Method for thermo-radio-therapy of malignant tumors
FIELD: medicine, in particular, oncology.
SUBSTANCE: in accordance to method, thermo-radio-therapy of malignant tumors is performed in form of split course in mode of enlarged dynamic fractioning of dose in 6 fractions of 4 Gy and 8 fractions of 2 Gy in first course, and 6 fractions of 4 Gy and 3 fractions of 2 Gy in second course in conjunction with hyper-thermal effect in the same day when radio-therapy is performed.
EFFECT: increased apparent counter-tumor local effect.
The invention relates to medicine, in particular to the treatment of superficial malignant tumors, and tumors of the internal organs by combined radiation and hyperthermia exposure.
The well-known series of works whose authors have successfully used the hyperthermia as a modifier of radiation therapy. In particular, it is known the use of hyperthermia as radiomodifying radiation therapy in breast cancer (Trofimova OP "Thermoradiotherapy in the complex treatment of breast cancer", dissertation, p.30, M., 2002). According to known technique courses of radiation therapy was performed by classical fractionation, dose GENUS 2 Gy over 5 treatment days per week, split the course up to SOD 66 Gr. Modification of hyperthermia was used in the second week of treatment, to achieve SOD 10 Gr. The disadvantage of this method is that when using it missed opportunity of hyperthermia as radiosensibility in the first week of treatment. As a result, when SOD 30 Gy in most patients experiencing local radiation reaction, which are an obstacle to the continuation of the course of radiation therapy and require interruption of treatment until they subsided.
Closest to the claimed invention by way of the same purpose is a method of treatment of Slokas the public tumors, including radiation therapy, which in the border of the tumor healthy tissue injected solution mezatona, and the subsequent hyperthermia (RF patent No. 2048, publ. 27.11.95, bull. No. 33) - the prototype. The use of this method leads to the enhancement of hyperthermic effect of radiation therapy due to vasoconstrictor effect, which reduces the blood flow in tumor vessels. However, the use of known techniques is limited to the treatment of superficial malignant neoplasms locally localized processes. On the other hand, the introduction into the tissues mezatona injection method proposed in this work is an additional risk factor for the development of complications (eg, abscess, allergic reactions and so on).
The claimed invention is directed to solving the problem of increasing the Express local antitumor effect.
Use in clinical practice, the proposed method allows to achieve several technical (medical) and economic performance:
- reducing the risk of metastasis of the tumor during treatment;
- the possibility of increasing SOD;
- providing surgical removal of the tumor;
- reduction in the incidence of radiation reactions;
- reduced the duration of treatment.
These therapeutic results by carrying out the invention to tigalda by much as in the known method of treatment of malignant tumors is carried out by radiation and subsequent hyperthermic effect on the tumor in the day session of radiotherapy. A feature of the invention lies in the fact that radiation exposure exercise split rate mode enlarged dynamic fractionation dose of 6 fractions of 4 Gy and 8 fractions of 2 Gy in the first course, 6 fractions of 4 Gy and 3 fractions of 2 Gy in the second course, and the sessions of hyperthermia spend 30 minutes after radiation treatments with a time interval between sessions of hyperthermia 72 hours.
The invention consists in the selection of the optimal mode of combined radiation and local thermal effects on the tumor to achieve maximum antitumor effect without lethal cell damage normal tissue. The specified optimal mode, according to the authors of the claimed invention is enlarged dynamic fractionation of the dose of radiation at which this energy is produced for the shortest possible time due to the rapid escalation of SOD (16 Grams for the first week) using the aggregate fractions in combination with hyperthermic effect.
The advantage of the aggregate fractions of ionizing radiation is before the classical fractionation is a quantitative increase and damage accumulation of tumor cells by increasing the degree of lipid peroxidation.
In the first four days of tumor cells exposed to the dose required for maximum destruction and death (4×4 Gy), and sessions of hyperthermia spend 30 minutes after radiation treatments in the 1-St and 4-th day of treatment. The specified dose of radiation exposure is the maximum allowable for the vitality of the surrounding normal tissues. The result is the sum of the aggregate fractions is the damage of tumor cells of various degrees is lethal and sublethal. When this destructive radiation exposure are the most active tumor cells capable of metastasis. At the same time, less-active tumor cells are transferred in sub - and potentially lethal condition. Thermal effect on the tumor in the first and fourth day of the sum of the aggregate fractions causes blocking of the recovery sub - and potentially lethal damage in the tumor, which ultimately leads to increased radiation tumor destruction. Subsequent use of fractions of 2 Gy along with increasing SOD and further accumulation of damage in tumor cells leads to the consolidation of the antitumor effect obtained when exposed aggregate fractions in combination with hyperthermia.
