Method of treating rectal cancer

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly oncology and surgery, and may be used in treating rectal cancer. That is ensured by teleirradiation, oral administration of capecitabine, intrarectal administration of metronidazole, local SHF hyperthermia followed by a surgical intervention. Capecitabine is administered 2000 mg/m2 from the 1st to 14th days. Metronidazole 10 g/m2 is intrarectally administered on the 3rd and 5th therapeutic days as a part of a composite mixture having the following proportions, wt %: metronidazole 12-22, sodium alginate 4-6, dimethylsulphoxide 2, distilled water up to 100. The 5-hour exposure of metronidazole is followed by a session of teletherapy. The local SHF hyperthermia at temperature 41-45° for one hour follows a session of teletherapy on 3rd, 4th and 5th therapeutic days. The surgical intervention is conducted 4 weeks after the completion of the preoperative therapy.

EFFECT: method provides ensuring complete therapeutic pathomorphism of the tumour in 25% of patients, reducing toxic and post-therapeutic complications, as well as enables conducting sphincter-preserving surgical interventions.

3 ex

 

The invention relates to medicine, namely to methods for treating cancer of the rectum.

Colorectal cancer is the 2nd place among tumors of the gastrointestinal tract and is 80% among tumors of the intestine. In recent years in Russia tends to increase the incidence of cancer of the rectum. The incidence in men has increased from 10.3% to 14.3%, and in women from 7.6% to 8.7%.

Surgical treatment of rectal cancer remains the main (Meyerhardt J, Saunders M. Colorectal Cancer: Dana-Farber Cancer Institute Handbook. 2009, p.77). However, it is known that during the first year after surgery in 70% of patients have local-regional recurrence and distant metastases of cancer (A.Chiappa, E.Bertani. Pelvic reccurence after surgery with total mesorectal excision for rectal cancer: Results in a consecutive series with a strict follow-up program. 7thInternational EFR Congress, Austria, 2011, p1-6; M.Kusters et al. EJSO 36 2010, p.470-476; Puchkov K.V., Hubenov D.A. Choice of the level of mobilization of the rectum rectal cancer. Materials of the conference dedicated to the memory of Professor Vignesh. Moscow. 2011, p.60-61).

To improve the results of treatment of rectal cancer using a combination of methods, including preoperative radiation therapy (Kapiteijn e, Marijnen CA, Nagtegaal I.D. et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N. Engl. J.Med., 2001, p.638-646; E. Ibragimov Results of surgical and combined treatment of patients with rectal cancer. Those who ISA II Congress of CIS oncologists. Kyiv. 2000, s). In recent years, to improve the care of great importance to study the extent of therapeutic pathomorphosis in the tumor (Matsko CU, OLEG Korytov, Therapeutic pathomorphosis in patients with locally advanced rectal cancer. Palliative medicine and rehabilitation: scientific-practical journal. 2008, N 1, s.43-46).

Divided into 4 degrees of therapeutic pathomorphosis (Slavnikova GA, Ghosh IE, Talalaev AV, Kobozev C.A., red L.V. Histopathological method for quantitative evaluation of the degree of radiation damage of the tumor. // Madriaga, 1978, V.23, N 3, p.6; Dworak O, Keilholz L, Hoffmann A: pathological features of rectal cancer after preoperativeradiochemotherapy. IntJ. Colorectal Dis 1997, 12:19-23):

Grade I (mild pathomorphosis): the preservation of the histological structure of the tumor and the ratio of parenchyma and stroma, minor polymorphism parenchymatous elements of the tumor;

II degree (moderate pathomorphosis): 1/3 of the tumor presents elements of necrosis and degeneration, focal disappearance of parenchymal and stromal overgrowth, partial absence of the epithelial lining in atypical glands;

Grade III (pronounced pathomorphosis): 2/3 of the tumor presents elements of necrosis and degeneration of the parenchyma of the tumor in the form of isolated Islands, sharp anaplasia and polymorphism of tumor cells;

IV degree (full pathomorphosis): substitution of tumor tissue and necrosis with elements of connective tissue, impregnation its salts of lime, the cysts. In the surrounding tissues atrophy, degenerative and sclerotic changes.

