Method for treating the cases of disseminated colorectal cancer

FIELD: medicine.

SUBSTANCE: method involves administering Capecitabine during 14 days within 15 days long treatment course in everyday mode and Oxyplatin at a dose of 50 mg/m2 at the first, eighth and fifteenth treatment day. Pause between treatment courses is 2-3 weeks long.

EFFECT: enhanced effectiveness of treatment.

 

The invention relates to the field of medicine, Oncology, and can be used in the treatment of patients with disseminated forms of colorectal cancer.

Closest to the proposed method is a method of treatment of patients with disseminated forms of colorectal cancer, which is to assign chemotherapy by intravenous oxaliplatin at a dose of 130 mg/m21-day treatment and involving capecitabine oral 2000 mg/m2per day 1 to day 14 of treatment every three weeks. The disadvantage of this method is not sufficiently high concentration oxaliplatin in the blood, which does not allow for contact of the drug with cancer cells at all phases of the cell cycle and does not lead to the desired effect.

The aim of the invention is to increase the effectiveness of treatment due to the reduction or stabilization of tumor process to the maximum possible period and increase survival of patients while improving or maintaining the quality of their lives.

This goal is achieved by a new method of treatment of patients with disseminated forms of colorectal cancer by assigning polychemotherapy oxaliplatin and involving capecitabine for 14 days, and oxaliplatin administered in the dose of 50 mg/m 1, 8, 15 days of treatment in each course with an interval between courses of 2-3 weeks.

New in the invention is conducted, that oxaliplatin is administered in a dose of 50 mg/m21, 8, 15 days of treatment in each course with an interval between courses of 2-3 weeks.

The proposed method of treatment is as follows. The patient performed three courses of chemotherapy with subsequent evaluation of the effect. Scheme of chemotherapy includes two products: 1) oxaliplatin is administered intravenously at a dose of 50 mg/m21, 8, 15 day of treatment, the total dose at the rate of 180 to 250 mg; 2) capecitabine at a dose of 2000 mg/m2the patient taking an oral oral total dose rate of the drug ranges from 33600 to 53200 mg.

Clinical example of the complete method. Patient K., aged 57, was treated from September 2002 Diagnosis: cancer of the sigmoid colon, T-2 N-0 M-0, condition after anterior resection of the sigmoid colon from 4.11.96, Progression (may, 1999), metastasis in the right lung condition after complex treatment (operative therapy + chemotherapy). Progression (may, 2001), metastatic lung damage, liver. The histological conclusion No. 020178-183/96 (surgical material): moderately differentiated adenocarcinoma. The surface area of the patient's body 1,94 m2. At admission according to radiography of the chest from 3.02.02, in the lung tissue in all segments of different sizes metastatic nodes from 5 to 15 mm By ultrasound org is a new abdominal cavity from 3.02.02 in posterolateral departments of the right lobe, pushing the right hepatic vein is determined metastatic education 116×84×106 mm, with rough contour uneven patterns.

A patient with 4.02.02, 18.02.02, conducted the first cycle of chemotherapy: oxaliplatin was administered at 100 mg / 1, 8, 15 days of treatment (50 mg/m2), the total dose of the drug on the rate was 300 mg; capecitabine patient ingested a daily dose of 3800 mg 1 to day 14 of treatment, the total dose of the drug was 53200 mg With 10.03.02, 24.03.02, the patient received a second course of chemotherapy for a similar program, with 12.04.02, 26.04.02, is the third course of chemotherapy, a total dose of chemotherapy received by patients during the second and third courses were the same as in the first course.

After chemotherapy at follow-up by ultrasound from 15.05.02, in the seventh segment of the liver focal education dimensions 74×69×50 mm, almost isoechogenic hilly path. According to radiography of the chest from 15.05.02, over the past period, the number and size of metastatic foci in the lung tissue without dynamics. Thus, the effect after chemotherapy metastatic lesion in the liver was more than 50% (partial regression), metastatic foci in the lungs - stabilization process, In the process of chemotherapy, the patient developed is such complications, as leukopenia 1 degree, anemia 1 degree, which were controlled through 2 weeks after the end of chemotherapy.

Later the patient was conducted three courses of chemotherapy on the proposed program, sixth course of chemotherapy was completed in September 2002, According to radiography of the chest from 24.09.02, in comparison with the previous data is saved stabilization of metastatic process. According to the ultrasound examination of abdominal cavity organs from 24.09.02, liver multiple focal lesions in the posterior of the seventh segment has significantly decreased in size (35×38×39 mm), the contours fuzzy, rough, structure hyperechoic, homogeneous. Thus, ultrasound of the liver after six courses of chemotherapy with oxaliplatin in combination with involving capecitabine patient was noted partial regression of metastatic lesion of the liver (over 75%).

The proposed mode of delivery of chemotherapy was selected on the basis of data analysis of clinical observations for this category of patients. Introduction oxaliplatin dose of 50 mg/m21, 8, 15 days of treatment each course allows you to increase the dose rate of the drug, and the combination involving capecitabine at a dose of 2000 mg/m2simulates the effect of prolonged administration of cytostatics. In the end, used a higher dose oxaliplatin, it allows you to to ensure the intact drug with cancer cells in all cell cycle phases, which ultimately leads to more effective treatment.

The proposed method only treated 11 patients with disseminated colorectal cancer at the age from 41 to 66 years, among them six women and five men. Morphological verification of diagnosis of cancer was performed in all patients, among them cancer of the colon was verified in nine patients, colorectal cancer - two patients. At the beginning of treatment, four patients had primary disseminated colorectal cancer in seven patients registered with the progression of cancer after completed earlier surgical intervention. No patient received treatment with cytostatic agents in the adjuvant therapy setting.

The effectiveness of the program was: complete regression was achieved in one observation (9,10±8,67%), partial regression in four (36,36±14,50%). In four cases (36,36±14,50%) registered the stabilization process, two patients (18,18±are 11.62%) - progression.

Just on the proposed programme was held on 27 courses of chemotherapy, during which were presented to the following complications: neutropenia III-IV degree - volume of 34.12%; thrombocytopenia III degree is 8.22%, anemia II degree - 10,15%, nausea/vomiting, II degree - 11,34%, diarrhea, II degree - 9,49%.

Thus, the efficiency of the proposed regime was 45,46±15,0% at a moderate toxicity program.

Method for the treatment of patients with disseminated forms of colorectal cancer, including chemotherapy by involving capecitabine and oxaliplatin, and capecitabine is taken within 14 days, wherein the oxaliplatin take a dose of 50 mg/m21, 8, 15 days of treatment, the treatment is 15 days, the interval between courses of 2-3 weeks.



 

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