Method for treatment of abdominal cavity primary and metastatic tumors

FIELD: medicine, oncology.

SUBSTANCE: method involves autoblood sample taking off in the amount 200-250 ml into a sterile flask with hemopreserving agent "Glugitsir" followed by centrifugation at 1500 rev/min for 30 min. Then supernatant plasma is placed into another sterile flask with a hemopreserving agent and cellular precipitate is reinfused. A single dose of a cytostatic agent is mixed with 10-100 ml of autoplasma, incubated at temperature 37°C for 1 h and administrated through catheter in abdominal cavity by puncture in lower quadrant of abdomen. Procedure is repeated if necessary. Method provides decreasing toxicity of chemotherapy, simple method and uniform distribution of volume of injected preparation for all abdomen cavity. Invention can be used in carrying out chemotherapy of abdomen cavity tumors with ascites.

EFFECT: improved method for treatment.

1 ex

 

The invention relates to medicine, namely to Oncology, and can be used in chemotherapy of tumors of the abdomen, accompanied by ascites.

The known method of chemotherapy for ovarian cancer (Perevozchikova NI Chemotherapy of neoplastic diseases. Moscow, 2000. S), which consists in the introduction of intravenous cisplatin 100 mg/m2on day 1 and cyclophosphamide 600 to 750 mg/m21 day, the course can be repeated after 2 weeks. However, the application of this method of treatment is associated with severe toxic effects systemic effects of chemotherapy that requires a significant change in pay and course doses of cytostatics, the negative impact on the immune system of patients, prolongs the duration of treatment, requires massive accompanying therapy, affects the quality of life of patients.

Known "Method of chemotherapy for ovarian cancer (see ed. mon. No. 1693742 from 10.04.89, bull. No. 11, ed. Sidorenko US, Galatina LU), namely, that a massive infusion of chemotherapy drugs is carried out through the catheters introduced into the abdominal cavity during surgery, the proximal ends of which hang down into the abdominal cavity, and the distal ends remain on the skin of the abdomen for a long time. Microcatheters injected into the abdominal cavity during the operation with the two sides on the border of the anterior axillary line and 11th ribs that provide the characteristic swelling of chemotherapy through microcatheters from top to bottom, and irrigate the abdominal cavity. Chemotherapy should be performed within 7-10 days, a second course of treatment after 3 months in the same area. This improves the effectiveness of treatment and prolong the life of cancer patients.

However, this method requires surgical intervention for the production of the catheter, the presence of the bottom drainage opening from the vagina, involves the introduction of chemotherapy, the solutions of which are small amounts of liquid (cyclophosphamide, thiotepa, sarcolysin), which necessitates the installation of a catheter in the top floor of the abdominal cavity (2-3 cm below 11 ribs) to require the draining of the drug down and his contact with the abdominal cavity.

Known "Method of treatment of locally advanced breast cancer" (abstract. Diss. CMN the Vladimirova LU "Neoadjuvant chemotherapy on the natural environment of the organism with the use of the peptide of the epiphysis of epithalamin in treatment of locally advanced breast cancer". Rostov-on-don, 2000, S. 10), selected as a prototype, which is that collect autologous blood in quantities of 200 to 250 ml in a sterile vial geoconservation "Gleyzer", centrifuged at V. 1500 rpm, the supernatant plasma were evacuated to another sterile bottle with geoconservation. The cell sediment is re-infused. A single dose of RA drugs is tworay in 40 ml of physical the solution is mixed with 100 to 150 ml of autoplasma, incubated at 37 °C for 1 hour and injected intravenously 3 times a week. The method increases the effectiveness of the treatment, reducing tumor size, increased overall and relapse-free morbidity. However, he has expressed General toxic effects associated with systemic chemotherapy chemotherapy administration, and is not indicated for the treatment of abdominal tumors and ascites.

The aim of the invention is to increase the efficiency of treatment of patients with tumors of the abdomen, accompanied by ascites.

This objective is achieved in that the patient make the fence autologous blood in quantities of 200 to 250 ml in a sterile vial geoconservation "Gleyzer", centrifuged at V. 1500 Rev/min for 30 min, take the supernatant plasma in another sterile bottle with geoconservation, cellular precipitate is re-infused, single dose drugs mixed with 10-100 ml autoplasma, incubated at 37 °C for 1 hour and injected intraperitoneally through a catheter in the abdominal cavity, if necessary the procedure is repeated.

The invention of "a Method of treatment of tumors of the abdominal cavity is new, because it is not known from the level of medicine in the field of drug therapy in the sociology.

The novelty of the invention lies in the fact that the patient make the fence autologous blood in quantities of 200 to 250 ml in a sterile vial geoconservation "Gleyzer", centrifuged at V. 1500 rpm for 30 min, take the supernatant plasma in another sterile bottle with geoconservation, cellular precipitate is re-infused. A single dose of the chemical is mixed with 10-100 ml autoplasma, incubated at 37 °C for 1 hour and injected intraperitoneally through a catheter into the abdominal cavity through the puncture, if necessary the procedure is repeated.

The principal difference of this method of treatment used so far in Oncology is the introduction of drugs on autoplasma sobrepena, pioneered a new way of introduction autoplasma intraperitoneal. This avoids the need for Oceania drug down the puncture of the abdominal cavity and the establishment of the catheter in the top floor, because a sufficient volume of fluid injected intraperitoneally, and autoplasma achieved sufficient volume, and the product is evenly distributed in the abdominal cavity. In addition, we found that autoplasma is a modifier of action of chemotherapeutic agents, since their joint incubation is fragmented albumin, contributing to rapid flow of drugs into the tumor, and the e acquisition of fragments of albumin prooxidant properties, which reinforces the damaging effect of drugs on tumor cells.

