tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2025-045tumors-1475Research ArticleОБЗОРЫ И АНАЛИТИКАREVIEWS AND ANALYSISПервично-рефрактерная саркома Юинга грудной стенки у взрослого больного (клинический случай). Возможности и роль лучевой терапииPrimary refractory Ewing sarcoma of the chest wall in an adult patient (case report). The potential and role of radiation therapyhttps://orcid.org/0000-0003-3078-091XПоляковА. А.PolyakovА. А.

Алексей Александрович Поляков

634009; пр-т. Ленина, 115; Томск

Aleksei Aleksandrovich Polyakov

634050; 115 Lenina Ave.; Tomsk

alexey_indie@mail.ruhttps://orcid.org/0000-0002-7465-3640ЛушниковаП. А.LushnikovaP. А.

Полина Александровна Лушникова

634009; пр-т. Ленина, 115; 634009; пер. Кооперативный 5; Томск

Polina Aleksandrovna Lushnikova

634050; 115 Lenina Ave.; 634009; 5 Kooperativny Str.; Tomsk

ОГАУЗ «Томский областной онкологический диспансер»РоссияTomsk Regional Oncology CenterRussian FederationОГАУЗ «Томский областной онкологический диспансер»; НИИ онкологии — филиал ФГБНУ «Томский национальный исследовательский медицинский центр Российской академии наук»РоссияTomsk Regional Oncology Center; Cancer Research Institute Tomsk “Tomsk national research medical center of the Russian Academy of Sciences»Russian Federation2025240820251525465Copyright © Поляков А.А., Лушникова П.А., 20252025Поляков А.А., Лушникова П.А.Polyakov А.А., Lushnikova P.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/1475

   Введение: Cаркома Юинга является второй по частоте опухолью костей, уступая только остеосаркоме, а среди группы детей до 15 лет это наиболее частая опухоль костной ткани. Достаточно редко эти опухоли встречаются у пациентов старше 30 лет и моложе 5 лет. Саркома Юинга грудной стенки является редким злокачественным новообразованием, о котором в научной литературе сообщается достаточно редко. В лечении данной нозологии зачастую применяется комплексный подход с применением химиотерапии, хирургии и лучевой терапии. Однако стандарта лечения данной опухоли при прогрессировании на фоне первой линии не существует.

   Хотя современные комбинированные подходы в лечении, включающие химиотерапию, хирургию и лучевую терапию позволяют добиться контроля заболевания у части больных, отсутствие стандартизированных протоколов для терапии рефрактерных и рецидивирующих форм создает значительные сложности в определении оптимальных терапевтических опций. В реальной клинической практике врачи имеют ограниченный личный опыт ведения таких больных, что приводит к вариабельности в выборе тактики лечения рефрактерных форм и необходимости принятия решений на основе ограниченных данных. В статье рассмотрены основные подходы к лечению, а также возможности и роль лучевой терапии в терапии данного заболевания и представлен клинический случай неоперабельной саркомы Юинга грудной стенки у пациента 50 лет с местным прогрессированием на фоне первой линии химиотерапии.

   Introduction: Ewing sarcoma is the second most common bone tumor, behind osteosarcoma, and is the most common bone tumor among children under 15 years of age. Quite rarely, these tumors occur in patients over 30 years of age and under 5 years of age. Ewing sarcoma of the chest wall is a rare malignant neoplasm, which is rarely reported in the scientific literature. An integrated approach combining chemotherapy, surgery, and radiation therapy is commonly used in the treatment of this neoplasm. However, there is no standard treatment for this tumor when the disease progresses during the first-line treatment.

   Although modern combined approaches to treatment, including chemotherapy, surgery, and radiation therapy, help achieve disease control in some patients, the lack of standardized protocols for the treatment of refractory and recurrent forms results in significant difficulties in determining optimal therapeutic options. In real-world clinical practice, physicians have limited personal experience in managing such patients, which leads to variability in the chosen treatment plans for refractory disease and the need to make decisions based on limited data. The article discusses the main approaches to the treatment, as well as the potential and role of radiation therapy in the treatment of this disease and presents a case report of unresectable Ewing sarcoma of the chest wall in a 50-year-old male patient with local progression during first-line chemotherapy.

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The authors declare that there are no conflicts of interest present.