Clinical Medicine and Pharmacology Clinical Medicine and Pharmacology Клиническая медицина и фармакология 2409-3750 99854 10.12737/2409-3750-2025-11-1-20-26 Оригинальные исследования original research Оригинальные исследования PREVENTIVE BRAIN IRRADIATION FOR SMALL CELL LUNG CANCER: A NEW LOOK AT THE OLD OPTION ПРОФИЛАКТИЧЕСКОЕ ОБЛУЧЕНИЕ ГОЛОВНОГО МОЗГА ПРИ МЕЛКОКЛЕТОЧНОМ РАКЕ ЛЕГКОГО: НОВЫЙ ВЗГЛЯД НА СТАРУЮ ОПЦИЮ Бобков М. С. Bobkov M. S. Блинцов В. М. Blincov V. M. Василенко А. А. Vasilenko A. A. Полетаева И. А. Poletaeva I. A. Согомонян И. Ш. Sogomonyan I. Sh. Уханов И. А. Uhanov I. A. Тульский государственный университет Tula State University Тульский областной клинический онкологический диспансер Тула Россия Тульский областной клинический онкологический диспансер Тула Russian Federation Тульский областной клинический онкологический диспансер Тула Россия Тульский областной клинический онкологический диспансер Тула Russian Federation Тульский областной клинический онкологический диспансер Тула Россия Тульский областной клинический онкологический диспансер Тула Russian Federation 17 06 2025 17 06 2025 11 1 20 26 16 06 2025 https://naukaru.ru/en/nauka/article/99854/view

Мелкоклеточный рак легких составляет почти 13% всех впервые диагностированных случаев рака легких. У большинства пациентов наблюдается агрессивное течение болезни, и без лечения средняя выживаемость составляет от 2 до 4 мес. При этом заболевании часто встречаются метастазы в головной мозг. На момент постановки диагноза по меньшей мере у 18% пациентов в случае надлежащего обследования обнаруживаются метастазы в головном мозге. Профилактическое облучение головного мозга является сегодня общепринятой частью терапии как локализованного, так и распространенного мелкоклеточного рака легкого. Однако, данные, подтверждающие его эффективность, базируются на мета-анализах исследований, проведенных до применения общепринятых и обязательных в настоящее время методов определения истинной распространенности болезни (например, МРТ головного мозга и ПЭТ/КТ). В настоящее время появляется всё больше данных о том, что в современных реалиях, при условии тщательного обследования и верного стадирования, опция профилактического облучения головного мозга представляется малоактуальной, а современная иммунотерапия способна обеспечить лучший церебральный контроль при меньшей потенциальной токсичности.

Small cell lung cancer accounts for almost 13% of all newly diagnosed lung cancer cases. Most patients have an aggressive course of the disease, and without treatment, the average survival is from 2 to 4 months. Brain metastases are common in this disease. At the time of diagnosis, at least 18% of patients have metastases in the brain if properly examined. Preventive irradiation of the brain is now a commonly accepted part of the treatment of both localized and widespread small cell lung cancer. However, the data confirming its effectiveness is based on meta-analyses of studies conducted before the use of generally accepted and currently mandatory methods for determining the true prevalence of the disease (for example, brain MRI and PET/CT). Currently, there is increasing evidence that in modern realities, subject to careful examination and proper staging, the option of preventive brain irradiation seems to be ineffective, and modern immunotherapy can provide better cerebral control with less potential toxicity.

 : мелкоклеточный рак легкого метастазы в головной мозг лучевая терапия профилактическое облучение головного мозга small cell lung cancer brain metastases radiation therapy preventive brain irradiation

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