Method for treating oncological patients with metastatic cerebral lesion

FIELD: medicine, oncology.

SUBSTANCE: one should carry out endoliquor therapy, moreover, after surgical removal of cerebral tumor, in early post-surgical period, it is necessary to fulfill catheterization of subarachnoidal cerebrospinal space at L4-L5 level and apply an endolumbar catheter. Then one should sample 5 ml cerebrospinal fluid and mix it with methothrexate at the dosage of 5 mg and hydrocortisone suspension at the dosage of 50 mg. The mixture should be incubated for 30 min at 37° C to be introduced into subarachnoidal space through endolumbar catheter by flow-type technique. There are 5 such infusions during one therapeutic course at 3-d-long interval. Totally, it is necessary to conduct 3 mentioned courses in combination with 5 cycles of adjuvant systemic polychemotherapy at injecting cytostatics upon autoblood. Application of such complex therapy enables to stabilize generalized tumoral process, increase relapse-free and metastases-free periods and prolong patient's life duration.

EFFECT: higher efficiency of therapy.

3 ex

 

The invention relates to medicine, in particular to integrated care in cancer, and can be used in the treatment of patients with generalized forms of cancer, suffering from metastatic lesions of the brain (MPGM), which were previously considered incurable.

There is a method of treatment of metastatic brain (see Martynov BV, Gaidar BV, Shchigolev US, Trufanov G. Metastatic brain tumors. // Practical neurosurgery (manual for doctors). St.-Petersburg, 2002. - S-485).

The authors noted that in real terms the increase in life expectancy in these patients the best approach is recognized as a combination of surgical removal of single or multiple metastases, followed by total brain irradiation, which increases the median survival on average up to 1 year.

In the work indicates that the value of chemotherapy in the treatment of cerebral metastases is minimal. Pointing to the leading role of the blood-brain barrier as the main cause of unsuccessful chemotherapy MPGM, authors, however, ignore the value of intrathecal chemotherapy as a method effects on tumor brain, bypassing the blood-brain barrier.

There is a method of treatment of intracerebral malignant is puhala by endolyumbalno the introduction of the cytostatic agent methotrexate (see Romodanov A.P., Sosnov UD, goldfinches V.I. Experience chemotherapy of malignant intracerebral tumors by endolyumbalno of methotrexate. // Questions of neurosurgery - 1975 - No. 1 - P.32-35). The authors noted the positive results of postoperative andlivorno chemotherapy methotrexate in single doses of 10 to 40 mg, which consists in improving treatment outcomes - regression of intracranial hypertension, cerebral and focal symptoms.

However, the research shows only 2 cases of treatment of patients with MPGN with homeocysteine metastases of chorionepithelioma in the cerebral hemispheres of the brain. There are no data evaluating the dynamics of extracranial tumor in the body of the patient, which at present is highly relevant, since it is known that more than 50% of patients with MPGN have generalized the primary tumor process that occurs with damage to vital organs. In this paper focuses on the application of andlivorno chemotherapy only as a local antitumor effects without considering the possibilities of this method in the treatment of systemic tumor process in General.

Known "Method of treatment of generalized breast cancer" (see Aiguaviva. Hormone therapy generalized cancer Molo is Noah gland introduction of hydrocortisone in the subarachnoid space. // Author's abstract on competition of a scientific degree of the candidate of med. Sciences. Moscow, 1983. - 20 C.), chosen as a prototype.

The author conducted andrecorra hormone therapy (SGT) hydrocortisone in 108 patients with advanced generalized breast cancer. ELGT was carried out using a typical lumbar punctures with the introduction into the subarachnoid space hydrocortisone company "Gedeon Richter" in the amount of from 75 to 150 mg 1 time per week. The number of punctures in the majority of patients amounted to 4-6 on the course of treatment.

The results of clinical studies have shown the possibility of achieving using the method of ALGT significant percentage of remission (68%) in patients with generalized breast cancer with a primary lesion of bone and increasing life expectancy more than 2 times in comparison with the control group. It was concluded that the main mechanism of antitumor activity of LGT associated with the Central inhibitory effect of hydrocortisone through the hypothalamic-pituitary system in the adrenal cortex, which results in persistent anti-estrogenic effect.

