Combined method for treating locally disseminated forms of thyroid gland carcinoma and its recurrences
SUBSTANCE: method involves applying intraoperative radiation therapy with rapid electrons of 6 MeV with single dose of 8 Gray per removed tumor bed. Then, postoperative remote gamma-therapy course is applied after having healed the wound and removing sutures to postoperative suture region and regional lymph discharge zone at a dose of 2 Gray with 5 fractions per week. The number of remote gamma-therapy sessions is calculated from formula N=8.8(3.4-X-0.169), where N is the number of postoperative remote gamma-therapy sessions; X is the time interval length in days between the intraoperative radiation therapy session and remote gamma-therapy session under condition that mixed irradiation dose (intraoperative radiation therapy and remote gamma-therapy) to thyroid gland tumor region or cancer recurrence area is equal to 60 Gray in terms of isoeffect.
EFFECT: increased total course dose per tumor focus; reduced risk of relapse; accelerated treatment course.
The invention relates to medicine, namely to Oncology, and can be used in the combined treatment of locally advanced common forms, ineradicable operated and recurrence of well-differentiated forms of thyroid cancer (thyroid cancer).
There is a method of treatment of differentiated forms and recurrence of thyroid cancer surgery, which is essential in the treatment of malignant tumors of the thyroid gland (analog) .
The disadvantage of this method is:
- the possibility of recurrence of thyroid cancer after surgery, as in 65.4% of cases  patients are found remains of the tumor tissue, resulting in continued tumor growth;
- risk of metastasis during or after surgery, as around the capsule of the thyroid gland expressed a network of lymphatic vessels , which may contribute to the spread of metastases during surgery.
Known combined method of treatment of cancer of the mucous membrane of the floor of mouth with the use of intraoperative radiation therapy (IORT) . Intraoperative radiation therapy was not carried out in the combined treatment of thyroid cancer and its recurrence.
In the treatment by known methods of differentiated forms of thyroid cancer and its recurrence has the following disadvantages:
when surgical treatment differences the bathrooms forms of thyroid cancer or its recurrence in more than 50% of cases remain the microsections tumor tissue ;
- during surgery can occur proliferation of tumor cells through the lymphatic ducts, due to the delayed application of the postoperative course of gamma therapy in SOD 40 Gy;
- due to the resistance of differentiated forms of thyroid cancer and its recurrence to photon radiation total focal dose of 40 Gy is insufficient;
- increase dose rate of postoperative rate of photon therapy to SOD - 60 Gy radiation increases the load on the spinal cord;
- combined treatment with IORT with thyroid cancer or its recurrence has not previously been used.
There is a method of combined treatment of locally common forms of cancer and recurrence of thyroid cancer with postoperative course of gamma-therapy on the area of the removed tumor and the area of regional lymph flow in standard mode: single focal dose of 2.0 Gy, 5 fractions per week to a total focal dose (SOD) - 40 Gy to the area of the removed tumor and areas of regional lymph (prototype) .
The disadvantage of this method is:
- during the operation fails exposure "box" removed tumor that may spread remaining microfocused tumor tissues through the lymphatic ducts;
- rate remote gamma-therapy in standard mode fractionation dose starts after the healing of postoperative wounds and SN is ment seams and lasts for 4-5 weeks;
- due to the resistance of differentiated forms of thyroid cancer, especially cancer recurrence to photon radiation total focal dose of 40 Gy of postoperative radiation therapy is insufficient;
- increase dose postoperative course until SOD 60 Gy, as with the radical program, increases the radiation dose to critical organs, in particular, on the spinal cord.
The task of the invention is to increase the effectiveness of treatment of locally common forms, ineradicable operated and recurrence of well-differentiated forms of thyroid cancer by increasing the total dose rate at the center target ("bed" of the removed tumor), reducing the number of relapses, prevent the spread of the remaining microfocused tumor tissues through the lymph system, the reduction of treatment time due to the use of radiation during surgery fast 6 MeV electrons with a single dose of 8 Gy and followed by postoperative remote gamma-therapy in standard mode on the hearth-target and area regional lymph flow.
