A method of preventing recurrence and metastasis in patients with cancer of the urinary tract

 

(57) Abstract:

The invention relates to oncourology and can be used for the treatment of patients with cancer of the bladder and kidneys with the different stages in the development of tumor T1-3NxOoprevention of recurrence and metastases. Patients with bladder cancer and kidney cancer with 3-5 days after radical surgery with the level of peripheral blood leukocytes, not exceeding 8,8109/l cause a stress reaction daily exposure. The first stage of the Central: on the neck of the head sinusoidal magnetic field frequency of 50 Hz, modulated by rectangular pulses with a duration of 0.5 s and a repetition period of 1 s, the induction of 1 MT, the initial exposure time of 5 s and its subsequent increase to 1-2 with the next impact, cumulatively, not exceeding 12 C. the Second stage is conducted magnetic impact locally: on the bladder in patients with bladder cancer and on the region of the kidneys in patients with kidney cancer two inductors sinusoidal field frequency of 50 Hz and the initial induction of 10 MT, with subsequent increase of 10 MT with each new impact, not exceeding 50 MT, constant 20 minutes after reaching the stress response with deistvie. Continue local without increasing doses to achieve adaptive responses with the total number of blood leukocytes, not exceeding 8,8109/l and the relative number of cells not more than 37%. The method improves General, antitumor resistance of the organism to reduce the incidence of recurrence and metastases in periods ranging from 3 to 36 months after radical surgery. 3 table.

The invention relates to medicine, namely to Oncology, and can be used in the treatment of patients with bladder cancer and cancer of the kidney.

Known "Method of prevention of recurrence of superficial (T1-2NxMo) bladder cancer with the use of intravesical chemotherapy after surgical removal of tumors" (see K. M. Figurine "Chemotherapy and immunotherapy of bladder cancer". Abstract of Diss. on competition of a scientific degree of the doctor of medical Sciences. M., 1993, S. 14-18).

The results of treatment of patients with superficial bladder cancer in this way suggests that among patients who received preventive chemotherapy (adriamycin and thiotepa), recurrences developed 39.3% of the observations in the first year after surgery.

Presents with whom the United complications in the form of chemical cystitis varying severity.

Secondly, this method is invasive, because it implies instrumental abdominal intervention, which in turn leads to an acute inflammatory complications in the urinary tract (urosepsis).

Third, this method allows to reduce the number of relapses only patients with superficial bladder cancer, excluding patients with stage T3-4NxMonot only with recurrences, and metastases, which limits the application of the proposed method.

Fourthly, a method for preventing recurrence of bladder cancer with intravesical chemotherapy refers to expensive treatments that require high material costs for drugs, mostly imported.

Fifthly, in kidney cancer at the present level of Oncology has no effective methods of prevention of recurrence and metastasis.

The known method of increasing the resistance by using adaptive reactions of the training and activation caused by the magnetic field (see our chosen as a prototype, L. H. Garkavi, E. B. Cucina and M. A. Ukolova "Adaptive response and resistance of organism". Rostov-on-don, 1990, S. 223).

The essence of the method to a memory in the neck at the level of direct, passing through the ear holes), the tension of 0.1 to 10 MT and the pathological focus AC or DC magnetic field exposure 5-20 minutes, the tension from 5.0 to 100 MT, and develop adaptive response training and activation with the total number of leukocytes from 4 to 8109/l and the relative number of lymphocytes from 21 to 27% and 28-45%, respectively, increases the body's resistance against various pathological processes.

Overseeing the development of adaptive reactions, the authors carried out on peripheral white blood cells and, above all, for the percentage of lymphocytes in the leukocyte formula. The blood sample is recommended that before treatment (original background), one day after pitching treatment and then 2 times a week.

Dose the magnetic influence of the authors of the method selected depending on the reaction of blood on the magnetic field relative to the number of lymphocytes in the leukocyte formula blood. When after the first exposure to the blood becomes characteristic response training (number of lymphocytes - 21 - 27%) and the need to support this reaction, the dose is left unchanged: the same applies to the case where in response to parmula blood becomes characteristic stress (lymphocyte count of less than 20%), then reduce the dose until the next analysis.

This way the authors recommend to use to achieve the anti-inflammatory effect, for protection when damages therapeutic effects (radiation therapy, chemotherapy) and others, as well as in the treatment of neoplastic disease.

The offered method of increasing the resistance of the body using a magnetic field is not without some disadvantages.

One of them should include a wide range of modes of magnetic influence, which gives the method a General nature, thereby complicating its use in each case.

