ЛЕЧЕНИЕ СУПРАТЕНТОРИАЛЬНЫХ ОПУХОЛЕЙ ГОЛОВНОГО МОЗГА У ЛИЦ ПОЖИЛОГО И СТАРЧЕСКОГО ВОЗРАСТА: ОТ КОНЦЕПЦИИ БИОЛОГИЧЕСКОГО ВОЗРАСТА К ПЕРСОНАЛИЗИРОВАННОЙ ТАКТИКЕ
DOI:
https://doi.org/10.52754/16948610_2026_3_3%20Ключевые слова:
нейроонкология; пожилой и старческий возраст; менингиома; глиобластома; старческая астения; нейровизуализация; послеоперационное ведениеАннотация
Старение населения меняет структуру нейрохирургического потока: доля пациентов пожилого и старческого возраста в профильных стационарах устойчиво растёт. Цель работы — обобщить современные данные об эпидемиологии, молекулярной биологии и клиническом ведении супратенториальных глиом и менингиом у гериатрических пациентов. Выполнен нарративный обзор публикаций последнего десятилетия: международных клинических руководств, рандомизированных исследований, систематических обзоров и данных популяционных регистров. Показано, что в этой возрастной группе преобладают менингиомы среди доброкачественных новообразований и глиобластомы без мутации изоцитратдегидрогеназы среди злокачественных, а растущая доступность томографии увеличивает выявление бессимптомных менингиом. Обоснована роль мультимодальной нейровизуализации в уточнении границ опухолевой инвазии. Снижение послеоперационной летальности определяется не только хирургической техникой, но и стандартизацией ведения пролонгированного послеоперационного периода с учётом полиморбидности и риска госпитальных инфекций. Приоритетной задачей остаётся разработка методических рекомендаций по персонализированному ведению таких пациентов.
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