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IAOe?IIAEUeIA AEAAeAI?ss IAOE OE?A?IE

?INOEOOO AENIA?EIAIOAEUeII? IAOIEIA??,

IIEIEIA?? ? ?AAe?IA?IEIA?? ?i. ?.?. EAAAOeUeEIAI

I?I?NOA?NOAI IOI?IIE CAeI?IA’ss OE?A?IE

OE?A?INUeEEE IAOEIAI-AeINE?AeIEE ?INOEOOO

IIEIEIA?? OA ?AAe?IEIA??

EI?IA?I NA?A?E ?AI?IAE*

OAeE: 616.5– 006.61– 005.277.3–089

OEssOE IIE?AUAIIss ?ACOEUeOAO?A E?EOAAIIss CEIssE?NII? IAEAIIIE
OE??E E?IOe?AIE OA OOEOAA

14. 01. 07 – Iieieia?y

A A O I ? A O A ? A O

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

aeieoi?a iaaee/ieo iaoe

Ee?a – 1998

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Oe?a?inueeiio iaoeiai-aeine?aeiiio ?inoeooo? iieieia??
oa ?aae?ieia?? IIC Oe?a?ie.

Iaoeiaee eiinoeueoaio ( aeieoi? iaaee/ieo iaoe, i?ioani?

Oienoii’yoia Ai?eneaa Ienaio?eiae/,

Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo

iieieia?? oa ?aae?ieia?? IIC Oe?a?ie, caa?aeoaa/ iaoeiai-aeine?aeiiai
a?aeae?eaiiy iooeei iii?ii-?ooiaiai aia?aoo.

Io?oe?ei? iiiiaioe: aeieoi? iaaee/ieo iaoe

Ai?iaeiaa Ethny ?aai?aia,

Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo iieiei-a?? oa ?aae?ieia?? IIC
Oe?a?ie, caa?aeoth/a iaoeiai-aeine?aeiei a?aeae?eaiiyi iieia?iaeieia??;

aeieoi? iaaee/ieo iaoe, i?ioani?

Iyni?aeia Aeieo?i Aieiaeeie?iae/,

Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe IIC Oe?a?ie ?i. I.E.
Ooieea, caa?aeoaa/ eaoaae?e iieieia??;

aeieoi? iaaee/ieo iaoe, i?ioani?

ss?ai/oe Ieaenaiae? sseiae/,

Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i. I.I.Aiaiiieueoey IIC Oe?a?ie,
caa?aeoaa/ eaoaae?e iieieia??.

I?ia?aeia onoaiiaa ( Aeiiaoeueeee iaaee/iee oi?aa?neoao ?i. I.
Ai?ueeiai IIC Oe?a?ie, eaoaae?a iieieia??.

Caoeno a?aeaoaeaoueny (16( a?oaeiy 1998 ?. i 13 aiae 30 oa ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae.26.155.01 a ?inoeooo?
aenia?eiaioaeueii? iaoieia??, iieieia?? ? ?aae?ia?ieia?? ?i. ?.?.
Eaaaoeueeiai IAI Oe?a?ie (252022, Ee?a , aoe. Aaneeuee?anueea, 45).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? ?inoeoooo
aenia?eiaioaeueii? iaoieia??, iieieia?? ? ?aae?ia?ieia?? ?i. ?.?.
Eaaaoeueeiai IAI Oe?a?ie.

Aaoi?aoa?ao ?ic?neaiee (11( eenoiiaaea 1998 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee

aeieoi? iaaee/ieo iaoe
Aa?aiaiei ?.A.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. Iaeaiiia oe??e noaiiaeoue eeoa 1(3%
ceiye?nieo caoai?thaaiue ethaeeie. Aea e?euee?noue ethaeae o na?o?,
oai?eo ia iaeaiiaeanoiio, eiaeiiai ?ieo c?inoa? ia 5% (A.A.
Aieneiia e niaao., 1995). I?inoaaeaia aeeiai?ea ca?eueoaiiy iieaciee?a
caoai?thaaiino? ianaeaiiy a Oe?a?i?. E?euee?noue ethaeae, ye? caoai??ee
ia ceiye?nio iaeaiiio, c?inea c 1553 o 1989 ?. aei 1944 o 1996 ?. Oea
aei??aith? 3,0 ? 3,8 ia 100 000 ianaeaiiy e?a?ie (C.I. Oaaei?aiei oa
ni?aaao., 1997).

O??o?a?/ia aeaeaeaiiy iaeaiiaeanoiie oe??e caeeoa?oueny ?aeeiei
?aaeeeaeueiei iaoiaeii e?eoaaiiy (A. Barth et al., 1994). Iacaaaeath/e
ia iiaeeea?noue oe?ieiai e aaeanoe/iiai aeaeaeaiiy ia?aeiii? iooeeie,
iiaeaeueoee ?icaeoie caoai?thaaiiy i?e II(V ??aiyo ?iaac?? iooeeie ca
Eea?eii (97% iaoe??io?a, ye? aia?oa caa?oathoueny aei e?ea?y), i?aeoe/ii
iaieio/ee (M. Thorn et al., 1994).

Iieieiae iino?eii aaaeooue iiooe cania?a ? iaoiae?a, caaaeyee yeei
iiaeia aeinyaoe o?eaaeeo, noaa?eueieo oa?i?i?a ?ai?n?? (P. Wolkenstein
et al., 1995). Aeiiei? oey i?iaeaia ia ae??oaia ? ? ia’?eoii iiooeo (J.
Overgaard et al.,1995). Oe?ieee niaeo? ?nioth/eo iaoiae?a
i?io?eaeoeee ? e?eoaaiiy iaoanoac?a iaeaiiie oe??e ? ?o eiia?iaoe?e
caeaee ?ac aeiaiaeeoue, ye aeaeaea oey i?iaeaia a?ae inoaoi/iiai
ae??oaiiy (C. Balch et al., 1997).

