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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">tumors</journal-id><journal-title-group><journal-title xml:lang="ru">Malignant tumours</journal-title><trans-title-group xml:lang="en"><trans-title>Malignant tumours</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2224-5057</issn><issn pub-type="epub">2587-6813</issn><publisher><publisher-name>Rosoncoweb</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">tumors-298</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>БРАХИТЕРАПИЯ МЕСТНОРАСПРОСТРАНЕННОГО РАКА ПИЩЕВОДА КАК КОМПОНЕНТ РАДИКАЛЬНОГО ЛЕЧЕНИЯ: ПРЕИМУЩЕСТВА И РИСКИ</article-title><trans-title-group xml:lang="en"><trans-title></trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Литвинов</surname><given-names>Р. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Litvinov</surname><given-names>R. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Литвинов Роман Петрович – кандидат медицинских наук, врач отделения радиохирургии </p></bio><email xlink:type="simple">litvinov-roman@mail.ru</email></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Черных</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Chernykh</surname><given-names>M. V.</given-names></name></name-alternatives></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Нечушкин</surname><given-names>М. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Nechushkin</surname><given-names>M. I.</given-names></name></name-alternatives></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гладилина</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gladilina</surname><given-names>I. A.</given-names></name></name-alternatives></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Козлов</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kozlov</surname><given-names>O. V.</given-names></name></name-alternatives></contrib></contrib-group><pub-date pub-type="collection"><year>2016</year></pub-date><pub-date pub-type="epub"><day>18</day><month>11</month><year>2016</year></pub-date><volume>0</volume><issue>4s1</issue><fpage>109</fpage><lpage>114</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Литвинов Р.П., Черных М.В., Нечушкин М.И., Гладилина И.А., Козлов О.В., 2016</copyright-statement><copyright-year>2016</copyright-year><copyright-holder xml:lang="ru">Литвинов Р.П., Черных М.В., Нечушкин М.И., Гладилина И.А., Козлов О.В.</copyright-holder><copyright-holder xml:lang="en">Litvinov R.P., Chernykh M.V., Nechushkin M.I., Gladilina I.A., Kozlov O.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.malignanttumors.org/jour/article/view/298">https://www.malignanttumors.org/jour/article/view/298</self-uri><abstract><p>При раке пищевода прогноз неблагоприятный. Радикальное хирургическое вмешательство на сегодняшний день является наиболее успешным лечением, но большинство пациентов в момент постановки диагноза не операбельны и для этих пациентов лучевая терапия с или без химиотерапии одновременно является наилучшим методом лечения.</p><p>У пациентов с местнораспространенным раком пищевода внутрипросветная брахитерапия была предложена в качестве дополнительного метода повышения локального контроля и улучшения результатов лечения.</p><p>Пролечено 62 больных неоперабельным раком пищевода. 20 больным брахитерапия была проведена через 2–3 недели после окончания  3D-CRT СОД=50Гр. Выполнено  3 фракции с интервалом 6–7 дней РОД=5Гр за фракцию до СОД=70Гр.</p><p>42 неоперабельным больным раком пищевода с выраженной дисфагией II–IV степени проведено лечение с применением на 1-м этапе брахитерапии пищевода. Лечение проведено за 3 фракции с интервалом 6–7 дней РОД= 7Гр СОД= 21Гр (30иГр). После 2-недельного перерыва в 80,9% случаев проводилось дальнейшая терапия: 71,4% курс конформной дистанционной лучевой терапии (3DCRT, IMRT) до 80иГр за 2 этапа лечения.</p><p>Время до восстановления проходимости пищевода составило 3–25 дней (в среднем 7 дней). Период наблюдения составил 4–40 месяцев. Во всех случаях отмечен эффект лечения (резорбция опухоли, снижение степени выраженности дисфагии, в 23,8% – полный ответ опухоли). Осложнения: 28,6% случаев эзофагит разной степени выраженности (купирован консервативно).</p><p>Проведение на 1 этапе внутрипросветной лучевой терапии пищевода снижает выраженность дисфагии, что способствует коррекции метаболических нарушений и улучшению общего состояния, создает возможность проведения дистанционной лучевой терапии и химиотерапии у пациентов, ранее считавшихся инкурабельными, и как следствие улучшает результаты лечения.</p><p>Внутрипросветная лучевая терапия пищевода является высокоэффективным  и безопасным методом лечения у больных при неоперабельном раке пищевода, особенно сочетающимся с дисфагией опухолевого генеза, значительно повышая качество жизни и ее продолжительность у данной категории больных.</p></abstract><kwd-group xml:lang="ru"><kwd>рак пищевода</kwd><kwd>сочетанная лучевая терапия</kwd><kwd>брахитерапия</kwd><kwd>дисфагия</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Каприн А. 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