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 Press384BONE SARCOMASСАРКОМЫ КОСТЕЙStereotactic radiation therapy (SRT) in the treatment of primary and metastatic bone lesionsСтереотаксическая лучевая терапия (СТЛТ) в лечении первичных и метастатических поражений костейNasarenkoA. V.НазаренкоА. В.
Russian Federation

Moscow

г. Москва

Ter-arutyunyantsS. A.Тер-арутюнянцС. А.
Russian Federation

Moscow

г. Москва

svetlana.ter-arutyunyants@onco-stop.comRadiation therapy center «Oncostop»Центр лучевой терапии «Онкостоп»220120168136442201202222012022Copyright ©; 2016, Nasarenko A.V., Ter-arutyunyants S.A.Copyright ©; 2016, Назаренко А.В., Тер-арутюнянц С.А.2016Nasarenko A.V., Ter-arutyunyants S.A.Назаренко А.В., Тер-арутюнянц С.А.https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/384

Background. Еvaluation of stereotactic radiation therapy (SRT) in the treatment of primary and metastatic bone lesions.Methods. We represent the results of bone treatment (both primary and metastatic bone tumors) in «Oncostop» clinic from 2013 up to 2015 – totally 74 cases, including 44 metastatic (61%) and 25 primary lesions (35%). all patients received Srt  using «Cyberknife-VSI».Results. The median follow-up in metastatic and primary tumor groups was 14,5 and 15 months correspondingly. We found 9 cases of local recurrence, including 2 among 44 metastatic tumors (4,5%) and 7 – among 25 primary bone tumors (28%). Median recurrence-free interval in metastatic group was 4,5 months, in primary tumors group – 12 months. Among 9 recurrences, 8 patients received SRT after previous irradiation. The average irradiated volume among recurrences was 169,5 cc (max 410 cc). Three patients with recurrence received stereotactic reirradiation with good effect.Conclusion. SRT is able to provide a long local disease and pain control among inoperable bone tumors (more than 12 months). The outcome of treatment depends on irradiated volume and sequence of methods. It is reasonable to use SRT in primary treatment of radioresistant disease, in case of recurrence repeated stereotactic irradiation is possible.

Цель исследования. Определить эффективность стереотаксической лучевой терапии (СТЛТ) в лечении первичных и метастатических поражений костей.Материалы и методы. Обобщены результаты лечения первичных и метастатических костных поражений в клинике «Онкостоп» с 2013 по 2015 г. – всего 74 случая, в том числе 44 (61%) случая метастазов в кости и 25 (35%) случаев первичных опухолей костей. Больным проводилась СТЛТ на установке «Cyberknife-VSI».Результаты. Медиана наблюдения в группах метастазов и первичных опухолей костей составила соответственно 14,5 и 15 мес. Диагностировано 9 случаев местного рецидива, при этом 2 из них – в группе метастатического поражения костей (2 из 44, или 4,5%), 7 – в группе первичных опухолей костей (7 из 25, или 28%). Средний срок возникновения рецидива в группе метастазов составил 4,5 мес, в группе первичных опухолей 12 мес. 8 из 9 больных с рецидивами получили СТЛТ после ранее проведенного облучения, средняя величина облучаемого объема среди рецидивов была равна 169,5 см3 (max 410 см3). трое больных с рецидивом получили повторный курс СТЛТ с эффектом.Заключение. СТЛТ способна обеспечить длительный локальный контроль в случаях неоперабельных опухолей костей (12 мес и более) и обеспечить стойкое обезболивание. успех лечения зависит от объема облучаемой опухоли и этапности применения методов. Следует стремиться к назначению СТЛТ в первичном лечении радиорезистентных опухолей, при рецидиве можно рассматривать повторное применение метода.

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