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Федеральное государственное бюджетное учреждение науки
Институт теоретической и экспериментальной биофизики
Российской академии наук


ООО "ИЦ КОМКОН"

Адрес редакции и реквизиты

192012, Санкт-Петербург, ул.Бабушкина, д.82 к.2, литера А, кв.378

ISSN 1999-6314


Клиническая медицина » Хирургия • Онкология, лучевая терапия

Том: 23
Статья: « 18 »
Страницы:. 278-297
Опубликована в журнале: 20 мая 2022 г.
English version

Метастазы увеальной меланомы в печень: патогенез, современные клинические опции и перспективы лечения (обзор литературы)

Унгурян В.М., Назарова В.В., Круглов Е.А, Петров Л.О.

ОГБУЗ «Костромской клинический онкологический диспансер». Российская Федерация, Костромская область, г. Кострома, улица Нижняя Дебря 19.
ФГБУ «Национальный медицинский исследовательский центр онкологии имени Н.Н. Блохина» МЗ РФ, Российская Федерация, Москва, Каширское шоссе, д. 24
МРНЦ им. А. Ф. Цыба - филиал ФГБУ «НМИЦ радиологии» МЗ РФ, Российская Федерация, Калужская область, г. Обнинск, ул. Королeва, д. 4.


Резюме
Увеальная меланома является наиболее распространенной первичной внутриглазной злокачественной опухолью у взрослых с частотой заболеваемости 5-7 случаев на 1 млн населения в год. Увеальная меланома имеет различные эпидемиологические, биологические и клинические особенности, включая преимущественное метастазирование в печень. Несмотря на первичное лечение у 50% пациентов развиваются отдаленные метастатические очаги, при этом в 90% случаев печень является первым и часто единственным органом для метастазирования. Диссеминация увеальной меланомы в печень связана с плохим прогнозом для жизни с медианой общей выживаемости от 6 до 12 месяцев. Лечение метастатической увеальной меланомы включает в себя системную химиотерапию, иммунотерапию и таргетную терапию. Отдельно выделяют методы локального лечения, такие как: хирургическая резекция, радиоэмболизация, химиоэмболизация, иммуноэмболизация, изолированная и чрескожная перфузия печени, а также термическая абляция. Тем не менее, на сегодняшний день, единого общепринятого алгоритма лечения больных с метастатической увеальной меланомы в печень не существует. Анализ фундаментальных исследований и понимания биологии опухоли, механизмов иммунного ответа и причин метастазирования может привести к разработке новых стратегий лечения, определяя путь к персонализированному подходу у этой категории пациентов.


Ключевые слова
увеальная меланома, метастазы, метастазы в печень, адъювантная терапия, таргетная терапия, иммунотерапия, комбинированная терапия, регионарное лечение, перфузия печени.


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