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Важность оценки функции яичников у женщин при назначении эндокринотерапии рака молочной железы

https://doi.org/10.21518/2079-701X-2018-10-118-126

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Аннотация

Эффективность добавления овариальной супрессии к тамоксифену или к ингибиторам ароматазы после адъювантной химиотерапии для женщин моложе 35 лет или старше, но при наличии хотя бы одного фактора высокого риска рецидива доказана в рандомизированных клинических исследованиях.

Однако отсутствие четких критериев оценки функции яичников после проведения гонадотоксичной химиотерапии, особенно у женщин в перименопаузе, значительно затрудняет выбор правильной тактики эндокринотерапии. Несмотря на доказанную эффективность в исследованиях SOFT и TEXT ингибиторов ароматазы в адъювантной терапии рака молочной железы у женщин с сохраненной функцией яичников, по мнению многих экспертов, данная тактика требует более дифференцированного подхода.

На основании международных исследований, имеющихся в литературе, по особенностям менструального цикла у женщин с гормоночувствительным раком молочной железы после химиотерапии были выделены относительные факторы (критерии STRAW, возраст, гонадотоксичность химиотерапии) определения вероятности восстановления функции яичников. Внедрение данных методов оценки овариальной функции после химиотерапии у женщин в пременопаузе в клинические рекомендации по адъювантному лечению раннего рака молочной железы, возможно, сделает выбор в пользу овариальной супрессии более обоснованным не только с клинической, но и с физиологической точки зрения.

Об авторах

И. Б. Кононенко
ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России
Россия

Кандидат медицинских наук



А. В. Снеговой
ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России
Россия
Доктор медицинских наук


Е. И. Коваленко
ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России
Россия

Кандидат медицинских наук



Л. В. Манзюк
ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России
Россия
Доктор медицинских наук. профессор


В. Ю. Сельчук
ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России
Россия
Доктор медицинских наук. профессор


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