Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press63710.17650/1726-9776-2017-13-2-43-48DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. RENAL CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак почкиCombined treatment of metastatic renal cell carcinoma in spineКомбинированное лечение метастазов почечно-клеточного рака в позвоночникShirokoradV. I.ШирокорадВ. И.
Russian Federation

27 Istra Settlement, Moscow Region 143423

143423 Московская область, пос. Истра, 27

KostritskiiS. V.КострицкийС. В.
Russian Federation

27 Istra Settlement, Moscow Region 143423

Кострицкий Станислав Викторович - врач-онколог онкоурологического отделения Московской онкологической больницы №62

143423 Московская область, пос. Истра, 27

Stas.medic@bk.ruZaborovskiyN. S.ЗаборовскийН. С.
Russian Federation

8 Acad. Baykova St., Saint Petersburg 195427

195427 Санкт-Петербург, ул. акад. Байкова, 8 

PtashnikovD. A.ПташниковД. А.

8 Acad. Baykova St., Saint Petersburg 195427

195427 Санкт-Петербург, ул. акад. Байкова, 8 

Moscow City Cancer Hospital No 62, Moscow Healthcare DepartmentГБУЗ г. Москвы «Московская городская онкологическая больница № 62 Департамента здравоохранения г. Москвы»R.R. Vreden Russian Scientific Research Institute of Traumatology and OrthopedicsФГБУ «Российский ордена Трудового Красного Знамени научно-исследовательский институт травматологии и ортопедии им. Р.Р. Вредена» Минздрава России3006201713243481912201613042017https://oncourology.abvpress.ru/oncur/article/view/637

This study is a retrospective analysis of the combined treatment of patients with metastatic renal cell carcinoma who had undergone spinal surgery. Objective: to evaluate the effect of the type of surgery on the spine, as well as targeted therapy on outcomes, quality of life and long-term outcomes of patients with mRCC in the spine. According to our data the survival of patients treated with targeted therapy was significantly higher than in patients without it. The use of targeted therapy in conjunction with surgery and sometimes teletherapy (DLT), increases survival and improves quality of life of patients with mRCC in the spine. 

Данная работа представляет собой ретроспективный анализ результатов комбинированного лечения пациентов с метастазами почечно-клеточного рака, перенесших операции на позвоночнике. Цель исследования – оценка влияния вида оперативного вмешательства на позвоночнике, а также таргетной терапии на исходы, качество жизни и отдаленные результаты лечения пациентов с метастазами почечно-клеточного рака в позвоночник. По нашим данным, выживаемость больных, получавших таргетную терапию, достоверно выше, чем у пациентов без нее. Применение таргетной терапии совместно с хирургическим лечением, а иногда и дистанционной лучевой терапией увеличивает выживаемость, улучшает качество жизни пациентов с метастазами рака почки в позвоночник.

