Современные подходы к реабилитации пациентов с онкологическими заболеваниями органов дыхательной системы

Злокачественные новообразования (ЗНО) органов дыхательной системы занимают одно из ведущих мест в структуре онкологической заболеваемости и смертности во всем мире. Несмотря на значительный прогресс в хирургическом лечении, лекарственной и лучевой терапии, многие пациенты сталкиваются со снижением функциональных резервов организма, нарушением физической работоспособности, респираторными симптомами и ухудшением качества жизни. В этих условиях реабилитация становится важным компонентом комплексного ведения больных на всех этапах противоопухолевого лечения. В обзоре обобщены современные данные об эффективности реабилитационных мероприятий у пациентов с ЗНО органов дыхательной системы на этапах пререабилитации, хирургического лечения, лекарственной и лучевой терапии. Рассмотрены результаты клинических исследований, посвященных физическим тренировкам, дыхательной реабилитации, нутритивной и психологической поддержке, а также мультимодальным программам. Показано, что наиболее убедительная доказательная база накоплена в отношении пререабилитации перед хирургической операцией и комплексных программ сопровождения пациентов с раком легкого. Реабилитационные вмешательства способствуют снижению частоты послеоперационных осложнений, сохранению функционального статуса, уменьшению выраженности симптомов и поддержанию качества жизни. Вместе с тем эффективность отдельных методов реабилитации во время лучевой и химиолучевой терапии изучена в меньшей степени и требует дальнейших исследований. Современные данные свидетельствуют о необходимости интеграции реабилитационных мероприятий в систему оказания помощи пациентам с ЗНО органов дыхательной системы с учетом этапа лечения, функционального состояния и индивидуальных потребностей.

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