To achieve the full therapeutic pathomorphosis tumors using combined treatment, including radiomodifying: microwave hyperthermia and electron connection - metronidazole and its derivatives (Tsyb A.F., and other Local microwave hyperthermia in increasing the effectiveness of radiation therapy of malignant tumors of various localizations. Abstracts of the II Congress of CIS oncologists. Kyiv. 2000, s; Yarmolenko S. p. in the book. "Radiomodifying in radiation therapy of tumors". Obninsk. 1982, pagination 126; Boiko A.V. and others in the abstracts of all-Russian conference "Radiobiological basis of radiation therapy", Moscow. 2005, p.16-17).

As an additional radio-sensitizing agents used anticancer drugs: 5-fluorouracil, capecitabine, Ftorafur, irinotecan (Verso M. et al. J Clin Oncol 2003; 21: 3665-3675; Saini A, Cunningham D, N0rman AR, et al. A multicenter randomized trial of protracted infusion (PNI) 5-FU compared to 5-FU, folinic acid as adjuvant therapy for colorectal cancer. In: Program and abstracts of the American Society of Clinical Oncology 263 th Annual Meeting; 20-23, 2000; New Orleans, Louisiana. Abstract 928.).

There is a method of treatment of colorectal cancer, including a short course of radiation therapy for 5 days in a single focal dose of 5 Gy, vnutriuretralnami introduction radio-sensitizing composite mixture, steriade the hydrogel metronidazole, local microwave hyperthermia and radical surgery (Patent RF №2234318).

The disadvantage of this method: the inefficient way in which the full therapeutic pathomorphosis tumors reached only 2% of patients.

There is a method of treatment of colorectal cancer, including vnutriuretralnami introduction 5-fluorouracil therapeutic doses (425 mg/m2) as part of a composite mixture for 3 days 1,2 and 4 days of exposure, vnutriuretralnami introduction of metronidazole (10 g/m2) as part of a composite mixture containing sodium alginate and 2% solution of dimethyl sulfoxide in 3 and 4 days of exposure, applied directly to the tumor, and local microwave hyperthermia with subsequent surgical intervention (RF Patent No. 2367489).

The disadvantages of this method: enterocolitica toxicity in 80% of patients. Full therapeutic pathomorphosis in the tumor was diagnosed in 11% of patients.

To achieve the full therapeutic pathomorphosis use prolonged courses of radiation therapy SOD 40-50 Gy in standard fractionation.

There is a method of treatment of colorectal cancer, including prolonged course of radiation therapy SOD 44 Gy in combination with anticancer drugs: irinotecan, 5-fluorouracil (Shelekhov A.V. a New approach to preoperative chemotherapy for colorectal cancer. Materials of the conference dedicated to the memory of Prof. Vignesh. Mos the VA. 2011, p.75). The use of preoperative radiotherapy in combination with anticancer drugs has allowed to achieve full therapeutic pathomorphosis tumors in 15% of patients.

The disadvantage of this method is the high frequency postradiation complications.

There is a method of treatment of colorectal cancer, including prolonged course of radiation therapy SOD 44-50 Gy, GENUS of 1.8-2 Gy in combination with derivatives ftorpirimidinu (capecitabine, Ftorafur, 5-fu) and oxaliplatin (Demin A.A. the Influence of different modes of induction therapy of cancer of the rectum at the level of therapeutic pathomorphosis. Abstracts 5 the Russian school of colorectal surgery. Moscow. 2011, 49-50). Full therapeutic pathomorphosis of the tumor is registered at 3-19,7% of patients. Variability achieve maximum therapeutic pathomorphosis due to small groups of patients included in this study, using different combinations of anticancer drugs.

The disadvantages of the method: high toxicity - 50% of patients, sphincteroplasty operations performed in 39.5% of patients.

The known method, including prolonged course preoperative radiotherapy in standard mode fractionation to a total focal dose of 50.4 Gy in combination with involving capecitabine at a dose of 825 mg/m2at which complete therapeutic pathomorphosis of the tumor would is achieved in 24% of patients (De Paoli, A., Chiara S., G. Luppi Capecitabine in combination with preoperative radiation therapy in locally advanced, resectable, rectal cancer: a multicentric phase II study. Ann. Oncol. 2006, Vol.17, No. 2. p.246-251).

The disadvantage of this method of treatment is high hematologic toxicity in 72% of cases, sphincteroplasty operations were performed in 59% of patients.

