.5978/islsm.12-RE-01
24. Elad S, Cheng KKF, Lalla RV, et al. Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO). MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2020;126(19):4423‑31. DOI:10.1002/cncr.33100; PMID: 32786044; PMCID: PMC7540329
25. Lodewijckx J, Robijns J, Bensadoun RJ, et al. Photobiomodulation Therapy for the Management of Chemotherapy-Induced Peripheral Neuropathy: An Overview. Photobiomodul Photomed Laser Surg. 2020;38(6):348-54. DOI:10.1089/photob.2019.4771; PMID: 32460667
26. Kilmartin L, Denham T, Fu MR, et al. Complementary low-level laser therapy for breast cancer-related lymphedema: a pilot, double-blind, randomized, placebo-controlled study. Lasers Med Sci. 2020;35(1):95-105. DOI:10.1007/s10103-019-02798-1; PMID: 31079232
27. Strouthos I, Chatzikonstantinou G, Tselis N, et al. Photobiomodulation therapy for the management of radiation-induced dermatitis: A single-institution experience of adjuvant radiotherapy in breast cancer patients after breast conserving surgery. Strahlenther Onkol. 2017;193(6):491-8.
DOI:10.1007/s00066-017-1117-x; PMID: 28243723
28. Franklin AE, Lovell MR. Pain and pain management. In: Textbook of palliative care. Eds. RD MacLeod, L van den Block. Cham: Springer International Publishing, 2019.
29. Gewandter JS, Chaudari J, Ibegbu C, et al. Wireless transcutaneous electrical nerve stimulation device for chemotherapy-induced peripheral neuropathy: an open-label feasibility study. Support Care Cancer. 2018;27(5):1765-74.
30. Carvalho A, Mendonca R, Tirolli M, et al. TENS effects on dysesthesia and quality of life after breast can-cer surgery with axilectomy: randomized contro-lled trial. Fisioter Mov. 2017;30(1):S285-95.
31. Angeles MM, Larios PBL, Martinez GMI. Effectiveness of transcutaneous electrical nerve stimulation associated to acetaminophen in the reduction of postmastectomy pain related to neoplasm in female patients at ISSSTE. Investigaciуn en Discapacidad. 2018;7(3):91-9.
32. Sakr A, Sauri FAM, Zakarnah E, et al. Assessment and management of low anterior resection syndrome after sphincter preserving surgery for rectal cancer. Chin Med J. 2020;133(15):1824-33. DOI:10.1097/CM9.0000000000000852
33. Rick O, von Hehn U, Mikus E, et al. Magnetic Field Therapy in Patients With Cytostatics-Induced Polyneuropathy: A Prospective Randomized Placebo-Controlled Phase-III Study. Bioelectromagnetics. 2017;38(2):85-94.
34. Delbrück H. Rehabilitation and palliation of cancer patients (Patient care). Paris, 2007.
35. Catarino R, Correia T, Cardoso A, et al. Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up. Actas Urológicas Españolas. 2020;44:561-7.
36. Paquette IM, Vogel JD, Abbas MA, et al. Clinical Practice Guidelines Committee of The American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Chronic Radiation Proctitis. Dis Colon Rectum. 2018;61(10):1135-40.
DOI:10.1097/DCR.0000000000001209; PMID: 30192320
37. Wei J, Meng L, Hou X, et al. Radiation-induced skin reactions: mechanism and treatment. Cancer Manag Res. 2018;11:167-77.
38. Watanabe T, Asai K, Fukuhara S, et al. Effectiveness of surgery and hyperbaric oxygen for antiresorptive agent-related osteonecrosis of the jaw: A subgroup analysis by disease stage. PloS One. 2021;16(1):e0244859.
39. Семиглазова Т.Ю., Ткаченко Г.А., Чулкова В.А. Психологические аспекты лечения онкологических больных. Злокачественные опухоли. 2016;4(1):54‑8 [Semiglazova TYu, Tkachenko GA, Chulkova VA. Psychological aspects of treatment of oncological patients. Malignant Tumors. 2016;4(1):54-8 (in Russian)]. DOI:10.18027/2224-5057-2016-4s1-54-58
40. Samushia MA. Psikhicheskie rasstroistva u bol'nykh zlokachestvennymi novoobrazovaniiami organov zhenskoi reproduktivnoi sistemy (klinika, epidemiologiia, terapiia). Dis. … d-ra med. nauk. Moscow, 2015; p. 368 (in Russian).
41. De Vries M, Stiefel F. Psychotherapy in the Oncology. Setting Recent Results Cancer Res. 2018;210:145-61. DOI:10.1007/978-3-319-64310-6_9
42. Chulkova VA, Semiglazova TYu, Pestereva EV, et al. Psychological rehabilitation of cancer patients. Malignant tumors. 2018;6(1234):39-41 (in Russian).
43. Psychological correction of the crisis state of the personality of women suffering from breast cancer. Siberian Psychological Journal. 2008;30:97‑101 (in Russian).
44. Tkachenko GA. Art therapy in the complex rehabilitation of cancer patients. Physical and Rehabilitation Medicine, Medical Rehabilitation. 2019;1(3):37-9 (in Russian). DOI:10.36425/2658-6843-2019-3-37-39
45. Simonton K, Simonton S. Vozvrashchenie k zdorov'iu (Novyi vzgliad na tiazhelye bolezni). Saint Petersburg: Peter Press, 1996 (in Russian).
1 Московский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России, Москва, Россия;
2 ФГБУ «Центральная клиническая больница с поликлиникой» Управления делами Президента РФ, Москва, Россия;
3 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
4 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
5 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
6 ФГБНУ «Федеральный научно-клинический центр реаниматологии и реабилитации», Лыткино, Россия
*gameeva@yandex.ru
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Elena V. Gameeva*1, Aleksandra M. Stepanova1, Galina A. Tkachenko2, Oleg V. Gridnev3, Sergey V. Sviridov4, Aleksandr E. Shestopalov5,6
1 Herzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre, Moscow, Russia;
2 Central Clinical Hospital with a Polyclinic of the President of the Russian Federation, Moscow, Russia;
3 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
4 Pirogov Russian National Research Medical University, Moscow, Russia;
5 Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
6 Federal Scientific and Clinical Center for Resuscitation and Rehabilitation, Lytkino, Russia
*gameeva@yandex.ru