Medical Radiology and radiation safety Medical Radiology and radiation safety Медицинская радиология и радиационная безопасность 1024-6177 2618-9615 45278 10.12737/1024-6177-2021-66-3-76-81 В помощь практическому врачу Medical practice issue В помощь практическому врачу Successful Case of Treatment the Patient with Synchronous Rectal and Sigmoid Cancers and Synchronous Lung Metastasis СЛУЧАЙ УСПЕШНОГО ЛЕЧЕНИЯ ПАЦИЕНТА С СИНХРОННЫМИ ОПУХОЛЯМИ ПРЯМОЙ И СИГМОВИДНОЙ КИШКИ И СИНХРОННЫМИ МЕТАСТАЗАМИ В ЛЕГКИЕ Полыновский А. В. Polynovskiy A. V.

кандидат медицинских наук;

candidate of medical sciences;

 Кузьмичев Д. В. Kuz'michev D. V.

кандидат медицинских наук;

candidate of medical sciences;

 Мамедли З. З. Mamedli Z. Z.

кандидат медицинских наук;

candidate of medical sciences;

 Ткачев Сергей Иванович Tkachev Sergey Ivanovich

доктор медицинских наук;

doctor of medical sciences;

 Черных М. В. Chernich M. V. Сураева Ю. Э. Suraeva Yu. E. Мадьяров Ж. М. Madyarov J. M.

кандидат медицинских наук;

candidate of medical sciences;

 Анискин А. А. Aniskin A. A. Колобанова Е. С. Kolobanova E. S. Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Национальный медицнский исследовательский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РФ, Москва Россия N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia Russian Federation ОРЦ ПЭТ Технолоджи, Подольск, Московская обл. Москва Россия PET-Technology, Podolsk, Moscow Region, Russia Moscow Russian Federation Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Национальный медицнский исследовательский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РФ, Москва Россия N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia Russian Federation Национальный медицнский исследовательский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РФ, Москва Россия N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia Russian Federation 66 3 76 81 20 07 2021 https://naukaru.ru/en/nauka/article/45278/view

Колоректальный рак (КРР) занимает лидирующие позиции по частоте заболеваемости и смертности во всем мире. Диссеминированный КРР при первичной диагностике составляет от 15 до 35 %. Метастазы в легких являются самым частым внебрюшным проявлением метастатического процесса. Доля больных, у которых выявлены изолированные метастазы в легких, составляет всего лишь от 2 до 7,4 %. Такие пациенты являются относительно редкими, и до настоящего времени нет четких рекомендаций по их лечебной тактике. Данное клиническое наблюдение описывает успешный случай применения предоперационной пролонгированной химиолучевой терапии на первичную опухоль и стереотаксическое облучение метастатических очагов в легких, с курсами лекарственной терапии, с дальнейшим оперативным вмешательством в радикальном объеме лапароскопическим доступом, у пациента с диссеминированным первично-множественным раком прямой кишки, синхронным раком сигмовидной кишки и 2 метастатическими очагами в обоих легких.

Colorectal cancers (CRC) takes the leading position in the incidence of morbidity and mortality worldwide. Metastatic CRC in the primary diagnosis ranges from 15 to 35 %. Lung metastasis are the most frequent extraperitoneal manifestation of the metastatic process. Such patients are relatively rare and there are no clear recommendations for their treatment tactics to date. This clinical case describes a successful strategy of using preoperative prolonged chemoradiotherapy on a primary tumor and stereotactic irradiation of lung metastasis, with courses of chemotherapy, with further radical laparoscopic operation, in a patient with disseminated primary multiple rectal cancer, synchronous sigmoid colon cancer and 2 metastatic focuses in both lungs.

 рак прямой кишки диссеминированный метастазы в легкие стереотаксическая лучевая терапия химиолучевая терапия rectal cancer metastatic lung metastasis stereotactic body radiotherapy ablative radiation therapy chemoradiotherapy

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