urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.25.3.7DMHWIHurmj-2227Research ArticleОригинальные статьи | Original articlesOriginal articlesПрименение фотодинамической терапии с фотосенсибилизатором «Радахлорин» на этапе хирургического лечения в комплексной терапии пациентов с нефробластомойThe Use of Photodynamic Therapy with the Photosensitizer Radachlorin at the Stage of Surgical Treatment in the Complex Therapy of Patients with Nephroblastomahttps://orcid.org/0000-0002-2823-8286РостовцевН. М.RostovtsevN. M.

Николай Михайлович Ростовцев — кандидат медицинских наук, заместитель главного врача по хирургии, Челябинская областная детская клиническая больница, Челябинск, Россия; доцент кафедры общей и детской хирургии, Южно-Уральский государственный медицинский университет 

Челябинск 

Nikolay M. Rostovtsev — Candidate of Sciences (Medicine), Deputy Chief Physician for Surgery, Chelyabinsk Regional Children’s Clinical Hospital; Associate Professor of the Department of General and Pediatric Surgery, South Ural State Medical University 

Chelyabinsk 

rostovcevnm@mail.ruhttps://orcid.org/0000-0002-8096-0874ПоляковВ. Г.PolyakovV. G.

Владимир Георгиевич Поляков — доктор медицинских наук, профессор, академик Российской академии наук, советник директора научно-исследовательского института детской онкологии и гематологии 

Москва 

Vladimir G. Polyakov — Doctor of Sciences (Medicine), Professor, Full Member (Academician) of the Rus‑ sian Academy of Sciences, Advisor to the Director of the Research Institute of Children’s Oncology and Hematology 

Moscow 

vgp04@mail.ruhttps://orcid.org/0009-0002-5915-0196КузьминаН. Е.KuzminaN. E.

Наталья Евгеньевна Кузьмина  — кандидат медицинских наук, врач-рентгенолог, Челябинская областная детская клиническая больница; ассистент кафедры онкологии, лучевой диагностики и лучевой терапии, Южно-Уральский государственный медицинский университет 

Челябинск 

Natalya E. Kuzmina — Candidate of Sciences (Medicine), Radiologist, Chelyabinsk Regional Children’s Clinical Hospital; Assistant of the Department of Oncology, Radiation Diagnostics and Radiation Therapy, South Ural State Medical University

Chelyabinsk 

knatalya@inbox.ruНеизвестныхЕ. А.NeizvestnykhE. A.

Елена Анатольевна Неизвестных — кандидат медицинских наук, доцент кафедры общей и детской хирургии 

 

Elena A. Neizvestnykh — Candidate of Sciences (Medicine), Associate Professor of the Department of Gen‑ eral and Pediatric Surgery

Chelyabinsk 

cheldethi@mail.ruКузьминаА. В.KuzminaA. V.

Анастасия Владимировна Кузьмина — студент стоматологического факультета 

Челябинск 

Anastasiya V. Kuzmina — Specialist’s Degree Student of the Faculty of Dentistry 

Chelyabinsk 

nastyakuzmina11@mail.ruМинкоМ. А.MinkoM. A.

Максим Александрович Минко — студент стоматологического факультета 

Челябинск 

Maksim A. Minko — Specialist’s Degree Student of the Faculty of Dentistry 

Chelyabinsk 

minko_max@mail.ruЧелябинская областная детская клиническая больница; Южно‑Уральский государственный медицинский университетРоссияChelyabinsk Regional Children’s Clinical Hospital; South Ural State Medical UniversityRussian FederationНациональный медицинский исследовательский центр онкологии имени Н. Н. БлохинаРоссияN. N. Blokhin National Medical Research Center of OncologyRussian FederationЮжно‑Уральский государственный медицинский университетРоссияSouth Ural State Medical UniversityRussian Federation2026020720262537–22Copyright © Ростовцев Н.М., Поляков В.Г., Кузьмина Н.Е., Неизвестных Е.А., Кузьмина А.В., Минко М.А., 20262026Ростовцев Н.М., Поляков В.Г., Кузьмина Н.Е., Неизвестных Е.А., Кузьмина А.В., Минко М.А.Rostovtsev N.M., Polyakov V.G., Kuzmina N.E., Neizvestnykh E.A., Kuzmina A.V., Minko M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/2227Введение

Введение. Злокачественные новообразования у детей относятся к категории социально значимой патологии в связи с высоким уровнем инвалидизации и смертности. Основным путем прогрессирования опухоли остается местный рецидив, субстратом которого является наличие резидуальной опухолевой ткани, определяемой микроскопически в зоне резекции (продолженный рост опухоли), что требует высокого уровня абластики оперативных вмешательств. Применение дополнительного воздействия на остаточную опухолевую ткань с использованием новых хирургических технологий способствует повышению радикальности оперативных вмешательств у пациентов с забрюшинными опухолями.

Цель исследования — оценить эффективность применения разработанной методики интраоперационной фотодинамической терапии (ФДТ) на этапе хирургического лечения детей с нефробластомой.

Материалы и методы

Материалы и методы. В исследуемую группу включено 66 пациентов с нефробластомой, из них 35 мальчиков и 31 девочка. Пациентам контрольной группы (n = 35) проведено хирургическое лечение в комплексе с химиотерапией и лучевой терапией по протоколу SIOP. Пациенты основной группы (n = 31) получили терапию по протоколу SIOP в комбинации с ФДТ. Комбинация оперативного лечения с интраоперационной ФДТ применена для повышения радикальности оперативных вмешательств и снижения количества местных рецидивов.

Результаты

Результаты. В группе пациентов, получивших ФДТ в дополнение к основной терапии, количество летальных случаев на протяжении 5-летнего периода наблюдения было ниже, а общая выживаемость, соответственно, выше — 90,3 % против 71,4 % (p = 0,050).

Заключение

Заключение. Предложенная методика интраоперационной ФДТ в рамках комплексного лечения забрюшинных опухолей приводит к лучшим результатам, повышая общую 5-летнюю выживаемость пациентов. ФДТ является перспективной противоопухолевой стратегией, технически осуществимой, и может успешно применяться в комплексной терапии забрюшинных опухолей у детей.

Introduction

Introduction. Malignant neoplasms in children belong to the category of socially significant pathology. Tumor progression results from local recurrence, the substrate of which is the presence of residual tumor tissue in the resection area, which requires a high level of surgical ablastics. Application of additional intervention on residual tumor tissue by means of new surgical technologies results in an increased radicalism of surgical treatment of patients with retroperitoneal tumors.

The purpose of the study is to evaluate the effectiveness of the developed technique of intraoperative photodynamic therapy (PDT) at the stage of surgical treatment of children with nephroblastoma.

Materials and methods

Materials and methods. The study group included 66 patients with nephroblastoma, 35 boys and 31 girls. Patients in the control group (n = 35) underwent surgical treatment in combination with chemotherapy and radiation therapy according to the SIOP protocol. Patients in the main group (n = 31) received the SIOP protocol therapy in combination with PDT. A combination of surgical treatment with intraoperative PDT was used to increase the radicality of surgical intervention and reduce the local recurrence rate.

Results

Results. In the group of patients who received PDT in addition to the surgical treatment, the death rate during the 5-year follow-up period was lower, and the survival rate, respectively, was higher — 90.3 % versus 71.4 % (p = 0.050).

Conclusion

Conclusion. The proposed technique of intraoperative PDT within the complex treatment of retroperitoneal tumors results in better outcomes, significantly increasing survival rate in patients with retroperitoneal tumors. 

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