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№ 17 (2013)
- Жылы: 2013
- Мақалалар: 13
- URL: https://journals.eco-vector.com/2073-4034/issue/view/6834
Articles
Lekarstvennaya terapiya limfomy Khodzhkina
Аннотация
Hodgkin's lymphoma (HL) is a high-curable malignant disease. Modern chemoradiation therapy can induce complete remission (CR) in 80-95 % of patients with Hodgkin's lymphoma, and the 5-year overall survival (OS) is greater than 80-90 %. ABVD chemotherapy regimen is the «gold» standard in the treatment of primary Hodgkin's lymphoma and is characterized by an optimal ratio of efficacy and toxicity compared with other chemotherapy regimens. Treatment Scheme escalated-dose BEACOPP is more effective in advanced stages of Hodgkin's lymphoma with high risk of recurrence (IPS 4-7). Currently, the potentials for the reduction of toxicity of escalated-dose BEACOPP in advanced stages of Hodgkin's lymphoma are evaluated. Escalated-dose BEACOPP improves OS, reduces the incidence of early recurrence compared to other regimens. Modern therapy of HL should be directed to the complete cure using first-line treatment with maximum efficiency and minimal toxicity.
Pharmateca. 2013;(17):10-14
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Sovremennye podkhody k sistemnomu lekarstvennomu lecheniyu metastazov v kosti zlokachestvennykh opukholey
Аннотация
The present review is dedicated to the effectiveness of modern therapy of bone metastases. Bisphosphonates, zoledronic acid and denosumab are compared. Results of clinical studies in patients with breast cancer, lung cancer and prostate cancer are presented. A number of large studies that confirmed efficacy of denosumab in many malignant tumors and its advantage over zoledronic acid in the prevention of bone complications and improving the quality of life of patients with breast cancer, lung cancer and prostate cancer are described.
Pharmateca. 2013;(17):15-19
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Sovremennye podkhody k diagnostike, lecheniyu i prognozu granulezokletochnykh opukholey yaichnikov (analiz literaturnykh dannykh i sobstvennykh issledovaniy)
Аннотация
The article is dedicated to the problem of ovarian granulosa cell tumors (GCT). Epidemiological data, information on the etiology, histological classification, morphological structure, clinical manifestation, features of diagnosis and principles of treatment of GCT are presented. Particular attention is paid to the pronounced hormonal dependence of GCT, which determines the clinical manifestation of the disease and sensitivity to the hormonal therapy. The results of own multivariate analysis of clinical and morphological data and results of treatment of 62 patients with adult-type ovarian GCT are presented. This analysis was aimed to evaluation of impact of these factors on the prognosis of the disease.
Pharmateca. 2013;(17):20-25
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Sravnitel'nyy analiz neposredstvennoy effektivnosti trekhkomponentnogo (antratsiklinsoderzhashchego) i dvukhkomponentnogo (bezantratsiklinovogo) rezhimov induktsionnoy khimioterapii mestno-rasprostranennogo raka nosoglotki
Аннотация
Therapeutic approach in nasopharyngeal carcinoma (NPC) depends on the extent of the process. Radiation therapy is the main method for treatment of localized forms of NPC. For the treatment of stage I, radiation therapy is used alone; in stage II, optimal treatment option includes simultaneous chemoradiation therapy with the addition of cisplatin. In locally advanced cases (III, IV A-, B-stages), radiation/concurrent chemoradiation therapy is limited by involvement or close proximity of vital structures with low tolerance to radiotherapy. In these situations, the application of induction chemotherapy (IHT) at 1st phase of treatment can be considered as optimal treatment approach. We have developed two IHT regimens (anthracycline - containing an no anthracycline - containing) and evaluated their efficacy and toxicity.
Pharmateca. 2013;(17):26-29
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Refnot® – novyy immunomodulyator dlya lecheniya onkologicheskikh bol'nykh
Аннотация
The article presents the data from clinical trials of the original domestic combined immunomodulator for cancer patients - tumor necrosis factor - thymosin alpha-1 recombinant (Refnot®). The results of these studies have demonstrated the unique immunomodulatory properties of Refnot. Features of this drug, differing from other known immunomodulators, include the positive impact simultaneously on the two cell populations - T- and NK-cells, which are the major components of the anti-tumor immunity. The use of Refnot® is recommended as monotherapy and in combination with cytotoxic drugs in cancer patients as an immunomodulator.