?ooeii? caniae aeei?enoaiiy oaeeo aeia?a a?aeiieo iaoiae?a e?eoaaiiy
ceiye?nieo iooeei, ye i?iiaiaaa ? o?i?ioa?ai?y, ia iie?aueee ?acoeueoaoo
?aaeeeaeueieo iia?aoe?e (H. Voigt, 1988). A?eueo ia?aeiieea? aeai? aoee
io?eiai? i?e iiaeeo?eaoe?? o?i?ioa?ai?? naeaeoeaiei niiniaii aaaaeaiiy
oeeoinoaoee?a (H. Hoekstra et al., 1993). Cie?aia, caaaeath/e ia aaeeeo
a??ia?aei?noue o?aaeaiiy iaoanoacaie ?aa?iia?iiai e?ioaoe/iiai
eieaeoi?o, aeey iaeaiiie oe??e e?ioe?aie ? ooeoaa iaeaeioe?euei?oith ?
iaoiaeeea aiaeie?ioaoe/ii? oa?ai??. Oeae iai?yiie aei oeueiai /ano
eeoa?oueny aeooaeueiei, aea ia? aeoaea aaeeeo e?euee?noue ieoaiue, ui
iio?aaothoue ae??oaiiy .

I?ioa iaeoaeaiiy oai?eo ia ceiye?nio iaeaiiio oe??e iaiiaeeeai o?eueee
caaaeyee oaoi?/iiio oaeineiiaeaiith iaoiaeee. Ia?aeaeueii ?c ?ic?iaeith
oeyo?a aaaaeaiiy oeeoinoaoe/ieo i?aia?ao?a ?aeooue iiooee oa ai?iaaoe??
iiaeo i?ioeiooeeiieo cania?a (M. Mitchell et al., 1995).

Iaeiei ?c ia?niaeoeaieo iai?yi?a i?ioeiooeeiii? oa?ai?? ? aeei?enoaiiy
iiaeeo?eaoi??a a?ieia?/ieo a?aeiia?aeae, aai oeeoie?i?a (A.E. Ai?iioeiaa
e niaao., 1996; A.O.Aiceaiia e niaao., 1998). Ia aeoieo aaaaoueio
aeine?aeiee?a, a oeueiio aaeeeiio ?icae?e? iiaeo e?ea?nueeeo i?aia?ao?a
i?e iaeaiii? ia?aaaaa iaaea?oueny ?ioa?oa?iio (J Kirkwood et al.,
1996). Ia nueiaiaei? ia ?nio? /?oeeo oyaeaiue i?i eiie?aoi? oa?aiaaoe/i?
noaie aeeth/aiiy ?ioa?oa?iio a eiiieaenio oa?ai?th iaeaiiaeanoiie.

Ca’ycie aeine?aeaeaiue c iaoeiaeie i?ia?aiaie. ?iaioa aeeiiaia a ?aieao
ieaiiaeo IAe? a?aeae?eaiiy iooeei iii?ii-?ooiaiai aia?aoo Oe?a?inueeiai
iaoeiai-aeine?aeiiai ?inoeoooo iieieia?? ? ?aae?ieia?? (OIAe?I?) IIC
Oe?a?ie ca oaeeie iiia?aie aea?aeaaii? ?a?no?aoe??: ? 0194EI18647, ?
01.9.20000845 , ? 0186.0054737.

Iaoa ?iaioe. Ioe?ieoe aoaeoeai?noue no/anieo iaoiae?a e?eoaaiiy oai?eo
ia iaeaiiio oe??e e?ioe?aie oa ooeoaa, ?ic?iaeoe aoaeoeai? noaie
aae’thaai-oii? oa?ai??, ui caeaoi? iie?aueoe a?aeaeaeai? ?acoeueoaoe
?aaeeeaeueieo iia?aoe?e.

Caaea/? aeine?aeaeaiiy

1. Aea/eoe ?acoeueoaoe o??o?a?/iiai iaoiaeo e?eoaaiiy oai?eo ia
iaeaii-io oe??e e?ioe?aie ? ooeoaa ia ??cieo aoaiao i?ia?an??
caoai?thaaiiy. Anoaiiaeoe iine?aeiai?noue ?icaeoeo aeaii? ceiye?nii?
iooeeie ? aecia/eoe aieea noao?, a?eo iaoe??io?a ? eieae?caoe?? iooeeie
ia ia?aa?a iaoieia??, ui aea/a?oueny.

2. Ioe?ieoe aoaeoeai?noue iaoiaeeee aae’thaaioii? i?iiaiaai? oa?ai?? a
eii-a?iaoe?? c ?aaeeeaeueiith iia?aoe??th o oai?eo ia iaeaiiio oe??e
e?ioe?aie ? ooeoaa.

3. ?ic?iaeoe iaoiaeeeo i?io?eaeoe/ii? nenoaiii? o?i?ioa?ai?? ?
i?iaia-e?coaaoe ?acoeueoaoe ?? aeei?enoaiiy o oai?eo ia ceiye?nio
iaeaiiio oe??e e?ioe?aie ? ooeoaa.

4. ?ic?iaeoe eiia?iiaaiee iaoiae aae’thaaioii? nenoaiii? o?i?ioa?ai?? a
ii?aeiaii? c ianiaoeeo?/iei ?ioiiiiaeoeyoi?ii eaaii?cieii aeey e?eoaaiiy
oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa.

