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Российский журнал гастроэнтерологии, гепатологии, колопроктологии

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Гепатотоксичность химиотерапии колоректального рака: современное состояние проблемы

Аннотация

Цель обзора. Проанализировать современное состояние проблемы хирургического лечения больных после неоадъювантной химиотерапии.
Основные положения. Печень – первый орган на пути гематогенного распространения опухоли. В настоящее время большинством онкологов принят тезис, что единственным лечением, определяющим высокие цифры выживаемости, является хирургическое. В последнее десятилетие все большее число больных оперируется после длительной химиотерапии. Учитывая системное воздействие цитостатиков, их выраженный иммуносупрессивный и гепатотоксичный характер, можно было ожидать резкого ухудшения показателя послеоперационной заболеваемости и летальности. Однако данные большинства исследований опровергают это предположение. Более того, изменения паренхимы печени и, как следствие, течение периоперационного периода может зависеть от состава и режима химиотерапии.
Заключение. Знание спектра гепатотоксичности цитостатиков вместе с пониманием процессов, ответственных за функциональную и регенераторную способность печени, позволит выбирать оптимальную тактику комбинированного лечения больных с метастазами колоректального рака.

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Рецензия

Для цитирования:

Полищук Л.О., Козмин Л.Д., Строяковский Д.Л., Доровской Е.С., Скипенко О.Г. Гепатотоксичность химиотерапии колоректального рака: современное состояние проблемы. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2009;19(5):10-19.

For citation:

Polishchuk L.O., Kozmin L.D., Stroyakovsky D.L., Dorovskoy Ye.S., Skipenko O.G. Hepatotoxic chemotherapy of colorectal cancer: state-of-the-art. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2009;19(5):10-19. (In Russ.)

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