Abstract
The aim. To increase the efficiency of treatment of BC patients with metastatic lesions of long tubular bones by using, Multidetector computed tomography (MDCT) and bone marrow markers for diagnostics and monitoring the clinical course of the oncologic process, accompanied by surgical intervention with endoprosthetics along with the treatment of polymorbid pathology in a specific patient.
 Materials and methods. Authors provide systemic personification including visualization of the tumor site and its vascularization; printing out the 3D model; surgical planning, including optimal surgical access to the tumor site considering the volume and topographic and anatomical location and dissemination of the tumor, the convenience of intraoperative tasks (removal of the tumor, bone grafting or endoprosthetics), preoperative planning of bone resection lines with maximum preservation of intact bone tissue.
 Results. Personalization of the treatment of breast cancer patients with metastatic bone lesions contributes to a significant reduction in postoperative complications of endoprosthetic replacement of large joints (up to 15.2 %) and increases the overall three-year survival rate (up to 40.6 %), as well as significantly improves their quality of life.
 Conclusions. The personalization of treatment of patients with tumor lesions of the skeletons contributes to a significant decrease in the indicator of postoperative complications of endoprosthetics of great joints and to an increase in the total three-year survival rate, as well as to the improvement of the quality of life after the conducted treatment.
Highlights
Breast cancer (BC) is the most common malignancy and the leading cause of cancer deaths among women worldwide [1, 2]
Materials and methods We propose a systemic personification including visualization of the tumor site and its vascularization; printing out the 3D model; surgical planning, including optimal surgical access to the tumor site considering the volume and topographic and anatomical location and dissemination of the tumor, the convenience of intraoperative tasks, preoperative planning of bone resection lines with maximum preservation of intact bone tissue
We studied the volume of blood perfusion in the area of the localization of the pathological lesion by multidetector computed tomography (MDCT), the content of markers of bone resorption and osteogenesis in blood and urine of the patients, and indicators of the overall survival and quality of life of the patients after treatment
Summary
Breast cancer (BC) is the most common malignancy and the leading cause of cancer deaths among women worldwide [1, 2]. According to the National Cancer Registry of Ukraine, more than 15,000 women are diagnosed with breast cancer; the rate of 5-year overall survival in Ukraine is 60.6 % and varies from 47.7 % to 72.2 % [5, 6]. In a systematic analysis of the results of the treatment of cancer patients in large clinical samples, it was found that cancer patients require removing the primary tumor and (2022), «EUREKA: Health Sciences» Number 1 restoration of organ function, and comprehensive monitoring of the quality of life with its possible deterioration in the presence of residual tumor disease, most notably tumor bone lesions [7, 8]. BM significantly impairs the quality of life and decreases the survival rate of patients with cancer [9, 10]. The research data suggest that bones are fertile ground for developing of metastases through the «vicious circle» of resorption/formation of bones and tumor growth [11, 12]
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