BOSH MIYA ICHIDAGI MENINGIOMANI DAVOLASH YONDASHUVLARIDAGI TENDENSIYALAR
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bosh miya ichidagi meningioma; neyroxirurgiya; stereotaksik radiojarrohlik; nurlanish terapiyasi; faol kuzatuv; WHO 2021; molekulyar markerlar; prognoz; omon qolish##article.abstract##
Kirish. Bosh miya ichidagi meningiomalar eng ko‘p uchraydigan birlamchi miya o‘smalari qatoriga kiradi va klinik hamda biologik jihatdan sezilarli geterogenlik bilan tavsiflanadi. So‘nggi yigirma yil ichida davolash paradigmalari o‘zgardi: jarrohlik rezektsiyasi bilan bir qatorda stereotaksik radiojarrohlik, fraksionlangan nurlanish terapiyasi hamda faol kuzatuv (active surveillance) strategiyasi, ayniqsa kichik va simptomsiz o‘smalarda, tobora muhim o‘rin egallamoqda.
Materiallar va usullar. Populyatsion kohortlar va yirik onkologik registrlar ma’lumotlari asosida retrospektiv analitik ko‘rib chiqish o‘tkazildi. Demografik ko‘rsatkichlar, o‘sma xususiyatlari (hajm, WHO darajasi), klinik holat, davolash strategiyasi (kuzatuv, jarrohlik, nurlanish terapiyasi, kombinatsiyalangan yondashuvlar) hamda omon qolishga ta’sir etuvchi omillar tavsifiy statistika, ko‘p omilli regressiya va omon qolish tahlillari yordamida baholandi.
Natijalar. Bemorlar orasida ayollar ulushi yuqori bo‘lib, o‘smalarning asosiy qismi WHO grade I ga to‘g‘ri keldi. Yillar davomida faol kuzatuv ulushining ortishi va jarrohlik davolash chastotasining nisbatan kamayishi, ayniqsa kichik o‘smalarda, kuzatildi. Katta hajmli yoki simptomatik o‘smalarda asosiy davolash usuli jarrohlik bo‘lib qoldi. Radiojarrohlik va ad’yuvant nurlanish terapiyasi ko‘proq murakkab lokalizatsiya (bosh suyagi asosida), subtotal rezektsiya va WHO grade II–III holatlarida selektiv qo‘llanildi. Katta yosh, komorbidlikning yuqoriligi, o‘smaning katta hajmi va yuqori daraja prognozning yomonlashuvi bilan bog‘liq bo‘ldi.
Xulosa. Bosh miya ichidagi meningiomalarni davolashda zamonaviy paradigma shaxsga yo‘naltirilgan, multidisiplinar yondashuvga siljimoqda; unda WHO 2021 doirasidagi klinik, radiologik va molekulyar-genetik ko‘rsatkichlar xavf stratifikatsiyasi, jarrohlik hajmini tanlash hamda radioterapiya yoki kuzatuv strategiyasini asoslashda muhim ahamiyatga ega.
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