Гигантоклеточная опухоль кости в эпоху Деносумаба: Показания, результаты и дискуссии
DOI:
https://doi.org/10.52889/1684-9280-2026-77-3-jto056Ключевые слова:
гигантоклеточная опухоль кости, деносумаб, RANKL, остеокластома, новообразования костей, неоадъювантная терапия, злокачественная трансформация, рецидивАннотация
Гигантоклеточная опухоль кости представляет собой локально-агрессивное новообразование, характеризующееся RANKL-индуцированной активацией остеокластов. Деносумаб существенно изменил подходы к ведению таких пациентов.
Цель обзора: провести анализ спорных вопросов в результатах применения деносумаба при гигантоклеточной опухоли кости, клинических исходов и нерешенных проблем для принятия клинических решений и определения приоритетных направления для будущих исследований.
Методы. Проведен нарративный обзор литературы с использованием баз данных PubMed, EMBASE и Cochrane (за период 2010–2025 гг.). Отбор публикаций осуществлялся на основе их релевантности, дизайна исследования и клинической значимости; в анализ были включены рандомизированные контролируемые испытания, проспективные исследования и крупные серии ретроспективных наблюдений. Собранные данные были изучены и систематизированы с особым акцентом на биологию опухоли, показания к терапии деносумабом, исходы лечения, характер рецидивирования, побочные эффекты, механизмы резистентности и современные дискуссионные вопросы, связанные с лечением гигантоклеточной опухоли кости.
Результаты. Деносумаб демонстрирует высокую частоту клинического ответа и снижает инвалидизацию после хирургических вмешательств при гигантоклеточной опухоли кости. Тем не менее, вопросы касательно риска рецидивов, оптимальной продолжительности лечения и долгосрочной безопасности остаются нерешенными.
Выводы. Деносумаб является эффективным вариантом лечения гигантоклеточной опухоли кости для определенной группы пациентов, однако критически важными условиями остаются тщательный отбор больных и долгосрочный мониторинг.
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