Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press153410.17650/1726-9776-2022-18-2-142-163DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. URINARY BLADDER CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак мочевого пузыряGuideline on trimodal therapy of bladder cancer (Nevskiy consensus 2021)Рекомендации по проведению тримодальной терапии рака мочевого пузыря (Невский консенсус 2021)https://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 – доктор медицинских наук, доцент.

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68; 199034 Санкт-Петербург, Университетская набережная, 7–9

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

https://orcid.org/0000-0003-4359-979XNovikovA. I.НовиковА. И.
Russian Federation

68А Leningradskaya St., Pesochnyy, Saint Petersburg 197758; 41 Kirochnaya St., Saint Petersburg 191015

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68А; 191015 Санкт-Петербург, ул. Кирочная, 41

https://orcid.org/0000-0003-3460-3427PetrovS. B.ПетровС. Б.
Russian Federation

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758; 6–8 L’va Tolstogo St., Saint Petersburg 197022; 4/2 Akademika Lebedeva St., Saint Petersburg 194044

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68; 197022 Санкт-Петербург, ул. Льва Толстого, 6–8; 194044 Санкт-Петербург, ул. Академика Лебедева, 4/

https://orcid.org/0000-0001-8704-7669ProtsenkoS. A.ПроценкоС. А.
Russian Federation

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

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

https://orcid.org/0000-0002-4996-2927ProtoshchakV. V.ПротощакВ. В.
Russian Federation

6 Akademika Lebedeva St., Saint Petersburg 194044

194044 Санкт-Петербург, ул. Академика Лебедева, 6

https://orcid.org/0000-0003-2767-7153PopovS. V.ПоповС. В.
Russian Federation

6 Akademika Lebedeva St., Saint Petersburg 194044; 46 Chugunnaya St., Saint Petersburg 194044

194044 Санкт-Петербург, ул. Академика Лебедева, 6; 194044 Санкт-Петербург, ул. Чугунная, 46

https://orcid.org/0000-0003-0589-7999ShkolnikM. I.ШкольникМ. И.
Russian Federation

70 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 70

https://orcid.org/0000-0003-0479-6555ShpilenyaE. S.ШпиленяЕ. С.
Russian Federation

41 Kirochnaya St., Saint Petersburg 191015

191015 Санкт-Петербург, ул. Кирочная, 41

KurenkovA. V.КуренковА. В.
Russian Federation

41 Kirochnaya St., Saint Petersburg 191015

191015 Санкт-Петербург, ул. Кирочная, 41

SokurenkoV. P.СокуренкоВ. П.
Russian Federation

70 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 70

https://orcid.org/0000-0002-9368-5517OrlovaR. V.ОрловаР. В.
Russian Federation

7–9 Universitetskaya Naberezhnaya, Saint Petersburg 199034; 56 Prospekt Veteranov, Saint Petersburg 198255

199034 Санкт-Петербург, Университетская набережная, 7–9; 198255 Санкт-Петербург, пр-кт Ветеранов, 56

https://orcid.org/0000-0003-3850-7109NosovА. K.НосовА. К.
Russian Federation

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

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

KorolV. D.КорольВ. Д.
Russian Federation

4/2 Akademika Lebedeva St., Saint Petersburg 194044

194044 Санкт-Петербург, ул. Академика Лебедева, 4/2

https://orcid.org/0000-0002-8906-0370LatipovaD. Kh.ЛатиповаД. Х.
Russian Federation

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

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

https://orcid.org/0000-0003-3224-2306MikheevaYu. V.МихееваЮ. В.
Russian Federation