5. ?ic?iaeoe iaoiaeeeo i?io?eaeoe/ii? niaoeeo?/ii? ?ioiioa?ai??
(aooi-aaeoeeiaoe??) i?e e?eoaaii? iiaoi?ieo oai?eo c ?aoeeaeeaieie
iaoanoacaie iaeaiiie oe??e a ?aa?iia?ieo e?ioaoe/ieo aoceao ? aecia/eoe
?? aoaeoeai?noue.

6. ?ic?iaeoe iaoiaeeeo naeaeoeaii? (aiaeie?ioaoe/ii?) aae’thaaioii?
o?i?i-oa?ai?? aeey e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ?
ooeoaa. Aeaoe ioe?ieo ?acoeueoaoai aeei?enoaiiy ai?iaaaeaeaiiai
eiia?iiaaiiai iaoiaeo.

7. Ai?iaoaaoe ? cai?iaaaeeoe a?o/eciyiee ?aeiia?iaioiee (-((-?ioa?-oa?ii
(eaoa?ii) a noaiao eiia?iiaaiiai e?eoaaiiy oai?eo ia ceiye?nio iaeaiiio
oe??e. Aeaoe ioe?ieo iiaeeeainoyi iiaiai i?aia?aoo. ?ic?iaeoe iaoiaeeee
? noaie eiai aeei?enoaiiy i?e e?eoaaii? oai?eo ia iaeaiiio oe??e
e?ioe?aie ? ooeoaa.

8. Ia i?aenoaa? aiae?co io?eiaieo ?acoeueoao?a cai?iiiioaaoe iioeiaeuei?
noaie e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa a
caeaaeiino? a?ae noaae?? caoai?thaaiiy.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. ?ic?iaeaii aoaeoeai?, iaoeiai
iaa?oioiaai? i?aeoiaee aei e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie
? ooeoaa, ye? aeicaieeee ca?eueoeoe oa?i?i ?ai?n?? caoai?thaaiiy ?
o?eaae?noue aeeooy iaoe??io?a (iieacieee 3- ? 5-??/iiai aeaeeaaiiy).

Anoaiiaeaii, ui aiaeie?ioaoe/ia o?i?ioa?ai?y iiaeiaaeo? oa?i?i aeeooy
oai?eo ? ?ai?n?? caoai?thaaiiy i?ney iia?aoe?e, aeeiiaieo c i?eaiaeo
ia?aeiii eieae?ciaaii? iaeaiiie oe??e.

Aia?oa anoaiiaeaia aoaeoeai?noue naeaeoeaiiai (aiaeie?ioaoe/iiai)
canoinoaaiiy ?aeiia?iaioiiai (-((-?ioa?oa?iio (eaoa?iio) oai?ei ia
iaeaiiio oe??e. ?ic?iaeaia iaoiaeeea ii?aeiaiiai aiaeie?ioaoe/iiai
aaaaeaiiy ?aeiia?iaioiiai ?ioa?oa?iio ? o?i?ii?aia?ao?a a noaiao
eiia?iiaaiiai e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa.
Aeiaaaeaia aoaeoeai?noue oeueiai i?io?eaeoe/iiai caniao i?ney iia?aoe?e,
aeeiiaieo c i?eaiaeo ia?aeiii eieae?ciaaii? iaeaiiie oe??e.

?ic?iaeaii aoaeoeaiee iaoiae aae’thaaioii? oa?ai?? e?eoaaiiy oai?eo c
iaoanoacaie iaeaiiie oe??e e?ioe?aie ? ooeoaa a ?aa?iia?ieo e?ioaoe/ieo
aoceao (ia?aaeiia?aoe?eia aiaeie?ioaoe/ia i?ioeiooeeiia oa?ai?y).

I?aeoe/ia cia/aiiy ? ai?iaaaeaeaiiy io?eiaieo ?acoeueoao?a. Ai?iaiaaii
oa cai?iaaaeaeaii aei oe?ieiai ee?i?/iiai aeei?enoaiiy a?o/eciyiee
?aeiia?iaioiee (-((-?ioa?oa?ii – eaoa?ii. ?ic?iaeaii noaie eiai
canoinoaaiiy o oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa.

?ic?iaeaia noaia aae’thaaioii? aiaeie?ioaoe/ii? o?i?ioa?ai?? aeicaieeea
ia 11,0% ca?eueoeoe iieaciee 5-??/iiai aeaeeaaiiy oai?eo ia ia?aeiii
eieae?ciaaio iaeaiiio oe??e e?ioe?aie ? ooeoaa.

?ic?iaeaia noaia aae’thaaioii? aiaeie?ioaoe/ii? oa?ai?? c aeei?enoaiiyi
o?i?ii?aia?ao?a ? eaoa?iio ia 15,0% i?aeaeueea iieaciee 3-??/iiai
aeaeeaaiiy oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e.

Ai?iaaaeaeaia noaia ia?aaeiia?aoe?eii? aiaeie?ioaoe/ii? i?ioeiooeeiii?
oa?ai?? (o?i?ioa?ai??, ?ioa?oa?iiioa?ai??) ia 19,0% iie?aueea iieaciee
3-??/iiai aeaeeaaiiy i?e e?eoaaii? ia?aeiieo oai?eo c iaoanoacaie
iaeaiiie oe??e a ?aa?iia?ieo e?ioaoe/ieo aoceao.

