Chemotherapy method for treating testicular carcinoma cases

FIELD: medicine.

SUBSTANCE: method involves taking blood sample into sterile flask in the amount of 150 ml before and after funiculo-orchectomy. Plasma and formed elements are separated by means of centrifuging. Plasma is taken and 300 mg Bleocin and 1000 mg Cyclophosphane are dissolved in a portion of it. Platinum preparation is added to the plasma and formed elements remaining in the flask in the amount of 75-100 mg/m2. When completely dissolved, the produced solutions are incubated in thermostat at 37°C during 40 min. Endolymphatic infusion of preparations on patient autoplasma is carried out into lymphatic vessel of foot back on the side where tumor process takes place, and intravenous autohemochemotherapy with platinum preparations are sequentially carried out under hyperhydration and forced diuresis conditions.

EFFECT: concentrated purposeful action upon primary testicular carcinoma and metastases into retroperitoneal lymph nodes; reduced risk of toxic complications.

 

The invention relates to medicine, in particular to oncourology, and can be used in neoadjuvant and adjuvant chemotherapy of testicular cancer seminomas and aseminae histological patterns for the treatment of metastatic disease, and to reduce the primary lesion.

The effectiveness of chemotherapy depends on the degree of tumor. At the present time as chemotherapy first lineordering is a diagram VER (cisplatin 50 mg/m2- 1, 2 days, etoposide 120 mg/m2- 1-3 days, bleomycin 30 mg), (Clinical oncourology, Moscow, 2003, s.635-637).

The disadvantages of this method of treatment of testicular cancer are the frequency and duration of courses of chemotherapy, which are accompanied by high toxicity, does not always allow the treatment to end. Often there are serious complications of the kidneys associated with irreversible damage to the renal tubules, ototoxicity, anemia and leukopenia.

There is a method of treatment of testicular cancer ("Endolymphatic chemotherapy in the treatment of malignant tumors", Moscow, 1985, C-130), which consists in the introduction of anticancer drugs in the lymph vessel of the rear foot. To conduct endolymphatic chemotherapy has been used in various combinations protivoopujolevy the o drugs: cyclophosphamide 1000 mg + 5-florouracil 1000 mg; of cyclophosphamide 100 mg + 5-florouracil 100 mg + methotrexate 50 mg and other well-known mixture of chemotherapy.

The use of this method of administration of drugs increases the effectiveness of treatment, reducing the toxicity of high doses of chemotherapy and reducing the duration of treatment. The disadvantage of this method is the lack of impact on metastasis to the retroperitoneal lymph nodes due to low tropism of anticancer drugs to tumor tissue.

The aim of the invention is a targeted effect on primary tumor and metastases to retroperitoneal lymph nodes while reducing the toxicity of high doses of chemotherapy.

This goal is achieved by the fact that patients with cancer of the testis before or after the execution of funiculaire produce fence 150 ml of blood into a sterile vial by centrifuging the blood is separated into plasma and the formed elements, shown in the supernatant portion. In the obtained plasma was dissolved bleocin 30 mg + 1000 mg of cyclophosphamide. Into the vial with the remaining plasma and formed elements of blood add a solution of platinum in the volume of 75-100 mg/m2. After complete dissolution, the resulting solution is incubated in a thermostat at a temperature of 37°C for 40 minutes. Then runs endolymphatic infusion preparation of the tov, dissolved on autoplasma patient in the lymph vessel of the rear foot from the side of the tumor process and intravenous autohemotherapy the platinum drugs in terms of hyperhidrotic with forced diuresis.

The invention "Method of chemotherapy of testicular cancer" is new, because it is unknown the level of medicine in the field of chemotherapeutic treatment of testicular cancer at different stages of the neoplastic process and the various histological patterns.

The novelty of the invention lies in the fact that patients with cancer, before and after the execution of funiculaire in the lymph vessel of the rear foot from the side of the tumor process, introducing a mixture of antineoplastic chemicals dissolved in autoplasma. Into the vial with the remaining plasma and formed elements of blood add a solution of platinum in the volume of 75-100 mg/m2. After complete dissolution, the resulting solution is incubated in a thermostat at a temperature of 37°C for 40 minutes and injected intravenously. The combined effect on metastases and retroperitoneal lymph nodes increases trapnest anticancer drugs to tumor tissue.

