rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2409-2231-2016-3-3-2rpmj-147Research ArticleОригинальные статьи. Онкология, лучевая терапияOriginal Articles. ОncologyВОЗМОЖНОСТИ ЛЕЧЕНИЯ БОЛЬНЫХ ЗЛОКАЧЕСТВЕННЫМИ НОВООБРАЗОВАНИЯМИ ОРГАНОВ ЖЕНСКОЙ РЕПРОДУКТИВНОЙ СИСТЕМЫ С МЕТАСТАТИЧЕСКИМ ПОРАЖЕНИЕМ ГОЛОВНОГО МОЗГАTHE POSSIBILITIES OF TREATMENT OF PATIENTS WITH MALIGNANT NEOPLASMS OF THE FEMALE REPRODUCTIVE SYSTEM WITH METASTATIC BRAIN LESIONЗайцевА. М.ZaytsevA. M.

к. м.н., заведующий отделением нейрохирургии МНИОИ им. П. А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России

PhD, head of neurosurgical department, P. Hertsen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia

НовиковаЕ. Г.NovikovaE. G.

д. м.н., профессор, руководитель гинекологического отделения отдела опухолей репродуктивных и мочевыводящих органов МНИОИ им. П. А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России

MD, professor, head of the gynecological department of the Division of tumors of reproductive and urinary organs, P. Hertsen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia

КирсановаО. Н.KirsanovaO. N.

младший научный сотрудник отделения нейрохирургии МНИОИ им. П. А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России

junior researcher of neurosurgical department, P. Hertsen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia

o.n.kirsanova@gmail.comКуржуповМ. И.KurzhupovM. I.

к. м.н., научный сотрудник отделения нейрохирургии МНИОИ им. П. А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России

PhD, researcher of neurosurgical department, P. Hertsen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia

ПотаповаЕ. А.PotapovaE. A.

врач-невролог отделения нейрохирургии МНИОИ им. П. А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России

neurologist of neurosurgical department, P. Hertsen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia

МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России; 125284, Россия, Москва, 2-й Боткинский проезд, 3РоссияP. Hertsen Moscow Oncology Research Institute-Branch, National M edical Radiology Research Center, Ministry of Health of Russia; 3, 2 nd Botkinskiy proezd, Moscow, 125284, RussiaRussian Federation201620092016331729Copyright © Зайцев А.М., Новикова Е.Г., Кирсанова О.Н., Куржупов М.И., Потапова Е.А., 20162016Зайцев А.М., Новикова Е.Г., Кирсанова О.Н., Куржупов М.И., Потапова Е.А.Zaytsev A.M., Novikova E.G., Kirsanova O.N., Kurzhupov M.I., Potapova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpmj.ru/rpmj/article/view/147

Обзор литературы за последние 10 лет позволяет утверждать, что головной мозг является редкой мишенью метастазирования злокачественных новообразований (ЗНО) женских половых органов. Тем не менее, за последние 20 лет частота вторичного поражения головного мозга выросла в 6,5 раз. Метастазы в головном мозге опухолей половых органов составляют около 5%. Оптимальная тактика лечения внутримозговых метастазов при этом является до сих пор не решенной проблемой: при наличии очагов более 3 см рекомендуется хирургическое лечение с последующим проведением химио- и лучевой терапии; при очагах меньших размеров методом выбора является стереотаксическая радиохирургия головного мозга с последующей химиотерапией.

Цель исследования

Цель исследования. Объединение собственного опыта лечения больных раком яичников (РЯ), раком шейки матки (РШМ) и раком эндометрия (РЭ) с метастазами в головном мозге и данных литературы для выработки тактики ведения пациентов с подобными заболеваниями.

Пациенты и методы

Пациенты и методы. В нейрохирургическом отделении МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России с 2007 по 2016 гг. было пролечено 9 больных с метастазами РЯ в головном мозге, 6 больных с метастазами РЭ, 4 больных с метастазами РШМ.

Результаты

Результаты. Пациенткам проведено микрохирургическое удаление метастатической опухоли из головного мозга с последующим комплексным лечением, на фоне которого достигнута высокая медиана общей выживаемости: у пациенток с метастазами РЯ – 14,0 мес при безрецидивной выживаемости 9,4 мес. Медиана выживаемости пациенток с метастазами РЭ и РШМ оказалась существ енно ниже, составив всего 5,4 мес.

Заключение

Заключение. В статье представлены современные взгляды на проблему лечения пациентов с внутричерепными метастазами злокачественных новообразований органов женской репродуктивной системы. Наш опыт демонстрирует, что проведение комплексного лечения, включающего нейрохирургическое, приводит к увеличению выживаемости больных, обеспечивая удовлетворительное качество жизни.

Literature review over the last 10 years suggests that the brain is a rare target of metastasis of neoplasms of female reproductive system. However, over the past 20 years, incidence of secondary brain damage increased 6.5 times. Genital tumor metastasis in the brain is around 5%. The optimal treatment strategy of intracerebral metastases in this case is still an unsolved problem: the presence of foci of more than 3 cm surgery and then chemotherapy and radiation therapy is recommended; with smaller foci method of choice is a stereotactic brain radiosurgery followed by chemotherapy.

Purpose

Purpose. The Union of our own experience of treatment of patients with ovarian cancer (OC), cervical cancer (СС) and endometrial cancer (EC) with brain metastases and data from literature to develop the tactics of conducting patients with these diseases.

 

 

Patients and methods

Patients and methods. The neurosurgical department of P. Hertsen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia from 2007 to 2016 we treated 9 patients with metastatic OC in the brain, 6 patients with metastatic ER, 4 patients with metastatic cervical cancer.

Resuts

Resuts. Patients received microsurgical removal of metastatic tumors of the brain, followed by complex treatment, so they achieved a high median overall survival: patients with metastatic ovarian cancer - 14.0 months with diseasefree survival of 9.4 months. The survival median of patients with metastatic ER and cervical cancer was significantly lower, amounting to only 5.4 months.

Conclusion

Conclusion. The article presents modern views on the problem of treating patients with intracranial metastases of malignant tumors of the female reproductive system. Our experience demonstrates that a comprehensive treatment, including neurosurgery, leads to increased survival of patients, providing a satisfac tory quality of life.

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The authors declare that there are no conflicts of interest present.