Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press81510.17650/2222-1468-2022-12-3-53-70DIAGNOSIS AND TREATMENT OF HEAD AND NECK TUMORSДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ ГОЛОВЫ И ШЕИRadiotherapy for cutaneous squamous cell carcinoma: current standards and outlooksЛучевая терапия плоскоклеточного рака кожи: современные стандарты и дальнейшие перспективыhttps://orcid.org/0000-0002-9181-7811GevorkovA. R.ГеворковА. Р.
Russian Federation

32nd Botkinsky proezd, Moscow 125284

Артем Рубенович Геворков 

125284 Москва,  2-й Боткинский пр-д, 3

dr.gevorkov@gmail.comhttps://orcid.org/0000-0003-1766-0059BoykoA. V.БойкоА. В.
Russian Federation

32nd Botkinsky proezd, Moscow 125284

125284 Москва,  2-й Боткинский пр-д, 3

https://orcid.org/0000-0003-2095-5931PolyakovA. P.ПоляковА. П.
Russian Federation

32nd Botkinsky proezd, Moscow 125284

125284 Москва,  2-й Боткинский пр-д, 3

https://orcid.org/0000-0003-1685-2729ChernichenkoA. V.ЧерниченкоА. В.
Russian Federation

32nd Botkinsky proezd, Moscow 125284

125284 Москва,  2-й Боткинский пр-д, 3

https://orcid.org/0000-0003-3443-7633GerasimovV. A.ГерасимовВ. А.
Russian Federation

32nd Botkinsky proezd, Moscow 125284

М

https://orcid.org/0000-0003-4091-2859MeshcheryakovaI. A.МещеряковаИ. А.
Russian Federation

32nd Botkinsky proezd, Moscow 125284

125284 Москва,  2-й Боткинский пр-д, 3

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

32nd Botkinsky proezd, Moscow 125284

4 Koroleva St., Obninsk 249036

6 Miklukho-Maklaya St., Moscow 117198

125284 Москва,  2-й Боткинский пр-д, 3

249036 Обнинск,  ул. Королева, 4

117198 Москва, ул. Миклухо-Маклая, 6

P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of RussiaМосковский научно-исследовательский онкологический институт им. П. А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииNational Medical Research Center of Radiology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииРeoples’ Friendship University of RussiaФГАОУ ВО «Российский университет дружбы народов»1410202212353701312202213122022Copyright ©; 2022, Gevorkov A.R., Boyko A.V., Polyakov A.P., Chernichenko A.V., Gerasimov V.A., Meshcheryakova I.A., Kaprin A.D.Copyright ©; 2022, Геворков А.Р., Бойко А.В., Поляков А.П., Черниченко А.В., Герасимов В.А., Мещерякова И.А., Каприн А.Д.2022Gevorkov A.R., Boyko A.V., Polyakov A.P., Chernichenko A.V., Gerasimov V.A., Meshcheryakova I.A., Kaprin A.D.Геворков А.Р., Бойко А.В., Поляков А.П., Черниченко А.В., Герасимов В.А., Мещерякова И.А., Каприн А.Д.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/815

Cutaneous squamous cell carcinoma accounts for 20 % of all malignant non-melanoma skin tumors, which is one of the most common cancers worldwide. Antitumor treatment is usually very effective: cure rate reaches 90 %, while local recurrence rate is 25 %. The main treatment option for primary skin cancers is surgery. The most significant risk factors for locoregional recurrence include tumor location (head and neck), size (>2 cm), depth of invasion (>4 mm), tumor differentiation grade, perineural invasion, immune system disorders (immunosuppression), severe concomitant diseases, and previous treatment.

In patients with advanced cutaneous squamous cell carcinoma, 1-year, 2-year, and 3-year survival rates are 50–80, 30–35 and 15–16 %, respectively. Radiotherapy is a radical treatment option that increases the 5-year survival rate to 90 % and ensures good cosmetic results in 80 % of cases. There are 3 main variants of radiotherapy for cutaneous squamous cell carcinoma: sole radiotherapy according to a radical program, adjuvant radiotherapy in combination with surgery, and palliative radiotherapy. most frequently, radiotherapy is used as part of adjuvant postoperative treatment and is not initially considered as a sole conservative treatment for cutaneous squamous cell carcinoma patients below 45 years of age with resectable tumors, especially high-risk tumors. palliative radiotherapy is an affordable and effective method for combating painful symptoms; moreover, it often provides long-term local control. 

Плоскоклеточный рак кожи составляет 20 % всех злокачественных немеланомных новообразований кожи, являющихся одними из самых распространенных онкологических заболеваний в мире. противоопухолевое лечение, как правило, достаточно эффективно. частота излечения достигает 90 %, а общая частота локальных рецидивов – 25 %. Основным методом лечения первичных злокачественных новообразований кожи является хирургическое вмешательство. К ключевым факторам риска локорегионарного рецидива относятся локализация (область головы и шеи), размер (диаметр >2 см), глубина инвазии (>4 мм), дифференцировка опухоли, периневральное поражение, нарушение иммунного статуса пациента (иммуносупрессия), выраженная сопутствующая патология и предыдущее лечение. при лечении больных с запущенными формами плоскоклеточного рака кожи показатели 1-, 2- и 3-летней общей выживаемости составляют 50–80, 30–35 и 15–16 % соответственно. лучевая терапия относится к радикальным вариантам лечения данной патологии и обеспечивает 5-летние показатели выживаемости на уровне 90 %, а также хорошие косметические результаты в 80 % случаев. существуют 3 основных направления применения этого вида лечения плоскоклеточного рака кожи: самостоятельное по радикальной программе, адъювантное в комбинации с оперативным вмешательством и паллиативная лучевая терапия. чаще всего лучевая терапия используется в рамках адъювантного послеоперационного лечения и изначально не рассматривается в качестве самостоятельного консервативного лечения пациентов с плоскоклеточным раком кожи моложе 45 лет и при резектабельности опухоли, особенно высокого риска. самостоятельная лучевая терапия проводится при неоперабельности пациентов, нерезектабельности опухоли, функционально или косметически неудовлетворительных потенциальных результатах хирургического вмешательства, а также при отказе от операции. паллиативная лучевая терапия является доступным, хорошо зарекомендовавшим себя методом борьбы с тягостной симптоматикой и нередко обеспечивает длительный локальный контроль над опухолью.

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