РОЛЬ ТАРГЕТНОЙ ТЕРАПИИ В КОМПЛЕКСНОМ ЛЕЧЕНИИ БОЛЬНЫХ РАКОМ ПОЧКИ С МЕТАСТАТИЧЕСКИМ ПОРАЖЕНИЕМ ГОЛОВНОГО МОЗГА

Частота метастатического поражения головного мозга (ГМ) у больных раком почки (РП) составляет 2−11 %, постоянно растет и является одной из важных причин неудач в лечении этих пациентов. Хирургическое лечение и лучевая терапия, в том числе радиохирургическое лечение, должны рассматриваться как оптимальные методы лечения больных РП с метастазами в ГМ. Системная лекарственная терапия играет в последние годы все бόльшую роль в лечении пациентов с прогрессированием опухолевого процесса в ГМ. При этом отсутствуют точные фармакокинетические данные о лекарственных препаратах, зарегистрированных для лечения диссеминированного РП, в отношении их концентрации в центральной нервной системе у людей при применении в терапевтических дозах. Исходя из данных литературного обзора и результатов собственных исследований можно сделать заключение, что пока еще ни один из новых таргетных препаратов не показал достоверного преимущества перед другими в лечении больных РП с метастазами в ГМ. Все препараты продемонстрировали способность достигать клинического и рентгенологически подтвержденного объективного эффекта (в большинстве случаев в виде стабилизаций) лечения метастазов в ГМ. Наибольшие данные по эффективности лечения имеются по препаратам сунитиниб и сорафениб. В случае прогрессирования опухолевого процесса в ГМ лекарственное лечение должно обсуждаться в каждой ситуации индивидуально, в соответствии со стандартными подходами в лечении больных диссеминированным РП.

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