In addition, when conducting magnetic therapy is not enough to focus only on the indices of lymphocyte blood count without taking into account the total number of leukocytes. So, in case of reaction of stress with the relative number of lymphocytes in the blood are less than normal, i.e., 19%, and leukocyte count, not exceeding the norm, i.e. 8,8109/l (see Handbook edited by centuries Menshikov "Laboratory methods in the clinic", M , 1987, S. 123-125) should talk about chronic stress. When under the influence of a magnetic field the total white blood cell count becomes too high (8,7109) when W is-stress or stress-reaction, Selye, 1936 (see Selye, "Essays on adaptation syndrome", M., 1960. S. 7-12; 47-89) means the development of adaptive reactions, further magnetotherapy Central (on the head) becomes impractical and can be limited to local effects (the pathological focus) without increasing the dose, so as not to cause exhaustion. In chronic stress, it is necessary to gradually increase the dose until you call the stress response with the development of adaptive reactions. While the authors of the method to determine the stress response without taking into account the total number of blood leukocytes, not dividing it into chronic and acute and recommending only the lower dose of the next exposure. In General, this can lead to errors in the interpretation of the control of blood tests and tactics of conducting magnetic therapy.

The aim of the invention is to prevent possible recurrence and metastasis in patients with bladder cancer and kidney cancer after radical surgery.

This goal is achieved by the fact that patients with bladder cancer and kidney cancer with 3-5 days after radical surgery with the level of peripheral blood leukocytes, not exceeding 8,8109/l cause a stress reaction daily attack by the Hz, modulated by rectangular pulses with a duration of 0.5 s, and with a repetition period of 1 to 1 MT induction, initial exposure time of 5 s and its subsequent increase to 1-2 with the next impact, in total not exceeding 12, and then (second stage) have a magnetic effect locally: on the bladder in patients with bladder cancer and on the region of the kidneys in patients with kidney cancer two inductors sinusoidal field frequency of 50 Hz initial induction 10 MT with each new impact, not exceeding 50 MT and held constant for 20 min, upon reaching the stress response with the level of blood leukocytes 10-11109/l on the second day after the double exposure stop Central impact, continuing local without increasing doses to achieve adaptive responses with the total number of blood leukocytes, not exceeding 8,8109/l, and the relative number of cells not more than 37%.

The invention is new, because it is unknown the level of medicine in the prevention of recurrence and metastasis after radical treatment - surgery in patients with bladder cancer and kidney cancer through the development of the stress response, which includes an adaptive response with the total number of blood leukocytes and Rel is inanaga field, modulated by rectangular pulses with a Central impact (on the head) and non - local (the pathological focus).

Our proposed method significantly differs from the prototype in that the selection of the modes of magnetic effects is to invoke the stress response (General adaptation syndrome), which is developing an adaptive response that increases total, including antitumor resistance of the body, and don't lead the body to exhaustion, thereby preventing relapses and metastases in the postoperative period.

This approach made it possible to develop a universal and, at the same time, the specific scheme of magnetotherapy in contrast to the prototype, where the authors propose a wide range of stimulation modes with an empirical selection of doses for end - adaptive reactions.

Overseeing the development of adaptive reactions were carried out on peripheral white blood cells and, above all, by the total number of leukocytes and the percentage of lymphocytes in the leukocyte formula. In the prototype described "Method of increasing the body's resistance, which provides only increase protivoopujolevy.

The invention has an inventive step if it is for the specialist is not obvious from the prior art, i.e., the level of medicine in the prevention of recurrence and metastasis in patients with bladder cancer and kidney cancer. The known method of prevention of recurrence of superficial (T1-2NxMo) bladder cancer by intravesical chemotherapy after surgical removal of tumors is accompanied by complications in the form of chemical cystitis varying severity, invasive, which leads to inflammatory complications in the urinary tract, is applicable only for patients with superficial bladder cancer to the exclusion of other advanced stages of the tumor process, and is not applicable in patients with kidney cancer. Developed by the authors, the selection of modes of magnetic influence to call stress reactions known in the medical literature and is most effective for prevention of recurrence and metastases in comparison with known methods in Oncology.

The invention is industrially applicable as it can be used in health care, cancer research institutes, clinics and medical facilities in polucheniya technical result - positive clinical effect driven clinical trial materials on 44 patients with bladder cancer (table. 1) and 31-m a diseased kidney cancer (table. 2).

Of these 17 patients with bladder cancer and 18 patients with kidney cancer after radical surgery was performed magnetotherapy device "Gradient - 1". Treatment was started with 3-5 days after surgery only to patients in whom the total leukocyte count did not exceed the norm - 8,8109l/ blood. The control were indicators of peripheral white blood and, above all, leukocytes and lymphocytes leukocyte formula.

