#1
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Êîëëåãè, êóäà íàïðàâèòü ïàöèåíòà - ïîäñêàæèòå...
Êîëëåãè, äîáðûé äåíü!
Ìîè äðóçüÿ ñ Óêðàèíû ïîïðîñèëè ïîìîùè... ×åëîâåê - ãðàæäàíèí Ðîññèè, íî æèâåò ïîñòîÿííî â Óêðàèíå (âèä íà æèòåëüñòâî) â ×åðêàññàõ.  Ðîññèè ðåãèñòðàöèè íåò, íî ìîæåò â òå÷åíèå ìåñÿöà îôîðìèòü åå â Ïîäìîñêîâüå. 12 ìàÿ 2014 óäàëèëè ìåëàíîìó 1.2 ñì â ïîäëîïàòî÷íîé îáëàñòè (×åðêàññêèé îáëàñòíîé îíêîäèñïàíñåð, ïîä ìåñòíîé àíåñòåçèåé). Ñåé÷àñ íà ÌÐÒ (ãîëîâû, øåè. ãðóäíîé è áðþøíîé ïîëîñòè, òàçà) - ñîëèòàðíûé Mts â òåëî L3. Íàïðàâèëè ê íåéðîõèðóðãó â ×åðêàññàõ. Ïîäñêàæèòå, ïîæàëóéñòà: 1. Êàêîâà äîëæíà áûòü ñòðàòåãèÿ ëå÷åíèÿ ñîëèòàðíîãî ìåòàñòàçà ìåëàíîìû â ïîçâîíî÷íèêå? 2. Êóäà åìó ëó÷øå îáðàòèòüñÿ - Óêðàèíà (Êèåâ, Îäåññà?) èëè Ìîñêâà? Åñëè âîçìîæíî - êàêèå-òî êîíòàêòû ñïåöèàëèñòîâ Ïëàòèòü çà ëå÷åíèå îí â öåëîì ãîòîâ. |
#2
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çäåñü ãîâîðÿò îá óäàëåíèè è êîìáèíàöèè ðàäèîòåðàïèè è èììóíîòåðàïèè, íî â öåëîì ïðîãíîç ïðè ìåòàñòàòè÷åñêîì ïîðàæåíèè ïîçâîíêîâ ìåëàíîìîé íå î÷åíü: "With comprehensive treatment, patient survival-times range between one week and 43 months following the diagnosis of vertebral metastatic melanoma" [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
ìåñòíûå âðà÷è èç ÌÄ Àíäåðñîíà â 2000-îì äàâàëè áîëåå ïåññèìèñòè÷íûå ïðîãíîçû: The median survival for the group was 4 months. It is concluded that melanoma metastatic to the spine represents a late event in the evolution of this illness. Palliation should be the goal of treatment, but symptom management should be individualized, bearing in mind the short anticipated survival of these patients. //Melanoma metastatic to the spine: a review of 133 cases. Melanoma Res. 2000 Feb;10(1):78-80.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#3
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Ñïàñèáî!
À ñòîèò ëè â Ðîññèè/Óêðàèíå ñòðåìèòüñÿ ñòàâèòü öåëüþ ïîïûòêè ðàäèêàëüíîãî ëå÷åíèÿ, èëè íàñòðàèâàòüñÿ íà ïàëëèàòèâíóþ ïîìîùü?.. |
#4
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Èììóíîòåðàïèÿ - ñêîðåå âñåãî âîò ýòîò ôèíàíñîâî íåïîäüåìíûé: Ipilimumab (Yervoy), òê äðóãèå âèäû èììóíîòåðàïèè òîò æå ðåêîìá. ÈË-2 íå ñëèøêîì ïîêàçàë ñåáÿ...
Ipilimumab (Yervoy) Prolongs Survival In Advanced Melanoma Serious Side Effects and a Hefty Price Tag May Limit Its Use [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#5
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À ðåàëèè â ÐÔ èëè Óêðàèíå ìíå íåèçâåñòíû, ìîæåò Àëåêñàíäð Áåðçîé èëè êòî èç ðîññèéñêèõ êîíñóëüòàíòîâ-îíêîëîãîâ ïîäñêàæåò ÷òî...
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#6
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çäåñü åùå îá îáùèõ ïðèíöèïàõ ëå÷åíèÿ ìåòàñòàòè÷åñêèõ ïðîöåññîâ â ïîçâîíî÷íèê - ìíîãîå çàâèñèò îò âîçìîæíîñòåé êëèíèêè è îò íàâûêîâ êîíêðåòíîãî ñïåöèàëèñòà:
The Diagnosis and Treatment of Metastatic Spinal Tumor [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#7
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Ïîçäíî óâèäåë òåìó...
Î "ðàäèêàëüíîì" ëå÷åíèè âîîáùå-òî ðå÷è è èäòè íå ìîæåò. Ñóãóáî ïîïûòêà ñòàáèëèçàöèè ïðîöåññà, ïðîôèëàêòèêè îñëîæíåíèé (ïàòîëîãè÷åñêîãî ïåðåëîìà). Åñëè ñîëèòàðíûé, òî ñêîðåå íå íåéðîõèðóðã, à êèáåð-íîæ ? Âåðòåáðîïëàñòèêà, |