Autoplasma - native biological environment for an organism, not an alien for intraperitoneal administration, does not cause a painful, inflammatory, other changes and complications of intraperitoneal injection.

Using this method does not increase the toxicity, if necessary, allows to combine intraperitoneal administration of cytostatics on autoplasma with standard chemotherapy.

A method of treating primary and metastatic tumors of the abdominal cavity is performed as follows.

A patient with a tumor of the abdomen, accompanied by ascites, in position on the back after percussion designated puncture to exclude the presentation of the colon perform the puncture of the anterior abdominal wall in place, typical parazette: in one of the lower quadrants (above the anterior iliac crest), lateral rectus, at the level of the navel or just below. After processing the puncture site with an antiseptic solution and anesthesia of the skin and the abdominal wall to the peritoneum solution of novocaine 0.25% or lidocaine 1% with a thick needle carry out the puncture. In the peritoneal cavity through the lumen of the needle conduct a thin plastic catheter with a diameter of 3 mm, Then pull the needle. The catheter may be tightened so that the cavity was up to 10 cm of the catheter is, the free end of the leave 3-6 refer to Evacuate ascitic fluid.

The patient produce the fence autologous blood in quantities of 200 to 250 ml sterile bottle geoconservation "Gleyzer", centrifuged at V about. 1500 Rev/min for 30 min, take the supernatant plasma in another sterile bottle with geoconservation, cellular precipitate is re-infused. A single dose of the cytostatic agent is mixed with 10-100 ml autoplasma, incubated at 37 °C for 1 hour. Then after sedation (analgin, Relanium) is injected through the catheter 0.25% solution of novocaine 20-40 ml) followed by the slow introduction of cytostatic agents on autoplasma. In the case of the use of cisplatin is intravenous drip water load up to 2-3 liters according to the conventional method, if necessary the procedure is repeated.

Examples of specific performance "method of treatment of tumors of the abdomen"

Example 1. Patient K., IB. No. 7871/0, 51 years, was in RNII treated with 8.05.02 on 24.06.02. Asked RNII with complaints of profuse watery vaginal discharge mixed with blood, pain in the lower abdomen on the left, constipation, rapid diuresis, the tumor in the right breast. Sick for 12 years, when the breast has been education. To doctors did not address. In April 2002, appeared above mentioned complaint from the genitals.

Objectively: the one integument pale gray color, right breast was purple in the outer squares rough tumor, up to 8 cm, axillary lymph nodes are palpable unclear. From respiratory and cardiovascular systems without pathology. The abdomen is enlarged, soft, palpation painful in hypogastrium, ascites. St. genitalis: the cervix is clean, the body of the uterus is normal in size, from the area of the left appendages comes tumor bumpy education, lower pole reaches back arch up to 15 cm in diameter.

When biopsy of the tumor mammary glands No. 1407-12 - moderately differentiated carcinoma. Ultrasound of abdominal organs from 10.05.02 marked increase in the epigastric lymph nodes up to 5×2 see ultrasound of the pelvic organs from 10.05.02 revealed the formation of the left ovary to 15 see the preliminary diagnosis: generalized cancer of the right breast with metastasis to the ovaries Art. IV. With 27.05. intraperitoneally introduced cisplatin 150 mg of cyclophosphamide 800 mg according to the described method. Of the side effects of nausea, vomiting II senior 18.06.02 introduction repeated. Upon completion of the course the patient's condition is satisfactory. The estimated effect regression of the tumor >50% and complete regression of retroperitoneal lymph nodes, confirmed by ultrasound. Complete resorption of ascites

23.06.02 - made supracervical amputation of the uterus with appendages, extirpation greater omentum. G.A. No. 648692-5 - in the left appendage: poorly differentiated serous adenocarcinoma, plots pappilary.

The final diagnosis: Primary multiple synchronous cancer: cancer of the right breast (T3N0M0) Article. III ovarian cancer with metastasis to the retroperitoneal lymph nodes, peritoneum, Art. IV ascites. Condition after combined treatment. Next, the patient continued chemo-and radiotherapy to the breast on the right.

Technical and economic efficiency "method of treatment of tumors of the abdominal cavity is to increase the efficiency of treatment of patients with tumors of the abdomen, accompanied by ascites due to application of autoplasma as a local modifier effects of chemotherapy. The method provides rapid tumor regression in 50% or more, does not increase the toxicity of chemotherapy that does not require additional expenses on the accompanying therapy, prolongs the life of patients with common cancers, improve their quality of life.

A method of treating primary and metastatic tumors of the abdomen, accompanied by ascites, including chemotherapy, characterized in that the patient make the fence autoblood in the amount of 200 to 250 ml in a sterile vial geoconservation "Gleyzer", centrifuged at 1500 rpm for 30 min, take the supernatant plasma in another sterile bottle with gameconsole is that the cell sediment is re-infused, a single dose of the cytostatic agent is mixed with 10-100 ml autoplasma, incubated at 37 °C for 1 h and injected intraperitoneally through a catheter into the abdominal cavity through a puncture in the lower quandrant belly, if necessary the procedure is repeated.



 

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