Closest to the claimed method (prototype) is a method, including 5-day course assessment radiotherapy ROD 5 Gr, capecitabine at a dose of 1500 mg/m2inside, 2 times a day every 12 hours for 5 days, vnutriuretralnami introduction of metronidazole in a dose of 10 g/m2as part of a composite mixture of 3 and 5 days of exposure. Surgical intervention was performed 24-48 hours after 5-day course of preoperative therapy (RF Patent N 2311909).

The disadvantages of the method are: enterocolitica toxicity. therapeutic pathomorphosis of III degree in 24% of patients. Sphincteroplasty operations performed in 76.6% of patients.

The present invention is the creation of an effective method of treatment of colorectal cancer by increasing achieve maximum therapeutic pathomorphosis of the tumor.

The problem is solved in that a method of treatment of colorectal cancer, including the preoperative period remote radiation therapy, oral ingestion involving capecitabine, vnutriuretralnami call for the giving of metronidazole in the composition of the composite mixture, Microwave hyperthermia with subsequent operative intervention, with external beam irradiation is carried out with a 1 to 5 days at a dose of 5 Gy, capecitabine at a daily dose of 2000 mg/m2orally 2 times a day 1 to 14 days metronidazole at a dose of 10 g/m2vnutriuretrale 3 and 5 days in the composition of the composite mixture in the following proportions of ingredients in wt.%: metronidazole 12-22, sodium alginate 4-6, dimethylsulfoxide 2, distilled water up to 100, and after 5 hours of exposure metronidazole conducting a remote session of radiotherapy, after which hold the session of the microwave hyperthermia treatment at a temperature of 41-45° for 1 hour in 3,4 and 5 days.

The treatment was carried out as follows:

1st day - capecitabine at a daily dose of 2000 mg/m2inside 2 times a day every 12 hours; 1-2 hours after the first dose involving capecitabine conduct a session of irradiation dose of 5 Gy;

2nd day - capecitabine at a daily dose of 2000 mg/m2inside 2 times a day every 12 hours; session irradiation dose of 5 Gy;

3rd day - capecitabine at a daily dose of 2000 mg/m2inside 2 times a day every 12 hours; 30 minutes after the first dose involving capecitabine spend vnutriuretralnami introduction of metronidazole in a dose of 10 g/m2as part of a composite mixture; after the introduction of metronidazole in 5 hours hold a session of irradiation at a dose of Gr; after completion of the exposure exercise session local microwave hyperthermia at temperatures 41-45°C for 1 hour;

4th day - capecitabine at a daily dose of 2000 mg/m2inside 2 times a day every 12 hours; session irradiation dose of 5 Gy; after irradiation exercise session local microwave hyperthermia at temperatures 41-45°C for 1 hour;

5th day - capecitabine at a daily dose of 2000 mg/m2inside 2 times a day every 12 hours; vnutriuretralnami introduction of metronidazole in a dose of 10 g/m2as part of a composite mixture; after 5 hours after administration of metronidazole conduct a session of irradiation dose of 5 Gy; after irradiation exercise session local microwave hyperthermia at temperatures 41-45°C for 1 hour. Capecitabine assign 1 to 14 days.

3 weeks after 2-week preoperative therapy was performed control tests to evaluate the effect of treatment, which included endovideolaparoscopic with endosonography, barium enema, transrectal ultrasound. The nature and scope of the operation was determined by the level of localization of the tumor in the rectum and the degree of its local distribution. Assessment of the severity of therapeutic pathomorphosis was performed histological examination of the surgical material.

Examples of the proposed method

Example 1

The patient is., 71. And/b No. 2010/9630.

Clinical diagnosis: Cancer of srednetemperaturnogo division of the rectum (cT2N0M0; ypT0N0M0). Histological diagnosis of adenocarcinoma.

If the comprehensive examination diagnosed the tumor, srednetemperaturnogo division of the rectum, up to 4 cm, infiltrating the muscular layer of the bowel wall, enlarged lymph nodes in the adrectal tissue was not detected.

The estimated surface area of 1.8 m2.