?ic?iaeaia noaia e?eoaaiiy (ia?aaeiia?aoe?eia aiaeie?ioaoe/ia aaaaeaiiy
eaoa?iio) oai?eo c ?aa?iia?ieie e?ioaoe/ieie iaoanoacaie oe??e ooeoaa,
ui aeieeaee i?ney aeaeaeaiiy ia?aeiii? iooeeie, ia 23,0% iie?ioeea
iieaciee 3-??/iiai aeaeeaaiiy iaoe??io?a i?ney e?ioaaeaiaeoii??.

Iaoa??aee aeena?oaoe?? aeeth/aii aei i?ia?aie iaa/aiiy e?ea??a ia
eaoaae?? iieieia?? Ee?anueei? iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe
IIC Oe?a?ie. ?acoeueoaoe ?iaioe aeeeaaeai? ia eaeoe?yo aeey e?ea??a, ye?
iaa/aeeny ia eo?nao ?ioi?iaoe?? ? noaaeoaaiiy o a?aeae?eaii? iooeei
iii?ii-?ooiaiai aia?aoo OIAe?I? IIC Oe?a?ie. ?acoeueoaoe aeine?aeaeaiiy
ai?iaaaeaeaii a i?aeoeeo iaaee/ieo caeeaae?a oeyoii aeaeaiiy iaoiaee/ieo
?aeiiaiaeaoe?e ? aeaio ?ioi?iaoe?eieo eeno?a, caoaa?aeaeaieo IIC
Oe?a?ie. ?ic?iaeai? iaoiaee e?eoaaiiy aeei?enoiaothoueny o a?aeae?eaii?
iooeei iii?ii-?ooiaiai aia?aoo OIAe?I? IIC Oe?a?ie ? o ??aiainueeiio
iaeaniiio iieieia?/iiio aeeniaina??.

Iniaenoee aianie caeiaoaa/a. Aaoi?ii iniaenoi ?ic?iaeai? oa ai?iaiaai?
an? iaoiaeeee aae’thaaioii? oa iaiaae’thaaioii? aiaeie?ioaoe/ii? oa?ai??
i?e e?eoaaii? oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa. Caeiaoaa/ai
naiino?eii i?iaaaeaia aiaeie?ioaoe/ia oa?ai?y on?i 360 oai?ei, ye?
oa?eoee aei aeine?aeaeoaaieo a?oi.

Caeiaoaa/ai aeanii?o/ii aeeiiaii on? ee?i?/i? ?iaioe c oa?ai?? oai?eo ia
iaeaiiio oe??e iaoiaeii i?io?eaeoe/ii? aooiaaeoeeiaoe??.

Aaoi? aoa aeeiiaaoeai ?iaeea?aeoaeueieo caaaeaiue IAe? i?e ?ic?iaoe? ?
ai?iaaoe?? iaoiae?a aae’thaaioii? nenoaiii? o?i?ioa?ai??, eiia?iiaaii?
o?i?i- ? ?ioiioa?ai?? oai?eo ia iaeaiiio oe??e ? a?aa aaciina?aaeith
o/anoue a e?eoaaii? oaiaoe/ieo oai?eo, a oaeiae o noai?aii?
eiii’thoa?ieo aac aeaieo, ia?iaoe? a?o?aiiai iaoa??aeo ? aea/aii?
a?aeaeaeaieo ?acoeueoao?a e?eoaaiiy.

Ai?iaaoe?y ?iaioe. Iniiai? ?acoeueoaoe aeena?oaoe?? aoei aeeeaaeaii ?
iaaiai?aii ia Ananithciiio neiiic?oi? “Ee?i?ea oa e?eoaaiiy iaeaiiie
oe??e” (Na?aoia, 1990); ?? Ananithciiio neiiic?oi? “Iaoanoacoaaiiy
ceiye?nieo iooeei. Iia? i?aeoiaee” (Ee?a, 1991); can?aeaiiyo Iaoeiaiai
oiaa?enoaa iieieia?a i. Ee?aa ? Ee?anueei? iaeano? (Ee?a, 1992);
?anioae?eainuee?e iaoeiai-i?aeoe/i?e eiioa?aioe?? “Eaoa?ii a eeiii/iie
iaaeeoeeii” (??aia, 1995); IX c’?cae? iieieia?a Oe?a?ie (A?iieoey,
1995); ?anioae?eainuee?e iaoeiai-i?aeoe/i?e eiioa?aioe?? “O?i?ioa?ai?y a
eiiieaeniiio e?eoaaii? iieieia?/ieo oai?eo” (*a?i?aoe?, 1996);
?anioa-e?eainuee?e iaoeiai-i?aeoe/i?e eiioa?aioe?? “?ae ia Oe?a?i?:
ai?aeai?ieia?/i? ? i?aai?caoe?ei? aniaeoe i?iaeaie” (Ee?a, 1997);
?anioae?eainuee?e iaoeiai-i?aeoe/i?e eiioa?aioe?? “?ioiioa?ai?y i?e
e?eoaaii? ceiye?nieo iiaiooai?aiue” (Ee?a, 1998); ?anioae?eainuee?e
iaoeiai-i?aeoe/i?e eiioa-?aioe?? “Aeooaeuei? i?iaeaie ee?i?/ii?
oa?iaeieia??” (A?iieoey, 1998).

Ioae?eaoe?? ?acoeueoao?a aeine?aeaeaiue. Ca iaoa??aeaie aeena?oaoe??
iioae?eiaaii 39 iaoeiaeo i?aoeue, c ieo 20 noaoae a i?ia?aeieo oaoiaeo
aeaeaiiyo.

