medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-266medsovet-8453Research ArticleШКОЛА ПЕДИАТРАPEDIATRICIAN SCHOOLАктуальные вопросы мультидисциплинарного наблюдения детей с медуллобластомой на педиатрическом участкеMultidisciplinary monitoring in pediatric patients with medulloblastoma by primary care physicianhttps://orcid.org/0000-0002-2003-0982ДиникинаЮ. В.DinikinaYu. V.

Диникина Юлия Валерьевна, к.м.н., заведующая отделением химиотерапии онкогематологических заболеваний и трансплантации костного мозга для детей, заведующая научно-исследовательской лабораторией детской нейроиммуноонкологии

197341, Санкт-Петербург, ул. Аккуратова, д. 2 

Yulia V. Dinikina, Cand. Sci. (Med.), Head of the Department of Chemotherapy of Oncohematological Diseases and Bone Marrow Transplantation for Children, Head of the Research Laboratory of Pediatric Neuroimmuno-Oncology

2, Akkuratov St., St Petersburg, 197341

dinikinayulia@mail.ruhttps://orcid.org/0000-0003-4013-0785НикитинаИ. Л.NikitinaI. L.

Никитина Ирина Леоровна, д.м.н., профессор, заведующая научно-исследовательской лабораторией детской эндокринологии Института эндокринологии

197341, Санкт-Петербург, ул. Аккуратова, д. 2 

Irina L. Nikitina, Dr. Sci. (Med.), Professor, Head of the Research Laboratory of Pediatric Endocrinology, Institute of Endocrinology

2, Akkuratov St., St Petersburg, 197341

nikitina0901@gmail.comhttps://orcid.org/0000-0002-8607-3635ЖелудковаО. Г.ZheludkovaO. G.

Желудкова Ольга Григорьевна, д.м.н., профессор

119620, Москва, ул. Авиаторов, д. 38

Olga G. Zheludkova, Dr. Sci. (Med.), Professor

38, Aviatorov St., Moscow, 119620

clelud@mail.ruhttps://orcid.org/0000-0001-6341-7856ЛеоноваИ. А.LeonovaI. A.

Леонова Ирина Александровна, к.м.н., доцент кафедры детских болезней с клиникой лечебного факультета Института медицинского образования

197341, Санкт-Петербург, ул. Аккуратова, д. 2 

Irina A. Leonova, Cand. Sci. (Med.), Assistant Professor of the Department of Pediatric Diseases, Faculty of General Medicine

2, Akkuratov St., St Petersburg, 197341

leonova_ia@almazovcentre.ruhttps://orcid.org/0000-0003-3115-5091ОбразцоваГ. И.ObraztsovaG. I.

Образцова Галина Игоревна, д.м.н., доцент кафедры детских болезней с клиникой лечебного факультета Института медицинского образования

197341, Санкт-Петербург, ул. Аккуратова, д. 2 

Galina I. Obraztsova, Dr. Sci. (Med.), Assistant Professor of the Department of Pediatric Diseases, Faculty of General Medicine, Medical Institution

2, Akkuratov St., St Petersburg, 197341

obraztsova_gi@almazovcentre.ruhttps://orcid.org/0000-0002-7063-1161БашнинаЕ. Б.BashninaE. B.

Башнина Елена Борисовна, д.м.н., профессор кафедры эндокринологии имени акад. В.Г. Баранова

191015, Санкт-Петербург, ул. Кирочная, д. 41 

Elena B. Bashnina, Dr. Sci. (Med.), Professor, Professor of the Department of Endocrinology Named after Acad. V.G. Baranov

41, Kirochnaya St., St Petersburg, 191015

bashnina@mail.ruhttps://orcid.org/0000-0002-6022-3420КосенковаТ. В.KosenkovaT. V.