Pharmateca. 2013;(17):30-33
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Implantiruemye morfinovye pompy v terapii khronicheskogo bolevogo sindroma u onkologicheskikh bol'nykh. Pervyy klinicheskiy opyt
Аннотация
The article describes the first experience of testing methodology of chronic intrathecal therapy with implantable programmable pumps in Russia. The study was aimed to development of method for the therapy of severe chronic pain syndrome (CPS) for the improvement of quality of life of patients receiving high doses of opioid analgesics by prolonged intrathecal administration of micro-doses of morphine using programmable implantable pump. The study included 10 patients, 9 of them - with HBS of cancer genesis, and 1 patient - with non-tumor pathology. The first step included morphine test; positive test was the indication for the pump implantation. The pain intensity was assessed by standard rating scales. All patients have reported better pain relief, no systemic opioid-related side effects and improvement of quality of life after the selection of the individual mode of morphine administration using pump.
Pharmateca. 2013;(17):34-39
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Interferon-gamma v onkologii
Аннотация
The article presents the data on the immunomodulating effect of interferon-y in clinical and experimental settings, and clinical data on the use and effectiveness of the domestic preparation of recombinant interferon-y - Ingaron. Studies have demonstrated that Ingaron has significant immunomodulating activity in the treatment of cancer patients with melanoma, cervical cancer and breast cancer. The most interesting is the effect of Ingaron on natural killer cells. Regardless of the number of these cells, Ingaron increases their cytotoxic potency relative to tumor cells. Ingaron can play an important role in enhancing the effectiveness of the treatment of cancer patients.
Pharmateca. 2013;(17):40-45
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Effektivnost' i bezopasnost' preparata Ekstimiya®, novogo pegilirovannogo filgrastima: rezul'taty otkrytogo sravnitel'nogo klinicheskogo issledovaniya II fazy patsientov s rakom molochnoy zhelezy, poluchayushchikh mielosupressivnuyu khimioterapiyu
Аннотация
The article is dedicated to the prevention and treatment of neutropenia associated with myelosuppressive chemotherapy in patients with malignant tumors, particularly breast cancer. For the prevention and treatment of neutropenia, recombinant drugs of human granulocyte colony stimulating factor are used for the last 20 years. The implementation of Extimia®, unique domestic drug of pegylated filgrastim (empegfilgrastim) in clinical practice would provide more available modern drug against neutropenia, with advantages over other pegylated filgrastim, for the target population of patients with cancer receiving myelosuppressive chemotherapy.
Pharmateca. 2013;(17):46-48
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Eribulin – novyy mikrotrubochkovyy ingibitor dlya lecheniya metastaticheskogo raka molochnoy zhelezy
Аннотация
According to current guidelines, there is no single standard of medical care for patients with metastatic breast cancer (BC) who have received prior therapy. Eribulin mesylate has recently been approved in Russia for the treatment of patients with locally advanced or metastatic breast cancer in whom progression occurred after the application of at least two chemotherapy regimens, which was administered for advanced disease and which included anthracyclines and taxanes. Due to the unique mechanism of action, eribulin have higher anti-tumor activity compared with other microtubule inhibitors, as well as potential for overcoming chemoresistance as a substantial clinical problem. Approval of Eribulin by the European Medicines Agency in 2011 was based on the results of the phase III EMBRACE trial, the first study that demonstrated a significant increase in survival in patients with advanced breast cancer previously treated with anthracyclines and taxanes. Moreover, the data obtained in the study 301, support the feasibility of use of eribulin in women with short-term duration of treatment compared with EMBRACE participants. Data subanalyses also indicate that in certain groups of patients, including those with triple negative phenotype of tumor, eribulin effect on overall survival could be more pronounced than in the general population of patients. In addition to advantages in efficiency, eribulin is well tolerated, has clinically acceptable and controlled side-effect profile. This review describes eribulin, including its mechanism of action and key data on efficacy and safety according phase III trials.
