persmedРоссийский журнал персонализированной медициныRussian Journal for Personalized Medicine2782-38062782-3814ФОНД АЛМАЗОВА10.18705/2782-3806-2024-4-1-44-57ZPQYNNpersmed-236Research ArticleНЕЙРОХИРУРГИЯДостижения и перспективы дальнейшего развития технологии фотодинамической терапии в лечении церебральных опухолей.Achievements and prospects for further development of photodynamic therapy technology in the treatment of cerebral tumorsКукановК. К.KukanovK. K.

Куканов Константин Константинович, к.м.н., врач-нейрохирург, старший научный сотрудник НИЛ нейроонкологии РНХИ им. проф. А. Л. Поленова — филиала ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России; секретарь Ученого совета РНХИ им. проф. А. Л. Поленова

ул. Маяковского, д. 12, Санкт-Петербург, 191014

Kukanov Konstantin K., MD, PhD, Neurosurgeon, Senior Researcher at the Polenov Russian Scientific Research Institute of Neurosurgery

Mayakovskogo str., 12, Saint Petersburg, 191014

kukanov_kk@almazovcentre.ruНечаеваА. С.NechaevaA. S.

Нечаева Анастасия Сергеевна, врач-нейрохирург, младший научный сотрудник НИЛ нейроонкологии, РНХИ им. проф. А. Л. Поленова — филиала ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России; младший научный сотрудник НИО трансляционной онкологии Научно-исследовательского центра персонализированной онкологии НЦМУ «Центр персонализированной медицины»

Nechaeva Anastasia S., neurosurgeon, Junior Researcher, Research Laboratory of Neurooncology of Polenov Russian Scientific Research Institute of Neurosurgery; junior researcher of the Research Department of Translational Oncology of the Research Center for Personalized Oncology of the World-Class Research Centre for Personalized Medicine

УлитинА. Ю.UlitinA. Yu.

Улитин Алексей Юрьевич, д.м.н., профессор, главный внештатный специалист нейрохирург Комитета здравоохранения Санкт-Петербурга, заслуженный врач РФ, заведующий кафедрой ИМО ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России, заведующий 4НХО РНХИ им. проф. А. Л. Поленова — филиала ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава Росси

Ulitin Alexey Yu., Doctor of Medical Sciences, Professor, MD, Neurosurgeon, chief freelance specialist- neurosurgeon of the Saint Petersburg Health Committee, Honored Doctor of the Russian Federation, Head of the Department of the Institute of Medical Education Almazov National Medical Research Centre; Head of the 4th neurosurgical department of the Polenov Russian Scientific Research Institute of Neurosurgery

СклярС. С.SklyarS. S.

Скляр Софья Сергеевна, к.м.н., старший научный сотрудник НИЛ нейроонкологии, врач-нейрохирург, онколог РНХИ им. проф. А. Л. Поленова — филиала ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава РФ

Sklyar Sofia S., MD, PhD, Neurosurgeon, Senior Researcher of Research Laboratory of Neurooncology of the Polenov Russian Scientific Research Institute of Neurosurgery

ВершининА. Э.VershininA. E.

Вершинин Александр Эдуардович, врач-нейрохирург, аспирант РНХИ им. проф. А. Л. Поленова — филиала ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России

Vershinin Alexander E., MD, Neurosurgeon, graduate Polenov Russian Scientific Research Institute of Neurosurgery

ДиконенкоМ. В.DikonenkoM. V.

Диконенко Михаил Викторович, врач-нейрохирург, аспирант РНХИ им. проф. А. Л. Поленова — филиала ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России

ул. Маяковского, д. 12, Санкт-Петербург, 191014

Dikonenko Miсhail V., MD, Neurosurgeon, graduate Polenov Russian Scientific Research Institute of Neurosurgery

Mayakovskogo str., 12, Saint Petersburg, 191014

mischa.tober2011@yandex.ruПолитоваА. О.PolitovaA. O.

Политова Алина Олеговна, ординатор кафедрынейрохирургии РНХИ им. проф. А. Л. Поленова — фи-лиала ФГБУ «НМИЦ им. В. А. Алмазова» МинздраваРоссии

Politova Alina O., resident Polenov Russian Scientific Research Institute of Neurosurgery

ПапаянГ. В.PapayanG. V.

Папаян Гарри Вазгенович, к.т.н., старший научный сотрудник НИО микроциркуляции и метаболизма миокарда ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России

Papayan Harry V., Ph.D., Senior Researcher at the Research Institute of Microcirculation and Metabolism of the Myocardium, Almazov National Medical Research Centre

ОлюшинВ. Е.OlyushinV. E.

