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Vol. 72 Br. 4 (2015)
Vol. 72 Br. 4 (2015)

Kliničkopatološke karakteristike, dijagnoza i lečenje melanoma u Srbiji – The Melanoma Focus studija

DOI: 10.2298/4657
Lidija Kandolf-Sekulović
Clinic for Dermatovenerology, Military Medical Academy, Belgrade Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Nada Babović
Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
Neven Jokić
Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
Mirjana Balić
Clinic for Oncology, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia
Borislava Nikolin
Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia
Dejan Nikolić
University Hospital Medical Center “Bežanijska Kosa”, Medical Faculty, University of Belgrade, Belgrade, Serbia
Zlata Janjić
Clinic for Plastic and Reconstructive Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
Željko Mijušković
Clinic for Dermatovenerology, Military Medical Academy, Belgrade Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Milica Rajović
Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic for Plastic and Reconstructive Surgery, Military Medical Academy, Belgrade Serbia
Marijan Novaković
Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic for Plastic and Reconstructive Surgery, Military Medical Academy, Belgrade Serbia
Svetislav Vrbić
Clinic for Oncology, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia
Ivica Pejčić
Clinic for Oncology, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia
Predrag Kovačević
Clinic for Plastic and Reconstructive Surgery, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia
Dragan Mihajlović
Clinical Center Niš, Niš, Serbia
Tatjana Roganović
Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia
Vicko Ferenc
Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia
Jelena Nikolić
Clinic for Plastic and Reconstructive Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
Marija Marinković
Clinical Center of Vojvodina, Novi Sad, Serbia
Zorana Bizetić
Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
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2015-03-29

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1.
Kandolf-Sekulović L, Babović N, Jokić N, Balić M, Nikolin B, Nikolić D, i drugi. Kliničkopatološke karakteristike, dijagnoza i lečenje melanoma u Srbiji – The Melanoma Focus studija. Vojnosanit Pregl [Internet]. 29. Mart 2015. [citirano 12. Juli 2026.];72(4). Dostupno na: https://asistent.ceon.rs/index.php/vsp/article/view/VSP131014052K
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Uvod/Cilj. Terapijske mogućnosti za metastatski melanom u Srbiji su ograničene zbog nedostupnosti novoodobrenih bioloških lekova i veoma malog broja multicentričnih internacionalnih kliničkih studija. Takođe, postoji mali broj podataka o terapijskom pristupu metastatskom melanomu u različitim tercijarnim centrima i efikasnosti raspoloživih protokola hemioterapije. Cilj ove studije bio je da se dobiju detaljniji podaci o protokolima lečenja u Srbiji, na osnovu strukturisane ankete u tercijarnim onkološkim centrima. Metode. Podaci o obolelima od melanoma, lečenih u 2011. godini u Srbiji, dobijeni su i analizirani iz bolničkih baza šest referentnih onkoloških centara u Srbiji, na osnovu strukturisane ankete, sa fokusom na metastatski melanom (inoperabilni stadijum IIIC i IV). Rezultati. Ukupno je lečeno 986 (79–315 u različitim centrima) bolesnika, od čega je 320 (32,45%) bilo novodijagnostikovanih. Bilo je 317 bolesnika u stadijumu inoperabilnog melanoma IIIC/IV, 77/317 (24,29%) starosti < 50 godina. U vreme postavljanja dijagnoze 47,3% bolesnika bili su < 60 godina starosti (24,2% < 40 godina, 38% 40–60 godina, 46% > 60 godina). Kod 12,5% bolesnika dijagnoza je postavljena u stadijumu III, a kod 4,5% u stadijumu IV bolesti. Najčešći kliničkopatološki tip bio je površnošireći (50–66%) i nodularni melanom (23,5–50%). Osim regionalnih i udaljenih metastaza limfnih čvorova, najčešće zahvaćeni organi u IV stadijumu bolesti bili su; udaljene metastaze kože i mekih tkiva (12–55%), pluća (19–55,5%), jetra (10–60%) i kosti (3–10%). Prva linija terapije u inoperabilnom stadijumu III i stadijumu IV metastatskog melanoma bio je dakarbazin (dimetril-triazeno-imidazol-karboksamid – DTIC) kod 61–93% bolesnika, dok je druga linija varirala između centara. Kontrola bolesti (kompletan odgovor + parcijalan odgovor + stabilna bolest) ostvarena je kod 25,7% bolesnika lečenih prvom linijom hemioterapije i 23,1% bolesnika sa drugom linijom terapije. Trajanje odgovora bilo je kratko: u prvoj liniji terapije 6,66 ± 3,36 meseci (medijana 6,75 meseci). Više od 90% bolesnika lečeni su van kliničkih studija. Zaključak. Ovo istraživanje ukazuje da postoji velika potreba za novim terapijskim opcijama za lečenje metastatskog melanoma u Srbiji. Razvoj nacionalnih smernica i veće učešće u međunarodnim kliničkim studijama može dovesti do proširenja opcije za lečenje ove bolesti otporne na hemioterapiju.

Ključne reči

melanoma||
||melanom
diagnosis||
||dijagnoza
neoplasm staging||
||neoplazme
određivanje stadijuma
neoplasm metastasis||
metastaze
therapeutics||
||lečenje
clinical protocols||
||protokoli
klinički
DOI: 10.2298/4657

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