Pharmateca. 2013;(17):49-56
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Znachenie molekulyarnykh markerov pri vybore neoad\"yuvantnoy khimioterapii mestno-rasprostranennogo raka molochnoy zhelezy
Аннотация
The randomized study «The role of taxanes in combination with anthracyclines (TAC) and without anthracyclines (TC) in the neoadjuvant treatment of patients with locally advanced breast cancer (BC)» (2010 to 2013) was performed; 120 patients were randomized in a ratio of 1:1 to receive chemotherapy according to the TAC or TC schemes. Patients with operable breast cancer forms, in accordance with the randomization in the first group, have received 4 to 8 (average 4,6) cycles of chemotherapy TAC scheme (docetaxel 75 mg/m 2, doxorubicin 60 mg/m 2, cyclophosphamide 600 mg/m 2) once a 3 weeks; second group of patients - 4 to 8 (mean 4,9) cycles of chemotherapy TC scheme (docetaxel 75 mg/m 2, cyclophosphamide 600 mg/m 2) once a 3 weeks against the background of standard pre- and postmedikation using dexamethasone. The treatment groups have shown a significant difference between the rate of objective clinical response (89.8 vs. 74.5 %; p < 0,05) and indicators of pathomorphological complete response (22.0 vs. 10.6 %, p < 0.05 ), respectively. Patients with HER2 + breast cancer have received targeted therapy with trastuzumab at standard doses in addition to the polychemotherapy. In different biological subtypes of breast cancer, significant differences in the rates of pathomorphological complete response of the tumor and regional lymph nodes (pCR) after neoadjuvant taxane - containing chemotherapy ( TAC and TC schemes) were revealed. In luminal subtype A. pCR rate was 7.3 %, luminal B - 16.7 %, triplenegative - 24 %, HER2 + breast cancer - 27.3 % (p < 0.05). BRCA1 mutation was found in 9 % of patients: triple-negative breast cancer was diagnosed in 5 (55%) patients with mutation in the gene BRCA1 5382insC, and luminal A subtype of breast cancer - 4 (45 %) patients. The high efficiency of TAC and TC schemes in patients with BRCA 1 - associated breast cancer was determined: overall objective response rate (complete + partial regression) was observed in 8 (88.9 %) patients, pathomorphological complete response (pCR) - in 4 (44.4 %) patients. Low level of в-tubulin III type breast cancer gene expression is reliable predictive factor for pathomorphological complete response (pCR) to taxane-containing chemotherapy in 23.8 % of patients vs 12.5 and 15.4 % with an average and high expression of markers (p < 0,05). High and medium level of TOR2a gene expression increases by 2.6 and 2.8 times the frequency of significant drug pathomorphism (4 + 5 stages by Miller-Payne) compared with its low level (p <0,05), which allows to consider TOR2a as a predictive marker of sensitivity to anthracycline antibiotics.
Pharmateca. 2013;(17):57-64
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Gormonoterapiya metatstaticheskogo i retsidivnogo raka endometriya
Аннотация
In economically developed countries, at least 30% of the patients with endometrial cancer (EC) die during the 5-year follow-up that determines the relevance of the treatment of these forms of the disease. Pronounced hormonal dependence is a distinctive feature of the EC. The article analyzes in detail the mechanisms of the pathogenesis of EC on the basis of a comparison of clinical, morphological and endocrinological data. The most common methods of treatment are described. The article presents the evidence that hormonal therapy is an effective palliative treatment of metastatic and recurrent EC, and promising field of clinical and experimental medicine.
Pharmateca. 2013;(17):65-69
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Osobennosti predoperatsionnoy podgotovki i vedeniya bol'nykh kolorektal'nym rakom starcheskogo vozrasta
Аннотация
The incidence of colorectal cancer (CRC) occupies the third place in most developed countries and the second place in the structure of mortality from cancer. Geriatric patient has the largest proportion of advanced forms of the disease, emergency surgeries and poor outcomes. The problem of adequate bowel preparation prior to intervention for colorectal cancer in senile patients is extremely important, but underinvestigated. The relatively high frequency of comorbidities and age-related decline in the functional reserve of senile organism significantly complicate the perioperative management of these patients. The article presents a protocol of preoperative assessment and preparation of senile patients. Preoperative bowel preparation for surgery is described in detail.
Pharmateca. 2013;(17):70-74
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Sluchay total'nogo limfomatoidnogo polipoza zheludochno-kishechnogo trakta pri limfome zony mantii
Аннотация
Total lymphomatoid polyposis of the gastrointestinal tract against the background of mantle zone lymphoma is a rare form of the disease with a poor prognosis. The article presents the description of the clinical case. In 45 year-old man with symptoms of gastrointestinal bleeding, multiple polyps throughout the gastrointestinal tract were revealed using endoscopic examination. The diagnosis of mantle zone lymphoma was verified by immunohistochemistry. On the basis of this case, problems of prediction, complications and treatment of this form of the disease are discussed.
Pharmateca. 2013;(17):75-79
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