rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2409-2231-2015-2-3-76-81rpmj-87Research ArticleОбзоры, лекцииReviews, lecturesПРОФИЛАКТИКА РАЗВИТИЯ ОСЛОЖНЕНИЙ У БОЛЬНЫХ РАКОМ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ С МЕТАСТАЗАМИ В КОСТЯХPREVENTION OF COMPLICATIONS IN CASTRATE-REFRACTORY PROSTATE CANCER PATIENTS WITH BONE METASTASESНюшкоК. М.NushkoK. M.

к.м.н., ведущий научный сотрудник отделения онкоурологии МНИОИ им. П. А. Герцена, филиала ФГБУ НМИРЦ Минздрава России

PhD, leading researcher of oncourological department, P. Hertsen MORI

kirandja@ya.ruКалпинскийА. С.KalpinskiyA. S.

к.м.н., старший научный сотрудник отделения онкоурологии МНИОИ им. П. А. Герцена, филиала ФГБУ НМИРЦ Минздрава России

PhD, senior researcher of oncourological department P. Hertsen MORI

kirandja@ya.ruКапринА. Д.KaprinA. D.

д.м.н., профессор, член-корреспондент РАН, директор ФГБУ НМИРЦ Минздрава России

MD, professor, corresponding member of RAS, director NMRRC

kirandja@ya.ruМНИОИ им. П.А. Герце на - филиал ФГБУ «НМИРЦ» Минздрава России (Москва, Российская Федерация)РоссияP. Hertsen MORI (Moscow, Russian Federation)Russian FederationФГБУ «НМИРЦ» Минздрава России (Обнинск, Российская Федерация)РоссияNMRRC (Obninsk, Russian Federation)Russian Federation201501102015237681Copyright © Нюшко К.М., Калпинский А.С., Каприн А.Д., 20152015Нюшко К.М., Калпинский А.С., Каприн А.Д.Nushko K.M., Kalpinskiy A.S., Kaprin A.D.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/87

Резюме:

Рак предстательной железы (РПЖ) является одной из наиболее актуальных проблем современной онкоурологии. Несмотря на улучшение методов диагностики, частота выявления РПЖ в распространенной стадии с наличием отдаленных метастазов остается высокой. У больных диссеминированным РПЖ с наибольшей частотой отдаленные метастазы локализуются в лимфатических узлах и костях. Частая локализация метастатических очагов в костях объясняется тропностью опухолевых клеток РПЖ к костной ткани. при развитии кастрационно-рефрактерной фазы заболевания риск развития костных осложнений у больных РПЖ существенно возрастает. Именно по этой причине профилактика костных осложнений с использованием препаратов, ингибирующих резорбцию костного матрикса, таких как бисфофонаты и ингибиторы лиганда RANKL, является рекомендуемой концепцией у больных кастрационно-рефрактерным РПЖ. В статье представлен обзор данных литературы, освещающих современные подходы к профилакти- ке развития костных осложнений у больных метастатическим РПЖ, приведены результаты крупных исследований, оценивших эффективность применения бисфосфонатов и других препаратов, применяемых для профилактики их развития.

Abstract:

Prostate cancer (PC) is one of the most urgent problems in modern oncourology. Every year the world is recording more than 900 thousands new cases of prostate cancer. For this reason, the diagnosis and treatment of this disease has recently been given more attention, both abroad and in the Russian Federation. Despite improvements in diagnostic methods and implementation of programs for active detection of the disease in its early stages, the number of patients suffering from advanced forms of prostate cancer remains high. Currently, the main method of treatment in patients with metastatic prostate cancer remains the hormone therapy (HT). Patients with metastatic prostate cancer most frequently have localization of metastatic lesions in the lymph nodes and bones. Frequent localization of metastatic lesions in the bones is due to tumor cell tropism of prostate cancer to the bone. Metastatic bone disease, as well as long-term HT conducted in patients with metastatic prostate cancer, leads to irreversible disruption of bone remodeling, which may be accompanied by osteoporosis and fragility fractures. Bone metastases in patients with PC are the most common cause of complications and significantly impair the quality of life of patients. Therapy underlying the prevention of bone complications can be specific, aimed directly at the tumor tissue and non-specific, to strengthen bones and decrease its resorption processes. The article provides an overview of the literature covering the effectiveness of modern drugs, aimed at non-specific prevention of bone complications in patients with metastatic prostate cancer, such as bisphosphonates, and inhibitors of the ligand RANKL, as well as an overview of studies to assess the effectiveness of domestic analogue zolendronovoy acid preparation Resorba in the prevention of osteoporosis.

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