46 Chugunnaya St., Saint Petersburg 194044

194044 Санкт-Петербург, ул. Чугунная, 46

https://orcid.org/0000-0002-1753-7926KanaevS. V.КанаевС. В.
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 UniversityФГБОУ ВО Санкт-Петербургский государственный университетSaint Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncological)ГБУЗ Санкт-Петербургский клинический научно-практический центр специализированных видов медицинской помощи (онкологический)I.I. Mechnikov North-West State Medical University, Ministry of Health of RussiaФГБОУ ВО Северо-Западный государственный медицинский университет им. И.И. Мечникова Минздрава РоссииI.P. Pavlov First Saint Petersburg State Medical UniversityФГБОУ ВО Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова Минздрава РоссииA.M. Nikiforov All-Russian Center for Emergency and Radiation Medicine, Russian Emergency Situations MinistryФГБУ Всероссийский центр экстренной и радиационной медицины им. А.М. Никифорова МЧС РоссииS.M. Kirov Military Medical Academy, Ministry of Defense of RussiaФГБВОУ ВО Военно-медицинская академия им. С.М. Кирова Минобороны РоссииSt. Luka’s Clinical HospitalСПб ГБУЗ Клиническая больница Святителя ЛукиA.M. Granov Russian Scientific Center for Radiology and Surgical Technologies, Ministry of Health of RussiaФГБУ Российский научный центр радиологии и хирургических технологий им. акад. А.М. Гранова Минздрава РоссииCity Clinical Oncology DispensaryСПб ГБУЗ Городской клинический онкологический диспансерФГБУ Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова Минздрава РоссииN.N. Petrov National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ Всероссийский центр экстренной и радиационной медицины им. А.М. Никифорова МЧС РоссииA.M. Nikiforov All-Russian Center for Emergency and Radiation Medicine, Russian Emergency Situations MinistryФГБУ Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова Минздрава РоссииN.N. Petrov National Medical Research Center of Oncology, Ministry of Health of RussiaСПб ГБУЗ Клиническая больница Святителя ЛукиSt. Luka’s Clinical HospitalФГБУ Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова Минздрава РоссииN.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia160820221821421631001202222032022https://oncourology.abvpress.ru/oncur/article/view/1534

The aim of this work was to clarify and extend the existing clinical guidelines on organ-sparing treatment of muscleinvasive bladder cancer. The standard protocol of radical conservative treatment for muscle-invasive bladder cancer includes transurethral resection of the bladder, external beam radiotherapy with simultaneous chemotherapy (radiosensitization), which is usually referred to as trimodal therapy. The implementation of trimodal therapy into routine practice in Russia is limited due to the lack of distinct criteria for each of the stages. The involvement of surgeons, radiation oncologists, and chemotherapists, on the one hand, provides the required multidisciplinary approach to cancer treatment; on the other hand, it might impede the entire algorithm. To address this problem, specialists from the Department of Radiology (project moderators), Department of Cancer Urology, and Department of Chemotherapy of N.N. Petrov National Medical Research Center of Oncology under the auspices of Saint Petersburg Oncological Research Society formed a group of experts, including radiation oncologists, urologists, and chemotherapists from federal and local cancer (educational) institutions of Saint Petersburg who had an experience of treating muscle-invasive bladder cancer. The guideline was developed with the consideration of available guidelines published by leading professional associations of radiotherapy and oncology (urological), research articles, and own experience.

         

Цель работы – уточнение и дополнение клинических рекомендаций по органосохраняющему лечению мышечноинвазивного рака мочевого пузыря. Стандартный протокол радикального консервативного лечения мышечно-инвазивного рака мочевого пузыря включает трансуретральную резекцию мочевого пузыря, дистанционную лучевую терапию с одновременной химиотерапией (радиосенсибилизацию) и называется тримодальной терапией. Широкое внедрение тримодальной терапии в отечественную практику ограничено отсутствием четких критериев для каждого из этапов. Участие в протоколе хирургов, радиационных онкологов и химиотерапевтов, с одной стороны, обеспечивает необходимый мультидисциплинарный характер лечения онкологического больного, с другой – затрудняет реализацию всего алгоритма. Для осуществления поставленной задачи отделениями радиотерапии (модераторы проекта) и онкоурологии, а также отделением химиотерапии и инновационных технологий НМИЦ онкологии им. Н.Н. Петрова под эгидой Петербургского онкологического научного общества сформирована группа экспертов, включающая радиационных онкологов, онкоурологов и химиотерапевтов федеральных и городских онкологических (образовательных) учреждений (г. Санкт-Петербург), имеющих опыт лечения мышечно-инвазивного рака мочевого пузыря. Разработка рекомендаций велась с учетом имеющихся рекомендаций ведущих профессиональных радиотерапевтических и онкологических (урологических) ассоциаций, опубликованных статей и собственного опыта.

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