The estimated number of metronidazole in the composite mixture is 18 grams (10 g/m2). The total mass of the composite mixture is 200,

Estimated daily dose involving capecitabine for this patient was 3600 mg

The treatment was carried out as follows:

1st day - capecitabine at a daily dose of 3600 mg orally 2 times a day every 12 hours; session irradiation dose of 5 Gy;

2nd day - capecitabine at a daily dose of 3600 mg/m2inside 2 times a day every 12 hours; session irradiation dose of 5 Gy;

3rd day - capecitabine at a daily dose of 3600 mg orally 2 times a day every 12 hours; vnutriuretralnami introduction of metronidazole at a dose of 18 g in the composition of the composite mixture; after 5 hours after administration of metronidazole conduct a session of irradiation dose of 5 Gy; after irradiation exercise session local microwave hyperthermia in which the temperature 41-45°C for 1 hour;

4th day - capecitabine at a daily dose of 3600 mg orally 2 times a day every 12 hours; session irradiation dose of 5 Gy; after irradiation exercise session local microwave hyperthermia at temperatures 41-45°C for 1 hour;

5th day - capecitabine at a daily dose of 3600 mg orally 2 times a day every 12 hours; vnutriuretralnami introduction of metronidazole at a dose of 18 g in the composition of the composite mixture; after 5 hours after administration of metronidazole conduct a session of irradiation dose of 5 Gy; after irradiation exercise session local microwave hyperthermia at temperatures 41-45°C for 1 hour.

Total focal dose preoperative irradiation was 25 Gr.

The total duration of treatment was 14 days.

3 weeks after completion of preoperative phase of treatment conducted comprehensive examinations. Achieved complete regression of the tumor. A week later performed surgery in the amount of abdomino-anal resection of the rectum with the binding of the sigmoid colon to the anal canal. The postoperative course smooth, no complications.

Histological examination of the surgical material at a distance of 10 cm from the proximal and 4 cm from the distal margins of resection of the colon was determined ulcerative defect up to 1 cm in diameter, the bottom of which was presented fibro is Kanu, on the surface granulation and fibrous leukocyte mass, there were signs of epithelialization of the ulcer. Tumor growth was not detected. Reach full therapeutic pathomorphosis of the fourth degree. In the lymph nodes reactive changes in lymphoid tissue.

The patient was discharged from hospital after 11 days after surgery. During the observation period (12 months) evidence of progression of the disease was not detected.

Example 2

Patient B., 51 years. And/b No. 2010/10072.

Clinical diagnosis: Cancer of srednetemperaturnogo division of the rectum (cT2N0M0; ypT0N0M0). Histological diagnosis of adenocarcinoma.

Examined, diagnosed tumor of srednetemperaturnogo division of the rectum, up to 4 cm, infiltrating the muscular layer of the bowel wall, enlarged lymph nodes in the adrectal tissue was not detected.

The estimated surface area of 1.8 m2.

The estimated number of metronidazole in the composite mixture was 18 g (10 g/m2). The total mass of the composite mixture was 200,

Settlement involving capecitabine dose 3600 mg per day.

The treatment was carried out as follows:

1st day - capecitabine at a daily dose of 3600 mg orally 2 times a day every 12 hours; session irradiation dose of 5 Gy;

2nd day - capecitabine at a daily dose of 3600 mg/m2inside 2 times in su the key every 12 hours; the session of irradiation dose of 5 Gy;

3rd day - capecitabine at a daily dose of 3600 mg orally 2 times a day every 12 hours; vnutriuretralnami introduction of metronidazole at a dose of 18 g in the composition of the composite mixture; after 5 hours after administration of metronidazole held a session of irradiation dose of 5 Gy; after irradiation performed a session of the local microwave hyperthermia at temperatures 41-45°C for 1 hour;

4th day - capecitabine at a daily dose of 3600 mg orally 2 times a day every 12 hours; session irradiation dose of 5 Gy; after irradiation conducted a session on the local microwave hyperthermia at temperatures 41-45°C for 1 hour;

5th day - capecitabine at a daily dose of 3600 mg orally 2 times a day every 12 hours; vnutriuretralnami introduction of metronidazole at a dose of 18 g in the composition of the composite mixture; after 5 hours after administration of metronidazole held a session of irradiation dose of 5 Gy; after irradiation performed a session of the local microwave hyperthermia at temperatures 41-45°C for 1 hour.