No?oeoo?a oa ianya aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia oe?a?inueeith
iiaith ia 284 noi?. iaoeiiieno. Neeaaea?oueny c? anooio, iaeyaeo
e?oa?aoo?e, oanoe ?icae?e?a aeanieo aeine?aeaeaiue, caeeth/aiiy,
aeniiae?a oa nieneo e?oa?aoo?ieo aeaea?ae, aei yeiai aoiaeeoue 481
iaeiaioaaiiy, c ieo 195 ( ia oe?a?inuee?e ? ?in?enuee?e iiaao, 286 ( ia
aiae?enuee?e. Aeena?oaoe?y ?ethno?iaaia 82 oaaeeoeyie ? 18 ?enoieaie.

INIIAIEE CI?NO ?IAIOE

IA’?EO ? IAOIAeE AeINE?AeAEAIIss

?iaioo aeeiiaii ia i?aenoaa? niinoa?aaeaiue ca 1703 oai?eie ia iaeaiiio
oe??e e?ioe?aie ? ooeoaa, ye? e?eoaaeeny o a?aeae?eaii? iooeei
iii?ii-?ooiaiai aia?aoo OIAe?I? IIC Oe?a?ie.

I?iaiae?ciaaii ?acoeueoaoe e?eoaaiiy oai?eo ia ia?aeiii eieae?ciaaio
iaeaiiio oe??e e?ioe?aie ? ooeoaa (I noaae?y, ca eeaneo?eaoe??th Stehlin
oa ni?aaao. – T(1-4)NoMo), ia?aeiieo oai?eo ia iaeaiiio oe??e e?ioe?aie
? ooeoaa c iae?eiaaiith ia?aeiiith iooeeiith ? ?aa?iia?ieie
e?ioiaaiieie iaoanoacaie (III B noaae?y, ca eeaneo?eaoe??th Stehlin oa
ni?aaao. – any Tc N1Mo) ? iiaoi?ieo oai?eo,ye? caa?ioeeny aei ian c
ee?i?/ieie i?iyaaie ?aa?iia?ieo e?ioiaaiieo iaoanoac?a, ui aeieeaee
i?ney aeaeaeaiiy iaeaiii oe??e e?ioe?aie ? ooeoaa

( III B noaae?y, ca eeaneo?eaoe??th Stehlin oa ni?aaao. – Tx
rN1Mo).

Aeey e?eoaaiiy oai?eo aoee canoiniaai? oae? iaoiaee:

1. O??o?a?/iee iaoiae.

2. O??o?a?/iee iaoiae noeoiii c i?iiaiaaith oa?ai??th.

3. O??o?a?/iee iaoiae noeoiii c nenoaiiith o?i?ioa?ai??th.

4. ?aaeeeaeueia iia?aoe?y ? nenoaiia o?i?ioa?ai?y noeoiii c
ianiaoeeo?/-iith ?ioiioa?ai??th (eaaii?cie).

5. ?aa?iia?ia e?ioaaeaiaeoii?y ? niaoeeo?/ia ?ioiioa?ai?y
(aooiaae-oeeia).

6. O??o?a?/iee iaoiae noeoiii c aiaeie?ioaoe/iith o?i?ioa?ai??th.

7. O??o?a?/iee iaoiae noeoiii c aiaeie?ioaoe/iith
?ioa?oa?iii-oa?ai??th (eaoa?ii).

8. O??o?a?/iee iaoiae ? aiaeie?ioaoe/ia o?i?ioa?ai?y noeoiii c
aiaeie?i-oaoe/iith ?ioa?oa?iiioa?ai??th (eaoa?ii).

A ia?o? aeine?aei? a?oie (A1 ( A7) oa?eoee oai?? ia ia?aeiii
eieae?-ciaaio iaeaiiio oe??e. Oea iaoe??ioe, o eio?eo aoea
ae?aaiinoiaaia ceiye?nia iaeaiiia oe??e II(V ??ai?a i?iieeiaiiy iooeeie
a aea?io ca Eea?eii, aac ee?i?/ieo iciae iaoanoac?a.

A?oia A1 ( oai?? (901 iaoe??io, eiio?ieueia a?oia), e?eoaaiiy yeeo
iaiaaeoaaeiny aeaeaeaiiyi ia?aeiii? iooeeie.

A?oia A2 ( oai?ei (90 iaoe??io?a) i?iaiaeeeanue i?neyiia?aoe?eia
i?iia-iaaa oa?ai?y: ia i?neyiia?aoe?eiee ?oaaoeue eo?niaa aeica 55(60
A?, ia?aeaeueii iai?aaeeaiea aaiaoa?ai?y ciie ?aa?iia?iiai
e?ioieieaeoi?o eo?niaith aeicith 40 A?.

A?oia A3 ( oai?? (38 iaoe??io?a) i?ney iia?aoe?? iaea?aeoaaee eo?ne
nenoaiii? o?i?ioa?ai??: o?noue eo?n?a i?ioyaii 2 ?ie?a c aeei?enoaiiyi
i?ini?aeeia, aeaeoeiii?oeeia ? dacarbazine.

A?oia A4 ( oai?ei (17 iaoe??io?a) i?ney iia?aoe?? i?iaiaeeeenue eo?ne
nenoaiii? o?i?ioa?ai?? (o?noue eo?n?a i?iaeiaae 2 ?ie?a c aeei?enoaiiyi
i?ini?aeeia ? aeaeoeiii?oeeia) noeoiii c ?ioiiiiaeoeyoi?ii eaaii?cieii
ii 150 ia per os aea?/? ia oeaeaeaiue, /ioe?ueiooeaeiaaee eo?n i?ney
eiaeii? o?i?ioa?ai??.

