spracticeХирургическая практикаSurgical practice (Russia)2223-2427АНО "Консорциум "Медицинская техника"10.38181/2223-2427-2021-3-61-68spractice-250Research ArticleСтатьиХИМИОЭМБОЛИЗАЦИЯ ПЕЧЕНОЧНОЙ АРТЕРИИ ПРИ ЛЕЧЕНИИ БОЛЬНЫХ С ХИМИОРЕЗИСТЕНТНЫМИ МЕТАСТАЗАМИ КОЛОРЕКТАЛЬНОГО РАКА. ОБЗОРCHEMOEMBOLIZATION OF THE HEPATIC ARTERY IN THE TREATMENT OF PATIENTS WITH CHEMORESISTANT METASTASES OF COLORECTAL CANCER. REVIEWhttps://orcid.org/0000-0003-3748-4750СтукаловаО. Ю.StukalovaO. Yu.

Стукалова Оксана Юрьевна – врач-колопроктолог колопроктологического (онкологического) отделения

Будайская ул., д. 2, 129128, Москва

Oksana Yu. Stukalova – Coloproctologist, Coloproctology (Oncology)

Budayskaya St., 2, 129128, Moscow

 

docstukalova@mail.ruhttps://orcid.org/0000-0002-7683-5042ПоликарповА. А.PolikarpovA. A.

Поликарпов Алексей Александрович – д.м.н., главный научный сотрудник отделения отдела интервенционной радиологии и оперативной хирургии, профессор кафедры радиологии, хирургии и онкологии

197758, Санкт-Петербург, поселок Песочный, ул. Ленинградская, д. 70

Aleksey A. Polikarpov – Dr. Sci., Main scientist researcher of Interventional Radiology and Surgical Technologies Department, Professor of the Department Radiology, Surgery and Oncology

Leningradskaya St., 70, tow. Pesochnyi, 197758, Saint-Petersburg

pol1110@mail.ruhttps://orcid.org/0000-0003-0260-6922ИщенкоР. В.IsсhenkoR. V.

Ищенко Роман Викторович – д.м.н., профессор кафедры хирургических болезней

ул. Ленинские Горы, д. 1, 119991, Москва

Roman V. Isсhenko – Dr. Sci., Professor of the Department of Surgery

Leninskie Gory, 1, 119991, Moscow

shenkorv@rambler.ruЦКБ «РЖД-Медицина»РоссияCentral Clinical Hospital "RZD-Medicine"Russian FederationФГБУ «Российский научный центр радиологии и хирургических технологий им. акад. А.М. Гранова» Минздрава РоссииРоссияSurgery and Oncology Granov Russian Research Center of Radiology and Surgical Technologies of Healthcare Ministry of the Russian FederationRussian FederationМосковский государственный университет имени М.В. Ломоносова, факультет фундаментальной медицины (МГУ имени М.В. Ломоносова)РоссияMoscow State Lomonosov University, Faculty of Medicine,Russian Federation202122102021036168Copyright © Стукалова О.Ю., Поликарпов А.А., Ищенко Р.В., 20212021Стукалова О.Ю., Поликарпов А.А., Ищенко Р.В.Stukalova O.Y., Polikarpov A.A., Isсhenko R.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.spractice.ru/jour/article/view/250

В структуре заболеваемости злокачественными опухолями на протяжении ряда лет, колоректальный рак занимает одно из лидирующих положений, с неуклонной тенденцией к росту. Пятилетняя выживаемость пациентов с метастатическим поражением печени при колоректальном раке не превышает 28 %. Значительный прорыв в изучении биологии колоректального рака привел к глубокому пониманию отдельных процессов канцерогенеза и персонифицированному подходу в лечебной тактике. Несмотря на это проблема химиорезистентности остается одной из самых острых. Высокая токсичность системной химиотерапии ограничивает ее применение у пациентов данной группы. В связи с чем, в клиническую практику были внедрены малоинвазивные и вместе с тем эффективные способы локального лечения злокачественных опухолей печени. К таким методам относят: химиоинфузию печеночной артерии (ХИПА), химиоэмболизацию (ХЭПА), масляную химиоэмболизацию (МХЭПА) и радиоэмболизацию. В настоящее время уже накоплен большой мировой опыт применения вышеописанных методов лечения. Однако вопрос о применении методов интервенционной хирургии в лечении больных с химиорезистентными метастазами до сих пор остается открытым. В представленном обзоре отражены результаты анализа научной литературы по лечению данной группы пациентов. Представлены основные этапы развития и совершенствования рентгенэндоваскулярных методов лечения.

In the structure of the incidence of malignant tumors for a number of years, colorectal cancer occupies one of the leading positions, with a steady tendency to growth. The five-year survival rate of patients with metastatic liver damage in colorectal cancer does not exceed 28%. A significant breakthrough in the study of the biology of colorectal cancer has led to a deep understanding of individual processes of carcinogenesis and a personalized approach to treatment tactics. Despite this, the problem of chemoresistance remains one of the most acute. The high toxicity of systemic chemotherapy limits its use in this group of patients. In this connection, minimally invasive and at the same time effective methods of local treatment of malignant liver tumors have been introduced into clinical practice. These methods include: hepatic artery chemoinfusion, chemoembolization, oil chemoembolization and radioembolization. At present, a large world experience has already been accumulated in the application of the above-described methods of treatment. However, the question of the application of methods of interventional surgery in the treatment of patients with chemoresistant metastases is still open. The presented review reflects the results of the analysis of scientific literature on the treatment of this group of patients. The main stages of development and improvement of X-ray endovascular methods of treatment are presented.

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The authors declare that there are no conflicts of interest present.