Total focal dose preoperative irradiation was 25 Gr.

The total duration of treatment was 14 days.

3 weeks after completion of preoperative phase of treatment carried out by a medical examination. Achieved regression of the tumor to 1.8 see After 1 week performed surgery in the volume Crispus the Oh resection of the rectum. The postoperative course smooth, no complications were noted.

Histological examination of the surgical material in the rectal wall were pitting size 1.8 cm, with elements of pronounced fibrosis, edema, proliferation of granulation tissue. The elements of the tumor was not determined. Reach full therapeutic pathomorphosis. 6 investigated lymph nodes signs of the tumor was not found.

The patient was discharged from the hospital within 10 days after the operation. The condition of the patient during the observation period within 12 months after surgery without evidence of disease progression.

Example 3

Patient M., 53 years. And/b No. 2010/22019.

Clinical diagnosis: Cancer nizhneamudarinskogo division of the rectum (cT3N1M0; ypT0N0M0). Histological diagnosis of poorly differentiated adenocarcinoma.

The survey was conducted. Diagnosed with a tumor nizhneamudarinskogo division of the rectum, with a length of 5 cm, infiltrating adrectal fiber, and 2 enlarged lymph node to 1.2, see

The estimated surface area of 1.7 m2.

The estimated number of metronidazole in the composite mixture is 17 grams (10 g/m2). The total mass of the composite mixture is 200,

The estimated dose involving capecitabine 3400 mg per day.

The treatment was performed in the following manner and on the ohms:

1st day - capecitabine at a daily dose of 3400 mg orally 2 times a day every 12 hours; session irradiation dose of 5 Gy;

2nd day - capecitabine at a daily dose of 3400 mg/m2inside 2 times a day every 12 hours; session irradiation dose of 5 Gy;

3rd day - capecitabine at a daily dose of 3400 mg orally 2 times a day every 12 hours; vnutriuretralnami introduction of metronidazole at a dose of 17 g as part of a composite mixture; after 5 hours after administration of metronidazole held a session of irradiation dose of 5 Gy, after which carried out a session of the local microwave hyperthermia at temperatures 41-45°C for 1 hour;

4th day - capecitabine at a daily dose of 3400 mg orally 2 times a day every 12 hours; session irradiation dose of 5 Gy; after irradiation conducted a session on the local microwave hyperthermia at temperatures 41-45°C for 1 hour;

5th day - capecitabine at a daily dose of 3400 mg orally 2 times a day every 12 hours; vnutriuretralnami introduction of metronidazole at a dose of 17 g as part of a composite mixture; after 5 hours after administration of metronidazole held a session of irradiation dose of 5 Gy; after irradiation conducted a session on the local microwave hyperthermia at temperatures 41-45°C for 1 hour.

Total focal dose preoperative irradiation was 25 Gr.

The total duration of treatment was 14 the day is.

3 weeks after completion of preoperative phase of treatment carried out by a medical examination. Achieved regression of the tumor to 1.2 see After 1 week performed surgery in the amount of abdomino-anal resection of the rectum with the binding of the sigmoid colon to the anal canal. The postoperative course smooth, no complications were noted.

Histological examination of the surgical material in the rectal wall, in the area of ulceration were vast fields of mucus within the muscle sheath and the adjacent fibro-fatty tissue without parenchymal cell tumors. Tricks clusters of giant polynuclear cells, focal accumulations of hemosiderin and moderately expressed signs of lymph plasmocytomas infiltration. Reach full therapeutic pathomorphosis of rectum tumor and metastatic cancer in lymph nodes. Complications are not registered.

Treatment by the present method was performed in 16 patients. Full therapeutic pathomorphosis tumors diagnosed in 4(25%) patients. Sphincterpreservation operations performed in 92.3% of patients. During the observation time within 12 months revealed no evidence of progression of disease and toxic effects of a single patient.

The technical result

The effectiveness of the proposed method of treatment is to achieve pornogalereja pathomorphosis of tumors in 25% of patients, the reduction in the incidence of toxic and postoperative complications resulting from the use of a two-week short course of treatment, increase the interval between the end of preoperative therapy and surgery to 4 weeks, increase sphincteroplasty surgical interventions to 92%.