A?oia A5 ( oai?? (110 iaoe??io?a) i?ney iia?aoe?? io?eioaaee eo?n
yiaeie?ioaoe/ii? o?i?ioa?ai??: iaeei eo?n i?ioyaii oeaeiy. O?e
aaaaeaiiy /a?ac 48 aiae c aeei?enoaiiyi i?ini?aeeia, dacarbazine,
iaoio?aenaoa ? oeeeeioinoaia. Aea?? ia?eoa??eii? e?ioaoe/ii? noaeeie
aeey eaoaoa?ecaoe?? ia noii? /e eeno? i?iaiaeeany a noai??e caeaaeiino?
a?ae eieae?caoe?? aeaeaeaii? iooeeie.

A?oia A6 ( oai?? (45 iaoe??io?a) i?ney iia?aoe?? iaea?aeoaaee e?eoaaiiy
?aeiia?iaioiei (-((-?ioa?oa?iiii (eaoa?iiii): iaeei eo?n
yiaeie?i-oaoe/ii? oa?ai?? ( o?e aaaaeaiiy /a?ac 48 aiae ii 3·106 II. A
ianooiiiio ( 11 eo?n?a e?ioio?iiiiai aaaaeaiiy i?iaeiaae 1 ?ieo /a?ac
i?nyoeue. Eo?niaa aeica ( 4·106 II.

A?oia A7 ( oai?? (72 iaoe??ioa), yeei i?ney iia?aoe?? aiaeie?ioaoe/ii
aaiaeeee nii/aoeo o?i?ii?aia?ao (1-e oa 3-e aei?), a iio?i eaoa?ii (
6-e oa 7-e aei?). I?ioyaii ianooiiiai ?ieo oai?? io?eioaaee 11 eo?n?a
e?ioio?iiiiai aaaaeaiiy eaoa?iio oeaeiaaeie eo?naie /a?ac i?nyoeue.

Iiaeaeueo? aeine?aeaeaiiy aoee i?enay/ai? ?acoeueoaoai e?eoaaiiy oai?eo
ia iaeaiiio oe??e e?ioe?aie ? ooeoaa c III B ee?i?/iith noaae??th
caoai?thaaiiy, ca Stehlin oa ni?aaao.

Na?aae iaoe??io?a aeaii? a?oie ie aeae?eeee ia?aeiieo oai?eo, eio??
caa?ioeeny aei ee?i?ee c iae?eiaaiith ia?aeiiith iooeeiith ? iaoanoacaie
iaeaiiie a ?aa?iia?ieo e?ioaoe/ieo aoceao (any Tc N1Mi) ? iiaoi?ieo
iaoe??io?a c iaoanoacaie iaeaiiaeanoiie a ?aa?iia?ieo e?ioaoe/ieo
aoceao, ui aeieeaee i?ney aeaeaeaiiy ia?aeiii eieae?ciaaii? iaeaiiie
oe??e e?ioe?aie ? ooeoaa (Tx rN1Mi).

Aei a?oi A1 ( A4 ia?aeiieo oai?eo c ?aa?iia?ieie e?ioiaaiieie
iaoanoacaie oa?eoee oae? iaoe??ioe.

A?oia A1 ( oai?ei (205 iaoe??io?a, eiio?ieueia a?oia) c?iaeaia
?aaeeeaeueia iia?aoe?y.

A?oia A2 ( oai?ei (24 iaoe??ioa) i?ney o??o?a?/iiai e?eoaaiiy
i?iaiaeeeanue i?io?eaeoe/ia i?iiaiaaa oa?ai?y ciie ?aa?iia?iiai
e?ioieieaeoi?o: ia ciio aeaeaeaieo ?aa?iia?ieo e?ioaoe/ieo aoce?a eo?n
iai?aaeeaiei? aaiaoa?ai?? noia?iith aeicith 35(40 A?.

A?oia A3 ( oai?? (28 iaoe??io?a) ia?aaeiia?aoe?eii io?eioaaee a
ia?eoa??eio e?ioaoe/io noaeeio o?aaeaiiai e?ioaoe/iiai eieaeoi?o iaeei
oeaeiaaee eo?n o?i?ioa?ai??.

A?oia A4 ( oai?ei (19 iaoe??io?a) ia?aaeiia?aoe?eii aiaeie?ioaoe/ii
aaiaeeany eaoa?ii. Aoa i?iaaaeaiee iaeei eo?n ( o?e aaaaeaiiy /a?ac 48
aiae ii 3·106 II eaoa?iio ? i?ney iia?aoe?? – eo?ne e?ioio?iiiiai
aaaaeaiiy eaoa?iio: 11 eo?n?a e?ioio?iiiiai aaaaeaiiy oeaeiaaeie eo?naie
ii 4·106 II /a?ac i?nyoeue.

O a?oie N1 ( N5 oa?eoee iiaoi?i? oai?? ia iaeaiiio oe??e e?ioe?aie ?
ooeoao, ye? caa?ioeeny aei ee?i?ee c iaoanoacaie iaeaiiaeanoiie a
?aa?iia?ieo e?ioaoe/ieo aoceao, ui aeieeaee i?ney aeaeaeaiiy ia?aeiii?
iooeeie.

A?oia N1 ( oai?ei (435 iaoe??io?a , eiio?ieueia a?oia) i?iaiaeeeanue
eeoa ?aa?iia?ia e?ioaaeaiaeoii?y.

A?oia N2 ( oai?? (42 iaoe??ioa) ii?yae c o??o?a?/iei e?eoaaiiyi
io?eioaaee eo?ne i?neyiia?aoe?eii? aae’thaaioii? nenoaiii? o?i?ioa?ai??:
o?noue eo?n?a i?ioyaii 2 ?ie?a c aeei?enoaiiyi i?ini?aeeia,
aeaeoeiii?oeeia ? dacarbazine.