The blood sampling was performed before treatment procedures on the same day (original background). Further blood tests were taken on the next day after the Central magnetotherapy (on the head) with the exposition of 8-12 with up until the total number of leukocytes was not reached level 10 - 11109/L. Further control analyses conducted no earlier than two days after the last Central impact, and repeated, achieving a decrease in total leukocyte count to 8,8109/l (or less) and the relative number of lymphocytes is not more than 37%.

Dose magnetic effects were increased gradually, so as not to cause any negative us scheme, seeking call short-term (usually within 3 days) stress response with the level of blood leukocytes 10-11109/l (on the second day after magnetotherapy), which is developing an adaptive response with the total number of blood leukocytes, not exceeding the upper limit of normal - 8,8109/l, and the relative number of cells not more than 37% (upper limit of normal), which increases the total resistance of the body and does not lead to exhaustion.

The control group of patients with bladder cancer, fail magnetic therapy, included 27 people in a control group of patients with kidney cancer is 13.

After a year or more after treatment was carried out comparative analysis of the number of recurrences and metastases, clinically in patients with bladder cancer and kidney cancer with magnetic therapy and without it (see tab. 1 and 2). According to the table. 1 in patients with bladder cancer, underwent magnetic treatment, relapses were detected in 3 people only in stage T3NxMoin terms from 3 months to 1 year of observation, which accounted for 18% of all patients (17 people). Metastases were not found a single patient.

In the control group relapses and metastases developed in 13 T3NxMo- 7, mostly in 3-6 months.

Therefore, magnetic therapy, conducted by our developed method for patients with cancer of the bladder, effectively prevents the development of recurrence and metastases in stage T1-2NxMoand reduces the number of relapses 2.6 times at stage T3NxMocompared with patients who magnetotherapy was not conducted.

For patients with kidney cancer, according to the table. 2, characterized by the fact that in the case of the use of magnetotherapy metastases were detected only 2 patients out of 18 at stage T3NxMoi.e., in 12% of cases in the period from 3 to 36 months of observation. In the control group without magnetic therapy metastases were detected in 5 patients out of 13 (38,4%), mainly at the stage of T3NxMoin the period from 3 to 12 months of observation.

Thus, magnetic therapy, conducted by our proposed method reduces the frequency of metastasis of kidney cancer in the postoperative period 3.2 times at stage T3NxMocompared to patients that magnetic therapy is not received.

In addition, the comparative analysis of the number of relapses and metastases between groups ill and control groups corresponding locations on the Fisher test - P (see C. J. Urbach "Statistical analysis in biological and medical research". M., 1975, S. 5-164), which has allowed to establish that the number of relapses and metastases in groups of patients with bladder cancer and kidney cancer with magnetic therapy statistically significantly lower than in groups without magnetotherapy - P<0,05.

Example 1.

Patient B., 1914, R. N history 45835/B was admitted in the urology Department of RNII diagnosed with bladder cancer, stage T3NxMoin connection with which the patient was performed razbrosana electroresection bladder. 5-th day after radical surgery the patient was started magnetotherapy scheme 1 (1) (see tab. 3). All patient received 10 sessions and was discharged on the 15th day without oslojneniya - 37%.

Now, after 3 years after treatment, the patient is alive, signs of recurrence of bladder cancer was not detected.

Example 2.

Patient B., 1941, R., N history 3770/and entered the urology Department of RNII with the diagnosis of bladder cancer, stage T1NxMo. On this occasion it was performed radical surgery - vnebrachnaya spectrometery bladder. Later, 5 days after the operation the patient was started on therapy according to the scheme 1 (2) (see table 3). All patient received 8 sessions and was discharged on the 13th day after surgery with no complications, the total number of blood leukocytes 4,4109/l and the relative number of lymphocytes - 25%. After 2 years of treatment signs of recurrence or metastasis of the tumor was not found.

Example 3.

Patient P. , 1924 R. N East. disease 6799/I was admitted in the urology Department of RNII diagnosed with bladder cancer stage T2NxMofor this reason it was performed radical surgery - vnebrachnaya electroresection bladder. Magnetic therapy in the early postoperative period the patient was not conducted. The patient was discharged on the 21st day after radical surgery b is in - 23%. After 2 years and 3 months after treatment with cystoscopically study of the bladder was diagnosed with a relapse of the tumor.

Example 4.

Patient A. , 1955 R., N East.disease 9493/I was admitted in the urology Department of the Institute with a diagnosis of bladder cancer, stage T3NxMoin connection with which the patient was performed razbrosana hemicolectomy with autoplastics bladder. The patient was discharged on the 25th day after radical surgery with no complications, indicators of white blood: the total number of leukocytes - 5,4109/l and the relative number of lymphocytes - 24%. 5 months after treatment the patient revealed multiple metastases in the lungs.

Example 5.

