oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2024-23-1-142-154oncotomsk-2958Research ArticleОБЗОРЫREVIEWSПовторная лучевая терапия на фоне приема бевацизумаба в лечении рецидивов глиобластомыRe-irradiation combined with bevacizumab in the treatment of glioblastoma recurrencehttps://orcid.org/0009-0002-1324-5966БелоконьС. В.BelokonS. V.

Белоконь Сергей Валерьевич - клинический ординатор.

249031, Обнинск, ул. Маршала Жукова, 10

Researcher ID (WOS): JTD-2612-2023

Sergey V. Belokon - clinical resident, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russia.

10, Marshala Zhukova St., Obninsk, 249031

Researcher ID (WOS): JTD-2612-2023

https://orcid.org/0000-0002-2759-297XГулидовИ. А.GulidovI. A.

Гулидов Игорь Александрович - доктор медицинских наук, профессор, заслуженный деятель науки России, заведующий отделом лучевой терапии.

249031, Обнинск, ул. Маршала Жукова, 10

Researcher ID (WOS): P-6870-2018; Author ID (Scopus): 6603150052

Igor A. Gulidov - MD, Professor, Honored Scientist of Russia, Head of the Department of Radiation Therapy, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russia.

10, Marshala Zhukova St., Obninsk, 249031

Researcher ID (WOS): P-6870-2018; Author ID (Scopus): 6603150052

https://orcid.org/0000-0001-5572-993XГоголинД. В.GogolinD. V.

Гоголин Данил Вячеславович - кандидат медицинских наук, старший научный сотрудник отделения протонной и фотонной терапии.

249031, Обнинск, ул. Маршала Жукова, 10

Researcher ID (WOS): O-2381-2017; Author ID (Scopus): 57193123523

Danil V. Gogolin - MD, PhD, Senior Researcher, Proton and Photon Therapy Department, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russia.

10, Marshala Zhukova St., Obninsk, 249031,

Researcher ID (WOS): O-2381-2017; Author ID (Scopus): 57193123523

dgogolin@yandex.ruhttps://orcid.org/0000-0001-6844-3076МедведеваК. Е.MedvedevaK. E.

Медведева Кира Евгеньевна - младший научный сотрудник отделения протонной и фотонной терапии.

249031, Обнинск, ул. Маршала Жукова, 10

Researcher ID (WOS): ABG-5071-2020; Author ID (Scopus): 57209497853

Kira E. Medvedeva - Junior Researcher, Department of Proton and Photon Therapy, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russia.

10, Marshala Zhukova St., Obninsk, 249031,

Researcher ID (WOS): ABG-5071-2020; Author ID (Scopus): 57209497853

https://orcid.org/0000-0001-7689-6032ИвановС. А.IvanovS. A.

Иванов Сергей Анатольевич - доктор медицинских наук, член-корреспондент PAH, директор, Медицинский радиологический научный центр им. А.Ф. Цыба – филиал ФГБУ «НМИЦ радиологии» Минздрава России; профессор кафедры онкологии и рентгенорадиологии им. В.П. Харченко медицинского института, ФГАОУ ВО «РУДН».

249031, Обнинск, ул. Маршала Жукова, 10; 117198, Москва, ул. Миклухо-Маклая, 6

Researcher ID (WOS): N-8221-2017; Author ID (Scopus): 16070399200

Sergey A. Ivanov - MD, DSc, Corresponding Member of the Russian Academy of Sciences, Director, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russia; Professor of Chair of Oncology and Radiology named after Kharchenko, RUDN University.

10, Marshala Zhukova St., Obninsk, 249031; 6, Miklukho-Maklaya St., Moscow, 117198

Author ID (Scopus): 16070399200

https://orcid.org/0000-0001-8784-8415КапринА. Д.KaprinA. D.

Каприн Андрей Дмитриевич - доктор медицинских наук, профессор, академик РАН и РАО, заведующий кафедрой онкологии и рентгенорадиологии им. В.П. Харченко, ФГАОУ ВО «РУДН»; директор, МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России; генеральный директор, ФГБУ «НМИЦ радиологии» Минздрава России.

117198, Москва, ул. Миклухо-Маклая, 6; 249036, Обнинск, ул. Королева, 4; 2-й Боткинский пр-д, 3, Москва, 125284

Author ID (Scopus): 6602709853; Researcher ID (WOS): K-1445-2014

Andrej D. Kaprin - MD, Professor, Academician of the Russian Academy of Sciences, Head of Chair of Oncology and Radiology named after Kharchenko, RUDN University; Director, P.A. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russia; Director General, National Medical Research Radiological Centre of the Ministry of Health of the Russia.

