medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2023-17-42-45medalphabet-3271Research ArticleСтатьиЛечение пациентов с прогрессированием первичных эпендимом головного мозга у взрослыхTreatment of patients with progression of primary cerebral ependymomas in adultshttps://orcid.org/0000-0002-0284-275XСарычеваМ. М.SarychevaM. M.

Сарычева Марина Михайловна, к. м. н., ассистент кафедры онкологии, лучевой диагностики и лучевой терапии; врач-радиотерапевт отделения радиотерапии № 1

г. Челябинск

Sarycheva Marina M., PhD Med, assistant at Dept of Oncology, Radiation Diagnostics and Radiation Therapy; radiotherapist of Radiotherapy Dept. No. 1

Chelyabinsk

pimenovamm@mail.ruhttps://orcid.org/0000-0002-7912-9039ВаженинА. В.VazheninA. V.

Важенин Андрей Владимирович, д. м. н., проф., акад. РАН, зав. кафедрой онкологии, лучевой диагностики и лучевой терапии

г. Челябинск

Vazhenin Andrey V., DM Sci (habil.), professor, academician of RAS, head of Dept of Oncology, Radiation Diagnostics and Radiation Therapy

Chelyabinsk

https://orcid.org/0000-0001-5269-7450МозероваЕ. Я.MozerovaE. Ya.

Мозерова Екатерина Яковлевна, доцент кафедры онкологии, лучевой диагностики и лучевой терапии; зав. отделением радиотерапии № 1

г. Челябинск

Mozerova Ekaterina Ya., associate professor at Dept of Oncology, Radiation Diagnostics and Radiation Therapy; head of Radiotherapy Dept No. 1

Chelyabinsk

ФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава России; ГАУЗ «Челябинский областной клинический центр онкологии и ядерной медициныРоссияSouth Ural State Medical University; Chelyabinsk Regional Clinical Center of Oncology and Nuclear MedicineRussian FederationФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РоссииРоссияSouth Ural State Medical UniversityRussian Federation202322102023017Диагностика и онкотерапия (2)4245Copyright © Сарычева М.М., Важенин А.В., Мозерова Е.Я., 20232023Сарычева М.М., Важенин А.В., Мозерова Е.Я.Sarycheva M.M., Vazhenin A.V., Mozerova E.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3271

Целью данной работы является оценка результатов лечения больных с прогрессированием первичных эпендимом головного мозга у взрослых. В исследование вошло 10 пациентов, находившимся на стационарном лечении в ГАУЗ «Челябинский областной центр онкологии и ядерной медицины» с 2016 по 2022 год. Средний возраст больных составил 33,00 ± 11,21 года. У 60 % (n = 6) диагностирована прогрессия эпендимомы grade 3, в 40 % (n = 4) отмечен рецидив эпендимомы grade 2. Все пациенты были женского пола. Среднее время возникновения рецидива составило 29,6 месяца (от 11 до 44 месяцев). По методу лечения рецидива: в 60 % (n = 6) случаев пациентам проводилась монохимиотерапия темозоломидом, 20 % (n = 2) больных была выполнена стереотаксическая радиотерапия на аппарате CyberKnife с разовой очаговой дозой (РОД) 5,5 Гр за пять фракций, до подведения суммарной очаговой дозы (СОД) 27,5 Гр, двум больным проведена повторная дистанционная лучевая терапия в традиционном режиме фракционирования с СОД 40 Гр. Медиана общей выживаемости (ОВ) для всех пациентов составила 48 месяцев. Показатели 1-летней ОВ – 100 %, 2-летней – 83,3 % 3-летней – 50 %. Медиана выживаемости без прогрессии составила 20 месяцев. В неврологическом статусе после завершения проведенного специального лечения отмечено уменьшение двигательного дефицита и одно афотическое расстройство.

The aim of this work is to evaluate the results of treatment of patients with progression of primary cerebral ependyma in adults. The study included 10 patients who have been hospitalized at the Chelyabinsk Regional Center for Oncology and Nuclear Medicine since 2016 to 2022. The mean age of the patients was 33.0 ± 11.21 years. In 60 % (n = 6) progression of grade 3 ependymoma was diagnosed, in 40 % (n = 4) relapse of grade 2 ependymoma was noted. All patients were female. The mean time to recurrence was 29.6 months (from 11 to 44 months). According to the method of relapse treatment, in 60 % (n = 6) of cases patients received monochemotherapy with temozolomide, 20 % (n = 2) of patients underwent stereotaxic radiotherapy on the CyberKnife device with a single focal dose (SOD) of 5.5 Gy in five fractions, before summing up the total focal dose (SOD) of 27.5 Gy, two patients underwent repeated external beam radiation therapy in the traditional mode of fractionation with SOD 40 Gy. The median overall survival (OS) for all patients was 48 months. Indicators of 1-year OR were 100 %, 2-year – 83.3 %, 3-year – 50 %. The median progression-free survival was 20 months. In the neurological status after the completion of the special treatment, a decrease in motor deficit and one aphatic disorder was noted.

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