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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">surgonco</journal-id><journal-title-group><journal-title xml:lang="ru">Креативная хирургия и онкология</journal-title><trans-title-group xml:lang="en"><trans-title>Creative surgery and oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2076-3093</issn><issn pub-type="epub">2307-0501</issn><publisher><publisher-name>Башкирский государственный медицинский университет</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.24060/2076-3093-2021-11-1-58-67</article-id><article-id custom-type="elpub" pub-id-type="custom">surgonco-571</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Современные методы лучевой терапии рака шейки матки</article-title><trans-title-group xml:lang="en"><trans-title>Modern Techniques for Cervical Cancer Radiotherapy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7465-3640</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лушникова</surname><given-names>П. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Lushnikova</surname><given-names>P. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лушникова Полина Александровна — радиотерапевтическое отделение</p><p>Томск</p></bio><bio xml:lang="en"><p>Polina A. Lushnikova — Department of Radiotherapy</p><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8251-2138</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сухих</surname><given-names>Е. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Sukhikh</surname><given-names>E. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сухих Евгения Сергеевна — к.ф.-м.н., отдел медицинской физики радиотерапевтического отделения, отделение ядерно-топливного цикла</p><p>Томск</p></bio><bio xml:lang="en"><p>Evgeniya S. Sukhikh — Cand. Sci. (Phys.-Math.), Department of Medical Physics, Department of Radiotherapy, Department of Nuclear Fuel Cycle</p><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4428-7328</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ижевский</surname><given-names>П. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Izhevsky</surname><given-names>P. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ижевский Павел Владимирович — к.м.н., кафедра медицины и безопасности жизнедеятельности</p><p>Москва</p></bio><bio xml:lang="en"><p>Pavel V. Izhevskiy — Cand. Sci. (Med.), Chair of Medicine and Operating Security</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сутыгина</surname><given-names>Я. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Sutygina</surname><given-names>Ya. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сутыгина Яна Николаевна — радиотерапевтическое отделение </p><p>Томск</p></bio><bio xml:lang="en"><p>Yana N. Sutygina — Department of Radiotherapy</p><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Татарченко</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tatarchenko</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Татарченко Мария Алексеевна — радиотерапевтическое отделение </p><p>Томск</p></bio><bio xml:lang="en"><p>Maria A. Tatarchenko — Department of Radiotherapy</p><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пыжова</surname><given-names>И. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Pyzhova</surname><given-names>I. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Пыжова Ирина Борисовна — радиотерапевтическое отделение </p><p>Томск</p></bio><bio xml:lang="en"><p>Irina B. Pyzhova — Department of Radiotherapy</p><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Томский областной онкологический диспансер</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Tomsk Regional Oncology Dispensary</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Томский областной онкологический диспансер; Национальный исследовательский Томский политехнический университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Tomsk Regional Oncology Dispensary; Tomsk National Research Polytechnic University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Государственный научный центр Российской Федерации — Федеральный медицинский биофизический центр имени А.И. Бурназяна Федерального медико-биологического агентства; Московский педагогический государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian State Research Center — Burnazyan Federal Medical Biophysical Centre; Moscow Pedagogical State University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>13</day><month>04</month><year>2021</year></pub-date><volume>11</volume><issue>1</issue><fpage>58</fpage><lpage>67</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Лушникова П.А., Сухих Е.С., Ижевский П.В., Сутыгина Я.Н., Татарченко М.А., Пыжова И.Б., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Лушникова П.А., Сухих Е.С., Ижевский П.В., Сутыгина Я.Н., Татарченко М.А., Пыжова И.Б.</copyright-holder><copyright-holder xml:lang="en">Lushnikova P.A., Sukhikh E.S., Izhevsky P.V., Sutygina Y.N., Tatarchenko M.A., Pyzhova I.B.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.surgonco.ru/jour/article/view/571">https://www.surgonco.ru/jour/article/view/571</self-uri><abstract><p>Рак шейки матки является социально значимым заболеванием и часто диагностируется у женщин репродуктивного и работоспособного возраста. Молодой и социально активный возраст данных пациентов делает необходимым разработку эффективных и безопасных методов лечения.</p><p>За последние десятилетия появились новые методики лучевого лечения рака шейки матки: внедрение 3DCRT-3D, IMRT и VMAT, адаптивная лучевая терапия, планирование внутриполостного облучения по КТ/МРТ-изображениям, комбинирование внутритканевой и внутриполостной лучевой терапии, замена внутриполостного этапа лучевой терапии дистанционным компонентом с последовательной или одновременной эскалацией дозы на шейку матки при невозможности проведения брахитерапии.</p><p>Современное оборудование и системы планирования позволяют подводить высокие дозы на опухоль, проводить внутриполостную лучевую терапию под визуальным контролем мишени и органов риска. Комбинация внутриполостной и внутритканевой лучевой терапии дает возможность лучшего охвата мишени дозой, максимально исключая органы риска из зоны облучения.</p><p>Замена внутриполостного этапа лучевой терапии дистанционным компонентом может дать возможность подвести канцерицидную дозу к опухоли при невозможности проведения внутриполостного лечения.</p><p>Целью поиска и внедрения новых методик является персонифицированная оптимизация лучевой терапии для улучшения результатов лечения, снижения частоты и/или выраженности побочных эффектов радиотерапии. В данной статье представлен обзор методов лучевого лечения рака шейки матки и направлений их развития.</p></abstract><trans-abstract xml:lang="en"><p>Cervical cancer is a socially significant illness often impacting women of reproductive and working age. The patients’ young age and social activity warrant the development of effective and safe therapies.</p><p>The past decades have witnessed the novel radiation techniques to contain cervical cancer: 3DCRT-3D, IMRT, and VMAT, adaptive radiotherapy, CT/MRI-guided intracavitary radiation, combined interstitial and intracavitary radiation, abandoning intracavitary intervention for external beam delivery with sequential or concurrent cervical dose escalation, under brachytherapy unfeasible.</p><p>Modern equipment and treatment planning systems allow a high dose delivery to the tumour and intracavitary treatment with visual control of the target and organs at risk. Combining of intracavitary and interstitial radiotherapy enables a better dose coverage of the target at a minimal radiation impact on organs at risk.</p><p>Phasing-out of intracavitary for external radiotherapy may enable a cancericide dose delivery to the tumour under intractable intracavitary treatment.</p><p>The major goal of technic novelties is the establishment of personalised radiotherapy for improving treatment outcomes and reducing the incidence and/or severity of radiation side effects. The article overviews the radiotherapy techniques for cervical cancer treatment and routes of their development.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак шейки матки</kwd><kwd>дистанционная лучевая терапия</kwd><kwd>брахитерапия</kwd><kwd>внутритканевая лучевая терапия</kwd><kwd>стереотаксическая лучевая терапия</kwd><kwd>адъювантная лучевая терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cervical cancer</kwd><kwd>external radiotherapy</kwd><kwd>brachytherapy</kwd><kwd>interstitial radiotherapy</kwd><kwd>stereotactic radiotherapy</kwd><kwd>adjuvant radiotherapy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Кравец О.А., Кузнецов В.В., Морхов К.Ю., Нечушкина В.М., Хохлова С.В. Рак шейки матки: клинические рекомендации. М.; 2018.</mixed-citation><mixed-citation xml:lang="en">Kravets O.A., Kuznetsov V.V., Morkhov K.Yu., Nechushkina V.M., Khokhlova S.V. 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