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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">10.21294/1814-4861-2023-22-1-24-34</article-id><article-id custom-type="elpub" pub-id-type="custom">oncotomsk-2424</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>КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Комбинированное лечение больных раком желудка IV стадии с канцероматозом брюшины</article-title><trans-title-group xml:lang="en"><trans-title>Combined modality treatment of patients with stage IV gastric cancer with peritoneal carcinomatosis</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>Маркович Виталий Александрович, младший научный сотрудник отделения торакальной онкологии, Научно-исследовательский институт онкологии</p><p>634009, г. Томск, пер. Кооперативный, 5</p><p>SPIN-код: 2954-8330</p></bio><bio xml:lang="en"><p>Vitaliy A. Markovich, MD, Junior Researcher, Department of Thoracic Oncology</p><p>5, Kooperativny St., 634009, Tomsk</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>Тузиков Сергей Александрович, доктор медицинских наук, профессор, Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук; профессор кафедры онкологии, ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России</p><p>634009, г. Томск, пер. Кооперативный, 5,</p><p>634050, г. Томск, Московский тракт, 2</p><p>SPIN-код: 56626431,</p><p>Researcher ID (WOS): D-1176-2012,</p><p>Author ID (Scopus): 6507842873</p></bio><bio xml:lang="en"><p>Sergey A. Tuzikov, MD, Professor, Tomsk National Research Medical Center Russian Academy of Sciences; Professor of the Department of Oncology, Siberian State Medical University</p><p>5, Kooperativny St., 634009, Tomsk,</p><p>2, Moskovsky tract, 634050, Tomsk</p><p>Researcher ID (WOS): D-1176-2012,</p><p>Author ID (Scopus): 6507842873</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>Родионов Евгений Олегович, кандидат медицинских наук, старший научный сотрудник отделения торакальной онкологии, Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук; ассистент кафедры онкологии, ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России</p><p>634009, г. Томск, пер. Кооперативный, 5,</p><p>634050, г. Томск, Московский тракт, 2</p><p>SPIN-код: 7650-2129,</p><p>Researcher (WOS): B-7280-2017,</p><p>Author ID (Scopus): 57189622130</p></bio><bio xml:lang="en"><p>Evgeniy O. Rodionov, MD, PhD, Senior Researcher, Department of Thoracic Oncology, Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences; Assistant, Department of Oncology, Siberian State Medical University</p><p>5, Kooperativny St., 634009, Tomsk,</p><p>2, Moskovsky tract, 634050, Tomsk</p><p>Researcher (WOS): B-7280-2017,</p><p>Author ID (Scopus): 57189622130</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/0000-0001-5294-778X</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>Попова Наталья Олеговна, кандидат медицинских наук, старший научный сотрудник отделения химиотерапии</p><p>634009, г. Томск, пер. Кооперативный, 5</p><p>SPIN-код: 7672-1029,</p><p>Researcher ID (WOS): I-9417-2017,</p><p>Author ID (Scopus): 7201879486</p></bio><bio xml:lang="en"><p>Natalia O. Popova, MD, PhD, Senior Researcher, Department of Chemotherapy</p><p>5, Kooperativny St., 634009, Tomsk</p><p>Researcher ID (WOS): I-9417-2017,</p><p>Author ID (Scopus): 7201879486</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>Цыганов Матвей Михайлович, кандидат биологических наук, старший научный сотрудник лаборатории онковирусологии</p><p>634009, г. Томск, пер. Кооперативный, 5</p><p>SPIN-код: 1253-0240,</p><p>Researcher ID (WOS): A-7212-2014,</p><p>Author ID (Scopus): 55366377400</p></bio><bio xml:lang="en"><p>Matvey M. Tsyganov, PhD, Senior Researcher, Viral Oncology Laboratory</p><p>5, Kooperativny St., 634009, Tomsk</p><p>Researcher ID (WOS): A-7212-2014,</p><p>Author ID (Scopus): 55366377400</p><p> </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>Миллер Сергей Викторович, доктор медицинских наук, исполняющий обязанности заведующего отделением торакальной онкологии</p><p>634009, г. Томск, пер. Кооперативный, 5</p><p>SPIN-код: 6510-9849,</p><p>Researcher ID (WOS): C-8970-2012,</p><p>Author ID (Scopus): 56525429400</p></bio><bio xml:lang="en"><p>Sergey V. Miller, MD, DSc, Head of Department of Thoracic Oncology</p><p>5, Kooperativny St., 634009, Tomsk</p><p>Researcher ID (WOS): C-8970-2012,</p><p>Author ID (Scopus): 56525429400</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>Подолько Данил Владиславович, врач-онколог отделения торакальной онкологии</p><p>634009, г. Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Danil V. Podolko, MD, Oncologist, Department of Thoracic Oncology</p><p>5, Kooperativny St., 634009, Tomsk</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>Цыденова Ирина Александровна, младший научный сотрудник лаборатории онковирусологии, Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук; аспирант Биологического института, ФГАОУ ВО «Национальный исследовательский Томский государственный университет» </p><p>634009, г. Томск, пер. Кооперативный, 5,</p><p>634050, г. Томск, ул. Ленина, 36</p><p>SPIN-код: 2254-6961</p></bio><bio xml:lang="en"><p>Irina A. Tsydenova, Junior Researcher, Viral Oncology Laboratory, Cancer Research Institute, Tomsk National Medical Research Center of the Russian Academy of Sciences; Postgraduate, Biological Institute, National Research Tomsk State University</p><p>5, Kooperativny St., 634009, Tomsk,</p><p>36, Lenina St., 634050, Tomsk</p><p> </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>Ибрагимова Марина Константиновна, младший научный сотрудник лаборатории онковирусологии, Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук; доцент кафедры зоологии позвоночных и экологии Биологического института, ФГАОУ ВО «Национальный исследовательский Томский государственный университет»</p><p>634009, г. Томск, пер. Кооперативный, 5,</p><p>634050, г. Томск, ул. Ленина, 36</p><p>SPIN-код: 2340-1628,</p><p>Researcher ID (WOS): C-8609-2012,</p><p>Author ID (Scopus): 57130579200</p></bio><bio xml:lang="en"><p>Marina K. Ibragimova, Junior Researcher, Viral Oncology Laboratory, Cancer Research Institute, Tomsk National Medical Research Center of the Russian Academy of Sciences; Associate Professor, Department of Vertebrate Zoology and Ecology, Institute of Biology, National Research Tomsk State University</p><p>5, Kooperativny St., 634009, Tomsk,</p><p>36, Lenina St., 634050, Tomsk</p><p>Researcher ID (WOS): C-8609-2012,</p><p>Author ID (Scopus): 57130579200</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/0000-0002-0714-8927</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>Litviakov</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Литвяков Николай Васильевич, доктор биологических наук, заведующий лабораторией онковирусологии, Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук; старший научный сотрудник, ФГАОУ ВО «Национальный исследовательский Томский государственный университет»</p><p>634009, г. Томск, пер. Кооперативный, 5,</p><p>634050, г. Томск, ул. Ленина, 36</p><p>SPIN-код: 2546-0181,</p><p>Researcher (WOS): C-3263-2012,</p><p>Author ID (Scopus): 6506850698</p></bio><bio xml:lang="en"><p>Nikolay V. Litviakov, DSc, Head of Viral Oncology Laboratory, Cancer Research Institute, Tomsk National Medical Center of Russia Academy of Sciences; Senior Researcher, National Research Tomsk State University</p><p>5, Kooperativny St., 634009, Tomsk,</p><p>36, Lenina St., 634050, Tomsk</p><p>Researcher (WOS): C-3263-2012,</p><p>Author ID (Scopus): 6506850698</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, Тomsk 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;
ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cancer Research Institute, Тomsk National Research Medical Center, Russian Academy of Sciences;&#13;
Siberian State Medical University of the Ministry of Health of Russia</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;
ФГАОУ ВО «Национальный исследовательский Томский государственный университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cancer Research Institute, Тomsk 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>2023</year></pub-date><pub-date pub-type="epub"><day>21</day><month>02</month><year>2023</year></pub-date><volume>22</volume><issue>1</issue><fpage>24</fpage><lpage>34</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Маркович В.А., Тузиков С.А., Родионов Е.О., Попова Н.О., Цыганов М.М., Миллер С.В., Подолько Д.В., Цыденова И.А., Ибрагимова М.К., Литвяков Н.В., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Маркович В.А., Тузиков С.А., Родионов Е.