In this work the emphasis is mainly on generalized breast cancer with metastases in bones. Interesting, in our opinion, would be to explore the possibilities of this method of treatment as componentcontext therapy and other generalized cancer with the presence of cerebral and extracerebral metastases.

The aim of the invention is to improve the direct and immediate results of treatment of cancer patients with lung cancer, breast cancer and kidney suffering from generalized tumor process with metastatic brain lesion, which were previously considered incurable.

This goal is achieved by the fact that after surgical removal of metastatic brain tumors in the early postoperative period, produce catheterization subarachnoid space of the spinal cord at the level of L4-L5with the establishment of flexible PVC endolyumbalno catheter. Make the fence 5 ml of cerebrospinal fluid, which is then mixed with methotrexate in a dose of 5 mg and suspension hydrocortisone (Gedeon Richter) in a dose of 50 mg. Mixture into a separate vial and sterile conditions, placed in a thermostat at a temperature of 37°and incubated with exposure time of 30 min, and then blasting through endolyumbalno catheter is injected back into the subarachnoid space. All in one course of treatment, make 5 such infusions with an interval of 3 days. Total spend 3 full course andlivorno chemohormonal that combine with five cycles of adjuvant systemic chemotherapy to conventional circuits.

The invention "Method of treatment is onkologicheskih patients with metastatic brain" is a new, since it is not known from the level of medicine in the field of Oncology, in the complex treatment of patients with generalized tumor process with the presence of cerebral metastases, which were previously considered incurable.

The novelty of the invention lies in the fact that andliving chemohormonal first conduct previously considered incurable cancer patients with lung cancer, breast cancer and kidney with generalized tumor process with metastatic brain by mixing known cytostatic and hormone with autologous cerebrospinal fluid. The essence of the method lies in the fact that after surgical removal of metastatic brain tumors in the early postoperative period, produce catheterization subarachnoid space of the spinal cord at the level of L4-L5with the establishment of flexible PVC endolyumbalno catheter. Make the fence 5 ml of cerebrospinal fluid, which is then mixed with methotrexate in a dose of 5 mg and suspension hydrocortisone (Gedeon Richter) in a dose of 50 mg. Mixture into a separate vial and sterile conditions, placed in a thermostat at a temperature of 37°and incubated with exposure time of 30 min, and then blasting through endolyumbalno catheter is injected back into the subarachnoid space of the TWT. All in one course of treatment, make 5 such infusions with an interval of 3 days. Total spend 3 full course andlivorno chemohormonal that combine with five cycles of adjuvant systemic chemotherapy to conventional circuits.

The invention "Method of treatment of cancer patients with metastatic brain" is industrially applicable, as may be used in health care, hospitals with cancer, oncologic dispensaries, cancer research institutes.

The invention "Method of treatment of cancer patients with metastatic. brain" involves an inventive step, as for a specialist oncologist it is not obvious from the level of development of medicine in the field of complex treatment of cancer patients with generalized tumor process with the presence of cerebral metastases and what was previously considered incurable.

EXAMPLES of SPECIFIC performance

"Method of treatment of cancer patients with metastatic brain"

The method was tested in the treatment of cancer patients suffering from lung cancer, breast cancer and kidney IV stages of the disease with metastatic lesions of the brain that were previously thought of incura the part.

Specific examples of the application of the method can serve as extracts from the histories of the following patients.

Clinical example No. 1.

Patient C-moat M., born in 1936, the case history No. 3007/R.

DIAGNOSIS: peripheral moderately differentsirovannyi glandular squamous cell carcinoma of the upper lobe of the left lung, T2N0M1, with multiple lesions of the ribs, spine (nizhnegrudnogo Department), solitary metastasis in the left parietal lobe of the brain, stage IV. Paraneoplastic syndrome.