Hyperthermia along with damaging effect is characterized by the significance of the additional radio-sensitizing effect due to temporary disruption of the repair processes, that leads to increased cellular radiosensitivity. After heating of the tumor is observed period induced thermotolerance, which increases in 1-2 days. The cause of tolerance is the accumulation in the cell heat shock proteins, so the session hyperthermia should not be done more than 2-3 times a week. Different temperature level causes in different tumor effect. When heating the tissue more 43-45°With the coagulation of proteins and mainly mechanical damage to the cells, and the temperature is below 41°may contribute to activation of tumor growth. Based on the data of the inverse relationship of the duration of the interval of tolerance and temperature level (i.e. with increasing temperature, decreasing the interval of tolerance), as radiomodification selected optimal level of tissue heating 42-43°With intervals between sessions of hyperthermia 72 hours, i.e. the period of maximal tolerance. Throughout the course of treatment to no more than 4-6 sessions of hyperthermia, because in connection with the development of thermotolerance tissues inappropriate conduct more than 2 sessions of hyperthermia in a week. Between sessions of hyperthermia in the second and third day of treatment, it is advisable to expose the tumor cells that are in thermoresistance condition, only radiation impacts the view enlarged fractions of 4 Gy, causing further damage. A two-week break in treatment is necessary in this scheme to restore normal tissue.
Thus, in the proposed method uses two complementary radiomodifying - hyperthermia and aggregated dose fractionation radiation exposure.
The inventive method is successfully tested for the treatment of patients with locally extensive tumor process. Namely, the superficial and deep soft tissue tumors, particularly tumors of the neck, as well as tumors of the pelvic organs: bladder, rectum, cervix, prostate. Restrictions for the treatment of locally advanced tumours caused only by instrumental effects and control of tissue temperature using the apparatus of hyperthermia.
The total duration of the two courses of treatment is five weeks versus seven weeks standard course of radiation therapy.
The method is as follows. Treatment begins on Monday. 1-St, 2-nd, 3-th and 4-th day of the fraction of radiation therapy are ROD 4 G; 5-th, 6-th and 7-th day - break in treatment, 8-day RACE 4 G, 9th and 10th days of GENUS 2 G, 11-day RACE 4 G, the 12th day of GENUS 2 G, 13-th and 14 th days break in treatment; 16th, 17th, 18th th, 19 th and 20 th days GENUS 2 Gr. Sessions of hyperthermia carried out after 30 minutes with the ANSA radiation therapy in the 1st, 4-th, 8-th and 11-th day of treatment. The time interval between sessions of hyperthermia is 72 hours. The number of fractions for the first half of the course is 14, SOD 40 Gr.
Prior to the second half of the course of treatment in accordance with the inventive method to control clinical diagnostic studies of the patient to clarify the dynamics of the tumor process.
Radiation exposure in the amount of SOD 40 Gy in combination with hyperthermia in accordance with the inventive technique can be used in clinical practice as a preoperative component of combined treatment, including hyperthermia with radiation therapy and surgical treatment. When initially insensitive or unresectable malignant processes using this method allows you to:
- to create conditions for surgery, due to the resorption of swelling, release of adjacent vital structures such as major neurovascular bundles;
to prevent or reduce metastasis of a tumor during surgery, to reduce the likelihood of generalization of the tumor due to the elimination of the most malignant cells;
- to reduce the volume of the tumor, facilitating the conduct of subsequent conserving surgery.
When radiation therapy radical programme of the donkey two-week break in treatment is the 2nd half of the course of radiation therapy: in the 1st, 2-nd, 3-th and 4-th day fraction radiotherapy is a GENUS of 4 G, 5 th, 6 th and 7 th days - a break in treatment, 8-day RACE is 4 G, 9-th and 10-th day - GENUS 2 G, 11-day - RACE 4 G, 12-day - RACE 2 Gr. Sessions of hyperthermia are conducted after a 30 minute session of radiotherapy in the 1st, 4th, 8th and 11th day of treatment. The time interval between sessions of hyperthermia is 72 hours. The number of fractions in the second half of the course is 9, SOD 30 Gr. The total dose per course of treatment 70 Gr.
Sessions of hyperthermia is performed on the device YACHT-4 with a working generator frequency 433.92 MHz. Radiation therapy - any radiotherapy technique presented in hardware Park radiological departments, for example, high energy accelerator Microtron-M devices with cobalt source - Rocus-AM.
