Sažetak
Uvod. Karcinom jajnika, jedan od najčešćih ginekoloških kancera, ima najveću stopu smrtnosti. Zlatni standard lečenja bolesnica sa uznapredovalim karcinomom jajnika, uz inhibitore angiogeneze koji se primenjuju u određenim uznapredovalim stadijumima, jeste citoreduktivna hirurgija, praćena primenom hemioterapije (HT). Primena HT kod bolesnika na hemodijalizi (HD) ima neke specifičnosti i ograničenja, a uz to ne postoje smernice HT za lečenje tih bolesnika. Prikaz bolesnika. Prikazujemo 45-godišnju bolesnicu sa terminalnim stadijumom bubrežne bolesti, na programu HD. Magnetska rezonanca abdomena i male karlice pokazala je multicističnu masu ukupnog prečnika 93 × 115 × 168 mm u desnom jajniku i dve subkapsularne lezije u VI segmentu jetre prečnika 22 × 14 mm i 9 mm (stadijum IVb karcinoma jajnika). Nivo tumor markera cancer antigen 125 (CA-125) u serumu iznosio je 93 U/mL. Učinjena je totalna histerektomija sa bilateralnom salpingo-ooforektomijom i infrakoličnom omentektomijom. Histopatološkom analizom hirurškog uzorka potvrđen je serozni adenokarcinom jajnika visokog gradusa, FIGO stadijuma IVb. Posle operacije, bolesnica je lečena kombinovanom HT karboplatinom i paklitakselom, uz određivanje doze karboplatina prema Kalvertovoj formuli i započinjanjem HD u roku od 20 sati od završetka HT infuzije. Dve godine posle postavljanja dijagnoze, bolesnica je u dobrom opštem stanju. Zaključak. Bolesnici na HD mogu biti lečeni kombinovanim režimom HT karboplatinom i paklitakselom, određivanjem doze karboplatina prema Kalvertovoj formuli i započinjanjem HD u roku od 20 sati od završetka infuzije hemioterapeutika.
Ključne reči
lečenje kombinovanjem antineoplastika, protokoli;
dijagnoza;
bubreg, hronična insuficijencija;
magnetska rezonanca, snimanje;
jajnik, neoplazme;
hemodijaliza
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