Patient N. , 1934, R., N East.disease 9774/I was admitted in the urology Department of RNII diagnosed with cancer of the right kidney, stage T3NxMo. In this regard, the patient was made right radical nephrectomy. 3 days after surgery the patient was conducted magnetotherapy scheme II (1) within 7 days (see table. 3). On the 10th day the patient was discharged without complications with the total number of blood leukocytes - 4,8109/l and the relative content of lymphocytes - 25%. At the present time, i.e. after 3 years of the settlement of the, p., N East.disease 10312/I, entered RNII diagnosed with cancer of the left kidney, stage T3NxMoon this occasion the patient was made radical nephrectomy on the left and 4 days after surgery conducted magnetotherapy. All patient received 7 sessions, then on the 11th day was discharged without complications with the total number of leukocytes - 8,8109/l and the relative number of lymphocytes - 11%. Now, 2 years after treatment, the patient is alive, the signs of metastases are absent.

Example 7.

Patient M. , 1929, R., N East.disease 10996/and was admitted in the urology Department of RNII diagnosed with cancer of the left kidney, stage T3NxMoabout which he was made a radical nephrectomy on the left. Magnetic therapy in the early postoperative period the patient was not conducted. On the 10th day after the operation the patient was discharged with no complications total number of leukocytes - 4,5109/l and the relative number of lymphocytes - 18%. One year after treatment, the patient revealed metastases to the brain.

Example 8.

Patient D. , 1940, R., N East.disease 3366/a, entered RNII diagnosed with cancer of the left kidney, stage T3NxMo. Because of the ode he was not conducted. Within 10 days after the operation the patient was discharged with no complications, blood counts: the total number of leukocytes - 6,5109/l and the relative number of lymphocytes - 16%. After 5 months after treatment, the patient revealed multiple metastases in the lungs.

The technical result of use of the Method of prevention of recurrence and metastasis in patients with cancer of the urinary tract" is that magnetotherapy double exposure causes short-term physiological stress response, meaning the development of adaptive reactions with the level of peripheral blood leukocytes, not exceeding 8,8109/l, and the relative number of lymphocytes is not more than 37%, which increases the total, including antitumor resistance of the body and does not lead to depletion that contributes to the prevention of relapses and metastases in the postoperative period. The use proposed by the authors of specific, individual for each patient circuit magnetotherapy in patients with bladder cancer and kidney cancer in the early postoperative period reduces the incidence of recurrence and metastases in the period from 3 to 36 months after radical surgery; effectively prevents the development of recurrence and met the T3NxMo; reduces the frequency of metastasis of kidney cancer in 3.2 times at stage T3NxMo.

A method of preventing recurrence and metastasis in patients with cancer of the urinary tract, including radical surgery and postoperative magnetic therapy, characterized in that, to prevent possible recurrence and / or metastases of patients with bladder cancer and kidney cancer with 3-5 days after radical surgery and peripheral blood leukocytes, not exceeding 8,8109/l cause a stress reaction daily exposure first (the first stage) of the Central area of the head, a sinusoidal magnetic field frequency of 50 Hz, modulated by rectangular pulses with a duration of 0.5 s and a repetition period of 1 s, the induction of 1 MT, the initial exposure time of 5 s and its subsequent increase to 1-2 with the next impact, cumulatively, not exceeding 12; then (second stage) have a magnetic effect locally: the bladder in patients with bladder cancer and on the region of the kidneys in patients with kidney cancer two inductors sinusoidal field frequency of 50 Hz and the initial induction of 10 MT, with subsequent increase of 10 MT with each new impact, not exceeding 50A the second day after the double exposure stop Central impact, continuing local without increasing doses to achieve adaptive responses with the total number of blood leukocytes, not exceeding 8,8109/l, and the relative number of cells not more than 37%.

 

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FIELD: medical engineering.

SUBSTANCE: device has power supply source, electromagnetic oscillation source, treatment element, having two inductance coils connected in series and compliance, and capacitor forming an LC-circuit with the treatment element. The electromagnetic oscillation source is designed as self-excited oscillator, which oscillatory circuit is the LC-circuit with the treatment element. The device also has modulator unit set between the power supply source and self-excited oscillator circuit, control circuit connected to the self-excited oscillator circuit and having amplitude detector, AC amplifier and indicator unit connected in series and sectional U-shaped dielectric carcass having inductance coils of the treatment element mounted on its vertical elements and electric units of the device mounted on horizontal electric elements of the device. The self-excited oscillator produces high frequency oscillations in frequency bandwidth of 100-1000 kHz. The modulator unit has low frequency oscillator operating in the bandwidth of 10-5000 Hz. Carcass members are manufactured from hard dielectric material and connected to each other by means of flexible connection members.

EFFECT: wide range of functional applications.

2 cl, 2 dwg

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