Саркома Юинга: диагностика, комбинированная терапия. Обзор литературы

Цель исследования – систематизировать опубликованные сведения по современной диагностике и лечению больных саркомой Юинга (СЮ). 
Материал и методы. Поиск материала для обзора проводился по библиотекам Medline, Web of science и РиНЦ. Для анализа выбрано 352 источника, опубликованных в 2004–2024 гг. Обзор составлен по данным 67 публикаций. 
Результаты. Несмотря на совершенствование хирургической техники и технологий лучевой терапии, существенного улучшения результатов комбинированного лечения больных СЮ удалось добиться при внедрении химиотерапии. Эффективные многокомпонентные схемы химиотерапии, разработанные еще в 1960–1970-х гг., вплоть до настоящего времени не утратили своего значения в качестве индукционной терапии больных СЮ. Большое внимание уделяется проблеме лечения больных с рецидивами СЮ и рефрактерным заболеванием, плохо поддающихся химиотерапии. В настоящее время в процессе выполнения находятся исследования, в которых изучается целесообразность сочетания цитостатиков с ингибиторами тирозинкиназ, ингибиторами репарации ДНК, ингибиторами других молекул, с аутологичными вакцинами. имеющиеся данные относительно результативности высокодозной химиотерапии с поддержкой аутотрансплантации, CaR-t клеточной терапии противоречивы. Препятствием для относительно быстрого получения результатов этих работ является малое количество больных, что диктует необходимость многоцентрового набора пациентов. Кроме того, свой отпечаток накладывают повышенные требования государственных регуляторных органов, обусловленные детским и юношеским возрастом большой части пациентов. 
Заключение. Несмотря на значительные успехи, достигнутые в лечении первичной локализованной саркомы Юинга, результаты лечения метастатического заболевания и рецидивов далеки от удовлетворительных. В то время как возможности цитостатической терапии, по-видимому, исчерпаны, препараты молекулярного действия все еще не получили убедительных доказательств их клинической значимости. Тем не менее достижений в лечении следует ожидать от препаратов, воздействующих на основные звенья онкогенеза СЮ.

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