This object is achieved in that in the conditions of the combined treatment of well-differentiated cancer or recurrence of thyroid cancer on the hearth-target spend intraoperative radiation therapy fast electron average energy of 6 MeV once the dose of 8 Gy. After the healing of postoperative wounds and removing operating seams spend postoperative remote gamma-therapy in standard mode fractionation ROD 2.0 Gy, 5 times a week on the area of the postoperative scar and the area of regional lymphatic drainage. The calculation of the number of sessions postoperative DHT is conducted according to the formula:
where N is the number of sessions postoperative DHT, X is the time interval in days between session IORT and DHT, provided that the dose of mixed irradiation (IORT and DHT) on the area of the removed tumor of the thyroid gland or cancer recurrence is for the treatment of 60 Gy in isoeffective, or 100 usled
Formula (1) was obtained based on the known formula :
In the formula (2) WDF - factor Time-Dose-Fractionation, Du, Xu- single dose of IORT in Gr and the time interval in days between session IORT and DHT, respectively; Df,iand Xf,i- single dose of DHT in Gr and the time interval in days between sessions DHT; N - number of sessions DHT .
If the formula (2) to Express explicitly the number of radiation sessions N for specific values included in (2) parameters, we can obtain the formula (1).
The proposed method of treatment is carried out as follows. During the operation, after removal of the residual (after PE the primary non-radical surgery) or recurrent tumors in well-differentiated thyroid cancer in the area focus target spend intraoperative radiation therapy fast 6 MeV electrons from one, rarely (if necessary) with two beams size 6x6 cm, or 7×11 see a Single dose of IORT - 8 Gr down for each irradiation field. The value of a single dose of IORT - 8 Gr selected after clinical testing of combined treatment and analysis of its results in patients with thyroid cancer. After healing of wounds and the removal of the stitches on the area of focus target and regional lymph flow (the area of the cervical lymph nodes) conduct remote gamma-therapy with one field exposure size 10-12×20-22 cm in standard mode fractionation dose: ROD 2.0 Gy, 5 fractions per week. The magnitude of the number of sessions postoperative DHT calculated according to the formula N=8,9(3,4-X-0,169), where N is the number of sessions postoperative DHT, X is the time interval in days between session IORT and DHT, provided that the dose of mixed irradiation (IORT and DHT) on the area of the removed tumor of the thyroid gland or cancer recurrence is for the treatment of 60 Gy in isoeffective, or 100 srvc. ed WDF.
Critical organs larynx, trachea - escaped lead blocks after reaching SOD remote gamma-therapy 20 Gy, which reduces radiation exposure by 20% and reduces the possibility of radiation reactions and remote radiation damage vital critical organs.
Required when carrying out the proposed method is that the course is the first dose in the center of the target should be 60 Gy (100 srvc. ed WDF)that does not exceed the established tolerance for normal tissues.
New in the proposed method is that during the operation used intraoperative radiation therapy (IORT) - 8 Grams of fast electrons average energy of 6 MeV at the center target, and after surgery and removal of sutures undergo remote gamma-therapy on the hearth-target and area of lymphatic drainage, while the calculation of the number of sessions postoperative DHT is conducted according to the formula:
where N is the number of sessions postoperative DHT, X is the time interval in days between session IORT and DHT, provided that the dose of mixed irradiation (IORT and DHT) on the area of the removed tumor of the thyroid gland or cancer recurrence is for the treatment of 60 Gy in isoeffective, or 100 used WDF.
Conducted clinical testing tolerability of a single dose of IORT in patients with thyroid cancer after non-radical surgery and recurrence of thyroid cancer showed that a dose of 8 Gy is well tolerated by patients, complications were observed in only one case (4%) of 24 patients in the form of edema from the mucosa of the trachea, which were stopped by means of medication during the day. To prevent swelling of the mucous membrane of the trachea in the following, all patients in the nearest postoperative period prescribed drug therapy, resulting in such complications in the future not OBS is given in any case. Used a beam of fast electrons average energy of 6 MeV has a limited mileage of fast electrons in the tissue, the 80% isodose curve, which is calculated doses, is located at a depth of 1.7 cm from the surface of the field of irradiation, which also contributes to sparing the mucosa of the trachea and larynx.