kidney cancermetastas of renal cell carcinoma in the spinetargeted therapysurgical treatmentsurvivalрак почкиметастаз почечно-клеточного рака в позвоночниктаргетная терапияхирургическое лечениевыживаемость1. Каприн А.Д., Старинский В.В., Петрова Г.В. Состояние онкологической помощи населению России в 2015 году. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России, 2016. 236 с. [Kaprin A.D., Starinskiy V.V., Petrova G.V. State of oncological care in Russia in 2015. Moscow: MNIOI im. P.A. Gertsena – filial FGBU “NMIRTS” Minzdrava Rossii, 2016. 236 p. (In Russ.)].Каприн А.Д., Старинский В.В., Петрова Г.В. Состояние онкологической помощи населению России в 2015 году. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России, 2016. 236 с. [Kaprin A.D., Starinskiy V.V., Petrova G.V. State of oncological care in Russia in 2015. Moscow: MNIOI im. P.A. Gertsena – filial FGBU “NMIRTS” Minzdrava Rossii, 2016. 236 p. (In Russ.)].2. Perrin R.G., McBroom R.J. Spinal fixation after anterior decompression for symptomatic spinal metastasis. Neurosurgery 1998;22(2):324–7. PMID: 3352882.Perrin R.G., McBroom R.J. Spinal fixation after anterior decompression for symptomatic spinal metastasis. Neurosurgery 1998;22(2):324–7. PMID: 3352882.3. Motzer R.J., Michaelson M.D., Redman B.G. et al. Activity of SU11248, a multitargeted inhibitor of vascular endothelial growth factor receptor and platelet-derived growth factor receptor, in patients with metastatic renal cell carcinoma. J Clin Oncol 2006;24(1):16–24. DOI: 10.1200/JCO.2005.02.2574. PMID: 16330672.Motzer R.J., Michaelson M.D., Redman B.G. et al. Activity of SU11248, a multitargeted inhibitor of vascular endothelial growth factor receptor and platelet-derived growth factor receptor, in patients with metastatic renal cell carcinoma. J Clin Oncol 2006;24(1):16–24. DOI: 10.1200/JCO.2005.02.2574. PMID: 16330672.4. Kume H., Kakutani S., Yamada Y. et al. Prognostic factors for renal cell carcinoma with bone metastasis: who are the long-term survivors? J Urol 2011;185(5):1611–4. DOI: 10.1016/j.juro.2010.12.037. PMID: 21419440.Kume H., Kakutani S., Yamada Y. et al. Prognostic factors for renal cell carcinoma with bone metastasis: who are the long-term survivors? J Urol 2011;185(5):1611–4. DOI: 10.1016/j.juro.2010.12.037. PMID: 21419440.5. Jung S.T., Ghert M.A., Harrelson J.M., Scully S.P. Treatment of osseous metastases in patients with renal cell carcinoma. Clin Orthop Relat Res 2003;(409):223–31. DOI: 10.1097/01.blo.0000059580.08469.3e. PMID: 12671506.Jung S.T., Ghert M.A., Harrelson J.M., Scully S.P. Treatment of osseous metastases in patients with renal cell carcinoma. Clin Orthop Relat Res 2003;(409):223–31. DOI: 10.1097/01.blo.0000059580.08469.3e. PMID: 12671506.6. Fürstenberg C.H., Wiedenhöfer B., Gerner H.J., Putz C. The effect of early surgical treatment on recovery in patients with metastatic compres-sion of the spinal cord. J Bone Joint Surg Br 2009;91(2):240–4. DOI: 10.1302/0301-620X.91B2.20894. PMID: 19190061.Fürstenberg C.H., Wiedenhöfer B., Gerner H.J., Putz C. The effect of early surgical treatment on recovery in patients with metastatic compres-sion of the spinal cord. J Bone Joint Surg Br 2009;91(2):240–4. DOI: 10.1302/0301-620X.91B2.20894. PMID: 19190061.7. Kim H.J., Buchowski J.M., Moussallem C.D., Rose P.S. Modern techniques in the treatment of patients with metastatic spine disease. J Bone Joint Surg Am 2012;94(10):943–51. DOI: 10.2106/JBJS.L00192. PMID: 22617926.Kim H.J., Buchowski J.M., Moussallem C.D., Rose P.S. Modern techniques in the treatment of patients with metastatic spine disease. J Bone Joint Surg Am 2012;94(10):943–51. DOI: 10.2106/JBJS.L00192. PMID: 22617926.8. Sciubba D.M., Gokaslan Z.L. Are patients satisfied after surgery for metastatic spine disease? Spine J 2010;10(1):63–5. DOI: 10.1016/j.spinee.2009.10.004. PMID: 19926344.Sciubba D.M., Gokaslan Z.L. Are patients satisfied after surgery for metastatic spine disease? Spine J 2010;10(1):63–5. DOI: 10.1016/j.spinee.2009.10.004. PMID: 19926344.9. Tomita K., Kawahara N., Baba H. et al. Total en bloc spondylectomy for solitary spinal metastases. Int Orthop 1994;18(5):291–8. PMID: 7852009.Tomita K., Kawahara N., Baba H. et al. Total en bloc spondylectomy for solitary spinal metastases. Int Orthop 1994;18(5):291–8. PMID: 7852009.10. Liu J.K., Apfelbaum R.I., Chiles B.W. 3rd, Schmidt M.H. Cervical spinal metastasis: anterior reconstruction and stabilization techniques after tumor resection. Neurosurg Focus 2003;15(5):1–7. PMID: 15323459.Liu J.K., Apfelbaum R.I., Chiles B.W. 3rd, Schmidt M.H. Cervical spinal metastasis: anterior reconstruction and stabilization techniques after tumor resection. Neurosurg Focus 2003;15(5):1–7. PMID: 15323459.11. Boriani S., Biagini R., de Lure F. et al. Lumbar vertebrectomy for the treatment of bone tumors: surgical technique. Chir Organi Mov 1994;79:163–74.Boriani S., Biagini R., de Lure F. et al. Lumbar vertebrectomy for the treatment of bone tumors: surgical technique. Chir Organi Mov 1994;79:163–74.12. Patchell R. A randomized trial of direct decompressive surgical resection in the treatment of spinal cord compression caused by metastases. Proceedings of the 39th Annual Meeting of the American Society of Clinical Oncology, 2003. Pp. 112.Patchell R. A randomized trial of direct decompressive surgical resection in the treatment of spinal cord compression caused by metastases. Proceedings of the 39th Annual Meeting of the American Society of Clinical Oncology, 2003. Pp. 112.13. Jackson R.J., Loh S.C., Gokaslan Z.L. Metastatic renal cell carcinoma of the spine: surgical treatment and results. J Neurosurg 2001;94(1):18–24. PMID: 11147860.Jackson R.J., Loh S.C., Gokaslan Z.L. Metastatic renal cell carcinoma of the spine: surgical treatment and results. J Neurosurg 2001;94(1):18–24. PMID: 11147860.14. Prabhu V.C., Bilsky M.H., Jambhekar K. et al. Results of preoperative embolization for metastatic spinal neoplasms. J Neurosurg 2003;98(2):156–64. PMID: 12650400.Prabhu V.C., Bilsky M.H., Jambhekar K. et al. Results of preoperative embolization for metastatic spinal neoplasms. J Neurosurg 2003;98(2):156–64. PMID: 12650400.15. Quraishi N.A., Purushothamdas S., Manoharan S.R. et al. Outcome of embolised vascular metastatic renal cell tumours causing spinal cord compression. Eur Spine J 2013;22(1):27–32. DOI: 10.1007/s00586-012-2648-6. PMID: 23328874.Quraishi N.A., Purushothamdas S., Manoharan S.R. et al. Outcome of embolised vascular metastatic renal cell tumours causing spinal cord compression. Eur Spine J 2013;22(1):27–32. DOI: 10.1007/s00586-012-2648-6. PMID: 23328874.16. Kato S., Murakami H., Demura S. et al. Spinal metastasectomy of renal cell carcinoma: a 16-year single center experience with a mini-mum 3-year followup. J Surg Oncol 2016;113(5):587–92. DOI: 10.1002/jso.24186. PMID: 26846902.Kato S., Murakami H., Demura S. et al. Spinal metastasectomy of renal cell carcinoma: a 16-year single center experience with a mini-mum 3-year followup. J Surg Oncol 2016;113(5):587–92. DOI: 10.1002/jso.24186. PMID: 26846902.