rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2409-2231-2017-4-4-9rpmj-223Research ArticleОбзорыReviewРАДИЙ-223. МЕСТО В ЛЕЧЕНИИ МЕТАСТАТИЧЕСКОГО КАСТРАЦИОННО-РЕФРАКТЕРНОГО РАКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫRADIUM-223. PLACE IN THE TREATMENT OF METASTATIC CASTRATION-REFRACTORY PROSTATE CANCERhttps://orcid.org/0000-0002-0792-6012КостинА. А.KostinA. A.

Костин Андрей Александрович - доктор медицинских наук, профессор, заведующий  кафедрой урологии, онкологии и радиологии ФПК МР РУДН, первый заместитель генерального директора.

249036, Калужская область, Обнинск, ул. Королёва, д. 4; 117198, Москва, ул. Миклухо-Маклая, д. 6

Andrey A. Kostin - MD., Professor, Head of Department  of Urology, Oncology and Radiology of FAS, MIPFU R; First Deputy General Director NMRRC.

4 Koroleva str., Obninsk, Kaluga region, 249036; 6 Miklukho-Maklaya, Moscow 117198

https://orcid.org/0000-0002-6601-6289МурадянА. Г.MuradyanA. G.

Мурадян Аветик Гагикович - клинический  аспирант  кафедры  урологии  и оперативной  нефрологии  с курсом  онкоурологии  Медицинского  института РУДН,  врач-онколог  поликлиники  МИНИОИ.

117198, Москва, ул. Миклухо-Маклая, д. 6; 125284, Москва, 2-й Боткинский проезд, д. 3

Avetik G. Muradyan - clinical post-graduate  student of the Department of Urology and Operative Nephrology with the course  of oncourology  MIPFU R, врач-онколог поликлиники P. Hertsen MORI.

6 Miklukho-Maklaya, Moscow 117198; 3, 2nd Botkinskiy proezd, Moscow, 125284

mdmuradyan@gmail.comТолкачевА. О.TolkachevA. O.

Толкачев Александр Олегович - младший научный сотрудник отделения онкоурологии.

125284, Москва, 2-й Боткинский проезд, д. 3

Aleksandr   O. Tolkachev, junior researcher,  Department of Oncourology, MORI.

3, 2nd Botkinskiy proezd, Moscow, 125284

alext06@mail.ruПоповС. В.PopovS. V.

Попов Сергей Витальевич - кандидат медицинских наук, врач-уролог,  заведующий  отделом анализа  деятельности  и перспективных программ развития.

249036, Калужская область, Обнинск, ул. Королёва, д. 4

Sergey  V. Popov - PhD, urologist,  head  of department for analysis of activities and prospective development  programs  NMRRC.

4 Koroleva str., Obninsk, Kaluga region, 249036

servit77@yandex.ruФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России; Медицинский институт ФГАОУВО «Российский университет дружбы народов»РоссияNational Medical Radiology Research Centre of the Ministry of Health of the Russian Federation; Medical Institute of Peoples Friendship University of RussiaRussian FederationМедицинский институт ФГАОУВО «Российский университет дружбы народов»; Московский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииРоссияMedical Institute of Peoples Friendship University of Russia; P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian FederationRussian FederationМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииРоссияP. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian FederationRussian FederationФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииРоссияNational Medical Radiology Research Centre of the Ministry of Health of the Russian FederationRussian Federation201713122017447988Copyright © Костин А.А., Мурадян А.Г., Толкачев А.О., Попов С.В., 20172017Костин А.А., Мурадян А.Г., Толкачев А.О., Попов С.В.Kostin A.A., Muradyan A.G., Tolkachev A.O., Popov S.V.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/223

Больные с кастрационно-рефрактерным раком предстательной железы (РПЖ) представляют собой сложную группу больных для лечения. На момент постановки диагноза 85% больных имеют локализованный опухолевый процесс, однако у 40% больных наблюдается его генерализация. Наиболее частой локализацией метастазирования РПЖ являются кости скелета, поражения которых достигают 90% случаев.

При этом рост заболеваемости РПЖ диктует необходимость поиска новых, более эффективных методов лечения данной группы больных. В настоящее время зарегистрировано шесть эффективных методов лечения метастатического кастрационно-рефрактерного рака предстательной железы (мКРРПЖ): воздействие на андрогенную стимуляцию (абиратерона ацетат, энзалутамид); химиотерапия препаратами из группы таксанов (доцетаксел, кабазитаксел); иммунотерапия (Сипулеуцел-Т (в РФ не зарегистрирован)), радионуклидная терапия радия-223 хлоридом (Ксофиго®). 223Ra является тропным к костной ткани альфа-излучателем, который, благодаря высокой линейной передаче энергии и короткой дистанции прохождения, обеспечивает увеличенный локализованный противоопухолевый эффект в силу более высокой доставки энергии. В статье представлен литературный обзор, освещающий механизмы развития кастрационной рефрактерности, характеристику и эффективность радия-223 в лечении больных мКРРПЖ.

Patients with castration-refractory prostate cancer (PC) are a complicated group of patients for treatment. At the time of diagnosis, 85% of patients have a localized tumor process, however, in 40% of patients, generalization of the tumor process is observed. The most common localization of prostate cancer metastasis is the skeletal bone, which affects up to 90% of cases.

At the same time, taking into account the increase in the morbidity of prostate cancer pathology, it dictates the need to search for new, more effective methods of treatment for this group of patients. Currently, there are six effective methods of treatment of metastatic castration-refractory prostate cancer (mCRPC): effects on androgenic stimulation (abiraterone acetate, enzalutamide); chemotherapy with drugs from the taxane group (docetaxel, cabazitaxel); immunotherapy (Sipuleucel-T), radionuclide therapy with Radium-223 chloride (Ksofigo®). 223Ra is a tropic to bone tissue alpha emitter, which, due to its high linear energy transfer and short transmission distance, provides an enhanced localized antitumor effect due to higher energy delivery. The article presents a literature review highlighting the mechanisms of development of castration refractoriness, the characteristic and efficacy of Radium-223 in the treatment of patients with metastatic castration-refractory prostate cancer.

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