A?oia N3 ( oai?? (26 iaoe??io?a) i?ney iia?aoe?? iaea?aeoaaee
aaeoeeiaoe?th oa aeai?aciao ?aaaeoeeiaoe?th iooeeiiith aooiaaeoeeiith
(ca iaoiaeeeith Ae.A.Caooee oa ni?aaao., 1983).

A?oia N4 ( oai?ei (49 iaoe??io?a) i?iaiaeeany oeaeiaaee eo?n
ia?aaei-ia?aoe?eii? aiaeie?ioaoe/ii? o?i?ioa?ai??: o?e aaaaeaiiy
?ioa?aaeii 48 aiae.

A?oia N5 ( oai?ei (47 iaoe??io?a) ia?aaeiia?aoe?eii aiaeie?ioaoe/ii
aaiaeeany eaoa?ii: iaeei eo?n ( o?e aaaaeaiiy /a?ac 48 aiae ii 3·106 II
? i?ney iia?aoe?? – eo?ne e?ioio?iiiiai aaaaeaiiy eaoa?iio: 11 eo?n?a
e?ioio?iiiiai aaaaeaiiy oeaeiaaeie eo?naie ii 4·106 II /a?ac i?nyoeue.

Ca iniiai? (eiio?ieuei?) ?acoeueoaoe e?eoaaiiy aoee i?eeiyo? iieacieee a
a?oiao, a yeeo aeey e?eoaaiiy canoiniaoaaeeny eeoa ?aaeeeaeuei?
iia?aoe??. Oe? nai? aaeee? ca e?euee?noth niinoa?aaeaiue a?oie (A1, A1,
N1) aeei?enoiaoaaeeny oaeiae ? aeey aea/aiiy aieeao ie?aieo oaeoi??a ia
ia?aa?a caoai?thaaiiy.

Aeey aea/aiiy aaciina?aaei?o ?acoeueoao?a e?eoaaiiy ioe?ithaaeeny ci?ie
iieaciee?a caaaeueiiee?ie/ieo aiae?c?a, niinoa?aaeaiiy ca oai?eie.

C iaoith aea/aiiy aieeao eaoa?iio ia aeeiai?eo e?euee?niiai aaeaino
noeioeyoi??a e ?ia?a?oi??a ee?oeiii? i?ie?oa?aoe?? a ne?iaaooe? e?ia?
oai?eo iaie i?iaaaeaii oanooaaiiy ni?aa?aeiioaiiy iiceoeaieo ?
iaaaoeaieo oaeoi??a ?inoo (O?-oano ( A.E. Ai?iioeiaa e niaao., 1991) o
27 iaoe??io?a aeine?aeaeo?ii? a?oie (A6), o 17 oai?eo ia ia?aeiii
eieae?ciaaio iaeaiiio oe??e eiio?ieueii? a?oie (A1) ? o 16 i?aeoe/ii
caei?iaeo aeiii??a. Aea/aany aieea ne?iaaoee e?ia? oai?eo ia
i?ie?oa?aoeaio aeoeai?noue noniaic?eii? eoeueoo?e ee?oei iooeeie
e?ioina?eiie iaoethe?a in vitro.

Na?aae oai?eo a?oi A1, A3, A4 ? N3 c iaoith aieeao canoiniaaieo
aae’thaaioieo iaoiaeee ia ?ioiieia?/iee noai iaoe??io?a aea/aeany
aeeiai?ea ci?i iieaciee?a oanoo ?icaoeiooai?aiiy ? oanoo a?ia?/ooeeaino?
iia?eueiiai oeio ia AeIOA.

Aeey ioe?iee a?aeaeaeaieo ?acoeueoao?a cai?iaaaeaeaieo eiia?iiaaieo
iaoiae?a e?eoaaiiy aea/aeeny iieacieee ui??/ii? aeeiai?ee ?ai?n??
caoai?thaaiiy (recurrence-free survival) ? aeaeeaaiiy oai?eo (overall
survival).

Ia?iaea aeaieo i?iaiaeeeanue ia IAAI ?AI ca i?ia?aiith aea/aiiy
aoaeoeaiino? iaoiae?a e?eoaaiiy. Ca aeai?eoi ?ic?aooieo iieacieea
aeaeeaaiiy acyoi aeoo??aeueiee (aeeiai?/iee) iaoiae, i?eeiyoee AIIC ca
noaiaea?o. Oi?ioaaiiy aea??ie i?iaiaeeeiny ia i?aenoaa? iaoa??ae?a
eaioea?-?aa?no?o a?aeae?eaiiy iooeei iii?ii-?ooiaiai aia?aoo OIAe?I? IIC
Oe?a?ie c o?aooaaiiyi ??cieo i?iaiinoe/ieo ia?aiao??a (noaae?y, a?e oa
?i.), a oaeiae a caeaaeiino? a?ae aeeiai?ee i?iaaaeaiiai e?eoaaiiy (O.
Jensen et al., 1991; E.I. Aoeae, 1994).

?ACOEUeOAOE OA ?O IAAIAI?AIIss

A ia?oo /a?ao iaie aoee aea/ai? iiaeeeaino? ?aaeeeaeueieo iia?aoe?e i?e
e?eoaaii? ceiye?nii? iaeaiiie oe??e ? ?? iaoanoac?a a ?aa?iia?ieo
e?ioaoe/ieo aoceao.

