Dzemdes kakla vēža aktualitāte un to ārstēšanai izmantotās ķīmijterapijas vadlīniju protokoli.
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Date
2023
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Pētnieciskā darba aktualitāte: Dzemdes kakla vēzis joprojām ir izplatīta slimība sievietēm Latvijā un pasaulē. Latvijā ik mēnesi audzējs tiek diagnosticēts apmēram 20 sievietēm. Ne vienmēr tas tiek atklāts pirmajā stadijā, kad pastāv lielāka iespējamība ilgākai dzīvotspējai un recidīvu mazināšanai. Saslimstība pēdējo 10 gadu laikā ir pieaugusi par 20%.
Dzemdes kakla vēzis - otrais biežāk sastopamais ļaundabīgais audzējs Latvijā sievietēm līdz 45 gadu vecumam. Pēc Slimību profilakses un kontroles centra (SPKC) datiem, “dzemdes kakla vēzis ir otrs izplatītākais vēža veids aiz krūts vēža, kas Eiropas Savienībā (ES) skar sievietes vecumā no 15–44 gadiem. Katru gadu ES tiek atklāti aptuveni 33 000 dzemdes kakla vēža saslimšanas un 15 000 nāves gadījumi”. Pēc jaunākiem NVD datiem, 2022.g. sešos mēnešos dzemdes kakla vēža skrīninga izmeklējumu visos Latvijas reģionos izmantoja 58,9% no kopēja uzaicināto skaita, kas liecina par zemu ieinteresētību sieviešu vidū laicīgi pārbaudīt savu veselību. SPKC un NVD radītāji par dzemdes kakla vēža jaunatklāto gadījumu skaitu un saslimstību Latvijā liek Veselības Ministrijai (VM) rūpīgi padomāt par vakcinācijas nepieciešamību un vakcinācijas plāna pārskatīšanu, ieskaitot to, ka tiek plānots vakcinēt ne tikai jaunas meitenes (no 12-18 gadiem), bet arī zēnus (no 12-15 gadiem).
Pētnieciskā darba mērķis: detalizēti apskatīt dzemdes kakla vēža izplatību pasaules mērogā un Latvijā, izmantojot statistikas datus, kā arī izpētīt izstrādātās vadlīnijas/protokolus ķīmijterapijai, imūnterapijai un mērķterapijai dzemdes kakla ārstēšanā Eiropas valstīs un Latvijā, detalizēti izpētīt to darbības mehānismus, kā arī noskaidrot un salīdzināt to blakusparādības.
Materiāli un metodes: Pētījuma rezultātu iegūšanai tika izmantotas brīvpieejas datubāzes, slimību profilakses un kontroles centra un pasaules veselības organizācijas datubāzes (PVO veselības novērošanas datubāze, PVO Eiropas veselības datubāze, PVO mirstības rādītāju datubāze un PVO biļeteni), kā arī tabulas un diagrammas, kas atspoguļo saslimstību ar audzēju Latvijā un pasaules mērogā.
Rezultāti: Darbā secināts, ka Latvijas onkologi ķīmijterapeiti vadās pēc ASV vadlīnijām dzemdes kakla vēža ārstēšanā, pielietojot staru terapiju, pirmās izvēles kombinēto terapiju, pirmās izvēles monoterapiju un otrās izvēles aizvietojošu terapiju, izvērtējot katru pacientu individuāli.
Secinājumi: Dzemdes kakla vēzis ir nāves cēlonis vienai sievietei katru otro minūti pasaulē. 90% gadījumos tas notiek valstīs ar zemiem vai vidējiem ienākumiem. Lokāli izplatīta dzemdes kakla vēža ārstēšanai tiek pielietota ķīmijterapijas/ monoterapijas medikamenti- cisplatīns, karboplatīns un staru terapija. Metastazētā dzemdes kakla vēža ārstēšanai onkologi izmanto medikamentus paklitakselu/karboplatīnu vai paklitakselu /cisplatīnu+bevacizumabu kā monoklonālo antivielu.
