mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/2072-3180-2025-2-171-175mossj-976Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWМожет ли лучевая терапия являться радикальным методом лечения латеральных метастазов при раке прямой кишки?Can radiation therapy be a radical method of treating lateral metastases in rectal cancer?https://orcid.org/0000-0001-6641-7229КарачунА. М.KarachunA. M.

Карачун Алексей Михайлович – д.м.н., профессор, заведующий отделением абдоминальной онкологии 

197758, г. Санкт-Петербург, п. Песочный, ул. Ленинградская д. 68

Karachun Alexei Mikhailovich – Doct. Med. Sci., professor, head of the Department of Abdominal Oncology 

197758, St. Petersburg, Pesochny, Leningradskaya Street, 68

dr.a.karachun@gmail.comhttps://orcid.org/0000-0002-2642-5440СамсоновД. В.SamsonovD. V.

Самсонов Денис Владимирович – канд. мед. наук, доцент, врач-онколог 

197758, г. Санкт-Петербург, п. Песочный, ул. Ленинградская д. 68

Samsonov Denis Vladimirovich – Cand. Med. Sci., docent, oncologist 

197758, St. Petersburg, Pesochny, Leningradskaya Street, 68

desavl@mail.ruhttps://orcid.org/0000-0003-4665-6999ГришкоП. Ю.GrishkoP. Yu.

Гришко Павел Юрьевич – канд. мед. наук, научный сотрудник научного отделения диагностической и интервенционной радиологии 

197758, г. Санкт-Петербург, п. Песочный, ул. Ленинградская д. 68

Grishko Pavel Yurievich – Cand. Med. Sci., researcher, Scientific Department of Diagnostic and Interventional Radiology 

197758, St. Petersburg, Pesochny, Leningradskaya Street, 68

dr.grishko@mail.ruhttps://orcid.org/0000-0001-9364-9332ОконечниковаД. В.OkonechnikovaD. V.

Оконечникова Дарья Викторовна – врач-рентгенолог 

197758, г. Санкт-Петербург, п. Песочный, ул. Ленинградская д. 68

Okonechnikova Daria Victorovna – radiologist 

197758, St. Petersburg, Pesochny, Leningradskaya Street, 68

okonechnikovad@gmail.comФГБУ «Национальный медицинский исследовательский центр онкологии имени Н.Н. Петрова» Минздрава России; ФГБОУВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава РоссииРоссияN.N. Petrov National Medical Research Center of Oncology; I.I. Mechnikov North-Western State Medical UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр онкологии имени Н.Н. Петрова» Минздрава России; ФГБВОУВО «Военно-медицинская академия им. С.М. Кирова» МО РФРоссияN.N. Petrov National Medical Research Center of Oncology; St. Petersburg S.M. Kirov Military Medical AcademyRussian FederationФГБУ «Национальный медицинский исследовательский центр онкологии имени Н.Н. Петрова» Минздрава РоссииРоссияN.N. Petrov National Medical Research Center of OncologyRussian Federation20251106202502171175Copyright © Карачун А.М., Самсонов Д.В., Гришко П.Ю., Оконечникова Д.В., 20252025Карачун А.М., Самсонов Д.В., Гришко П.Ю., Оконечникова Д.В.Karachun A.M., Samsonov D.V., Grishko P.Y., Okonechnikova D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/976

Введение. Одной из причин неудовлетворительного локального контроля рака прямой кишки может являться метастатическое поражение латеральных лимфатических узлов таза. Восточная и западная стратегии профилактики местного рецидива для данного заболевания развивались в разных направлениях. Если в Японии латеральная лимфодиссекция стала обязательным дополнением тотальной мезоректумэктомии, то западная лечебная программа делает ставку на санирующий эффект предоперационного облучения возможных регионарных метастазов. Результаты. Статья представляет собой обзор публикаций, демонстрирующих результаты лучевого воздействия на лимфатический коллектор бокового компартмента таза при раке прямой кишки. Поиск статей по тематике обзора осуществлен с использованием баз данных Web of Science и PubMed. В ходе проведённого анализа литературы изучению подвергнуты 94 источника, из которых для формирования обзора отобраны 30. Большинство представленных публикаций указывают на необходимость хирургического удаления увеличенных латеральных лимфоузлов в связи с неспособностью лучевой терапии надежно обеспечить полный регресс лимфогенных метастазов. Выводы. Имеющиеся в настоящее время данные не позволяют рассматривать лучевую терапию в качестве радикального метода лечения латеральных тазовых метастазов. Однако дальнейшее изучение вариантов усиления лучевой нагрузки на данную зону, возможно, в некоторой степени ограничит хирургическую агрессию в отношении указанного лимфоколлектора.

Introduction. One of the reasons for unsatisfactory local control of rectal cancer may be metastatic lesions of the lateral pelvic lymph nodes. Eastern and Western strategies for preventing local recurrence of this disease have developed in different directions. If in Japan lateral lymph node dissection has become a mandatory addition to total mesorectumectomy, the Western concept relies on the sanitizing effect of preoperative irradiation of possible regional metastases. Results. The article is a review of publications demonstrating the results of radiation exposure to the lymphatic collector of the lateral compartment of the pelvis in rectal cancer. The search for articles on the topic of the review was carried out using the Web of Science and PubMed databases. In the course of the literature analysis, 94 sources were studied, of which 30 were selected to form the review. Most of the presented publications indicate the need for surgical removal of enlarged lateral lymph nodes due to the inability of radiation therapy to reliably ensure complete regression of lymphogenous metastases. Conclusions. The currently available data do not allow us to consider radiotherapy as a radical method of treating lateral pelvic metastases. However, further study of options for increasing the radiation load on this area may, to some extent, limit surgical aggression towards this lymph collector.

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The authors declare that there are no conflicts of interest present.