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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">oncotomsk</journal-id><journal-title-group><journal-title xml:lang="ru">Сибирский онкологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Siberian journal of oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1814-4861</issn><issn pub-type="epub">2312-3168</issn><publisher><publisher-name>Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21294/1814-4861-2021-20-6-104-113</article-id><article-id custom-type="elpub" pub-id-type="custom">oncotomsk-1992</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Рак желудка: современные подходы и перспективы лечения при канцероматозе брюшины (литературный обзор)</article-title><trans-title-group xml:lang="en"><trans-title>Gastric cancer: modern approaches and prospects of treatment for peritoneal carcinomatosis (literature review)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7599-1211</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маркович</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Markovich</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>младший научный сотрудник отделения торакальной онкологии </p><p>SPIN-код: 2954-8330 </p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p></bio><bio xml:lang="en"><p>MD, Junior Researcher, Thoracic Oncology Department</p><p>SPIN-code: 2954-8330 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p></bio><email xlink:type="simple">vitalii.markovich.87@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0884-1838</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тузиков</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tuzikov</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, заведующий отделением торакальной онкологии; профессор кафедры онкологии</p><p>SPIN-код: 5662-6431. Researcher ID (WOS): D-1176-2012. Author ID (Scopus): 6507842873</p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p><p> Россия, 634050, Томск, Московский тракт, 2 </p></bio><bio xml:lang="en"><p>MD, DSc, Professor, Head of Thoracic Oncology Department; Professor of Oncology Department</p><p>SPIN-code: 5662-6431. Researcher ID (WOS): D-1176-2012. Author ID (Scopus): 6507842873 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p><p>2, Moskovsky Trakt, 634050, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4980-8986</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Родионов</surname><given-names>Е. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Rodionov</surname><given-names>E. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат медицинских наук, старший научный сотрудник отделения торакальной онкологии; ассистент кафедры онкологии</p><p>SPINкод: 7650-2129. Researcher ID (WOS): B-7280-2017. Author ID (Scopus): 57189622130</p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p><p> Россия, 634050, Томск, Московский тракт, 2 </p></bio><bio xml:lang="en"><p> MD, PhD, Senior Researcher, Thoracic Oncology Department; Assistant of Oncology Department</p><p>SPIN-code: 7650-2129. Researcher ID (WOS): B-7280-2017. Author ID (Scopus): 57189622130 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p><p>2, Moskovsky Trakt, 634050, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0714-8927</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Литвяков</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Litvyakov</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> доктор биологических наук, заведующий лабораторией онковирусологии; старший научный сотрудник</p><p>SPIN-код: 2546-0181. Researcher ID (WOS): C-3263-2012. Author-ID (Scopus): 6506850698 </p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p><p> Россия, 634050, г. Томск, пр. Ленина, 36 </p></bio><bio xml:lang="en"><p>DSc, Head of Viral Oncology Laboratory; Senior Researcher</p><p>SPIN-code: 2546-0181. Researcher ID (WOS): C-3263-2012. Author-ID (Scopus): 6506850698 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p><p>36, Lenin Ave., 634050, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5294-778X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попова</surname><given-names>Н. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Popova</surname><given-names>N. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат медицинских наук, старший научный сотрудник отделения химиотерапии</p><p>SPIN-код: 7672-1029. Researcher ID (WOS): I-9417-2017. Author ID (Scopus): 7201879486</p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p></bio><bio xml:lang="en"><p> MD, PhD, Senior Researcher of Chemotherapy Department</p><p>SPIN-code: 7672-1029. Researcher ID (WOS): I-9417-2017. Author ID (Scopus): 7201879486 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7419-4512</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цыганов</surname><given-names>М. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsyganov</surname><given-names>M. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат биологических наук, старший научный сотрудник лаборатории онковирусологии</p><p>SPIN-код: 1253-0240. Researcher ID (WOS): A-7212-2014. Author-ID (Scopus): 55366377400</p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p><p> Россия, 634050, г. Томск, пр. Ленина, 36 </p></bio><bio xml:lang="en"><p>PhD, Senior Researcher, Viral Oncology Laboratory</p><p>SPIN-code: 1253-0240. Researcher ID (WOS): A-7212-2014. Author-ID (Scopus): 55366377400 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p><p>36, Lenin Ave., 634050, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4742-9050</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Левонян</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Levonyan</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-онколог отделения торакальной онкологии, Научно-исследовательский институт онкологии</p><p>SPIN-код: 2084-0085</p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p></bio><bio xml:lang="en"><p>MD, Oncologist, Thoracic Oncology Department</p><p>SPIN-code: 2084-0085 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5365-9840</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Миллер</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Miller</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> доктор медицинских наук, ведущий научный сотрудник отделения торакальной онкологии</p><p>SPIN-код: 6510-9849. Researcher ID (WOS): C-8970-2012. Author-ID (Scopus): 56525429400  </p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p></bio><bio xml:lang="en"><p>MD, DSc, Leading Researcher, Thoracic Oncology Department</p><p>SPIN-code: 6510-9849. Researcher ID (WOS): C-8970-2012. Author-ID (Scopus): 56525429400 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7725-176X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Подолько</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Podolko</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> врач-онколог отделения торакальной онкологии </p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p></bio><bio xml:lang="en"><p> MD, Oncologist, Thoracic Oncology Department </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цыденова</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsydenova</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>лаборант-исследователь лаборатории онковирусологии</p><p>SPIN-код: 2254-6961 </p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p><p> Россия, 634050, г. Томск, пр. Ленина, 36 </p></bio><bio xml:lang="en"><p>Laboratory of Viral Oncology</p><p>SPIN-code: 2254-6961 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p><p>36, Lenin Ave., 634050, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8815-2786</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ибрагимова</surname><given-names>М. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Ibragimova</surname><given-names>M. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p> младший научный сотрудник лаборатории онковирусологии </p><p>SPIN-код: 2340-1628. Researcher ID (WOS): C-8609-2012. Author ID (Scopus): 57130579200</p><p> Россия, 634050, Томск, пер. Кооперативный, 5 </p><p> Россия, 634050, г. Томск, пр. Ленина, 36 </p></bio><bio xml:lang="en"><p>Junior Researcher, Laboratory of Viral Oncology</p><p>SPIN-code: 2340-1628. Researcher ID (WOS): C-8609-2012. Author ID (Scopus): 57130579200 </p><p>5, Kooperativny Street, 634009, Tomsk, Russia</p><p>36, Lenin Ave., 634050, Tomsk, Russia</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy Of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук;&#13;
Сибирский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy Of Sciences;&#13;
Siberian State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук;&#13;
Национальный исследовательский Томский государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy Of Sciences;&#13;
National Research Tomsk State University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>12</day><month>01</month><year>2022</year></pub-date><volume>20</volume><issue>6</issue><fpage>104</fpage><lpage>113</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Маркович В.А., Тузиков С.А., Родионов Е.О., Литвяков Н.В., Попова Н.О., Цыганов М.М., Левонян Л.В., Миллер С.В., Подолько Д.В., Цыденова И.А., Ибрагимова М.К., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Маркович В.А., Тузиков С.А., Родионов Е.О., Литвяков Н.В., Попова Н.О., Цыганов М.М., Левонян Л.В., Миллер С.В., Подолько Д.В., Цыденова И.А., Ибрагимова М.К.</copyright-holder><copyright-holder xml:lang="en">Markovich V.A., Tuzikov S.A., Rodionov E.O., Litvyakov N.V., Popova N.O., Tsyganov M.M., Levonyan L.V., Miller S.V., Podolko D.V., Tsydenova I.A., Ibragimova M.K.