Thus, in the combined treatment of locally advanced common forms, ineradicable operated and recurrence of well-differentiated forms of thyroid cancer (thyroid cancer) radiation therapy mixed irradiation (IORT and DHT) is performed under the control of the assessment of biological effects indicators factor WDF, while the total course dose of 60 Gy in isoeffective, and the factor of WDF is 100 srvc. units
The proposed method were treated 24 patients with differentiated forms ineradicable operated cancer and recurrent thyroid cancer. Of the 24 patients, only one (4%) patient was observed in mild edema of the mucosa of the trachea and larynx in the immediate postoperative period. Other complications and radiation damage in the remote period of observation in patients with thyroid cancer was not observed after conducting a combined treatment with IORT a single dose of 8 Gy and remote gamma-therapy to SOD 60 Gr. The characteristic indicators of the rate of mixed irradiation (IORT and DHT) in patients with diff is linzirovannye forms of thyroid cancer and observed during the course of DHT in the form of light radiation reaction are presented in table 1.
Here is additional clinical examples:
Example 1. Patient A., 53, case History No. 118075. Diagnosis: thyroid Cancer T3N0M0condition after non-radical surgery. Continued growth. Histology: follicular cancer. In the hospital oncological profile performed surgery in the amount of resection of the left lobe of the thyroid gland about the alleged nodular goiter. At Oncology research Institute conducted reoperate in the amount of thyroidectomy (removal of the remnants of the thyroid gland) with IORT, GENUS 8,0 Gr a single field. The postoperative period was uneventful wound healing by primary intention, the sutures were removed on the 7th day. On the ninth day after the operation started, the rate of postoperative gamma therapy conducted to SOD 60 Gr. The calculation of the number of sessions postoperative gamma therapy carried out according to the formula:
N=8,9(3,4-X-0,169), where N is the number of sessions postoperative DHT, X is the time interval in days between session IORT and DHT. The value of N was 24 session.
Considering the magnitude of the GENUS IORT-8,0 G, the duration of the postoperative period until the early postoperative radiotherapy course is 9 days and the amount of DHT was 48 Gy to a total dose rate of 60 Gy (100 srvc. ed WDF) isoeffective that does not exceed the tolerance of normal tissues. The terms dynamic follow-up was 8 years old. P and dynamic monitoring data for recurrence, metastasis is not received.
Example 2. Patient U., 21, case History No. 121147. Was in OOGS with 22.11.99 on 17.02.00. Diagnosis: thyroid Cancer T3N0M0condition after non-radical surgery. In General physicians about the alleged nodular goiter performed Subtotal resection of the thyroid gland in Nikolaev. Histology: follicular cancer. At Oncology research Institute performed the surgery: Thyroidectomy (removal of the thyroid gland), IORT - 8 Gy in "bed" of the right lobe. Postoperative paresis of the right recurrent nerve, light swelling of the mucous membrane of the larynx and upper divisions of the trachea. Healing by primary intention. On the 14th day started the postoperative course of radiation gamma therapy. Held 25 sessions DHT (50 Gy) to dose rate of SOD - 60 Gr. The observation period is 4.5 years. For dynamic monitoring data for recurrence, metastasis is not received.
Thus, the proposed set of distinctive features has resulted in a new unknown early positive effect, which consists in increasing the effectiveness of treatment and reducing treatment time, reducing the number of relapses.
|№ p/p||The patient's age, no East. disease||Mor is ideological diagnosis||Indications for surgery with IORT and DHT in patients with thyroid cancer||Single focal dose IORT||Time interval (days) DHT||Tgthr (number of sessions)||CD (G)||Radiation reaction|
|1.||A., 53, No. 118075||Follicular thyroid cancer||Residual tumor after non-radical surgery.||8,0 Gr||9||48 Gy (24th session)||60||Catarrhal laryngitis|
|2.||U., 21, No. 121147||Follicular thyroid cancer||Continued tumor growth||8,0 Gr||14||50 G (25 sessions)||60||Dry epidermis|
|*KD - dose rate of the mixed radiation.|
Sources of information
1. Pačes A.I. of head and neck Tumors - M - 1997, - 479 S. (prototype).
2. Birzu I., Grigorescu PCs. Radiotherapy in the clinic. Medical publishing house, Bucharest, 1981. s-726. (similar).
3. Clark R.L, Ibanez M.L., Write E.C. // Arch. Surg. 1966. 92, 23.
4. Popovich V. Zyryanov BN. and other Intraoperative and electronic therapy of head and neck tumors. Tomsk. - Publishing house map Vector, 1999, 144 S. (similar).
5. Musabayev LI, Tyukalov SCI, Lisin, V.A. et al. Combined treatment of sarcomas of the soft tissues with the use of intraoperative lucev the th therapy and remote gamma-therapy // Medical radiology and radiation safety. Volume 42, 1997, No. 2. - p.58-63.