Олюшин Виктор Емельянович, д.м.н., профессор, врач-нейрохирург, главный научный сотрудник НИЛ нейроонкологии РНХИ им. проф. А. Л. Поленова — филиала ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России, заслуженный врач России

Olyushin Victor E., Doctor of Medical Sciences, Professor, Neurosurgeon, Chief Researcher of the Institute of Neuro-Oncology of the Polenov Russian Scientific Research Institute of Neurosurgery

Российский научно-исследовательский нейрохирургический институт имени профессора А. Л. Поленова — филиал Федерального государственного бюджетного учреждения «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияPolenov Russian Scientific Research Institute of Neurosurgery — branch of the Almazov National Medical Research CentreRussian FederationРоссийский научно-исследовательский нейрохирургический институт имени профессора А. Л. Поленова — филиал Федерального государственного бюджетного учреждения «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации; Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации, Научный центр мирового уровня «Центр персонализированной медицины»РоссияPolenov Russian Scientific Research Institute of Neurosurgery — branch of the Almazov National Medical Research Centre; Almazov National Medical Research Centre, World-Class Research Centre for Personalized MedicineRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации, Научный центр мирового уровня «Центр персонализированной медицины»РоссияAlmazov National Medical Research Centre, World-Class Research Centre for Personalized MedicineRussian Federation202422032024414457Copyright © Куканов К.К., Нечаева А.С., Улитин А.Ю., Скляр С.С., Вершинин А.Э., Диконенко М.В., Политова А.О., Папаян Г.В., Олюшин В.Е., 20242024Куканов К.К., Нечаева А.С., Улитин А.Ю., Скляр С.С., Вершинин А.Э., Диконенко М.В., Политова А.О., Папаян Г.В., Олюшин В.Е.Kukanov K.K., Nechaeva A.S., Ulitin A.Y., Sklyar S.S., Vershinin A.E., Dikonenko M.V., Politova A.O., Papayan G.V., Olyushin V.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://persmed.elpub.ru/jour/article/view/236

Выполнен обзор литературы, отражающий современное состояние и степень разработанности методики интраоперационной фотодинамической терапии (ФДТ) в нейроонкологии. Представлены к обсуждению результаты наиболее значимых исследований, посвященных ФДТ в нейроонкологии. Проведен анализ научных публикаций по данной тематике в базах данных Pubmed, EMBASE, CochraneLibrary и eLibrary, вышедших с января 2000-го по декабрь 2022 года. Найдено 204 публикации в зарубежных источниках и 59 — в отечественных изданиях, в которых рассматриваются вопросы применения ФДТ в нейроонкологии. Анализ литературы показал, что в клинической практике интраоперационная ФДТ в нейроонкологии является важным инструментом, способствующим увеличению радикальности операции и локального контроля. Фундаментальное обоснование эффективности ФДТ заключается в изучении путей, ведущих к полной девитализации злокачественной опухоли, изучении механизмов локального и системного иммунного ответа. При этом субклеточные мишени при ФДТ обусловлены свойствами фотосенсибилизаторов (ФС). В многочисленных исследованиях показана противоопухолевая эффективность использования ФДТ с ФС на основе хлорина е6, 5-аминолевулиновой кислоты, производных порфиринов. Установлены механизмы действия и мишени этих ФС. В России в ряде исследований подтверждена клиническая эффективность ФДТ у групп нейроонкологических пациентов с глиальными опухолями и вторичными метастатическими опухолями, однако до сих пор метод не включен в клинические рекомендации по оказанию высокотехнологичной нейрохирургической помощи. Безусловно, необходима дальнейшая разработка методики ФДТ в нейроонкологии, особенно у пациентов с высоким риском рецидива и агрессивными опухолями ЦНС.

Literature review reflects the current status and development status of intraoperative photodynamic therapy in neurooncology and discusses the results of the most important studies on photodynamic therapy (PDT). We searched the Pubmed, EMBASE, Cochrane Library and eLibrary databases for publications published between January 2000 and December 2022. Found 204 publications in foreign sources and 59 publications in domestic editions, dealing with the issues of photodynamic therapy in neurooncology. An analysis of the literature has shown that intraoperative PDT in neurooncology is an important tool that contributes to increasing the radicality of the operation and local control. The basic rationale for the effectiveness of PDT lies in the study of the pathways leading to the complete devitalization of a malignant tumor, the study of the mechanisms of the local and systemic immune response. In addition, subcellular targets in PDT are determined by the properties of photosensitizers (PS). Second generation PSs have already been introduced into clinical practice. The effectiveness of PDT using photoditazine, 5-aminolevulinic acid has been demonstrated. The mechanisms of action and targets of these PS have been established. In Russia, a number of studies have repeatedly shown and proved the clinical effectiveness of PDT in groups of neurooncological patients with glial tumors and secondary metastatic tumors, but so far, the method has not been included in the clinical guidelines for the provision of high-tech neurosurgical care. There is certainly a need for further development of PTD techniques in neurooncology, especially in patients at high risk of recurrence and aggressive CNS tumors.

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