Clinical example 1
Patient S., 19 years, clinical diagnosis: soft tissue sarcoma of the right tibia Ia stage T1dN0M0G1. If the comprehensive examination in the soft tissues of the medial third of the right tibia on the lateral surfaces of the identified tumor 3,0×2.0 cm, length - 3.5 cm, depth from the surface of the skin 1 cm, with distinct irregular contours, moving, painful to palpation, swelling motoblaze covered fibula that was a contraindication to perform limb-sparing surgery. Combined modality treatment plan myrabolans given the young age of the patient, prospects of its further rehabilitation and socialization, as well as with regard to cancer prognosis. Given the morphological structure of the tumor and low radiocontaminated, it was decided to hold the first stage of preoperative radiation therapy on the background of hyperthermia: the 1st, 2nd, 3rd and 4th day fraction radiotherapy was RACE 4 G; 5-th, 6-th and 7-th day - break in treatment, 8-day RACE 4 G, 9th and 10th days of GENUS 2 G, 11-day RACE 4 G, the 12th day of GENUS 2 G, 13-th and 14 th days break in treatment; 16th, 17th, 18th, 19th and 20th days of GENUS 2 Gr. Sessions of hyperthermia was performed after 30 minutes of sessions of radiation therapy in the 1st, 4th, 8th and 11th day of treatment. The time interval between sessions of hyperthermia was 72 hours. The number of fractions for the first half of the course is 14, SOD 40 Gr. On the 10th day after the end of the 1st course held control tests, which revealed a linear decrease of tumor size in 2 times and the appearance in it of necrosis. In the second stage of treatment in accordance with the results of the examination performed surgical treatment in the amount of removal of tumors of the soft tissues of the right tibia with resection of the fibula, autodermoplastiki. Histological examination of postoperative material M-55 - angioleiomyoma with extensive foci of necrosis beam pathomorphosis of the 3rd degree, which corresponds to a significant extent the damage is the origin of the tumor process under the action of radiation therapy and hyperthermia.
The observation period of 1 year, with no signs of recurrence and distant metastasis.
Clinical example 2.
Patient C., 65. Clinical diagnosis: prostate cancer stage II T2N0M0. In February 2000, held Rasputina prostatectomy, the Institute identified morphologically and biochemically recurrence of the tumor: in the bed of the remote prostate tumor formation in sizes 3,4×3.2 cm, with a rough, bumpy contours adjacent to the rear wall of the bladder.
Patients received radiotherapy with hyperthermia radical programme by the claimed method: 1-St, 2-nd, 3-th and 4-th day of the fraction of radiation therapy are ROD 4 G; 5-th, 6-th and 7-th day - break in treatment, 8-day RACE 4 G, 9th and 10th days of GENUS 2 G, 11-day RACE 4 G, the 12th day of GENUS 2 G, 13-th and 14 th days break in treatment; 16th, 17th, 18th, 19th and 20th days of GENUS 2 Gr. Sessions of hyperthermia conducted after a 30 minute session of radiotherapy in the 1st, 4th, 8th and 11th day of treatment. The time interval between sessions of hyperthermia was 72 hours. The number of fractions for the first half of the course is 14, SOD 40 Gy, field sizes 5×8 cm, SOD 40 Gr. On the background of the aggregate fractions held 4 sessions of hyperthermia apparatus YACHT-4 at a temperature of 42°, session duration 60 minutes, the first half of the course was without complications, radiation reactions not detected.
After a two-week p is rarawa treatment held the 2nd half of the course of radiation therapy: in the 1st, 2-nd, 3-th and 4-th day of the fraction of radiation therapy are ROD 4 G, 5 th, 6 th and 7 th days - a break in treatment, 8-day RACE is 4 G, 9-th and 10-th day - GENUS 2 G, 11-day - RACE 4 G, 12-day - RACE 2 Gr. Sessions of hyperthermia conducted after a 30 minute session of radiotherapy in the 1st, 4th, 8th and 11th day of treatment. The time interval between sessions of hyperthermia is 72 hours. The number of fractions in the second half of the course is 9, SOD 30 Gr. The total dose per course of treatment was 70 Gy. On the background of the aggregate fractions sessions of hyperthermia. Manifestations of ranjita and cystitis in early pollution period is not observed. The observation period a year with no signs of biochemical recurrence, regional and distant metastasis.
Thus, the inventive method has considerable advantages over known methods of the same purpose and meets the criteria of patentability.
How thermoradiotherapy malignant tumors, including radiation and subsequent hyperthermic effect on the tumor in the day session of radiotherapy, characterized in that the radiation exposure exercise split rate mode enlarged dynamic fractionation dose of 6 fractions of 4 Gy and 8 fractions of 2 Gy in the first course, 6 fractions of 4 Gy and 3 fractions of 2 Gy in the second course in combination with hypertension.stimulation the day of the session of radiation therapy.