I?e noaoenoe/i?e ia?iaoe? iaoa??aeo i?aeoaa?aeaeaii oaeo i?ei?eoaoiiai
iaoanoacoaaiiy iaeaiiie oe??e a ?aa?iia?i? e?ioaoe/i? aocee (L. Craig et
al., 1993).

I?ney ?aaeeeaeueiiai aeaeaeaiiy ia?aeiii eieae?ciaaii? iaeaiiie na?aae
eiio?ieueii? a?oie oai?eo A1, ui neeaaeaeany c 901 iaoe??ioa, o 709
(78,6% on??? a?oie) aeieeaee iaoanoace iooeeie. O 701 (98,8% na?aae
iaoe??io?a c ee?i?/ieie i?iyaaie iaoanoac?a) oai?iai a ia?oo /a?ao aoei
aeyaeaii o?aaeaiiy ?aa?iia?ieo e?ioaoe/ieo aoce?a.

Oa?i?i iiyae e?ioiaaiieo iaoanoac?a ciaoiaeeoueny a aeoaea oe?ieiio
ae?aiacii? ( a?ae 1 i?nyoey aei 20 ?ie?a. Aea i?inoaaeaia /?oea
caeiiii??i?noue: iniiaia /anoeia iaoanoac?a (640 oai?eo; 90,2%)
aeieea? a ia?o? 5 ?ie?a niinoa?aaeaiiy i?ney ?aaeeeaeueieo iia?aoe?e.

O?aaa aeacaoe ia oaeo aeineoue oaeaeeiai ?icaeoeo iaeaiiie oe??e.
I?ioyaii ?ieo i?ney ?aaeeeaeueii? iia?aoe?? c i?eaiaeo ia?aeiii
eieae?ciaaii? iaeaiiaeanoiie oe??e (noaae?y I) iaoanoace aeieeaee o 360
oai?eo, ui noaiiaeei 50,7% iaoe??io?a, o eio?eo aeyaeaii iaoanoace
iaeaiiie. Ioaea,

o eiaeiiai ae?oaiai oai?iai na?aae oeo, ooi caa?ioany c i?eaiaeo
?aoeeaeeao caoai?thaaiiy, iaoanoace aeieeaee i?iaeiaae ia?oeo 12
i?nyoe?a i?ney iia?aoe??.

Iieacieee a?aeaeaeaieo ?acoeueoao?a iia?aoe?e, aeeiiaieo o a?aeae?eaii?
iooeei iii?ii-?ooiaiai aia?aoo OIAe?I? IIC Oe?a?ie c i?eaiaeo ia?aeiii
eieae?ciaaii? iaeaiiie oe??e, aoee oaeeie: 3 ?iee i?ney iia?aoe??
i?iaeeei 67,7 ( 1,5% oai?eo, 5 ?ie?a ( 53,5 ( 1,6%, 10 ?ie?a ( 41,6
( 1,6%.

Na?aae oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e 3- oa 5-??/ia
aeaeeaaiiy /ieia?e?a aei??aithaaei 63,2 ( 2,6 oa 49,4 ( 7,4%
a?aeiia?aeii. O ae?iie o? ae nai? iieacieee noaiiaeee a?aeiia?aeii 70,4
( 1,9 oa 59,1 ( 2,0%. I?e ii??aiyii? oeeo oa?aeoa?enoee anoaiiaeaii
noaoenoe/ii a??ia?aeio ia?aaaao iaio iieaciee?a aeaeeaaiiy na?aae
ae?iie (P0,05).

??? ioe?iee a a?oi? oai?eo, eio?ei aei iia?aoe?? aeiaeaaaeany i?iiaiaaa
oa?ai?y (a?oia A2).

Inoaiiy aeine?aeaeoaaia a?oia (A4) ia?aeiieo oai?eo ia iaeaiiio oe??e c
neio?iiiei o?aaeaiiyi ?aa?iia?ieo e?ioaoe/ieo aoce?a neeaaeaeany c
iaoe??io?a, ye? io?eioaaee eaoa?ii.

Aiae?coth/e iieacieee a?aeaeaeaieo ?acoeueoao?a iiaeia aeneiaeoeny eeoa
i?i iayai?noue oaiaeaioe?? iie?auaiiy iieaciee?a 3-??/iiai aeaeeaaiiy
ii??aiyii c eiio?ieueieie aeaieie (noaoenoe/ii a??ia?aeio ??cieoeth ia
io?eiaii). O?aaa aeacaoe, ui ye a iiia?aaeiueiio aeine?aeaeaii? (oai?? ?
noaae?? caoai?thaaiiy, a?oie A5 ? A6), oae ? a aeaiiio (a?oie A3 ? A4),
iane?aeee aeei?enoaiiy eaoa?iio aoee noiaeeie c ?acoeueoaoaie
aiaeie?ioaoe/ii? o?i?ioa?ai??.

Oaaeeoey 4

Ii??aiyeueia ioe?iea iieaciee?a aeaeeaaiiy ia?aeiieo oai?eo ia
iaeaiiio oe??e c neio?iiieie iaoanoacaie a ?aa?iia?ieo
e?ioa-oe/ieo aoceao a caeaaeiino? a?ae canoiniaaiiai iaoiaeo
e?eoaaiiy

(M ( m)

Iaoiae

e?eoaaiiy

A?oia oai?eo E?euee?noue oai?eo Aeaeeaaiiy, %

3-??/ia 5-??/ia

O??o?a?/iee

A1

205

41,3(3,4

(

30,6(3,2

O??o?a?/iee + i?iiaiaaa oa?ai?y

A2

24

35,0(10,4

15,0(7,9

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