oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2022-21-4-147-155oncotomsk-2250Research ArticleОБЗОРЫREVIEWSОсобенности ведения пациентов с первично-множественными злокачественными опухолями в практике современного онколога. Клинический пример и обзор литературыManagement of patients with multiple primary сancer in the practice of a modern oncologist. Case report and literature reviewhttps://orcid.org/0000-0002-9106-5277ХлантаД. А.KhlantaD. A.

Хланта Даяна Арсеновна - ординатор кафедры онкологии и лучевой терапии.

127473, Москва, ул. Делегатская, 20/1.

SPIN-код: 2672-8124.

Daiana A. Khlanta - MD, Resident of the Department of Oncology and Radiation Therapy, A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russia.

20/1, Delegatskaya St., 127473, Moscow.

daianakhlanta@gmail.comhttps://orcid.org/0000-0001-8708-2712ГенсГ. П.GensG. P.

Генс Гелена Петровна, доктор медицинских наук, профессор, заведующая кафедрой онкологии и лучевой терапии.

127473, Москва, ул. Делегатская, 20/1.

SPIN-код: 3867-9491. Author ID (Scopus): 26537295500.

Gelena P. Gens - MD, DSc, Professor, Head of the Department of Oncology and Radiation Therapy, A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russia.

20/1, Delegatskaya St., 127473, Moscow.

Author ID (Scopus): 26537295500.

Московский государственный медико-стоматологический университет им. А.И. Евдокимова Минздрава РоссииРоссияA.I. Evdokimov Moscow State University of Medicine and Dentistry of The Ministry of Health of RussiaRussian Federation202203092022214147155Copyright © Хланта Д.А., Генс Г.П., 20222022Хланта Д.А., Генс Г.П.Khlanta D.A., Gens G.P.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/2250

Цель исследования ‒ рассмотреть наиболее актуальные позиции медицины в отношении первично-множественных злокачественных опухолей (ПМЗО), которые представляют собой феномен туморогенеза и одну из малоизученных категорий в современной клинической онкологии. Увеличение распространенности онкологических заболеваний в популяции, полинеоплазий в частности, а также необходимость принятия непростых решений о дальнейшей тактике лечения усиливают актуальность изучения ПМЗО. В обзоре показаны современные взгляды на данную категорию злокачественных заболеваний, а также представлен клинический пример. Материал и методы. Проведен анализ результатов международных исследований по проблеме первично-множественного рака. Поиск соответствующих источников производился в системах Web of Science, Scopus, Medline, в фокусе нашего внимания были работы 2016–21 гг. Из проанализированных исследований 60 наиболее актуальных и информативных использованы для составления систематического обзора с клиническим примером. Результаты. Своевременный диагностический поиск, совершенствование скрининговых онкологических программ, а также адекватный уровень онкологической настороженности среди врачей первичного звена являются условиями, необходимыми для совершенствования контроля ПМЗО. Психологическая работа с пациентом, усиление его приверженности к терапии и выполнению врачебных рекомендаций относительно сроков наблюдения в период ремиссии и диспансерное наблюдение – неотъемлемые составляющие совершенствования онкологической помощи. Заключение. Всесторонний анализ первично-множественных злокачественных опухолей требует длительного наблюдения за большой популяцией, учета генетических факторов, факторов окружающей среды, воздействия курения и питания, а также коморбидной патологии. Своевременный диагностический поиск, совершенствование скрининговых онкологических программ, а также адекватный уровень онкологической настороженности среди врачей первичного звена являются необходимыми условиями контроля ПМЗО.

The purpose of the study. Multiple primary malignant neoplasms or polyneoplasia are a phenomenon of tumorigenesis and one of the little-studied categories in modern clinical oncology. The increase in the cancer incidence, as well as the need to make difficult decisions about further treatment strategy, enhance the relevance of studying multiple primary malignant neoplasms. This review discusses the current positions of medicine in relation to this category of malignant neoplasms, and presents a case report of a patient with this disaese. Material and methods. We have analyzed the results of international studies on the management of patients with multiple primary cancer. the search for relevant sources was carried out in the Web of Science, Scopus, Medline systems with a chronological interval of 2016–2021. of the analyzed studies, 60 were used to compile a systematic review with a case report. Results. The analysis showed that timely diagnosis and improvement of cancer screening programs are necessary to improve the control of these tumors. Psychological work with a patient, strengthening of his commitment to therapy and the implementation of medical recommendations are integral parts of improving cancer care for patients with such disease. Conclusion. A comprehensive analysis of multiple primary malignant tumors requires long-term follow-up of a large population, taking into account genetic factors, environmental factors, exposure to smoking and nutrition, and comorbid pathology. Timely diagnosis and improvement of cancer screening programs are necessary to improve the control of multiple primary malignant tumors.

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