Sadašnji pristupi lečenju metastatskih promena na mozgu
Sažetak
Uvod/Cilj. Oko 10% bolesnika sa dijagnozom sistemskog karcinoma imalo je metastaze u mozgu u centralnom nervnom sistemu. Bolesnici sa obolelim plućima, dojkama, mokraćnim i digestivnim traktom, kao i oni sa melanomom kože, sve češće se, zbog širenja metastaza i stvaranja sekundarnih naslaga u mozgu, leče kod neurohirurga. Cilj rada bio je da se proceni efikasnost modaliteta lečenja bolesnika sa metastazama u mozgu prema njihovom tipu – solitarne ili multiple, kao i prema lokalizaciji primarnog karcinoma. Metode. Retrospektivna studija rađena je na Klinici za neurohirurgiju i Klinici za onkologiju u periodu od 2018. do 2020. godine. Pregledano je 111 bolesnika sa solitarnim promenama na mozgu i 122 bolesnika sa višestrukim promenama. Rezultati. Utvrđeno je da su višestruke metastaze bile češće kod obolelih od primarnog karcinoma pluća, dok su pojedinačne metastaze bile češće kod obolelih od adenokarcinoma. Međutim, preminuo je značajno veći broj bolesnika sa primarnim adenokarcinomom. Zaključak. Hirurgija i zračenje ostaju kamen temeljac terapije simptomatskih lezija. Potrebno je težiti unapređenju hirurške tehnike u pravcu što manjeg oštećenja okolnog zdravog tkiva. Radiohirurgija, kao i radioterapija celog mozga, ostaju osnovni oblici u lečenju višestrukih metastaza.
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