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.siboncoj.ru/jour/article/view/1992">https://www.siboncoj.ru/jour/article/view/1992</self-uri><abstract><p>Рак желудка (РЖ) является одним из самых распространенных онкологических заболеваний в мире. У 50–65 % пациентов с РЖ, на момент первичного обращения имеются отдаленные метастазы. Канцероматоз брюшины представляет собой основной и наиболее неблагоприятный вид прогрессирования первичного РЖ, который встречается у 14–43 % пациентов. Цель исследования – освещение современных методов лечения рака желудка с перитонеальным канцероматозом. Материал и методы. Поиск источников был осуществлен в международных системах pubmed, medline, cochrane library, elibrary. В результате литературного поиска первично было получено 136 статей, по изучаемой тематике. В окончательный анализ вошли 46 исследований, соответствующих заданным параметрам. Результаты. Приведен обзор современных методов лечения РЖ с канцероматозом брюшины: cRs – циторедуктивная хирургия, Hipec – сочетание циторедуктивной хирургии и интраоперационной внутрибрюшной гипертермической химиотерапии; неоадъювантная внутрибрюшная химиотерапия (Nips) и pipac – внутрибрюшная аэрозольная химиотерапия под давлением. Проведен анализ результатов крупных рандомизированных исследований и метаанализов, с оценкой их преимуществ и ограничений. Заключение. Индекс перитонеального канцероматоза (pci) и степень циторедукции (ccR), являются двумя ключевыми прогностическими факторами для увеличения медианы общей выживаемости. Уменьшив количество опухолевой массы за счет циторедукции, можно позволить опухолевым клеткам повторно войти в пролиферативную фазу клеточного цикла и, возможно, сделать их более чувствительными к противоопухолевым агентам. Гематоперитонеальный барьер является основной причиной, которая препятствует эффективной доставке лекарств из системного кровотока в брюшную полость, из-за чего влияние системной химиотерапии на перитонеальные метастазы крайне ограничено. Внутрибрюшная химиотерапия предлагает более эффективную и интенсивную региональную терапию, создавая так называемое «депо» химиопрепарата, и тем самым пролонгировать действие вводимых препаратов. Циторедуктивная хирургия в сочетании с гипертермической внутрибрюшной химиотерапией (cRs + Hipec) в качестве комплексной стратегии лечения РЖ с ПК с использованием комбинации хирургической резекции, цитотоксической химиотерапии, гипертермической абляции опухоли и гидродинамической промывки предлагает многообещающие преимущества.</p></abstract><trans-abstract xml:lang="en"><p>Gastric cancer (gc) is one of the most common cancers worldwide. The majority of newly diagnosed gastric cancer cases present with distant metastases. Peritoneal carcinomatosis (pc) is the most unfavorable type of progression of primary gc, which occurs in 14–43 % of patients. The purpose of the study was to highlight modern approaches to the treatment of gc with pc. Material and methods. We analyzed 136 publications available from pubmed, medline, cochrane library, and elibrary databases. The final analysis included 46 studies that met the specified parameters. Results. The modern approaches to the treatment of gc with peritoneal carcinomatosis were reviewed, namely: cytoreductive surgery (crs), combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (crs/hipec); neoadjuvant intraperitoneal/systemic chemotherapy (nips) and pressurized intraperitoneal aerosol chemotherapy (pipac). The results of large randomized trials and meta-analyses were analyzed. Benefits and limitations of these trials were assessed. Conclusion. The peritoneal cancer index (pci) and the level of cytoreduction are two key prognostic factors for increasing the median overall survival. By reducing tumor volume through cytoreductive surgery, it is possible to allow tumor cells to re-enter the proliferative phase of the cell cycle and make them more sensitive to antitumor agents. The hematoperitoneal barrier is the main reason that prevents the effective delivery of drugs from the systemic bloodstream to the abdominal cavity, which is why the effect of systemic chemotherapy on peritoneal metastases is extremely limited. Intraperitoneal chemotherapy offers a more effective and intensive regional therapy, creating a so-called «depot» of a chemotherapy drug, thereby prolonging the effect of the administered drugs. Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (crs + hipec) using the combination of surgical resection, cytotoxic chemotherapy, hyperthermic ablation of the tumor and hydrodynamic flushing, is a promising approach in the treatment of gc with peritoneal carcinomatosis.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>перитонеальный канцероматоз</kwd><kwd>циторедуктивная хирургия</kwd><kwd>гипертермическая интраоперационная внутрибрюшная химиотерапия</kwd><kwd>внутрибрюшная аэрозольная химиотерапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>peritoneal carcinomatosis</kwd><kwd>cytoreductive surgery</kwd><kwd>hyperthermic intraoperative intraperitoneal chemotherapy</kwd><kwd>intraperitoneal aerosol chemotherapy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. 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