From the anamnesis: considers himself ill for 3 months, when I first noted the emergence of General weakness, weight loss, intermittent fever up to subfebrile figures, persistent headache, nausea and vomiting, weakness in the left extremities, recurrent convulsive twitches in my right leg; in addition, the relatives of the patient were noted he lost consciousness with the development of generalized convulsive seizure intensity 1-2 times per month. Asked for a consultation with neurooncology in the clinic Rostov research Institute of Oncology 25.02.2003,

Objective: emaciated, pale skin, signs osteoarthropathy Marie-Bamberger. In neurological status convulsive syndrome, right-sided spastic hemiparesis, right-wing hemihypesthesia.

Directed by x-ray computer study (RCT) of m is ZGA 3.03.2003,, when it was revealed extensive education in the form of a ring-shaped shadow in the left parietal lobe of the brain (in the projection of the upper section of the Central convolutions), with a diameter of 4 cm, with a zone of perifocal edema. This extensive education was seen as solitary metastatic site.

Upon further examination by performing CT of the chest from 4.03.2003, identified peripheral tumor of the upper lobe of the left lung, multiple lesions of the ribs and nizhnegrudnogo spine.

The patient was hospitalized in the Department of neurosurgery, RNII. 6.03.2003, the first stage treatment was performed decompressive craniotomy in the left parietal region with total destruction of cerebral metastasis within the visible healthy tissue (HA No. 682819-822: metastasis of poorly differentiated squamous cell carcinoma with extensive foci of necrosis and small lymphocytic infiltrates). The postoperative period was uneventful, with no complications; wound healed by first intention, the sutures were removed on the 9th day after the operation.

On the 10th day of the postoperative period was produced catheterization subarachnoid space of the spinal cord at the level of L4-L5with the establishment of flexible PVC endolyumbalno catheter, and then made 5 andliving introductions m is otrexate dose of 5 mg of hydrocortisone in a dose of 50 mg autorequire with an interval of 3 days. At the same time started a course of systemic autohemotherapy with intravenous drugs: nikana 100 mg on day 1, etoposide 200 mg in the 1st, 3rd and 5th days and carboplatin 150 mg in the 2-th and 9-th day of the cycle. Took the treatment satisfactorily, without side effects.

Before discharge in the neurological status was observed complete regression of cerebral and convulsive syndromes, partial regression spastic hemiparesis (left paresis of moderate severity in the right leg). In General, the patient was discharged with satisfactory quality of life.

For the second stage of treatment the patient was sent to the Department of thoracic surgery, RNII, where he 10.04.2003 was made upper lobectomy left over peripheral lung tumor (HA No. 687923-924: moderately differentsirovannyi glandular squamous cell carcinoma).

After rehabilitation the patient was repeatedly hospitalized in the Department of neurosurgery again for a comprehensive treatment. Later in the year it was made 2 full course andlivorno chemohormonal in combination with four cycles of adjuvant systemic chemotherapy as described above.

In the dynamic process of monitoring the patient felt satisfactory, side effects from the treatment are not nab the time ugali.

After 1.5 years after the initial operation during the next follow-up examination the patient was thoroughly doubledown. Objectively continued systemic symptoms of the tumor process: weight loss, intermittent fever up to subfebrile figures, osteoarthropathy. In the neurological status of signs of cerebral and convulsive syndromes, as well as severe focal neurological symptoms were not determined. Dynamic CT study of brain data for the progression of the CNS is not revealed. When CT examination of the chest in light of the data for the metastatic lesion no bone metastases (ribs and vertebrae) in the stage osteoliticescoy stabilization.

At the end of 2004 when the next follow-up examination revealed a deterioration of the General condition of the patient, determined, as it turned out during instrumental examination, the appearance of metastatic foci in the liver.

In the end, after the first operation the patient lived almost 2 years in a state of stable stabilization as the primary tumor process and cerebral metastatic disease. Died 20.01.2005, due to the uncontrolled progression of the primary tumor process.

Clinical example No. 2.

Patient B-h T.A., born in 1944, history, No. 167/p

DIAGNOSIS: infiltrating rotoscopy cancer of the left breast, T2N2M1, with multiple lesions of the cranial bones, ribs, nizhnegrudnogo and lumbosacral spine, pelvis, solitary metastasis in the right frontal lobe of the brain, stage IV. Hypertension-dislocation syndrome, extreme pain in the bones.

