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Медицинский Совет

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Ведение больных раком толстой кишки в условиях эпидемии коронавирусной инфекции

https://doi.org/10.21518/2079-701X-2020-9-213-224

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Аннотация

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.

Об авторе

М. Ю. Федянин
Национальный медицинский онкологический центр им. Н.Н. Блохина; Российский университет дружбы народов
Россия

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



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Для цитирования:


Федянин М.Ю. Ведение больных раком толстой кишки в условиях эпидемии коронавирусной инфекции. Медицинский Совет. 2020;(9):213-224. https://doi.org/10.21518/2079-701X-2020-9-213-224

For citation:


Fedyanin M.Yu. Practical recommendation for treatment of patients with colon cancer during covid-19 pandemic. Meditsinskiy sovet = Medical Council. 2020;(9):213-224. (In Russ.) https://doi.org/10.21518/2079-701X-2020-9-213-224

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ISSN 2079-701X (Print)
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