The method of combined treatment of locally common forms of differentiated thyroid cancer and its recurrence from postoperative course remote gamma-therapy (DHT) on the area of the postoperative scar and the area of regional lymph Gr 2 5 fractions per week, characterized in that on the bed of the removed tumor spend intraoperative radiation therapy (IORT) fast 6 MeV electrons with a single dose of 8 Gy, and after healing of wounds and the removal of the stitches hold DHT, the number of sessions which are calculated according to the formula
N=8,9(3,4-X-0,169), where N is the number of sessions postoperative DHT; X is the time interval in days between session IORT and DHT, provided that the dose of mixed irradiation (IORT and DHT) on the area of the removed tumor of the thyroid gland or cancer recurrence is for the treatment of 60 Gy in isaffected.
SUBSTANCE: method involves carrying out radical operation in combination with intra-operative radiation therapy at a dose of 15 Gray per removed tumor bed and regional metastasis path. The operation combined with intra-operative radiation therapy is done in 3 weeks after finishing polychemotherapy composed of at least 2 courses to reach positive result of tumor reduction more than 75%. Pause between the courses is 3 weeks long. Following scheme is administered: Hemcytabin 1250 mg/m2 in intravenous drop-by-drop introduction during half-an-hour long infusion at the second and the ninth day, Cisplatin 50 mg/m2 is introduced at the first and the eighth day.
EFFECT: stopped progressive tumor development; prevented metastases formation.
SUBSTANCE: method involves introducing means containing heavy elements into tumor and expose it to X-ray radiation. A heavy chemical element having number of 53, 55-83 is used. The means contains one or several of said elements with additional ligand introduced as iminodiacetic acid or its derivatives or crownethers or porphyrins and a water-soluble polymer. The means is introduced in systemic or direct way into tumor with following X-ray irradiation of power of 10-200 keV being applied.
EFFECT: increased photon therapy dose concentrated in tumor tissue with concurrently reduced radiation exposure upon the unaffected tissues.
4 cl, 4 dwg, 6 tbl
SUBSTANCE: method involves administering local tumor cell radiomodification with following radiation therapy and radical surgical operation being applied. The local radiomodification is carried out by applying endovascular tumor tissue perfusion with 5% Metronidasole via superior rectal artery in superoampular rectal cancer cases and via superior rectal artery and one of internal iliac arteries in medial and inferoampular rectal cancer cases with said blood vessel occlusion done using non-lytic radiopaque emboli. Single remote radiation therapy is carried out at a dose of 10 Gy 1 h later after radiomodification being over. Surgical operation is done not later than in 24 h after the irradiation.
EFFECT: increased radiation therapy destruction effectiveness.
SUBSTANCE: method involves carrying out radiation treatment combined with textile material application on the tumor. Tumor-transformed vaginal uterus neck portion volume is determined with ultrasonic examination techniques. Koletex napkin impregnated with therapeutic cytostatic preparation dose is used as the textile material. The napkin pattern is produced on the basis of ultrasonic examination data. The napkin is quilted with ligature along the perimeter and fixed at the level of vagina fornix by drawing tightly in purse-string mode. Napkin is changed every 24 h within 10-20 days long treatment course.
EFFECT: improved life quality.
FIELD: medical equipment; X-ray diagnostics.
SUBSTANCE: device can be used in X-ray digital visualization systems. X-ray electron-beam detector has case, conversing member, collecting electrode, deflection system and electron searchlight. Conversing member has to be air-proof gas ionization chamber, which has drift electrode to be output window of the case. Electrodes of signal electrode system of air-proof ionization chamber are withdrawn onto surface of the chamber at the side of collecting electrode, deflection system and electron searchlight.
EFFECT: improved counting characteristics; higher quality of image; widened field of X-ray check.
FIELD: medicine, pediatrics, hematology.