From the anamnesis: treated according to the main disease since 1998. 5.04.2001 radical mastectomy on Pati left (HA No. 33048-52 - infiltrating ductal cancer). Total received 6 cycles of neo - adjuvant chemotherapy. After treatment was observed a stable remission. The deterioration came 6.01.2003 when the patient lost consciousness, then joined Jacksonian seizures in the left extremities and behavior type of the frontal psyche. 20.01.2003 consciousness was broken to the level of stun-spoor, there was deep left-side hemiparesis. According to the urgent CT-studies from 20.01.2003 was revealed a tumor of the right frontal lobe 58×43×50 mm with perifocal edema and offset median structures left by 2, see

23.01.2003 delivered to the Department of neurosurgery of RNII in serious condition, spoor, with signs of increasing hypertension-dislocation syndrome. On the same day for health reasons was made osteoplastic craniotomy in the right frontal region with total removal of the tumor within the visible healthy tissue (HA No. 67732-334 - metastasis of a cancer of a solid structure).

The postoperative period was uneventful, the wound healed by first intention, the sutures were removed on the 10th day. In the neurological status was observed complete regression of convulsions, hypertension-dislocation and focal syndromes. In General the status was dominated by extreme pain in the affected areas of bone structures, hyperthermia and secondary blastomussa anemia (Hb - 73 g/l).

Clinical examination at the hospital revealed the presence of the patient multiple osteolytic metastases in the bones of the skull, the vertebral bodies nizhnegrudnogo and lumbosacral spine, the bones of the pelvis.

On the 12th day after the operation was performed catheterization subarachnoid space of the spinal cord at the level of L4-L5with the establishment of flexible PVC endolyumbalno catheter, and then made 5 andliving injections of methotrexate in a dose of 5 mg of hydrocortisone in a dose of 50 mg autorequire with an interval of 3 days. At the same time carried out the course system chemohormonal with the introduction of androgenic hormone Omnadren intramuscularly at a dose of 1.0 ml once and drugs: cyclophosphamide 400 mg in the 1st, 3rd, 5th, 8th, 12th and 15th days, methotrexate 25 mg in the 1st and 8th days, 5-fluorouracil 500 mg in the 1st, 3rd, 5th, 8th, 12th and 15th days and doxorubicin is 50 mg 1, The 8th and 15th days intravenous drip on autologous blood. Patient underwent a course of treatment satisfactorily; side effects which was a barrier to treatment were observed.

As a result of operative and conservative treatment the patient was discharged in satisfactory condition: in addition to the normalization in the neurological status showed a significant regression of pain in the bones, normalization of body temperature, recovery of the level of hemoglobin (108 g/l). Managed to significantly improve the quality of life patient - she went from the Department of themselves on their feet.

Subsequently, during the year, in a Department of neurosurgery, RNII patient was held 2 courses of intrathecal chemohormonal and 4 courses of adjuvant systemic IGHT mode CMF-Doxo + Omnadren.

During treatment the patient was examined. According to CT brain from 3.12.2003 - at the disposal of cerebral metastases spinal fluid cavity, data for recurrence no; CT of the chest and abdomen from 3.12.2003 - osteopaticheskii changes in the vertebrae and the bones of the pelvis at the stage of consolidation.

Dynamic observation throughout the subsequent period of time demonstrated the continued satisfactory quality of life in our patient, the absence of signs about what massirovanie as the primary tumor. so cerebral metastatic disease.

Currently, the patient is alive and is in the stage rack stabilization of generalized neoplastic process.

Clinical example No. 3.

Sick f-VA NN, born in 1945, history No. 17302/0.

DIAGNOSIS: cancer of the left kidney, T2N0M1, with metastatic lesions in the parenchyma of both lungs, mediastinal lymph nodes, solitary metastasis in the left parieto-occipital lobe of the brain, stage IV. Hypertension-dislocation syndrome.

