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 Press399SOFT TISSUE SARCOMASСАРКОМЫ МЯГКИХ ТКАНЕЙImplications and opportunities for radiotherapy in soft tissue sarcomas treatmentО роли и возможностях лучевой терапии в лечении мягкотканных саркомDenginaN. V.ДеньгинаН. В.
Russian Federation

Ulyanovsk

г.    Ульяновск

indigo171201@yahoo.comSHL regional clinical oncological dispensaryГУЗ Областной клинический онкологический диспансер221120157452622201202222012022Copyright ©; 2015, Dengina N.V.Copyright ©; 2015, Деньгина Н.В.2015Dengina N.V.Деньгина Н.В.https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/399

The belief about radioresistance of soft tissue sarcomas remained unchanged within several decades; however, recent data on heterogeneity of these tumors and radiotherapy effectiveness doubted that. Radiation therapy has been traditionally applied in the postoperative setting after R0 and, especially, R1 resection of tumors more than 5 cm in diameter, mostly for local control improvement. such approach appears to be standard and recommended by many oncological centers. however, preoperative irradiation of sarcomas may have firm theoretical advantages supported by experimental and clinical data. currently, the most promising therapeutic options with external beam radiotherapy are: combination with chemotherapy and targeted treatment; modern radiotherapy technique such as IMRT, intraoperative radiotherapy, brachytherapy; hadron therapy (protons, neutrons, heavy ions); combination with local hyperthermia.

Постулат о радиорезистентности сарком существует уже несколько десятилетий. но современные представления о гетерогенности этой группы опухолей позволяют усомниться в его абсолютности. Лучевая терапия традиционно применялась на послеоперационном этапе лечения для улучшения показателей локального контроля, практика адъювантного облучения после радикального удаления сарком размером более 5 см в диаметре и особенно после R1-резекции является стандартной в настоящее время и рекомендована многими известными онкологическими центрами. Однако и предоперационное облучение сарком имеет явные теоретические преимущества, в ряде случаев подкрепленные экспериментальными и клиническими данными. в настоящее время наиболее перспективными направлениями в радиотерапии мягкотканных сарком признаны следующие: комбинация с химиопрепаратами и таргетными агентами; современные технологии облучения: IMRT, интраоперационная лучевая терапия, брахитерапия; применение альтернативных видов излучения: протонная, нейтронная лучевая терапия и облучение тяжелыми ионами; гипертермия.

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