SUBSTANCE: the present innovation could be applied in treating surgical and oncological diseases in children during treating and preventing anemia of different etiology. One should introduce ceruloplasmin at daily single dosage ranged 50-200 mg depending upon child's age against 100-200 ml 0.9%-sodiumchloride solution intravenously by drops at the rate of 40-50 drops/min. Moreover, for preventing and/or treating posthemorrhagic anemia in case of surgical operations one should introduce ceruloplasmin during 2 d before surgical operation, intraoperationally, and for 2-10 d after operation. For preventing and/or treating anemia in case of purulent-septic diseases ceruloplasmin should be introduced during chemotherapeutic days during the whole period of the course conducted, for preventing and treating radiation anemia at the background of radiation therapy ceruloplasmin should be injected once weekly during the whole period of radiotherapy course, for preventing and treating toxic and radiation anemia at the background of chemoradiation therapy ceruloplasmin should be introduced once weekly on the day of chemotherapy during the whole course of chemoradiation treatment. The innovation enables to avoid inflows of erythrocytic mass and donor's blood along with shortened number of procedures on introduction of ceruloplasmin and 4-times decrease in the risk for the development of severe anemia in children due to matching peculiar mode for ceruloplasmin introduction.
EFFECT: higher efficiency of therapy and prophylaxis.
4 cl, 5 ex
FIELD: medicine, oncology.
SUBSTANCE: one should carry out chemoradiation therapy at applying a cytostatic preparation followed by distance and intracavitary irradiation. Depending upon development of tumor lesion during the first 3 or 6 d it is necessary to conduct monochemotherapy only due to introducing proxiphen together with dimethyl sulfoxide at weight ratio of 4.5-5.0 : 0.5-1.5, correspondingly by applications in "Coletex" napkins. Moreover, a napkin should be pre-impregnated in 20%-dimethylsulfoxide solution and fixed with a tough vaginal tamponade by changing napkins every 24 h. Then since the 4th d or the 7th d simultaneously with application it is necessary to carry out contact irradiation and distance impact onto minor pelvis every 4-6 h at single focal dosage (SFD) being 2 Gy at 10 seances 5 times/weekly with high-activity sources of SFD 2 Gy. The innovation provides tumor regress under conditions of no therapeutic complications, thus, improving patients' quality of life.
EFFECT: higher therapy.
SUBSTANCE: invention is directed, in particular, to treatment of patients with Ewing's sarcoma and osteogenic sarcoma at different stages of malignant process. Method comprises chemotherapy and beam therapy. Samples of venous blood are taken from children in age of 5 to 12 years in amounts not larger than 5% of the total volume of circulating blood per 1 introduced dose of chemical preparation and, from adolescents and young persons, in amount of 200 ml. Then 4 courses of polychemotherapy are fulfilled with autoblood according to standard treatment schemes for given diseases, taking into account stages of disease, in recommended doses. Between 2nd and 3rd chemotherapy courses, radiotherapy is fulfilled on metastatic focuses in lungs. After 4 courses of induction autohemo-chemotherapy, local therapy on the primary focus (radiotherapy and/or surgical treatment) is fulfilled and also radiotherapy on metastatic focuses in other bones, after which follows consolidation involving chemical preparation of the second line.
EFFECT: improved remote results of treatment , suppressed metastatic focuses, reduced tumor dimensions, and weakened toxic manifestations of therapy.
SUBSTANCE: the present innovation deals with measuring radioactivity in alive organisms and could be applied for detecting really absorbed dosage under conditions of intra-operational impact. The method suggested includes detecting clinical volume for the target of radiation impact including the volume of healthy tissues to be subjected for radiation impact, developing the plan of radiation impact based upon data obtained with the help of tissue-equivalent phantoms, location in interest sites of clinical volume of sterilized separate fragments of dosimetric device being the matrix of functional units and designed as thermoluminescent detectors being hermetically isolated at the distance of 10 mm between their edges and fixed between the layers of flexible biocompatible material, registering the location of detectors, performing the séance for intra-operational radiation therapy followed by removing the fragments of dosimetric device out of target's volume. Information should be read from thermoluminescent detectors.
EFFECT: higher accuracy of measuring.
1 cl, 1 dwg, 1 ex
SUBSTANCE: the present innovation deals with treating malignant tumors of central bronchi and trachea due to argonoplasmatic recanalization of tracheal lumen and/or bronchi, at power being 60-90 W followed by brachitherapy at source's trajectory length being 5-20 cm, pace of 5 mm and the depth of reference isodose being 10 mm against the source. Moreover, one should move applicator above and below the tumor ranged 1-3 cm to apply the dose ranged 14-28 Gy once weekly per 7 Gy. Additionally, one should carry out distance radiation therapy 5 times weekly per 1-2 Gy up to total focal dose of 30-40 Gy. The present innovation enables to highly increase the passability of respiratory tract in case of malignant stenosis and prevent the development of their relapse.
