A method for the treatment of patients with gastric cancer stage iv

 

(57) Abstract:

The invention relates to medicine, namely to Oncology. With the purpose of increase of efficiency of treatment of patients with gastric cancer stage IV process the chemotherapy is administered simultaneously with the endolymphatic interval - every 24 hours, at a single dose of fluorouracil 2 g of adriablastin 40-50 mg methotrexate 50-60mg; dose rate, respectively 8-10 g 80-100 mg, 100-120 mg, and adriablastin and methotrexate is administered only in 1-5 days after imposition of the catheter, and fluorouracil - 1-3-5-7-9 days, repeat the treatment after 4 weeks. The total number of courses lead to three.

The invention relates to medicine, namely to Oncology.

The aim of the invention is to increase the efficiency of treatment of patients with gastric cancer IV stage of the process.

The method is as follows. Used well-known technique of catheterization of the lymphatic vessels in the region of the rear foot (Monograph. Pankov R. T. et al., 1984). On the rear foot suitable for catheterization of vessels are located mainly in the projection of the first and second interdigital intervals.

For 5-10 min before surgery introduce 1-2 ml of 0.4% Indigo-Carmine subcutaneously in the first or second MIPA is eaten after processing operating margins alcohol 96aboutand anesthesia 0.25% solution of novocaine, cut through the skin lengthwise in the middle third of the rear foot. Directly under the skin detect the painted vessels. For catheterization mobilitat vessel at a distance of 1 cm, down under two ligatures, scissors cross netscout vessel and injected to a depth of 3-4 cm thin plastic catheter type epidurals, tied above and below the ligature of the catheter. Before suturing the wound, check the patency of the catheter, which introduce a solution of 0.25% novocaine, the catheter is fixed to the skin and connected to electroindustry. We used infostor firm "Lineomat". Infostor according to a preset speed for 4-5 h slowly drip enters drugs. In infostor load syringes with chemotherapy, i.e. fu 2 g, adriablastin 40-50 mg, methotrexate 50-60 mg, this is all on simultaneously and alternately.

On the first day, enter one of all of the aforementioned drugs. After 24 h, i.e., on the third day after imposition of endolymphatic catheter give 2 g of fluorouracil, before the introduction each time a mandatory monitoring of blood on the 5th again enter: 2 g of fluorouracil + 40-50 mg of adriablastin + 50-60 mg of methotrexate, 7 day to 2 g of fluorouracil, 9-2 g fluorine is lymphatic chemotherapy lead to three with pauses in between 4-5 weeks.

An example of successful treatment include the history N 3433 patient D., aged 47, who was treated in the thoracic Department of the Karaganda Oncology center with 5.10.88 on 25.11.88 g with a diagnosis of cancer of the proximal stomach with the transition to the abdominal esophagus with metastasis to the retroperitoneal lymph nodes stage IV, T3N2M4P4. Was admitted with complaints of dysphagia, weakness, weight loss of 15 kg has been Ill since June 1988, when first appeared the above complaints. The doctor asked only in October, was examined radiographically at the place of residence in the clinic and diagnosed with cancer of the proximal stomach is aimed at the Oncology center. Were esophagoscopy, when detected: tumor of the gastric cardia with the transition to the abdominal esophagus, stage III, T3NxMaboutPx. Biopsy, histologically and cytologically - adenocarcinoma. After appropriate training 25.10.88 were fulfilled trial thoracotomy as a tumor of the proximal stomach with the transition to the abdominal esophagus with invasion of the stomach wall and multiple retroperitoneal metastases in lymph nodes. In g, adriablastin 80 mg, methotrexate 120 mg Treatment satisfactorily, marked with immediate effect, i.e., disappeared dysphagia, appetite was restored, the patient began to gain in weight, has recovered the ability to work. The patient could perform the same work (shoemaker). In the following two courses endolymphatic chemotherapy, total dose: fluorouracil 20 g of adriablastin 160 mg, methotrexate 240 mg Twice a survey was conducted in April and December 1989, i.e. esophagogastroscopy with biopsy, x-ray and ultrasound. Tumor process is stable, no new metastases, morphologically - adenocarcinoma with symptoms of drug-disease variability. The patient died after 16 months from the start of treatment, i.e. 28.04.90, with increasing cachexia and dysphagia.

Reportedly Schein, R. H. (1987) the use of schema FEMME-2 in advanced cancer of the stomach gives encouraging results, the median survival of treated patients was 15 months.

We have also used the above scheme drugs, only endolymphatic. Treatment subjected 80 patients with advanced gastric cancer, a diagnosis that was verified morphologically or cytologically Choi is innosti and without further progression of the tumor process was 17,85,6 months. The direct effect was observed in 100% of patients, which was expressed in the disappearance of pain, reduction of dysphagia, 25 patients appetite was restored, recovered the ability to work, the 15 - marked weight gain, improvement of General condition. Long-term from 6 to 15 months. patients underwent re-examination, i.e., esophagoscopy with biopsy, Cytology, mammography, and ultrasound examination of abdominal cavity organs. It was only observed in 5 (6.2%) was the progression of cancer from 80 patients.

The advantage of endolymphatic chemotherapy in contrast to conventional IV therapy is the administration of high doses of cytostatic drugs with less toxicity to the body, long-term presence of drugs in the lymph, slow absorption and the almost complete absence of side effects of drug therapy in patients, which improves the effectiveness of treatment, can improve the terms of patients ' survival.

A METHOD for the treatment of PATIENTS with GASTRIC CANCER STAGE IV by infusion FEMME-2, characterized in that, to increase the effectiveness of treatment, the drugs enter the endolymphatic simultaneously with the mode of introduction CESA respectively 8 - 10 g 80 - 100 lhs, 100 - 120 lhs, and adriablastin and methotrexate is administered only in 1 - 5 days after application of the catheter, and fluorouracil in 1-3-6-7-9 days, repeat the treatment after 4 weeks, the total number of courses lead to three.

 

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