The invention "Method of chemotherapy of testicular cancer is industrially applicable, as may be used in health care, medical practice, treating patients in the research of cancer institutes, ecodisaster.

"The way the chemotherapy of testicular cancer" is as follows.

Patients with cancer of the testis before or after the execution of funiculaire produce fence 150 ml of blood into a sterile vial by centrifuging the blood is separated into plasma and the formed elements, shown in the supernatant portion. In the parts of the resulting plasma is dissolved bleocin 30 mg + 1000 mg of cyclophosphamide. Into the vial with the remaining plasma and formed elements of blood add a solution of platinum in the volume of 75-100 mg/m2. After complete dissolution, the resulting solution is incubated in a thermostat at a temperature of 37°C for 40 minutes. Then runs endolymphatic infusion of drugs dissolved in autoplasma patient in the lymph vessel of the rear foot from the side of the tumor process and intravenous autohemotherapy the platinum drugs in terms of hyperhidrotic with forced diuresis.

A specific example of "the Way the chemotherapy of testicular cancer on the patient M, and b/N of 3,649/T. Enrolled in the Department of urology, RNII 20.02.04 with complaints of pain in the lumbar region, General weakness, temperature up to 37.5°C for 4 months, presence of palpable tumors in both testicles. Patients consider themselves to be 2 years, when there were tumor formation in both testicles. To the doctor did not address. When Yes is th ultrasound and CT patients revealed increased to 4.5 cm retroperitoneal lymph nodes. Tumor formation in both testicles are left with a diameter of 8.0 cm, on the right diameter 11,0 see Tumor process in the scrotum by a single conglomerate, the testicles are not separated from each other, the skin of the scrotum infiltrated by the tumor. Needle biopsy - immature teratoma with elements of embryonal cancer on both sides.

The first stage of treatment, patients received two courses of chemotherapy on the proposed methodology with the introduction of chemotherapy in the rear foot of both limbs and subsequent intravenous chemotherapy for autologous blood. After two courses of chemotherapy, according to the proposed technique, MRI and CT of the patient revealed no increase in retroperitoneal lymph nodes, tumor formation in the testes decreased left to 4.0 cm, right up to 6.0 cm, both differentiated testis in the scrotum, mobile. Infiltration of the skin of the scrotum is not.

03.04.04 the operation - double-sided funiculaire with simultaneous prosthetic testicles on both sides. Histological analysis of N 751858-60 (left testicle) poorly-differentiated embryonal cancer with Subtotal necrosis sclerosis, the presence of large foci of chronic inflammation, the 4th degree of therapeutic pathomorphosis; N 751861-63 (right testis) teratoma in combination with poorly differentiated embryonal cancer, Subtotal necrosis, chronic inflammation, 4-the degree of therapeutic pathomorphosis.

In the postoperative period was also performed 4 year autohaemotherapy. According to the comprehensive examination the patient is in a state of stable clinical remission.

Technical and economic efficiency "of the Way the chemotherapy of testicular cancer" is that the method improves the efficiency of treatment of testicular cancer at different stages of the neoplastic process and the various histological patterns. Massive targeted effect on primary tumor and metastases to retroperitoneal lymph nodes in the pre - and postoperative periods can reduce the course of treatment, to reduce the size of the primary tumor and metastasis, reduce toxic adverse effects of anticancer chemotherapy.

The way the chemotherapy of testicular cancer, characterized in that in patients with cancer before and after the execution of funiculaire produce fence 150 ml of blood into a sterile vial by centrifuging the blood is separated into plasma and the formed elements, selected plasma, in part derived plasma dissolve bleocin 30 mg + 1000 mg of cyclophosphamide, into the vial with the remaining plasma and formed elements of the blood type drug platinum in the amount of 75-100 mg/m2after complete dissolution, the resulting solution is incubated in a thermostat at a temperature of 37°C for 40min, then perform endolymphatic infusion of chemotherapeutic agents dissolved in autoplasma patient in the lymph vessel of the rear foot from the side of the tumor process and intravenous autohemotherapy the platinum drugs in terms of hyperhidrotic with forced diuresis.



 

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1 ex

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1 ex

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1 tbl

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EFFECT: higher efficiency.

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