EFFECT: higher efficiency of therapy.
FIELD: medicine, oncology.
SUBSTANCE: the present innovation deals with treating patients with uterine cervix cancer with relapses in parametral fiber and in case of no possibility for radical operative interference and effect of previous radiation therapy. During the 1st d of therapy one should intravenously inject 30 mg platidiam incubated for 1 h at 37 C with 150 ml autoblood, during the next 3 d comes external irradiation per 2.6 G-r. During the 5th d of therapy one should introduce the following composition into presacral space: 60 ml 0.5%-novocaine solution, 1 ml hydrocortisone suspension, 2 ml 50%-analgin solution, 1 ml 0.01%-vitamin B12 solution, 1.6 g gentamycine, 800 mg cyclophosphan, 10 mg metothrexate. These curative impacts should be repeated at mentioned sequence four times. The method enables to decrease radiation loading and toxic manifestations of anti-tumor therapy at achieving increased percent of tumor regression.
EFFECT: higher efficiency of therapy.
FIELD: medicine, oncology.
SUBSTANCE: invention relates to a method for treatment of uterus body topically spread cancer involving applying chemotherapy and intrauterus irradiation. Method is carried out by the following manner: at the 1-st day of treatment cyclophosphan is administrated in the dose 1200-1600 mg by interstitial paratumoral route; at the 2-d day cream-like based fluorouracil in the dose 300-550 mg or adriablastin in the dose 20-30 mg is administrated into uterus cavity; on the next day sйance of intracavitary irradiation is carried out in the dose 10 Gr. All these procedures are repeated three times with interval for 6 days. Method provides high topical concentrations of chemopreparations in tumor zone in reducing their adverse toxic effect that results to the curative effect of patients of elderly age with accompanying therapeutic diseases.
EFFECT: improved method for treatment.
SUBSTANCE: method involves carrying out argon plasma of tracheal and/or bronchial lumen recanalization by applying power of 60-90 W with argond discharge rate being 2.0-2.4 l/min large. Brachitherapy is applied next to it moving the source with 5 mm large step. Trajectory length is 5 to 20 cm large. Reference isodose depth is 10 mm far from the source with applicator moving above and below the tumor from 1 to 3 cm. Dose from 14 to 28 Gr is to be administered once a week in 7 Gr large portions.
EFFECT: enhanced effectiveness of treatment; reduced risk of complications; prolonged remission period.
FIELD: medical equipment; radiation therapy.
SUBSTANCE: radioactive source has radioisotope disposed inside air-tight biocompatible container. At least some part of container is made profiled and have rough, non-smooth surface. Radioactive source is made by loading it inside air-tight container. Composition has assemblage of radioactive sources mounted in line onto biologically decomposed material. Invention helps to improve ultrasonic visibility of source and/or reduce the trend of source to migrate in patient's body after implantation.
EFFECT: improved quality of treatment.
22 cl, 8 dwg
SUBSTANCE: the innovation deals with irradiating lymphatic collector, that is: at the first stage it is necessary to perform irradiation for the whole volume of affected lymph collector at total focal dose being 26 Gy, at the second stage one should carry out irradiation at collector's areas depending upon the degree of their destruction at decreasing the size of fields: for the area of residual lymph nodes remained after polychemotherapy - up to the total focal dose being 44 Gy, for the area of massively affected lymph nodes in case of total effect after polychemotherapy - up to 36 Gy, for the area of moderately affected lymph nodes in case of total effect after polychemotherapy - up to 30 Gy. The method enables to decrease the number of complications and local relapses, shorten terms for therapy, improve values for patients' survival rate at decreasing total integral dose of irradiation.
EFFECT: higher efficiency of radiation therapy.
FIELD: medical engineering.
SUBSTANCE: device has active zone of water-to-water nuclear reactor, biological reactor protection concrete mass, slow neutron collimator, which internal surface is coated with material like polyethylene having large scattering cross-section and conically shaped, filter for cleaning slow neutron radiation beam from gamma-quanta and aperture for regulating slow neutron radiation beam diameter. Retarder manufactured from beryllium or graphite or heavy water is available in the space between whole-metal water pool tank casing and adjacent active zone surface. Retarder height and width is not less than corresponding dimensions of the adjacent active zone surface. A hole is available in the bulk of biological reactor protection concrete mass for discharging slow neutrons. The collimator is arranged in the hole so that spatial angle cut out with it contains the whole active zone surface. Its outlet opening is manufactured flush with the external wall of the bulk of biological reactor protection concrete mass and conjugated with the aperture.