Atslēgas vārdi: Dzemdes kakla vēzis; monoklonāla antiviela; ķīmijterapija; CPV
Introduction: Cervical cancer is still a common disease among women in Latvia and the world. About 20 women are diagnosed with the tumor every month. It is not always detected in the first stage, when there is a greater possibility of longer survival and reduction of relapses. In Latvia the incidence has increased by 20% in the last 10 years. Cervical cancer - the second most common malignant tumor in Latvian women under the age of 45". According to the Center for Disease Prevention and Control (CDC), "cervical cancer is the second most common type of cancer after breast cancer affecting women aged 15-44 in the European Union (EU). Around 33,000 cases of cervical cancer and 15,000 deaths are detected in the EU every year". According to the latest NVD data, in 2022 in six months, 58.9% of the total number of invited persons used the cervical cancer screening examination in all regions of Latvia, which indicates a low interest among women to check their health in time. The creators of SPKC and NVD regarding the number of newly discovered cases of cervical cancer and the morbidity in Latvia make the Ministry of Health (MoH) think carefully about the need for vaccination and the revision of the vaccination plan, including the fact that it is planned to vaccinate not only young girls, but also boys. The purpose of the research work: to examine in detail the spread of cervical cancer worldwide and in Latvia, using statistical data, as well as to study the developed guidelines/protocols for chemotherapy, immunotherapy and targeted therapy in the treatment of the cervix in European countries and Latvia, to study in detail their mechanisms of action, as well as to clarify and compare their side effects. Materials and methods: Open access databases, Centers for Disease Control and Prevention and World Health Organization databases (WHO Health Surveillance Database, WHO European Health Database, WHO Mortality Database and WHO Bulletins) were used to obtain the study results, as well as tables and charts representing incidence of cancer in Latvia and worldwide. Results: The paper concluded that Latvian oncologists-chemotherapists follow US guidelines in the treatment of cervical cancer, applying radiation therapy, first-choice combined therapy, first-choice monotherapy and second-choice replacement therapy, evaluating each patient individually. Conclusions: Cervical cancer is the cause of death for one woman every second minute. 90% of cases occur in low- or middle-income countries. Chemotherapy/monotherapy – cisplatin, carboplatin and radiation therapy is used for the treatment of locally spread cervical cancer. For the treatment of metastatic cervical cancer, oncologists use paclitaxel/carboplatin or paclitaxel/cisplatin+bevacizumab as a monoclonal antibody. Keywords: Cervical cancer; monoclonal antibody; chemotherapy; HPV Introduction: Cervical cancer is still a common disease among women in Latvia and the world. About 20 women are diagnosed with the tum
Introduction: Cervical cancer is still a common disease among women in Latvia and the world. About 20 women are diagnosed with the tumor every month. It is not always detected in the first stage, when there is a greater possibility of longer survival and reduction of relapses. In Latvia the incidence has increased by 20% in the last 10 years. Cervical cancer - the second most common malignant tumor in Latvian women under the age of 45". According to the Center for Disease Prevention and Control (CDC), "cervical cancer is the second most common type of cancer after breast cancer affecting women aged 15-44 in the European Union (EU). Around 33,000 cases of cervical cancer and 15,000 deaths are detected in the EU every year". According to the latest NVD data, in 2022 in six months, 58.9% of the total number of invited persons used the cervical cancer screening examination in all regions of Latvia, which indicates a low interest among women to check their health in time. The creators of SPKC and NVD regarding the number of newly discovered cases of cervical cancer and the morbidity in Latvia make the Ministry of Health (MoH) think carefully about the need for vaccination and the revision of the vaccination plan, including the fact that it is planned to vaccinate not only young girls, but also boys. The purpose of the research work: to examine in detail the spread of cervical cancer worldwide and in Latvia, using statistical data, as well as to study the developed guidelines/protocols for chemotherapy, immunotherapy and targeted therapy in the treatment of the cervix in European countries and Latvia, to study in detail their mechanisms of action, as well as to clarify and compare their side effects. Materials and methods: Open access databases, Centers for Disease Control and Prevention and World Health Organization databases (WHO Health Surveillance Database, WHO European Health Database, WHO Mortality Database and WHO Bulletins) were used to obtain the study results, as well as tables and charts representing incidence of cancer in Latvia and worldwide. Results: The paper concluded that Latvian oncologists-chemotherapists follow US guidelines in the treatment of cervical cancer, applying radiation therapy, first-choice combined therapy, first-choice monotherapy and second-choice replacement therapy, evaluating each patient individually. Conclusions: Cervical cancer is the cause of death for one woman every second minute. 90% of cases occur in low- or middle-income countries. Chemotherapy/monotherapy – cisplatin, carboplatin and radiation therapy is used for the treatment of locally spread cervical cancer. For the treatment of metastatic cervical cancer, oncologists use paclitaxel/carboplatin or paclitaxel/cisplatin+bevacizumab as a monoclonal antibody. Keywords: Cervical cancer; monoclonal antibody; chemotherapy; HPV Introduction: Cervical cancer is still a common disease among women in Latvia and the world. About 20 women are diagnosed with the tum
Description
Farmācija
Pharmacy
Veselības aprūpe
Health Care
Pharmacy
Veselības aprūpe
Health Care
Keywords
Atslēgas vārdi: Dzemdes kakla vēzis; monoklonāla antiviela; ķīmijterapija; CPV, Keywords: Cervical cancer; monoclonal antibody; chemotherapy; HPV