Комплексное лечение злокачественных неорганных забрюшинных сарком и их рецидивы

Аннотация

В статье обсуждаются анализ результаты 76 больных с неорганными саркомами забрюшинного пространства, которым произведены комплексные лечения. Опухоли злокачественной природы были гистологически верифицированы путем трепанбиопции у всех пациентов (100%). В зависимости от метода лечения больные были распределены на 2 группы- основная=38 и контрольная=46. Неадьювантная химиотерапия произведены 45.2% 202 БИОМЕДИЦИНА ВА АМАЛИЁТ ЖУРНАЛИ | ЖУРНАЛ БИОМЕДИЦИНЫ И ПРАКТИКИ | JOURNAL OF BIOMEDICINE AND PRACTICE №4 | 2021 больным дооперации которые принадлежат в основной группе. Всем больным после 3 курсов ПХТ произведено радикальное хирургическое вмешательство. Послеоперации они получали курс лучевой терапии (РОД-1,8-2Гр). Проведение химиотерапии в дооперационном этапе привели к частичной регрессии опухоли у 22 (53%) больных. У 9 (23.7%) больных стабилизация и у 7 (18.4%) отмечалось прогрессирование процесса. Безрецидивный период в основной группе составил 10,2+0,4мес, безметастатический период 11,4+0,5 мес. Ключевые слова: неорганные забрюшинные саркомы, неадьювантная химиотерапия, комплексные лечения, лучевая терапия, без рецидива. ULMASOV Firdavs G’ayratovich JO’RAYEV Mirjalol Dehqonovich ESANKULOVA Bustonoy Sobirovna Samarqand Davlat Tibbiyot Instituti, Samarqand, O’zbekiston NOORGAN RETROPERITONEAL SARKOMALARI VA RESIDIVLARINI KOMPLEKS DAVOLASH ANNOTATSIYA Maqolada retroperitoneal bo'shliqning noorgan sarkomalariga chalingan, kompleks davolanishni boshdan kechirgan 84 bemorning yaqin va uzoq muddat oralig’idagi natijalari tahlil qilinadi. Yomon sifatli o'smalar barcha bemorlarda trepan biopsiyasi bilan gistologik tekshirilgan (100Davolash uslubiga qarab, bemorlar 2 guruhga bo'lingan – asosiy- n = 38 va kontrol- n = 46. Asosiy guruhga kiruvchi bemorlarda (45.2%) operatsiyadan oldin noadyuvant kimyoviy terapiya o'tkazildi. Barcha bemorlarga PXTning 3 kursidan so'ng radikal jarrohlik amaliyoti o'tkazildi. Operatsiyadan keyin ular nur terapiyasi kursini (ROD-1.8-2Gy) olishdi. Operatsiyadan oldin o'tkazilgan kimyoviy terapiya natijasida 22 (57.9%) bemorlarda qisman o'smaning regressiyasi kuzatildi. 9 (23.7%) bemorda stabillashuv kuzatilgan va jarayonning rivojlanishi 7 (18.4%) bemorda qayd etilgan. Residivsiz davr vaqti asosiy guruhda 10,2 + 0,4 oy, metastazsiz davri 11,4 + 0,5 oyga o’zgargan. Kalit so'zlar: noorgan retroperitoneal sarkomalar, neoadyuvant kimyoviy terapiya, kompleks davolash, nur terapiyasi, residivsiz. Relevance: The diagnosis and treatment of non-organ retroperitoneal tumors (NRT) is one of the most important and difficult areas of clinical oncology. NRT make up from 0.03 to 1% of all human neoplasms, however, they are distinguished by an extraordinary variety of morphological variants. Existing publications in our country and in the world are based, as a rule, on few observations or present a description of individual clinical cases. Most foreign researchers consider NRT in a single complex with soft tissue neoplasms, proceeding only from histogenesis, not taking into account their localization, however, it is the latter that largely determines the specificity of diagnostic and therapeutic tactics. The fact that NRTs most often occur between the ages of 40 and 60 gives this problem a particular socioeconomic significance. The anatomical features of the retroperitoneal space determine the absence of specific clinical symptoms, requiring extraordinary diagnostic and therapeutic tactics3. The main feature of their clinical course is the tendency to recurrence and the achievement of large sizes, the connection with the surrounding organs and tissues, including the great vessels, causing significant difficulties and requiring the performance of combined operations 2. Among soft tissue sarcomas, the share of retroperitoneal sarcomas is 10-20%. According to some data, NRTs constitute 0.03 - 1.0% of all neoplasms of a person 7. According to various authors, 60 - 80% of tumors of the retroperitoneal space are malignant, and 14 - 40% are benign 1. Malignant retroperitoneal tumors are characterized by a high percentage recurrence after surgical treatment (13 - 82%). However, the metastatic potential of NRT is relatively low (19 - 32%) 5. Purpose of the study: To improve the effectiveness of treatment of retroperitoneal sarcomas by developing an integrated approach using neoadjuvant endoarterial chemotherapy, surgical intervention followed by radiation therapy. 203 БИОМЕДИЦИНА ВА АМАЛИЁТ ЖУРНАЛИ | ЖУРНАЛ БИОМЕДИЦИНЫ И ПРАКТИКИ | JOURNAL OF BIOMEDICINE AND PRACTICE №4 | 2021 Materials and methods: The research includes an analysis of the results of treatment of 84 patients in the period from 2017 to 2021 in the Samarkand branch of the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology. Histological verification was obtained in 100% of patients by trephine biopsy at the stage of examination. In the group, liposarcoma was verified in 29 (34.5%) patients, leiomyosarcoma - in 25