medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2020-9-213-224medsovet-5738Research ArticleОБЗОРЫREVIEWSВедение больных раком толстой кишки в условиях эпидемии коронавирусной инфекцииPractical recommendation for treatment of patients with colon cancer during covid-19 pandemichttps://orcid.org/0000-0001-5615-7806ФедянинМ. Ю.FedyaninM. Yu.

Федянин Михаил Юрьевич, д.м.н., старший научный сотрудник отделения клинической фармакологии и химиотерапии; доцент кафедры онкологии и гематологии факультета непрерывного медицинского образования

РИНЦ: SPIN: 4381-5628

115478, Москва, Каширское шоссе, д. 24

117198, Москва, ул. Миклухо-Маклая, д. 6

Mikhail Yu. Fedyanin, Dr. of Sci. (Med), medical oncologist in oncological department of chemotherapy #2; Associate Professor of the Department of Oncology and Hematology of the Faculty of Continuing Medical Education

24, Kashirskoye Shosse, Moscow, 115478

6, Miklukho-Maklai St., Moscow, 117198

fedianinmu@mail.ruНациональный медицинский онкологический центр им. Н.Н. Блохина; Российский университет дружбы народовРоссияBlokhin Russian Cancer Research Center; Peoples’ Friendship University of RussiaRussian Federation20203007202009213224Copyright © Федянин М.Ю., 20202020Федянин М.Ю.Fedyanin M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/5738

Ограничение оказания онкологический помощи в условиях эпидемии наблюдается в большинстве стран мира. Это связано, прежде всего, с появившейся в первых небольших публикациях из Китая информацией о повышенной восприимчивости онкологических пациентов и повышенном риске тяжелого течения новой инфекции, что привело к отмене плановых операций, отсрочке начала адъювантной терапии, переводу консультаций специалистов в формат телемедицины. Свой вклад внесли и случаи заболевания медицинского персонала, и перепрофилирование клинических подразделений и целых клиник, которые ранее оказывали помощь онкологическим больным, на лечение пациентов с COVID-19. Это все породило чувство страха перед неизвестностью у онкологов и больных. В данной статье представлен опыт лечения вирусной инфекции у онкологических больных разных стран. Рассмотрены рекомендации противоопухолевых обществ различных стран мира по оказанию терапии онкологическим пациентам. На примере рака толстой кишки рассмотрены подходы к лечению, которые в условиях повышенной эпидемической опасности позволят проводить нашим пациентам полноценное противоопухолевое лечение. Обоснована необходимость проведения короткого курса лучевой терапии совместно с химиотерапией на предоперационном этапе лечения местнораспространенного рака прямой кишки, уменьшения числа курсов адъювантной химиотерапии при 3-й стадии рака ободочной кишки. Определены приоритеты в выборе первой и последующих линий терапии метастатических опухолей; отсутствие необходимости удаления бессимптомной первичной опухоли при неоперабельных метастазах; возможности иммунотерапии при опухолях с микросателлитной нестабильностью высокого уровня; комбинации таргетной терапии при опухолях с мутацией в гене BRAF.

Restrictions on the cancer care in an epidemic are observed in the most countries of the world. The first small publications gave information of the increased susceptibility of cancer patients to a new infection which led to the postpone of elective surgery, initiation of adjuvant therapy, and the transfer of specialist consultations to telemedicine. The cases of infections of medical personnel, as well as the reassignment of clinical units and clinics that previously assisted cancer patients to the treatment of patients with COVID-19, also contributed. This article presents the experience of treating viral infections in cancer patients from different countries. On the example of colon cancer, treatment approaches are considered that, in conditions of increased epidemic danger, will allow our patients to provide effective antitumor treatment. We recommend to use short course of radiotherapy with chemotherapy in patients with locally-advanced rectal tumors; short course of adjuvant chemotherapy in stage 3 colon cancer; rational decisions for choosing regimen in 1st and subsequent lines of systemic therapy in patients with metastatic disease.

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