Medical Radiology and radiation safety Medical Radiology and radiation safety Медицинская радиология и радиационная безопасность 1024-6177 2618-9615 28919 10.12737/article_5cf3e4354d3276.60963732 Лучевая терапия Radiation therapy Лучевая терапия The Evolution of Neoadjuvant and Adjuvant Component of Treatment of Patients with Locally Advanced Rectal Cancer Эволюция неоадьювантного и адьювантного компонентов комплексного лечения больных местнораспространенным раком прямой кишки Кузьмичев Д. В. Kuz'michev D. V.

кандидат медицинских наук;

candidate of medical sciences;

 Мамедли З. З. Mamedli Z. Z.

кандидат медицинских наук;

candidate of medical sciences;

 Анискин А. А. Aniskin A. A. Полыновский А. В. Polynovskiy A. V.

кандидат медицинских наук;

candidate of medical sciences;

 Мадьяров Ж. М. Madyarov J. M.

кандидат медицинских наук;

candidate of medical sciences;

 Ткачев Сергей Иванович Tkachev Sergey Ivanovich

доктор медицинских наук;

doctor of medical sciences;

 Егорова А. В. Egorova A. V. Анискина А. С. Aniskina A. S. Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Российский национальный исследовательский медицинский университет имени Н.И. Пирогова Минздрава РФ Москва Россия Pirogov Russian National Research Medical University Moscow Russian Federation Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Российский национальный исследовательский медицинский университет имени Н.И. Пирогова Минздрава РФ Москва Россия Pirogov Russian National Research Medical University Moscow Russian Federation Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation 64 3 64 73 https://zh-szf.ru/en/nauka/article/28919/view

Представлены результаты многочисленных одноцентровых и многоцентровых рандомизированных и нерандомизированных исследований, посвященных лечению пациентов с местнораспространенной формой рака прямой кишки (МРРПК) за 70-летний период. Репрезентирована последовательность хирургического, лекарственного, лучевого и химиолучевого лечения. Описаны дозы и объем лучевого воздействия как в монорежиме, так и с применением различных комбинаций химиотерапевтических препаратов в неоадьювантном и адъювантном режимах. Произошедшая эволюция комплексного лечения сместила акценты к использованию химиолучевой терапии в неоадъювантный период, а внедрение новых химиотерапевтических препаратов и режимов позволили значительно увеличить показатели выживаемости среди больных МРРПК. Подходы к лечению больных МРРПК не являются статичными и постоянно совершенствуются. В данном литературном обзоре отображена хронологическая последовательность и основные современные тенденции неоадъювантного и адъювантного компонентов лечения больных с местнораспространенной формой рака прямой кишки.

The results of numerous single-center and multicenter randomized and non-randomized studies on the treatment of patients with locally advanced rectal cancer (LARC) over a 70-year period are presented. The sequence of surgical, medicinal, radiation and chemoradiation treatment is represented. The doses and amount of radiation exposure are described, both in mono mode and with the use of various combinations of chemotherapeutic drugs in neoadjuvant and adjuvant regimens. The evolution of complex treatment that has shifted has shifted the emphasis to the use of chemoradiation therapy in the neoadjuvant period, and the introduction of new chemotherapeutic drugs and regimens have significantly increased the survival rates among patients with LARC. The approaches to the treatment of patients with LARC are not static and are constantly being improved. This literature review shows the chronological sequence and major current trends in the neoadjuvant and adjuvant components of the treatment of patients with locally advanced rectal cancer.

 местнораспространенный рак прямой кишки комплексное лечение консолидирующая химиотерапия индукционная химиотерапия лечебный патоморфоз locally advanced rectal cancer complex treatment consolidation chemotherapy induction chemotherapy medical pathomorphosis

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