6, Miklukho-Maklaya St., Moscow, 117198; 4, Koroleva St., Obninsk, 249036; 3, 2nd Botkinsky drive, Moscow, 125284

Author ID (Scopus): 6602709853; Researcher ID (WOS): K-1445-2014

Медицинский радиологический научный центр им. А.Ф. Цыба – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииРоссияA. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the RussiaRussian FederationМедицинский радиологический научный центр им. А.Ф. Цыба – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России; ФГАОУ ВО «Российский университет дружбы народов» РоссияРоссияA. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russia; RUdN UniversityRussian FederationФГАОУ ВО «Российский университет дружбы народов»; ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России; Московский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииРоссияRUdN University; National Medical Research Radiological Centre of the Ministry of Health of the Russia; P.A. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre of the Ministry of Health of the RussiaRussian Federation202421032024231142154Copyright © Белоконь С.В., Гулидов И.А., Гоголин Д.В., Медведева К.Е., Иванов С.А., Каприн А.Д., 20242024Белоконь С.В., Гулидов И.А., Гоголин Д.В., Медведева К.Е., Иванов С.А., Каприн А.Д.Belokon S.V., Gulidov I.A., Gogolin D.V., Medvedeva K.E., Ivanov S.A., Kaprin A.D.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/2958

Введение. Глиобластома остается заболеванием с плохим прогнозом. Ввиду высокой агрессивности опухоли, несмотря на комплексный подход к лечению заболевания, практически неизбежен рецидив. До сих пор не существует единого стандарта лечения рецидивов глиобластомы, многие руководства рекомендуют ведение данных пациентов в рамках клинических исследований. Имеется множество подходов, таких как хирургическое вмешательство, лучевая терапия, системная или локальная химиотерапия или лечение таргетными препаратами, различные стратегии иммунотерапии, применение низкоинтенсивных среднечастотных электрических полей, а также их комбинации. Сочетание двух неинвазивных методик: повторной лучевой терапии и таргетной терапии бевацизумабом, остается наиболее часто применяемым подходом у данной группы пациентов, потенциал которого до конца не раскрыт. Цель исследования – анализ литературных данных по использованию повторной лучевой терапии с бевацизумабом в качестве лечебной опции у пациентов с глиобластомой. Материал и методы. Поиск литературы производился в системах Medline, Cochrane Library, E-library, Scopus, PubMed и Google Scholar. Результаты. Определено текущее состояние проблемы, проанализированы данные по повторной лучевой терапии с конкурентным и/или адъювантным приемом бевацизумаба при лечении редицидивов глиобластомы, сопоставлены различные режимы их применения, описаны перспективы и возможные пути решения проблем данной терапевтической опции. Заключение. Повторная лучевая терапия с сопутствующим приемом бевацизумаба может обеспечить более безопасное лечение рецидивов глиобластомы, в том числе большого объема, с приемлемыми показателями токсичности, в частности радиационного некроза, особенно при использовании соответствующего графика фракционирования.

Background. Glioblastoma (GB) remains an aggressive disease with a poor prognosis. despite a comprehensive approach to the treatment of the primary disease, recurrence is almost inevitable. There is still no standard of care for GB recurrence, and many guidelines recommend treating these patients within clinical trials. There are various treatment options available. They include surgery, radiation therapy, systemic or regional chemotherapy or targeted therapy, various immunotherapy strategies, low- and medium-frequency electric fields, and their combinations. The combination of two non-invasive techniques: re-irradiation and systemic targeted therapy remains the most commonly used approach in this group of patients, the potential of which has not been fully realized. The aim of the study was to analyze the literature data on the use of the combination of re-irradiation with bevacizumab as a therapeutic option in patients with GB. Material and Methods. Literature search was performed using Medline, Cochrane Library, E-library, Scopus, PubMed and Google Scholar databases. Results. The current state of the problem was determined, the data available to date on the use of repeated radiotherapy with competitive and/or adjuvant bevacizumab in the treatment of GB recurrence were summarized and analyzed, different regimens of this approach were compared, and the prospects and possible ways of solving the existing problems of this therapeutic option were described. Conclusion. Re-irradiation with concomitant administration of bevacizumab may provide safer treatment of GB recurrence, including large-volume glioblastoma, with acceptable toxicity, in particular radiation necrosis, especially when an appropriate fractionation schedule is used.

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