From the anamnesis: 30.10.2002 patient was performed radical left nephrectomy for tumor of the left kidney (HA No. 667897-98 - renal cell carcinoma, clear variant with large areas of necrosis). After surgery, felt quite satisfactory. Deterioration occurred in early 2004, when the patient noted the emergence of persistent headache, dizziness, nausea, vomiting, loss of visual fields on the right. The symptoms grew quickly, appeared slow, began to lose consciousness. District neurologist was focused on CT brain, in which 6.01.2004 revealed gipertenzivne lesion of the left parietal-occipital lobe of the brain 23×36×40 mm with a marked perifocal edema and offset median structures left by 8 mm, Then was sent to RNII to spetslechenie.

14.01.2004 delivered to the Department of neurosurgery of RNII in serious condition. In neurological status - stun I, sensorimotor aphasia, right-sided spastic hemiparesis. After special training 15.01.2004 was performed decompressive craniotomy in the left parieto-occipital region with total destruction of cerebral metastasis within the visible healthy tissue (HA No. 725269-270 - metastasis pochernkletocny cancer with extensive foci of hemorrhage, severe lymphocytic infiltration and necrotic foci).

The postoperative period was uneventful, the wound healed by first intention, the sutures were removed on the 10th day. In the neurological status was observed regression and cerebral hypertension-dislocation syndrome, Opticheskie violations and paresis of the limbs remained not significant.

Clinical examination in the hospital (CT of the chest) has revealed the presence of the patient metastatic lesions in the parenchyma of both lungs (small foci) and mediastinal lymph nodes. Clinically detectable changes in the lungs was shown.

On the 11th day after the operation was performed catheterization subarachnoid space of the spinal cord at the level of L4-L5with the establishment of flexible PVC endolyumbalno catheter. The scheme developed done the but 5 andliving injections of methotrexate in a dose of 5 mg of hydrocortisone in a dose of 50 mg autorequire with an interval of 3 days. At the same time carried out the course system chemoimmunotherapy with the introduction of drugs of carmustine 100 mg 1st day and vinblastine 15 mg in the 1st and 8th days intravenous drip on autologous blood and immunomodulator Reaferona 5 million ME intramuscularly 3 times a week. Patient underwent a course of treatment satisfactorily without side effects.

As a result of operative and conservative treatment the patient was discharged in satisfactory condition.

Subsequently, during the year, in a Department of neurosurgery, RNII patient was held 2 courses of intrathecal chemohormonal and 4 year system chemoimmunotherapy.

In the process of dynamic examination of the progression was not noted as the primary tumor process, so cerebral metastatic disease. According to CT brain from 17.11.2004 - at the disposal of cerebral metastases spinal fluid cavity, data for recurrence no; CT of the chest from 17.11.2004 in the lungs and mediastinal lymph nodes metastatic changes without negative growth. Thus, we can celebrate the fact resistant stabilization of generalized neoplastic process.

Currently, the patient is alive, her quality of life is satisfactory.

TECHNICAL and ECONOMIC EFFICIENCY

"How the Le is to be placed cancer patients with metastatic brain" is the use of the method in patients with generalized lung cancer, breast cancer and kidney contributes to effective regression of life-threatening neurological symptoms due to cerebral metastasis, pain, anemia, hyperthermia, and other systemic symptoms, due to the presence of generalized primary tumor process, improve patients ' quality of life, manifested in the increase in their activity, the increase in relapse-free and resetstatistics periods, and duration of life for cancer patients, based on the development of the phenomenon of counter stabilization of generalized neoplastic process.

The method of treatment of cancer patients with metastatic lesions of the brain, including andliving therapy, characterized in that after surgical removal of metastatic brain tumors in the early postoperative period, produce catheterization subarachnoid space of the spinal cord at the level of L4-L5with the establishment of flexible PVC endolyumbalno catheter produce fence 5 ml of cerebrospinal fluid, which is then mixed with methotrexate in a dose of 5 mg and suspension hydrocortisone in a dose of 50 mg, a mixture in a separate vial and sterile conditions, placed in thermostat at the same time is the temperature value 37° C and incubated with exposure time of 30 min, and then blasting through endolyumbalno catheter is injected back into the subarachnoid space, all within a single course of treatment, make 5 such infusion intervals in 3 days, total spend 3 course andlivorno chemohormonal in combination with five cycles of adjuvant systemic chemotherapy with the introduction of drugs on autologous blood.



