Как достигается значимое увеличение выживаемости при раке поджелудочной железы. Роль нутритивного статуса и сопроводительной терапии
Как достигается значимое увеличение выживаемости при раке поджелудочной железы. Роль нутритивного статуса и сопроводительной терапии
Жукова Л. Г., Бордин Д. С., Дубцова Е. А., Ильин М. А., Кирюкова М. А., Феоктистова П. С., Егоров В. И. Как достигается значимое увеличение выживаемости при раке поджелудочной железы. Роль нутритивного статуса и сопроводительной терапии. Современная Онкология. 2023;25(4):472–483.
DOI: 10.26442/18151434.2023.4.202541
Zhukova LG, Bordin DS, Dubtsova EA, Ilin MA, Kiriukova MA, Feoktistova PS, Egorov VI. How a significant increase in survival in pancreatic cancer is achieved. The role of nutritional status and supportive care: A review. Journal of Modern Oncology. 2023;25(4):472–483. DOI: 10.26442/18151434.2023.4.202541
Как достигается значимое увеличение выживаемости при раке поджелудочной железы. Роль нутритивного статуса и сопроводительной терапии
Жукова Л. Г., Бордин Д. С., Дубцова Е. А., Ильин М. А., Кирюкова М. А., Феоктистова П. С., Егоров В. И. Как достигается значимое увеличение выживаемости при раке поджелудочной железы. Роль нутритивного статуса и сопроводительной терапии. Современная Онкология. 2023;25(4):472–483.
DOI: 10.26442/18151434.2023.4.202541
Zhukova LG, Bordin DS, Dubtsova EA, Ilin MA, Kiriukova MA, Feoktistova PS, Egorov VI. How a significant increase in survival in pancreatic cancer is achieved. The role of nutritional status and supportive care: A review. Journal of Modern Oncology. 2023;25(4):472–483. DOI: 10.26442/18151434.2023.4.202541
Рак поджелудочной железы (РПЖ) представляет серьезную проблему для здравоохранения. Летальность больных РПЖ остается одной из самых высоких среди онкологических заболеваний. Ранняя диагностика РПЖ затруднена, поэтому опухоль часто выявляется на поздних стадиях. Современные подходы к лечению, включающие хирургическое вмешательство, нео- и адъювантную химиотерапию, химиолучевую и сопроводительную терапию, продемонстрировали улучшение исходов лечения. Важной проблемой остается экзокринная недостаточность поджелудочной железы (ЭНПЖ) у больных РПЖ, которая требует заместительной ферментной терапии. Однако этому не придается должное значение в отечественной литературе. В обзоре рассматриваются динамика выживаемости пациентов с РПЖ, современные возможности лечения с учетом заместительной ферментной терапии как неотъемлемой части вспомогательного лечения и восстановления нутритивного статуса и проблемы маршрутизации пациентов с ЭНПЖ. Подчеркивается, что диагностика и коррекция ЭНПЖ являются обязательными для улучшения и поддержания нутритивного статуса и качества жизни, без чего эффективное противоопухолевое лечение РПЖ сегодня невозможно.
Pancreatic cancer (PC) is a serious public health problem. The mortality rate of patients with PC remains one of the highest among cancers. Early diagnosis of PC is challenging, so it is often diagnosed in the later stages. Current treatment approaches, including surgery, neoadjuvant and adjuvant chemotherapy, chemoradiotherapy, and supportive care, have demonstrated improved outcomes. A significant problem remains exocrine pancreatic insufficiency (EPI) in patients with PC, which requires enzyme replacement therapy. However, this is not given due attention in the Russian literature. This review addresses the survival trends of patients with PC, current therapies, and enzyme replacement therapy as an integral part of supportive care and improvement of nutritional status; also, the issues of routing patients with PC are addressed. It is emphasized that the diagnosis and treatment of EPI are mandatory to improve and maintain the nutritional status and quality of life; failure to treat EPI renders antitumor treatment ineffective.
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Авторы
Л. Г. Жукова1, Д. С. Бордин*1–3, Е. А. Дубцова1, М. А. Ильин4,5, М. А. Кирюкова1, П. С. Феоктистова1, В. И. Егоров5,6 1ГБУЗ «Московский клинический научно-практический центр им. А. С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия; 2ФГБОУ ВО «Российский университет медицины» Минздрава России, Москва, Россия; 3ФГБОУ ВО «Тверской государственный медицинский университет» Минздрава России, Тверь, Россия; 4ФГБУ «Российский научный центр рентгенорадиологии» Минздрава России, Москва, Россия; 5АО «Ильинская больница», Красногорск, Россия; 6ФГБУ «Государственный научный центр Российской Федерации – Федеральный медицинский биофизический центр им. А. И. Бурназяна», Москва, Россия
*dbordin@mail.ru
________________________________________________
Liudmila G. Zhukova1, Dmitry S. Bordin*1–3, Elena A. Dubtsova1, Matvey A. Ilin4,5, Mariia A. Kiriukova1, Polina S. Feoktistova1, Vyacheslav I. Egorov5,6
1Loginov Moscow Clinical Scientific Center, Moscow, Russia; 2Russian University of Medicine, Moscow, Russia; 3Tver State Medical University, Tver, Russia; 4Russian Scientific Centre of Roentgenoradiology, Moscow, Russia; 5Ilyinsky Hospital JSC, Krasnogorsk, Russia; 6State Research Center – Burnasyan Federal Medical Biophysical Center, Moscow, Russia
*dbordin@mail.ru