EFFECT: high density of slow neutron flux; reduced share of fast neutrons.
3 cl, 3 dwg
SUBSTANCE: the method deals with 2 courses of polychemotherapy at the first stage due to regional intra-arterial introduction of cisplatin at the dosage of 100 mg/m2 during the first day of every course and 6-h-long intra-arterial infusion of 5-fluorouracil at total dose of 750 mg/m2 in the morning since the 2nd to the 6th d of every course. Chemotherapy should be performed at the background of total magnetotherapy at frequency of magnetic field being 98-112 Hz, intensity of 25-30 oersted, duration of every seance being 30 min, the number of seances corresponds to the duration of chemotherapeutic courses. At the second stage in 2-3 wk after finishing chemotherapy it is necessary to conduct the course of distance radiation therapy (DRT) at multifractioning the dosage by SFD being 1.2 Gy twice daily 5 times weekly up to TFD being equivalent to TDF (time-dosage-fraction) of 62-70 Gy onto primary focus and 40-46 Gy onto areas of regional lymph outflow. As modifiers one should apply cisplatin during the first 2 wk of radiation therapy, hyperbaric oxygenation during the first 10 d of radiation therapy and total magnetotherapy since the 11th d of DRT course till its ending. At the third stage in case of residual metastases in lymph nodes of patient's neck in 2-3 wk after the end of radiation therapy one should conduct operative interference in lymph outflow pathways. The method enables to decrease toxicity of chemo-and radiation therapy due to decreased radiation reactions, stimulation of immune system and improved microcirculation.
EFFECT: higher efficiency of therapy.
FIELD: experimental medicine, oncology, biology.
SUBSTANCE: invention relates to a method for inhibition of tumor growth using radiation therapy as ionizing radiation with additional administration of mixture of octa-4,5-carboxyphthalocyanine sodium cobalt salt or oxocobalamine with sodium ascorbate in the ratio = (1:10)-(1:30). Method of combined using irradiation and indicated mixture of substances provides enhancing the effectiveness of anti-tumor treatment resulting to 70-100% recovery of experimental animals and reducing radiation loading and toxicity.
EFFECT: improved method for inhibition.
2 tbl, 3 dwg, 3 ex
FIELD: medicine, oncology.
SUBSTANCE: the method deals with applying chemopreparations incubated with autolymph and radiation therapy. Lymph taken out of patient's thoracic duct should be centrifuged for 30 min at 2200 rot./min, lymphatic plasma should be taken and frozen at -40 C, lymphatic formic elements should be incubated in a thermostat at 37 C for 1 h together with chemopreparations by a certain scheme to be reinfused for a patient intravenously by drops according to the given scheme. Then, 2 wk later, one should perform therapy with a split course of distance gammatherapy at single focal dosage (SFD) of 4 Gy. At the first stage one should apply per 2 Gy twice daily at 4-5-h-long interval 5 times weekly, at achieving focal dosage of 28 Gy it is necessary to have a week-long interval. Then radiation therapy should be continued but SFD of 4 Gy should be applied at once. One should fulfill 3 fractions of irradiation per a week, there are 6 fractions during the second stage, totally. Total focal dosage (TFD) per the whole course of irradiation corresponds to 52 Gy. About 4 wk after radiation therapy one should defrost lymphatic plasma to incubate it with the same chemopreparations in a thermostat at 37 C for 1 h to be then reinfused for a patient intravenously by drops. The method enables to decrease tumor volume and tumor process metastasing without any operative interference.
EFFECT: higher efficiency of therapy.
FIELD: medicine, oncology.
SUBSTANCE: before irradiation it is necessary to cool the tumor to achieve the temperature of freezing at clinically detectable border between the tumor and healthy tissue to perform irradiation directly after natural tissue defrosting with a single focal dosage (SFD) being 2-2.5 Gy daily for 5 d a week at 2-d-long interval to achieve total focal dosage (TFD) of 60-65 Gy. Moreover, the area of healthy tissue should be protected with a shielding applicator - a lead plate - during irradiation. The present innovation enables to maximally keep anatomical relief and function of local tissues.
EFFECT: higher efficiency of therapy.
1 cl, 4 ex