The method of treatment of colorectal cancer, including the preoperative period external beam radiation, oral administration involving capecitabine, vnutriuretralnami introduction of metronidazole in a dose of 10 g/m2as part of a composite mixture with the following ratio of ingredients, wt.%: metronidazole 12-22, sodium alginate 4-6, dimethylsulfoxide 2, distilled water to 100 in 3 and 5 days with subsequent surgical intervention, wherein the capecitabine is administered at a dose of 2000 mg/m2from 1 to 14 days, the remote session radiation therapy is carried out after 5 hours of exposure to metronidazole, then run the session local microwave hyperthermia at temperatures 41-45° for 1 h in 3, 4 and 5 days of treatment, surgery was performed 4 weeks after completion of preoperative therapy.



 

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1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, oncology, and may be used for treating locally advanced unresectable oesophageal cancer. Preliminary argon-plasma coagulation of a tumour is followed by high-power intraluminal brachytherapy on 1st, 8th and 15th day of the therapeutic course at single basic dose 7 Gy combined with the intravenous introduction of taxane preparations and carboplatine. Further, the tumour is exposed to tele-radiation at single basic dose 1.8 Gy, 5 fractions/week, SOD 40-45 Gy, supported by the use of fluoropyrimidine derivatives in the following doses: oral administration of capecitabine 600 mg/m2 in degree 0-1 dysphagia in days of radiation therapy, intravenous infusions of 5-fluorouracil 1000 mg/m2 in degree 2-3 dysphagia every week.

EFFECT: method provides optimising cytoreductive reaction of chemoradiation therapy components and more complete response of the tumour with relieved severe systemic and local reactions.

2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, oncology, and may be used for treating the patients with stomach cancer T3-4N1-3M0. Microirrigators are inserted in an abdominal cavity during a surgical intervention. An adjuvant treatment is applied 2-3 weeks later. It involves the endolymphatic introduction of methotrexate. It is followed by a two-week gamma-therapy in accelerated fractionation mode with single radiation dose (SRD) 1.2 Gy twice a day every 5 h. Eloxatine dissolved in ozonised 5% glucose is introduced drop-by-drop in microirrigators with underlying emission on 4th, 8th and 12th day from the beginning between fractionations. In the middle of an arranged pause, the radiation therapy involves single intravenous introduction of etoposide, leucovorin, 5-fluorouracil. The second stage involves the endolymphatic introduction of methotrexate, and 2 days later gamma-therapy is applied once more in the accelerated fractionation mode with SRD 1 Gy twice a day every 5 h with underlying on 32nd, 36th and 40th day from the beginning of treatment, eloxatine dissolved in ozonised 5% glucose is introduced drop-by-drop in microirrigators between fractionations.

EFFECT: method prolongs remission, terminates process generalisation, eliminates recurrences.

2 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely paediatric surgery, and may be used for treating hemangiomas of complicated anatomical localisation. That is ensured by the intravenous bolus injection of prednisolone at 2 mg/kg of child's weight in physiologic saline 5 ml. It is followed by the intravenous introduction of cyclopohsphane at 10 mg/kg of child's weight in physiologic saline 50 ml at 50 ml/h. The therapeutic course of intravenous treatment is repeated 2 weeks later. Thereafter, the remained soft-tissue component is once exposed to close-focus roentgenotherapy in dose 1.8 to 2.5 Gy depending on a growth size.

EFFECT: method provides the effective therapy of hemangiomas of complicated anatomical localisation, reduced risk of developing potential complications, no hemangioma recurrences and en excellent cosmetic effect.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, dentistry, oncology and radiology, and may be used for improving the quality of dental aid to the patients suffering malignancies in head and neck after radiation therapy. Reduction of the mechanical properties of dental dentine radiated in therapeutic doses in vitro is stated in a maxillofacial phantom representing a tissue-equivalent heterogenous antropomorphic human oral phantom with cells to place extracted teeth of an individual. Tissue substitutes for creating the phantom are presented by porcine bones and mixed imitated soft tissue, weight portions: paraffin - 100, magnesium oxide (MgO) - 29.06, calcium carbonate - 0.94. The dose control is ensured by light-sensitive film and thermoluminescent dosimetry.

EFFECT: method provides evaluation of a degree of radiation damages of dental dentine, higher accuracy of dose correlation in therapeutic maxillofacial tumour radiation with changing the mechanical properties of the dentine and its strength.