FIELD: medicine, namely, medicinal use of radiation, possible use for determining dose really received by pathologic focus having absorbed open radioactive nuclide.
SUBSTANCE: method for verification of dose during medicinal usage of open radioactive nuclides includes measuring intensiveness of radiation, with consideration of changes in radiation source activity in time, during that, by means of tissue-equivalent phantom, original intensiveness of radiation of open radionuclide is measured immediately prior to injecting it into organism of patient as well as average intensiveness of radiation from focuses having absorbed radionuclide, and after that individual relative dose of open radionuclide injected into pathologic focuses is computed using formula
where Dn/o - value of relative dose in %, Io - original intensiveness of radiation at the moment of injection of radionuclide, In - average intensiveness of radiation from focuses at day or hour of measurement of n, B0 and Bn - background values of radiation intensiveness at the moment of injection of radionuclide and at the day of measurement, respectively, k - coefficient of daily or hourly decomposition of radionuclide, n - number of days or hours having passed since the moment of injection of radionuclide.
EFFECT: invention allows verification of relative dose in most precise and individual manner.
FIELD: medical facilities.
SUBSTANCE: device can be used as a tool for malignant tumors surgery. Device for radionuclide surgery has gamma radiation detector, collimator and handle. Wire of detector is connected with measuring unit. Gamma radiation detector is fixed in metal tip with sharpened side edge, which passes in plane being perpendicular to optical axis of gamma radiation detector. Detector is made in form of semiconductor crystal; two collimators adjoin opposite surfaces of crystal. Collimators have cells which pass in parallel to optical axis of gamma detector. Measuring unit has electronic circuit with sonic signal source.
EFFECT: ability of reaching area of lesion for removing it.
4 cl, 2 dwg
SUBSTANCE: device belongs to wide spectrum of influence devices, which is able to make prophylactic and medicinal influence onto human body; in particular, it can be used for destroying benign and malignant tumors and other concentrated formations. Device for making physiotherapeutic effect has control unit and influence localization unit connected with influence localization area. It also has hard base and unit for movement along x, y and z coordinates. Physiotherapeutic device is made in form of frame mounted onto hard base for shift in linear coordinates x, y and z, and n physiotherapeutic influence sources. The sources are disposed along perimeter of frame, which frame is connected mechanically with corresponding outputs of shift unit along coordinates x, y and z. Inputs o shift unit are connected with corresponding outputs along coordinates x, y and z of control unit. Corresponding inputs of control unit are connected with additional outputs of shift unit along coordinates x, y and z. Control input of control unit is connected with output of influence localization unit.
EFFECT: improved efficiency of physiotherapeutic effect; reduced negative reactions of organs and tissues surrounding the area.
13 cl, 5 dwg
SUBSTANCE: method involves administering Wobenzyme combined with brachytherapy with radiomodification and transpupillary thermotherapy or combined with isolated transpupillary thermotherapy. When combined with brachytherapy with radiomodification, Wobenzyme is given 2 days before brachytherapy at a dose of 3 pills 3 times a day with the exception of 8 h before fixation and removal of β-applicator. Next to it, Wobenzyme is given at a dose of 4-6 pills 3 times a day during 3 months. Then, the dose is reduced by 2 pills every month at the fourth, fifth and sixth months. Adjuvant transpupillary thermotherapy is carried out 6 months later after brachytherapy. Wobenzyme is given at a dose of 2-3 pills 3 times a day 2 days before transpupillary thermotherapy. Then, the dose is 4-6 pills 3 times a day during 2 months with following dose reduction by 3 pills every month to prophylactic dose of 1 pill a day. When carrying out isolated transpupillary thermotherapy, Wobenzyme is given in the same mode that it was the case when carrying out adjuvant transpupillary thermotherapy after brachytherapy. To prevent metastasis occurrence, Wobenzyme administration is continued at a dose of 1 pill 7 days every month during the first year and at a dose of 1 pill 3 days every month during the second observation year.
EFFECT: accelerated resorption processes; reduced risk of radiation treatment complications.
FIELD: medicine, oncology.
