Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press145510.17650/1726-9776-2021-17-3-64-77DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. PROSTATE CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак предстательной железыTechnologies to reduce radiation toxicity in prostate cancer patients: spacers - a simple and effective solutionТехнологии снижения лучевой токсичности у больных раком предстательной железы: спейсеры - простое и эффективное решениеhttps://orcid.org/0000-0003-1873-1293NovikovR. V.НовиковР. В.
Russian Federation

68 Leningradskaya St., Pesochnyy, Saint-Petersburg 197758; 7—9 Universitetskaya Naberezhnaya, Saint-Petersburg 199034

Роман Владимирович Новиков

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

novikov-spb@mail.ruhttps://orcid.org/0000-0002-7185-1967NovikovS. N.НовиковС. Н.
Russian Federation

68 Leningradskaya St., Pesochnyy, Saint-Petersburg 197758

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова Минздрава РоссииSaint-Petersburg State UniversityФГБУ Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова Минздрава РоссииN.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia1111202117364772506202114092021https://oncourology.abvpress.ru/oncur/article/view/1455

The basic principles of the treatment of prostate cancer patients have underwent significant revisions in recent years. Modern radiotherapy techniques, which have demonstrated high efficacy and safety in long-term randomized trials, are beginning to take a leading position in the treatment of prostate cancer in an overwhelming number of clinical scenarios (National Comprehensive Cancer Network, 2021). Despite the obvious successes of radiation oncology, a number of important problems remain unresolved, first of all - the need to reduce the rates of radiation complications. The topographical anatomy of the prostate gland determines the main profiles of post-radiation damage: rectal and genitourinary radiation toxicity. The previous five years have been marked by a significant intensification of research work abroad aimed at clinical testing of a number of biopolymer compositions and products for use as spacers between irradiated structures and normal tissues. The experience has made it possible for the first time to consider the possibility of using spacers in radiotherapy treatment of prostate cancer in the modern recommendations of the European Association of Urology (2021). The analysis of the national literature shows a complete lack of publications on the possibilities of optimizing the radiation treatment of prostate cancer through the use of specers. The purpose of this work was the need to highlight this important and perspective clinical problem.

Основные принципы лечения больных раком предстательной железы в последние годы были подвергнуты существенному пересмотру. Современные методики лучевой терапии, продемонстрировавшие высокие эффективность и безопасность в рамках длительных рандомизированных исследований, начинают занимать лидирующие позиции в лечении рака предстательной железы в подавляющем числе клинических сценариев (рекомендации Национальной сети по борьбе с раком (NCCN) 2021). Несмотря на очевидные успехи радиационной онкологии, остается нерешенным целый ряд важных проблем, в первую очередь - необходимость снижения показателей лучевых осложнений. Топографическая анатомия предстательной железы определяет основные профили характерных постлучевых повреждений: прямокишечная и мочеполовая лучевая токсичность. Предшествующие 5 лет ознаменованы значительной интенсификацией исследовательской работы за рубежом, направленной на клиническую апробацию ряда биополимерных композиций и изделий по использованию в качестве механических разделителей или спейсеров между облучаемыми структурами и здоровыми тканями. Накопленный опыт позволил впервые рассматривать возможность их применения при лучевом лечении рака предстательной железы в рамках последних рекомендаций Европейской ассоциации урологов (2021). Анализ данных отечественной литературы свидетельствует о полном отсутствии публикаций, посвященных возможностям оптимизации лечения рака предстательной железы посредством спейсеров. Цель настоящей работы - освещение данной важной и перспективной клинической проблемы.

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