Pediatrics. Consilium MedicumPediatrics. Consilium MedicumПедиатрия. Consilium Medicum2658-66302658-6622Consilium Medicum5707810.26442/26586630.2020.2.200234ArticlesСтатьиResearch ArticleSecond malignant tumors in pediatric cancer survivorsВторые злокачественные опухоли у лиц, перенесших онкологическое заболевание в детствеPavlovaTatiana Yu.ПавловаТатьяна Юрьевна

врач-педиатр, детский онколог детского отд-ния химиотерапии гемобластозов

ValievTimur T.ВалиевТимур Теймуразович

д-р мед. наук, зав. детским отд-нием химиотерапии гемобластозов

timurvaliev@mail.ruBlokhin National Medical Research Center of OncologyФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России150620202NO2 (2020)№2 (2020)121629122020Copyright ©; 2020, Consilium MedicumCopyright ©; 2020, ООО "Консилиум Медикум"2020Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://pediatria.orscience.ru/2658-6630/article/view/57078

The development of a second malignancy is one of the most serious late effect for children who have been cured from the first malignancy. Chemoradiotherapy is a carcinogenic factor of the developing of the second malignancy. Organs and tissues of the child's body, taking into account the degree of maturity, microenvironment, age and life factors, are differently susceptible to the carcinogenic effects of chemo- and radiation therapy. Given the increase in the number of patients cured from the first malignancy, improving therapy is aimed at reducing the risk of developing a second malignancy as the child's body grows and develops. Determining the risk factors for secondary malignancy and developing measures aimed at reducing the frequency of secondary tumors in pediatric cancer survivors is an important task of modern oncopediatry. This paper presents the most common childhood tumors, after treatment of which the development of the second malignancy occurs. Risk factors and timing of secondary tumors are highlighted. Special attention is paid to recommendations for monitoring people who have been cured of malignancy in childhood.

Развитие второго злокачественного новообразования (ЗНО) является одним из наиболее серьезных отдаленных осложнений у детей, перенесших лечение по поводу первой злокачественной опухоли. Проводимое химиолучевое лечение является канцерогенным фактором развития второго ЗНО. Органы и ткани детского организма с учетом степени зрелости, микроокружения, возраста и факторов образа жизни по-разному восприимчивы к канцерогенному воздействию химиопрепаратов и лучевой терапии. С учетом увеличения числа больных, излеченных от первого ЗНО, совершенствование терапии направлено на уменьшение риска развития вторых ЗНО по мере роста и развития детского организма. Определение факторов риска вторых ЗНО и разработка мер, направленных на снижение частоты развития вторых опухолей у лиц, излеченных от первого онкологического заболевания, являются важной задачей современной онкопедиатрии. В настоящей работе представлены наиболее часто встречающиеся опухоли детского возраста, после терапии которых происходит развитие вторых ЗНО. Освещены факторы риска и сроки развития вторых опухолей. Отдельное внимание уделено рекомендациям по наблюдению лиц, излеченных от ЗНО в детском возрасте.

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