SUBSTANCE: one should carry out radiation therapy with quick neutrons 6.3 Mev twice weekly in two stages: at the first stage it is necessary to prescribe 3-4 seances of neutron therapy at interval of 48-72 h directly onto area of tumoral relapse and onto surrounding normal tissues at the distance of about 3-5 cm against tumoral foci, single focal dosage being 1.6-2.0 Gy, relative biological efficiency corresponds to 2.91-2.79, onto the skin - 2.0-2.2 Gy, up to total focal dosage being 6.6±1.5 Gy, onto the skin - 8.3±1.3 Gy, at the second stage it is necessary to carry out gamma- or electronic therapy at single focal dosage being 2.0-3.0 Gy, 5 fractions weekly, moreover, total course dosage of neutron-photon irradiation per a focus corresponds to 60 Gy by isoeffect at duration of irradiation course of about 20-25 d.
EFFECT: higher efficiency of therapy.
2 dwg, 3 ex
SUBSTANCE: assembly can be used for revealing pathologic cells when determining elemental composition of matter from gamma-radiation, for example, from 59Fe isotope stored in mammal gland. Gamma-spectrometry assembly for inspection of mammal gland has patient's chair, collimators, radiation protection, drives for moving chair, spectrometer, ionizing radiation detectors and control board. Collimators are disposed in radiation protection aid and they are made of material which well absorbs ionizing radiation. Collimators are mounted for direction of radiation onto ionizing radiation detectors. Collimators and ionizing radiation detectors are mounted in unit with cavities in form of cups for placing objects to be tested.
EFFECT: improved radiation safety.
2 cl, 3 dwg
FIELD: medicine, ophthalmology.
SUBSTANCE: before the onset of protonotherapy one should surgically withdraw eyelids beyond bony orbital borders for the purpose of complete prevention of complications associated with blepharoirradiation at conducting protonotherapy and creating conditions for the next valuable prosthetics. Thus, after external canthotomy one should make two through vertical incisions of the upper eyelid up to bony orbital border at developing a P-shaped fragment of the upper eyelid, moreover, internal incision should be made about 2-3 mm laterally against the upper lacrimal point, and external one - against internal edge of canthotomic incision. Then one should apply per one P-shaped suture onto both external and internal angles of the fragment, moreover, it is necessary to puncture in needles from cutaneous side of the fragment by applying ligatures in palpebral thickness at capturing a cartilage and perform punctures out into intramarginal space. Similarly, one should apply a single similar P-shaped suture onto the lower eyelid in area of its middle part. The ends of P-shaped sutures should be fixed without tightening frontal and buccal skin, correspondingly. Before carrying out the seance of protonotherapy it is necessary to tighten sutures till eyelids come beyond bony orbital borders, and on finishing the seance of protonotherapy sutures should be weakened till the moment of palpebral juncture.
EFFECT: higher efficiency of prophylaxis.
1 cl, 1 dwg, 1 ex
FIELD: medicine, oncology.
SUBSTANCE: one should carry out morphological testing of therapy results, moreover, in the course of therapy it is necessary to conduct immunohistochemical study for the levels of Ki-67 antigen expression, markers to protein-negative regulator of apoptosis: p53 and Bcl-2 and the level of melanoma marker expression HMB-45 and at decreased levels against the values in untreated tumors it is possible to state upon therapy as efficient. The innovation enables to achieve high clinical efficiency of therapy due to applying neoadjuvant autohemochemotherapy in combination with radiation therapy.
EFFECT: higher accuracy of detection.
SUBSTANCE: method involves applying chemotherapy and/or multi-fraction irradiation daily in two fractions. Variable volume irradiation is carried out during 12 days under radiation dose of 16-20 Gy with dose power being control by means of control unit at the level of 0.18-0.22 Gy/min. Systemic irradiation of tumor dissemination region is carried out with single fraction through a large field. Lymph nodes locally participating into the process and clinically proved lesion foci are irradiated with another fraction after 4.5-6 h long reparation period to total dose equal to 22-24 Gy with unit dose equal to 1.4-1.6 Gy. Medicated sensibilization is carried out during the reparation period.
EFFECT: enhanced effectiveness of treatment; high frequency of no relapse cases.
3 dwg, 1 tbl
FIELD: medical engineering.
SUBSTANCE: device has elongated bioabsorbing carrier containing radioactive sources inside. The sources are separated with spaces. The elongated bioabsorbing carrier is solid composition molded around radiation sources. Moulds are used when producing cells containing radioactive material. A set of radioactive grains is introduced into the mould. Liquid material is introduced into the mould for making it harden. Hardened product is removed from the mould. To treat patients for states manifested as response to radiation therapy, a cell containing radioactive material is arranged in immediate proximity to the patient body zone under treatment for time period required for providing therapeutically effective radiation dose.
EFFECT: produced easy-to-use cell having rigid coating stable in operation.
24 cl, 5 dwg
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