О., Попова Н.О., Цыганов М.М., Миллер С.В., Подолько Д.В., Цыденова И.А., Ибрагимова М.К., Литвяков Н.В.</copyright-holder><copyright-holder xml:lang="en">Markovich V.A., Tuzikov S.A., Rodionov E.O., Popova N.O., Tsyganov M.M., Miller S.V., Podolko D.V., Tsydenova I.A., Ibragimova M.K., Litviakov N.V.</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/2424">https://www.siboncoj.ru/jour/article/view/2424</self-uri><abstract><p>Перитонеальный канцероматоз – крайне неблагоприятный вариант прогрессирования рака желудка (РЖ). Рак желудка IV стадии выявляется у 39,8 % первичных пациентов, локальный канцероматоз без других отдаленных метастазов встречается в 18–20 % случаев от общей доли РЖ IV стадии.</p><p>Цель исследования – оценить эффективность персонализированного назначения химиотерапии в комбинированном лечении больных раком желудка IV стадии с перитонеальным канцероматозом.</p><sec><title>Материал и методы</title><p>Материал и методы. Циторедуктивные операции проведены 70 больным РЖ с перитонеальной диссеминацией. В контрольной группе (n=35) проводилась послеоперационная химиотерапия по схеме FOLFOX. В основной группе (n=35) персонифицированная системная и интраперитонеальная химиотерапия назначалась на основании экспрессии генов химиочувствительности и резистентности.</p></sec><sec><title>Результаты</title><p>Результаты. В основной группе достигнута медиана общей выживаемости 18,7 мес, что выше, чем в группе контроля и в исследованиях, представленных в мировой литературе (CRS + HIPEC). В основной группе за счет персонифицированного подбора режима химиотерапии удалось увеличить медиану времени без прогрессирования (ВБП) на 4,6 мес (29,1 %) и медиану общей выживаемости (ОВ) – на 6 мес (32 %); однолетняя выживаемость достигнута у 35 (100 %), 2-летняя – у 9 (27 %), 3-летняя – у 1 (3 %) пациента.</p></sec><sec><title>Заключение</title><p>Заключение. Разработанный метод лечения рака желудка с перитонеальной диссеминацией позволяет улучшить отдалённые результаты комбинированного лечения за счет увеличения медианы ВБП и ОВ.</p></sec></abstract><trans-abstract xml:lang="en"><p>Peritoneal carcinomatosis is associated with poor prognosis in gastric cancer patients. Stage IV gastric cancer (GC) is diagnosed in 39.8 % of patients; local metastases without evidence of distant metastases occur only in 18–20 % of stage IV gastric cancer patients.</p><p>The purpose of the study was to estimate the efficacy of personalized chemotherapy in the combined modality treatment of patients with stage IV GC with peritoneal carcinomatosis.</p><sec><title>Material and Methods</title><p>Material and Methods. Cytoreductive surgery was performed in 70 patients with GC with peritoneal dissemination. The control group patients (n=35) received postoperative chemotherapy with the FOLFOX regimen. The study group patients (n=35) received personalized systemic and intraperitoneal chemotherapy based on the expression of chemosensitivity and resistance genes.</p></sec><sec><title>Results</title><p>Results. The median survival time (18.7 months) in the study group patients was higher than that in the control group and in studies described in the world literature (CRS + HIPEC). Personalized chemotherapy improved median progressionfree survival (PFS) by 4.6 months (29.1 %) and median overall survival (OS) by 6 months (32 %) compared to FOLFOX regimen chemotherapy. In the study group, the 1-, 2and 3-year survival rates were observed in 35 (100 %), 9 (27 %) and 1 (3 %) patients, respectively.</p></sec><sec><title>Conclusion</title><p>Conclusion. Personalized chemotherapy in the combined modality treatment can improve long-term treatment outcomes (longer median PFS and OS) in GC patients with peritoneal dissemination.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>рак желудка</kwd><kwd>перитонеальный канцероматоз</kwd><kwd>циторедуктивная хирургия</kwd><kwd>персонифицированная системная и интраперитонеальная химиотерапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>gastric cancer</kwd><kwd>peritoneal carcinomatosis</kwd><kwd>cytoreductive surgery</kwd><kwd>personalized systemic and intraperitoneal 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. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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