 

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19 cl, 2 tbl, 3 ex

FIELD: medicine, oncology.

SUBSTANCE: the present innovation could be applied in complex therapy of cancer, particularly, mammary gland cancer and locally metastasizing colonic cancer. Moreover, in pre-surgical period it is necessary to sample 200 ml patient's blood to isolate autoplasma due to centrifuging, put 10 ml autoplasma and a chemopreparation into the first vial, into the second vial - the rest blood cells, autoplasma and a chemopreparation. Vials should be separately incubated for 40 min at 37° C, then comes the operation in the course of which one should intravenously introduce incubated blood with chemopreparation out of the second vial by drops. Before mobilization and removal of the tumor it is necessary to contrast tumor-abducting lymph vessels with methylene blue solution by standard technique to isolate the most proximal lymph vessel at the border of the area of removed tissues to introduce incubated autoplasma with chemopreparation out of the first vial. The innovation enables to decrease the frequency for the development of lympho- and hematogenic metastases due to complex therapy intrasurgically, at taking antilogarithms of systemic effect of intravenous autoerythrothromboleukochemotherapy and regional and systemic effects of endolymphatic autoplasmochemotherapy at low toxicity.

EFFECT: higher efficiency of therapy.

3 ex

FIELD: medicine, oncology.

SUBSTANCE: the present innovation deals with complex therapy of mammary gland cancer at T1-2NO-1MO. The method includes chemo- and radiation therapy and operation procedure. Moreover, in post-surgical period, before the onset of radiation therapy course it is necessary to sample 200 ml patient's blood and due to centrifuging technique isolate autoplasma. One should place 20 ml autoplasma and chemopreparations into the first vial, into the second vial - remained blood cells and autoplasma. Vials should be separately incubated for 40 min at 37° C, then during the first day of radiation therapy before the onset of the seance one should introduce the half of autoplasma volume incubated with chemopreparations from the first vial into the ducts of operated mammary gland, as for the remained part of autoplasma incubated with chemopreparations, from the first vial it should be introduced into the site of surgical withdrawal of drainage tube. Blood incubated with chemopreparations from the second vial should be reinfused intravenously by drops. The innovation is of low toxicity and enables to carry out complex organ-saving therapy in short terms, decrease the frequency of local relapses and remote metastases, the number of radiation reactions and complications.

EFFECT: higher efficiency.

2 ex

FIELD: medicine.

SUBSTANCE: method involves introducing photosensitizer of photosense at a dose of 0.1-1.0 mg/kg of patient weight. Photodynamic therapy is applied in 48-72 h with laser radiation at wavelength of 675 nm after having introduced the photosense. Iradiation is carried out in transscleral way after having determined tumor base projection place over sclera in transillumination way. Exposure dose is equal to 80-800 mW/cm2 with cylindrical light guide set at a distance from sclera that laser radiation beam diameter overlaps tumor base diameter by 1-2 mm at its projection place on sclera.

EFFECT: enhanced effectiveness of treatment.

FIELD: medicine.

SUBSTANCE: method involves mixing patient liquor with 3 ml of 10% albumin solution, with chemopreparation and incubating. Then, the mixture is introduced via catheter into subarchnoid space. Repeated introduction is carried out 7 days later.

EFFECT: alleviated intracranial hypertension phenomena in cases of endolumbal drugs introduction; reduced risk of toxic complications.

FIELD: medicine.