Косенкова Тамара Васильевна, д.м.н., профессор кафедры детских болезней с клиникой лечебного факультета Института медицинского образования

197341, Санкт-Петербург, ул. Аккуратова, д. 2 

Tamara V. Kosenkova, Dr. Sci. (Med.), Professor, Professor of the Department of Pediatric Diseases, Faculty of General Medicine

2, Akkuratov St., St Petersburg, 197341

kosenkova_tv@almazovcentre.ruНациональный медицинский исследовательский центр имени В.А. АлмазоваРоссияAlmazov National Medical Research CenterRussian FederationНаучно-практический центр специализированной медицинской помощи имени В.Ф. Войно-ЯсенецкогоРоссияVoino-Yasenetsky Scientific and Practical Center for Specialized Medical CareRussian FederationСеверо-Западный государственный медицинский университет имени И.И. МечниковаРоссияNorth-Western State Medical University named after I.I. MechnikovRussian Federation202412082024011275–284Copyright © Диникина Ю.В., Никитина И.Л., Желудкова О.Г., Леонова И.А., Образцова Г.И., Башнина Е.Б., Косенкова Т.В., 20242024Диникина Ю.В., Никитина И.Л., Желудкова О.Г., Леонова И.А., Образцова Г.И., Башнина Е.Б., Косенкова Т.В.Dinikina Y.V., Nikitina I.L., Zheludkova O.G., Leonova I.A., Obraztsova G.I., Bashnina E.B., Kosenkova T.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.med-sovet.pro/jour/article/view/8453

Возможности диагностики и лечения онкологических заболеваний у пациентов детского возраста в критически быстрые сроки достигли высокотехнологичного уровня, способствуя улучшению показателей безрецидивной и общей выживаемости. Очевидно, что ключевым фактором является усовершенствование программ диагностики и скрининга, противоопухолевой, сопроводительной терапии и в том числе персонификации протоколов диспансеризации с целью мониторинга и своевременной коррекции ранних и отдаленных осложнений. Высокую актуальность приобретают вопросы качества жизни излеченных пациентов, включая социальную и психологическую реабилитацию, а также аспекты реализации репродуктивного потенциала. Следует отметить критическую важность участия осведомленной мультидисциплинарной команды специалистов на всех этапах лечения онкологического заболевания. В соответствии с объемом противоопухолевого лечения в индивидуальном порядке необходимо прогнозировать ожидаемые варианты токсических осложнений с целью последующей реализации программ диспансерного наблюдения. Кроме этого, важно, что иммунокомпрометированные пациенты имеют повышенный риск осложнений и смерти от болезней, предупреждаемых вакцинацией, что подчеркивает ее значимость у данной категории пациентов. В представленной публикации на примере медуллобластомы как самой частой злокачественной опухоли центральной нервной системы у детей представлены основные алгоритмы и наиболее значимые вопросы диагностики и курации пациентов с онкологическим диагнозом, заслуживаю щие внимания врача-педиатра и других специалистов узкого профиля. Предлагаемые рекомендации основаны на изучении особенностей течения медуллобластомы в рамках ретроспективного анализа регистра пациентов детского возраста с рецидивирующими и рефрактерными формами медуллобластомы (n = 270), получавших противоопухолевую терапию в период с 01.07.1993 по 01.07.2023 г., а также международных клинических данных.

Diagnostic and treatment facilities in pediatric oncology have reached a very technological advances in a short period of time, contributing to increased relapse-free and overall survival rates. Obviously, the key factors are the improvement of diagnostic and screening programs, anticancer and concomitant therapy, including personification of clinical guidelines for monitoring and correction of early and late complications in time. Issues regarding the quality of life of patients, including social, psychological rehabilitation and aspects of reproductive potential, are becoming highly actual. The critical importance is that an informed multidisciplinary team of specialists at all stages of anticancer treatment should be involved. This article presents the main algorithms and the most significant issues for pediatricians in the diagnosis and supervision of patients with an oncological diagnosis, using the example of medulloblastoma, as the most common malignant tumor of the central nervous system in children. The proposed recommendations are based on a retrospective analysis of pediatric patients with relapsed and refractory forms of medulloblastoma (n = 270) who received antitumor therapy in the period from 07/01/1993 to 07/01/2023, as well as international clinical data.

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