Лечение лейомиосарком матки
Аннотация
Данная статья посвящена обзору лечения лейомиосарком матки. На основании данных различных исследований мы рекомендуем проводить следующие этапы лечения. Хирургическое лечение в объеме пангистерэктомии должно обязательно проводиться при местно-распространенном заболевании, далее возможно применение адъювантной химиотерапии, но решение должно приниматься индивидуально. Проведение адъювантной лучевой терапии не показано, так как это не увеличивает общую выживаемость. Основным методом лечения диссеминированных лейомиосарком матки является комбинированная химиотерапия. В I линию лечения мы рекомендуем применять комбинированные схемы лечения с включением ифосфамида, доксорубицина, дакарбазина и гемцитабина, доцетаксела. Монотерапия трабектедином, в виде 24-часовой инфузии, показала хороший процент длительных стабилизаций и может применяться во II и более линии лечения. Применение гормональной терапии возможно в качестве поддерживающего лечения при положительном статусе рецепторов стероидных гормонов в опухоли. Решение о хирургическом лечении диссеминированного процесса должно приниматься индивидуально. Также представлены данные РОНЦ им. Н.Н. Блохина РАМН по применению трабектедина в лечении больных с лейомиосаркомами матки. Эффективность и токсичность сравнима с результатами международного исследования STS-201. При редукции дозы до 1,3 мг/м2 в виде 24-часовой инфузии значительно снижается токсичность при сохранении показателей эффективности, однако это требует дальнейшего изучения.
Об авторах
А. А. Феденко
ФГБУ Российский онкологический научный центр им. Н.Н. Блохина РАМН
Россия
Россия
г. Москва
А. А. Конев
ФГБУ Российский онкологический научный центр им. Н.Н. Блохина РАМН
Россия
Россия
г. Москва
В. А. Горбунова
ФГБУ Российский онкологический научный центр им. Н.Н. Блохина РАМН
Россия
Россия
г. Москва
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Рецензия
Для цитирования:
Феденко А.А., Конев А.А., Горбунова В.А. Лечение лейомиосарком матки. Саркомы костей, мягких тканей и опухоли кожи. 2014;(1):56-63.
For citation:
Fedenko A.A., Konev A.A., Gorbunova V.A. Treatment of uterine leiomyosarcoma. Bone and soft tissue sarcomas, tumors of the skin. 2014;(1):56-63. (In Russ.)
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