4 prof. S.v. ochapovsky territorial Clinical hospital one, Krasnodar; 5 p.A. herzen Moscow oncology research institute, Ministry of health of russia, Moscow в обзоре представлены возможности антагонистов лютеинизирующего гормона -рилизинг-гормона (ЛГрГ) третьего по-коления в лечении гормоночувствительного рака предстательной железы (рпЖ). в настоящее время наиболее изученным и применяемым антагонистом ЛГрГ является дегареликс. Он приводит к быстрому подавлению тестостерона и снижению простатспецифического антигена без колебания уровня тестостерона, и, таким образом, предотвращает риск клиниче-ской вспышки при распространенном заболевании. последние исследования показали, что терапия дегареликсом улуч-шает результаты лечения рпЖ по сравнению с агонистами ЛГрГ с точки зрения безрецидивной выживаемости. пред-полагается, что дегареликс задерживает прогрессирование кастрационно-резистентного рака предстательной железы и имеет более существенное влияние на метастазы в костях, щелочную фосфатазу и фолликулостимулирующий гормон. в последнее время получены результаты клинических исследований, подтверждающие целесообразность назначения дега-реликса во второй линии гормонотерапии при биохимическом прогрессировании болезни на фоне курсового применения агонистов ЛГрГ. Дегареликс обладает хорошей переносимостью, низкой токсичностью и отсутствием системных аллер-гических реакций. таким образом, последняя генерация антагонистов ЛГрГ вносит новый и важный вклад в стратегию антиандрогенной терапии гормоночувствительного рпЖ. Ключевые слова: андрогенная депривация, дегареликс, антагонисты лютеинизирующего гормона рилизинг-гормона, рак предстательной железы, гормоночувствительный рак предстательной железы.the review shows the abilities of third-generation luteinizing hormone-releasing hormone (lhrh) antagonists in the treatment of hormone-responsive prostate cancer (pC). Degarelix is presently the most studied and most commonly used lhrh antagonist. it leads to a rapid suppression of testosterone and a reduction in prostate-specific antigen without ranging the level of testosterone and thus prevents the risk of a clinical exacerbation of the disseminated disease. the latest investigations have shown that therapy with degarelix versus lhrh agonists improves the results of pC treatment in relapse-free survival rates. Degarelix is assumed to delay the progression of castration-resistant prostate cancer and to have a more considerable effect on bone metastases, alkaline phosphatase (Ap) and follicle-stimulating hormone. the results of clinical trials, which support that it is expedient to use degarelix in second-line hormone therapy or the biochemical progression of the disease during the cycle therapy with lhrh agonists, have been recently obtained. Degarelix shows good tolerability, low toxicity, and no systemic allergic reactions. thus, the newest-generation lhrh antagonists make novel and important contributions to the anti-androgenic therapy strategy for hormone-responsive pC.
Esophageal cancer is the sixth leading cause of death from cancer worldwide. Most patients with esophageal cancer die from relapses or metastases, with a 5-year survival rate ranging from 15% to 25%. The most common places of metastasis are the liver, lungs, bones and adrenal glands. Metastases in the kidney are extremely rare. We present the clinical case of a 61-year-old patient who was surgically radically treated at the A.V. Vishnevsky Surgery Center about esophageal cancer. The lesion was localized in the middle third of the esophagus along the posterior one, with spreading to the right wall, protruding into the lumen, slightly narrowing it. The situation was complicated by the fact that preoperatively the patient was diagnosed with coronary artery stenosis: the middle third of the anterior interventricular branch (AIB) of 80%, the proximal third of the envelope of the left coronary artery to 70%, the right coronary artery in the middle third to 50%. In this connection, the first stage of treatment was performed by stenting of AIB and the envelope of the left coronary artery. With the dynamic observation of the patient's condition, metastasis to the kidney was revealed in two years, and the patient was also operated on. This clinical case demonstrates the possibility of using a complex radiology (including X-ray, ultrasound, MSCT and angiography) at the stages of examination and treatment of such category of patients, allowing timely detection and correction of both the manifestations of the underlying pathology and concomitant diseases.
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