Bone and soft tissue sarcomas, tumors of the skinBone and soft tissue sarcomas, tumors of the skinСаркомы костей, мягких тканей и опухоли кожи2219-46142782-3687Publishing House ABV Press325EDITORIALОТ РЕДАКЦИИTreatment results of children with osteosarcoma according to protocols «Osteosarcoma 2006» and «Osteosarcoma 2014»: experience of pediatric hematology and oncology research institute of N.N. Blokhin russian cancer research centerРезультаты лечения детей с остеосаркомой по протоколам «Остеосаркома 2006» и «Остеосаркома 2014»: опыт НИИ ДОГ ФГБУ «РОНЦ им. Н.Н. Блохина»SenzhapovaE. R.СенжаповаЭ. Р.
Russian Federation

Moscow

г. Москва

senzhapova@gmail.comDzampaevA. Z.ДзампаевА. З.
Russian Federation

Moscow

г. Москва

FedenkoA. A.ФеденкоА. А.
Russian Federation

Moscow

г. Москва

HestanovD. B.ХестановД. Б.
Russian Federation

Moscow

г. Москва

NisichenkоD. V.НисиченкоД. В.
Russian Federation

Moscow

г. Москва

AlievM. D.АлиевМ. Д.
Russian Federation

Moscow

г. Москва

N.N. Blokhin Russian Cancer Research Center Ministry of Health of the Russian FederationФГБУ «РОНЦ им. Н.Н. Блохина» Минздрава России16042017923151501202215012022Copyright ©; 2017, Senzhapova E.R., Dzampaev A.Z., Fedenko A.A., Hestanov D.B., Nisichenkо D.V., Aliev M.D.Copyright ©; 2017, Сенжапова Э.Р., Дзампаев А.З., Феденко А.А., Хестанов Д.Б., Нисиченко Д.В., Алиев М.Д.2017Senzhapova E.R., Dzampaev A.Z., Fedenko A.A., Hestanov D.B., Nisichenkо D.V., Aliev M.D.Сенжапова Э.Р., Дзампаев А.З., Феденко А.А., Хестанов Д.Б., Нисиченко Д.В., Алиев М.Д.https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/325

Background/Objectives. During the last 30 years treatment results of children with osteosarcoma according to different international trials were analyzed. 5years overall survival (OS) of children with localized osteosarcoma was near 75%, 5years eventfree survival (EFS) – 62%, with primary metastatic osteosarcoma – 35% and 25% respectively. In this article we presented results of two pediatric clinical protocols «Osteosarcoma 2006» and «Osteosarcoma 2014».Design/Methods. From 2009 to 2017 years 221 patients (less than 18 years old age group) with primary diagnosed osteosarcoma were included in trials. 128 patients were treated according to «Osteosarcoma 2006» protocol and 93 – «Osteosarcoma 2014».Results. Received data showed appropriateness of neoadjuvant chemotherapy in alternating regimen. Higher OS and EFS rates were revealed in children with localized osteosarcoma (р=0,001; р=0,001), good response (grade III and IV of tumor cells necrosis rate) to neoadjuvant chemotherapy after surgery of the primary site (р=0,001; р=0,001). Lung metastases quantity (single or multiple) also determined prognosis of disease (p=0,032). Surgery treatment of lung metastases increased OS and EFS rates (p=0,001; p=0,001).Conclusion. OS and EFS of patients who treated according to «Osteosarcoma 2006» and «Osteosarcoma 2014» protocols were compared with international trials. Long-term treatment experience of children with osteosarcoma, absence of results improvement open the way to development of new protocols according to molecular-biological tumor features, that determined drug resistance, invasive and metastatic tumor activity, prognosis of disease.

Введение. за прошедшие 30 лет опубликованы результаты лечения детей с остеосаркомой в соответствии с различными международными протоколами. при этом у пациентов с локализованным вариантом остеосаркомы 5-летняя общая выживаемость (ОВ) не превышала 75%, 5-летняя бессобытийная выживаемость (БсВ) – 62%, у пациентов с метастатическим вариантом остеосаркомы – 35 и 25% соответственно. В данной статье представлены результаты лечения детей с остеосаркомой по протоколам «Остеосаркома 2006» и «Остеосаркома 2014».Материалы и методы. с 2009 по 2017 г. в исследование включен 221 пациент с впервые диагностированной остеосаркомой в возрастной группе до 18 лет. программное лечение «Остеосаркома 2006» проведено 128 пациентам, «Остеосаркома 2014» – 93.Результаты. полученные данные свидетельствуют о целесообразности применения альтернирующих курсов химиотерапии в неоадъювантном режиме. Более высокие показатели ОВ и БСВ выявлены у пациентов с локализованным вариантом остеосаркомы (р=0,001; р=0,001), наличием в опухоли лечебного патоморфоза 3–4-й степени (р=0,001; р=0,001) после удаления первичного очага. у пациентов с метастатическим поражением количество очагов в легких (единичные, множественные) определяет прогноз заболевания (р=0,032). удаление метастатических очагов способствует повышению показателей ОВ и БСВ (р=0,001; p=0,001).Заключение. показатели ОВ и БСВ при проведении программ терапии «Остеосаркома 2006» и «Остеосаркома 2014» соответствуют данным международных исследований. многолетний опыт лечения детей с остеосаркомой, отсутствие улучшения результатов лечения свидетельствуют о необходимости совершенствования программ терапии с учетом молекулярно-биологических особенностей опухоли, определяющих чувствительность к химиотерапии, инвазивный и метастатический потенциал опухоли, а также прогноз заболевания.

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