Abstract
The basic principles of the treatment of prostate cancer patients have underwent significant revisions in recent years. Modern radiotherapy techniques, which have demonstrated high efficacy and safety in long-term randomized trials, are beginning to take a leading position in the treatment of prostate cancer in an overwhelming number of clinical scenarios (National Comprehensive Cancer Network, 2021). Despite the obvious successes of radiation oncology, a number of important problems remain unresolved, first of all - the need to reduce the rates of radiation complications. The topographical anatomy of the prostate gland determines the main profiles of post-radiation damage: rectal and genitourinary radiation toxicity. The previous five years have been marked by a significant intensification of research work abroad aimed at clinical testing of a number of biopolymer compositions and products for use as spacers between irradiated structures and normal tissues. The experience has made it possible for the first time to consider the possibility of using spacers in radiotherapy treatment of prostate cancer in the modern recommendations of the European Association of Urology (2021). The analysis of the national literature shows a complete lack of publications on the possibilities of optimizing the radiation treatment of prostate cancer through the use of specers. The purpose of this work was the need to highlight this important and perspective clinical problem.
Highlights
Основные принципы лечения больных раком предстательной железы в последние годы были подвергнуты существенному пересмотру
Рак предстательной железы abroad aimed at clinical testing of a number of biopolymer compositions and products for use as spacers between irradiated structures and normal tissues
The experience has made it possible for the first time to consider the possibility of using spacers in radiotherapy treatment of prostate cancer in the modern recommendations of the European Association of Urology (2021)
Summary
Процедура дополнительной сшивки коллагена, повышающая биологическую стабильность, существенно удорожает конечную стоимость спейсера. Биодеградирующие спейсеры на основе гиалуроновой кислоты имеют целый ряд важных практических преимуществ Наиболее значимым из них представляется возможность корректировки окончательного объема и формы вводимой субстанции без учета временног о фактора. Четкого вхождения в так называемый слой между фасцией Денонвиллье и прямой кишкой изначально удается достичь не всегда. В ходе введения препарата появляются ультразвуковые артефакты, затрудняющие визуализацию и требующие дополнительного времени для восстановления правильной ориентировки в тканях, что при использовании ПЭГ фактически невозможно. Сравнительная характеристика зарегистрированных спейсеров на основе жидких биополимеров Table 2. Comparison of commercially available liquid biopolymer spacers
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