Serozni karcinom jajnika visokog gradusa kod bolesnice u terminalnom stadijumu bubrežne bolesti
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.
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