Фармакотерапия мелкоклеточного рака легкого: современное состояние
Авторы
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Татьяна А. Бережнова
Воронежский государственный медицинский университет им. Н.Н. Бурденко
https://orcid.org/0000-0002-8401-3460
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Елена А. Лунева
Воронежский государственный медицинский университет им. Н.Н. Бурденко
https://orcid.org/0000-0002-6077-3043
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Ксения С. Дядина
Воронежский государственный медицинский университет им. Н.Н. Бурденко
https://orcid.org/0000-0003-2454-729X
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Владимир А. Борисов
Воронежский государственный медицинский университет им. Н.Н. Бурденко
https://orcid.org/0000-0002-6175-7336
DOI:
https://doi.org/10.18413/rrpharmacology.9.10001Аннотация
Введение. Онкологические заболевания продолжают занимать лидирующие позиции в структуре смертности во всем мире и являются глобальной проблемой. Показатели заболеваемости и смертности варьируют в зависимости от регионов и уровня их социально - экономического развития. Карцинома легких является главной причиной смертности у мужчин и имеет четкую взаимосвязь с курением. В статье представлены актуальные статистические данные этой патологии в мире.
Материалы и методы. Обзор литературы проводился с использованием электронной базы статей PUBMED. В рамках данного обзора использовались статьи за последние 15 лет (с 2006 по 2021 год). Были проанализировали существующие в настоящее время схемы химиотерапии и диагностики мелкоклеточного рака легкого. Рассмотрены механизмы действия препаратов на опухолевые клетки. Анализ публикационной активности авторов в поисковой системе PubMed по проблеме фармакотерапии мелкоклеточного рака легкого позволил установить двукратный рост количества публикаций за период с 2007 по 2017 гг.
Обсуждение. Проведен систематический обзор, в котором представили виды стадирования мелкоклеточного рака легкого и его лучевая диагностика. Как показывает практика - в настоящее время не существует методов с доказанной эффективностью для раннего выявления данной патологии, но было проведено исследование в области ранней диагностики мелкоклеточного рака легкого, в котором было обнаружено, что ежегодные скрининги КТ с низкой дозой выявляют значительное число случаев. Но все равно доля мелкоклеточного рака на поздней стадии была очень высокой. По анализу многих исследований при лечении мелкоклеточного рака легкого ключевыми остаются комбинации цисплатин/этопозид (EP) или карбоплатин/этопозид (EC), которые показывают высокую эффективность лечения. В статье также рассматривается химиотерапия мелкоклеточного рака легкого, в частности принцип ее воздействия на опухолевые клетки. Однако такая химиотерапия до сих пор остается очень токсичной и вызывает ряд опасных для жизни побочных реакций. Оценку эффективности химиотерапии необходимо проводить практически сразу после начала лечения для соотношения пользы и риска.
Вывод. В настоящее время ведутся поиски менее токсичных, но эффективных соединений. На сегодняшний день – это важная задача здравоохранения в обеспечении качества медицинской и фармацевтической помощи больным онкологическими заболеваниями. Химиотерапия исследуемой патологии требует высоких затрат, поэтому необходима фармакоэкономическая оценка назначения химиотерапии при мелкоклеточном раке легкого для сравнения затрат на лечение и его эффективности.
Графическая аннотация
Графическая аннотация
Ключевые слова:
онкологическое заболевание, мелкоклеточный рак легкого, мелкоклеточная карцинома, новообразование, химиотерапия, карбоплатин, цисплатин, иринотекан, доксорубицин, этопозидБиблиографические ссылки
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