The way the preoperative treatment of patients with ovarian cancer iii - iv stages)

 

(57) Abstract:

The invention relates to medicine, namely and gynecology, and can be used with chemotherapy ascitic ovarian cancer III-IV stages. Proposed outpatient preoperative period to immunomodulation by intraperitoneal administration of T-activin 1 ampoule per day - 100 μg in 10 days with simultaneous intraperitoneal infusion of chemotherapy drugs: 1 day 1 - 2 g of platinum, 2-day 150 - 200 mcg drug, platinum derivative, depending on the patient weight. The application of the method increases the interoperability, reduces toxic complications and relapses. Preoperative treatment in the outpatient setting allows you to reduce the time of stay of patients in hospital and the economic costs of the sick.

The invention relates to medicine, namely to gynecology, and can be used in chemotherapy and surgical treatment of ascitic ovarian cancer III-IV stages of the disease.

The known method comprehensive preoperative chemotherapy in patients with cancer of the vulva (see Doc.dis."Chemotherapy in treatment of malignant tumors of the external genital organ is polychemotherapy in conventional doses with simultaneous endolymphatic introduction of the hormone of the thymus-T-activin.

The use of preoperative impact on malignant tumor in the form of endolymphatic introduction of chemo - and immunopreparatov, significantly increases the overall five-year survival rates for all stages of cancer of the vulva.

However, this method of treatment is effective in the outer localizations of cancer of the genitals. Known "Method of chemotherapy for ovarian cancer" (ed. mon. N 1693742 from 22.07.91, authors: Y. Sidorenko S., Galatina L. Yu), including intraperitoneal administration of chemotherapeutic drugs in the postoperative period for 7-10 days, after 2 catheter inserted during surgery on the level of the eleventh rib on the anterior axillary line, repeat the treatment after 3 months. The method is used in common form of cancer of the ovaries to prolong the lives of patients.

The disadvantage of this method is the underestimation of the immune status and the absence of individual correction of the immune status of patients with common forms of ovarian cancer.

The aim of the invention is the transfer of patients from inoperable to operable status, the reduction of complications of chemotherapy and recurrence in patients with ascitic form of ovarian cancer III-IV stages of the disease.correction by intraperitoneal administration of T-activin 1 ampoule - 100 μg in 10 days with simultaneous intraperitoneal infusion of chemotherapy drugs: in the I-th day 1-2 g of cyclophosphamide, in the II day 150 - 200 mcg drug, platinum derivative, depending on the patient weight.

The novelty of the invention lies in the fact that patients ascitic form of ovarian cancer III-IV stages of the disease, in an outpatient setting, in the preoperative period, intraperitoneally import T-activin 1 ampoule 100 mcg for 10 days and simultaneously, the first day of the introduction of T-activin, enter intraperitoneal cyclophosphamide-1-2 g, the second day - 1500-200 mcg of the drug, platinum derivative, depending on the patient weight.

Since the results of treatment of common forms of ovarian cancer are not effective, and high dose chemotherapy as the most effective followed by serious complications, severe systemic toxicity, the role of the immune how to prevent complications and to improve the efficiency of therapeutic effects.

Taking into account the tolerance of ovarian tumors to chemotherapy, and that the spread of tumor process for a long time limited to the abdominal cavity, of particular importance to the primary tumor, colonization by the peritoneum, tumor invasion into the blood vessels of the gland, to separate tumor cells suspended in ascitic fluid.

The invention involves an inventive step, because of the specialist gynaecological oncologist is not obvious from the level of medicine in the field of gynecological Oncology treatment ascitic ovarian cancer stage III-IV disease.

Known methods of treatment ascitic ovarian cancer III-IV stations do not provide preoperative intraperitoneal chemotherapy with simultaneous intraperitoneal immunotherapy. The proposed method achieved a higher local concentration of drugs with reduced systemic toxicity due to intraperitoneal application of T-activin. This T-activin retains maximum biological activity, as it is directly injected into the peritoneal cavity compared with other systemic routes of administration.

The proposed method for the preoperative treatment of common forms of ovarian cancer original, not obvious, not obvious from the level of medicine in the field of gynecological Oncology neither CIS nor abroad.

The invention is industrially applicable as m is slichnih medical institutions with cancer and cancer institutes. The method of treatment of ascitic ovarian cancer III-IV stages of the disease consists in the following:

Before surgery, on an outpatient basis, in the region of the rib on both sides of the anterior axillary line, some distance from the bottom edge XI ribs 2-3 cm down, make a puncture in the skin, the dotted line the peritoneum of the anterior lateral wall of the abdomen thick needle under visual control and ultrasonography (ultrasound), so that the needle tip has entered into the free abdominal cavity. Through the lumen of the needle into the abdominal cavity conduct a thin plastic catheter with a diameter of 3 mm, and then pull the needle out, and the catheter is gently pushed into the abdominal cavity so that its free end was 10-12 cm Tissue along the oblique puncture tightly hug the catheter and thus it is fixed. Special fixation of the catheter is not required. Outside the catheter is cut so that its free end were above the skin at a distance of 3-6 see Further transports the introduction of T-activin through the microcatheter: 100 µg 1 vials for 10 days. Starting on the 1st day intraperitoneal administration of T-activin is injected through the microcatheter 1-2 g of cyclophosphamide in the II day - drug platinum derivative: 150-200 mcg, Savnik ovarian cancer stage III-IV disease.

Patient I., 53 years, history N 14853(a) from the ascitic form of ovarian cancer with metastases in the posterior fornix and large stationary tumors in the pelvis. The patient had complained of health status on admission to the clinic Rostov research Institute of Oncology. After cytological studies in punctate back arch detected cancer cells from reliabilily cysts. After laboratory examination made the introduction of the catheter into the peritoneum on the right and left, upper quadrant, according to the above method.

The treatment was carried out for the proposed method: according to the scheme: in the I-th day 100 ug (1 vial) of T-activin and 2 g of cyclophosphamide, in the II day - 100 μg of T-activin (vials) and 200 mg of CIS-platinum, and in the next 8 days at 100 µg T-activin.

As a result of treatment, the patient was tumor resorption and reduced tumors by more than 50%. The health of the patient improved significantly. Toxic effects of chemotherapy were observed. The patient underwent an operation in full. The patient is observed for 2 years with no signs of recurrence.

Technical and economic efficiency "Means the preoperative treatment of patients with ovarian cancer stage III-IV disease" is therapy, reduces relapses.

Preoperative treatment in the outpatient setting allows you to reduce the time of stay of patients in hospital and the economic costs of the sick.

The way the preoperative treatment of patients with ovarian cancer III - IV stages of the disease, including intraperitoneal chemotherapy, characterized in that in the preoperative period, outpatient, are immunomodulation by intraperitoneal administration of T-activin 1 ampoule per day - 100 μg in 10 days with simultaneous intraperitoneal infusion of chemotherapy drugs: day 1 - 1 - 2 g of platinum, 2-day 150 - 200 microns drug platinum derivative, depending on the patient weight.

 

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