5 dwg, 2 tbl

FIELD: medicine.

SUBSTANCE: group of invention refers to medicine, medical equipment, urology, radiation therapy in oncology. Penile brachytherapy is ensured by an individual applicator by simulating a profile of its internal surface. The method involves individual radiation-monitoring planning, selection of a radiation target, placement of the organ inside the applicator and a session of radiation therapy by radiation sources placed in endostate channels. The individual applicator is made of a biocompatible material, comprises receiving channels for endostates able to move and enclose the radiation sources, two working half-cylinders made of an elastic silicone compound and a double fixing platform. The shape of the internal surface of the half-cylinders is matched with the penis surface profile and provided with a balanus retainer in the form of a circular flange at the level of a coronary groove. The half-cylinder thickness is 8-13 mm, the body comprises the twelve equispaced parallel channels for endostates of the internal diameter 2.0 mm. The double fixing platform represents two equal-sized rings; its upper part comprises a cylinder coupling the working half-cylinders of the internal diameter equal to the external diameter of the working half-cylinders with equal heights; and two holes coinciding with guide bushings of a lower part of the platform. Both parts of the platform are provided with coinciding fixing holes.

EFFECT: inventions provide the application radiation therapy in the irregular surface profile, immediate delivery of the radiation source to the tumour without damaging the surrounding tissues, reproducibility of the sessions in any brachytherapeutic apparatus with wireline supply of the radiation source, homogenous graduated distribution in the target, minimised dose for urethra, reduced frequency and intensity of radioreactions.

4 cl, 3 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, oncology, and may be used for treating squamous cell cancer of anal canal. The therapy is two-staged. The first stage involves radiation teletherapy in a dynamic dose fractionation mode with the paratumoural introduction of chemopreparations. The remote teletherapy is preceded by anaesthesia from 2 sides in a lateral direction from rectal walls at the distance of 3-4 cm at conditional 9 and 3 o'clock and at the depth of 8-10 cm behind M. Levatoris ani. As chemopreparations, 5-fluorouracil and methotrexate are administered sequentially via the same injection canals in standard calculated doses 4 times every second day. Thereafter 2-3 days later, it is followed by the remote teletherapy according to the dynamic dose fractionation schedule. Before the radiation, the similar anaesthesia is provided in enlarged fractions, and metronidazole is administered paratumourally at 2-3 mg/cm3 of the tumour. The second stage follows after a 2-week pause and involves endoluminal brachytherapy.

EFFECT: implementing the method enables higher clinical effectiveness and reduced toxic load on the patient's body ensured by the targeted administration of the preparation and possibility to achieve a high concentration in a loci-regional system of the tumour.

2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, oncology. It involves 3-5 sessions of argon-plasma recanalisation of a tumour stenosis area at power 60-70 Wt, duration of each application max. 5 sec, argon supply rate 2.0-2.2 l/min, every 3-5 days. It is followed by 3 sessions of endoluminal brachytherapy of single radiation dose 7 Gy, once a week, total radiation dose 21 Gy. An endostate is placed so that to enable the source moving at the distance covering the tumour and the oesophageal wall above and below the tumour by 2-3 cm. It is combined with 2 cycles of chemotherapy according to the schedule: cisplatin 75 mg/m intravenously on the 1st day, 5- fluorouracil 1000 mg/m2 daily, continuous intravenous infusion on the 1st-5th days. The first session of brachytherapy is combined with the beginning of chemotherapy. The next course of polychemotherapy follows in 28 days. A tumour regression degree is estimated to consider a possibility of the surgical management to the extent of sub-total esophagectomy accompanied by three-zone lymphodissection and single-step repair with a wide gastric graft.

EFFECT: method enables higher resectability and radicality of the surgical management ensured by downsizing the initial tumour.

2 ex

FIELD: medicine.

SUBSTANCE: to induce cytological action on tumour cells, culture of human tumour cells linear - K562 or freshly isolated - cells of primary epidermoid carcinoma of oral cavity are subjected to combined impact of colloidal solution of silver nanoparticles in concentration 34 mcg/ml and SHF-irradiation with frequency 915 MHz. Impact is performed during 30 minutes.

EFFECT: essential increase of cytotoxic effect.

1 tbl

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