SUBSTANCE: method involves introducing water-soluble chemopreparation as a course in lymphotropic way. Riva-Rocci apparatus cuff is applied to lower part of femur and pressure of 40 mm of mercury column is created. 20 ml of chymotrypsin dissolved in 0.5% Novocain solution is subcutaneously introduced into the middle area of lateral shank surface 30 min later. Water-soluble chemopreparations are slowly subcutaneously introduced 0.5 cm below the chymotrypsin injection place in 5-7 min as single dose. The cuff is left in swollen state for 2 h. After having taken off the cuff, 50 ml of 0.5% Novocain solution is subcutaneously introduced into the place of previous water-soluble chemopreparations injection. Then the lower extremity is dressed with elastic bandage. The lymphotropic water-soluble chemopreparations introduction procedure is carried out once a day combined with standard chemotherapy course. Detralex is daily given to the patient on the background of the chemotherapy course at a dose of 2 pills twice a day combined with subcutaneous Fraxiparin injections introduced at a dose of 0.3 ml once a day.

EFFECT: avoided surgical intervention; increased antitumor effectiveness; reduced risk of recurrences, metastases and toxic complications.

5 dwg

FIELD: medicine, oncology.

SUBSTANCE: the present innovation deals with treating metastatic hepatic disorder in patients with malignant neoplasms. The method of regional polychemotherapy (RPCT) concentrates upon catheterization of proper hepatic artery (PHA) through gastro-omental artery to fulfill intra-arterial RPCT. Moreover, additionally after PHA catheterization it is necessary to catheterize an umbilical vein (UV) due to fulfilling arterio-venous shunting. For this purpose, one should connect catheters introduced into UV and PHA, with the help of a T-joint valve appliance (TVA); before carrying out RPCT it is important to conduct hepatic arterialization due to directing the blood from PHA through UV into the liver by setting TVA valves in position being open for PHA and UV; for carrying out RPCT one should locate TVA valves in position being open for introducing chemopreparations out of the system with a dosing tank of medicinal substances into PHA to carry out the infusion of chemopreparations. Seances for alternating hepatic arterialization and RPCT should be fulfilled daily once a day during the whole course of therapy. The innovation enables to simultaneously increase the concentration of chemopreparations in metastatic hepatic foci, detoxication hepatic function and sensitivity of tumor cells to chemopreparations as a result of additional preliminary oxygenation of hepatocytes.

EFFECT: higher efficiency of therapy.

1 cl, 6 dwg, 1 ex

FIELD: medicine, prophylactic oncology, pharmacy.

SUBSTANCE: invention proposes an agent belonging to class of nonsteroid anti-inflammatory preparations, namely, associate comprising 2[(2,6-dichlorophenyl)amino]-benzene acetic acid, inosine and N-methylglucosamine. In oral administration this associate inhibits effectively origination and development of malignant and benign tumors of brain, spinal cord, kidneys, breast, esophagus, forestomach, uterus cervix and vagina induced by chemical carcinogens in laboratory animals. Invention provides preparing the preparation possessing the more expressed anti-carcinogenic activity and lesser toxic ulcerous effect.

EFFECT: improved and valuable medicinal properties of agent.

5 tbl, 6 ex

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.

FIELD: medicine, oncology.

SUBSTANCE: in patients with prognostically unfavorable laryngeal and pharyngeal cancer therapy should be started with carrying out chemotherapy with preparations that enhance radiation action. Local hyperthermia should be conducted twice weekly at the background of radiation therapy. Moreover, during hyperthermal days a single focal dosage corresponds to 4 Gy - 2 Gyx2 at 4-h-long interval. The innovation enables to increase efficiency in treating patients with cerebral and cervical squamous cell cancer stage III-IV, improve viability values in this category of patients, decrease toxicity and improve therapeutic results at acceptable increase of topical radiation alterations and hematological toxicity.

EFFECT: higher efficiency of therapy.

1 ex

FIELD: medicine, surgery.

SUBSTANCE: the present innovation deals with surgical treatment of destructive pancreatitis complicated with retroperitoneal phlegmon. It is necessary to carry out ultrasound chromatic mapping of large vessels and lumbar organs and under its control one should conduct local infiltration anesthesia in projection of the site where long muscle of the back and the 12th rib intersect. Then it is important to move puncture needle to penetrate purulent focus, dissect the skin, insert a trocar's needle with the drainage along infiltration into purulent focus and fix the drainage to the skin. The innovation enables to apply low-invasive interference in case of destructive pancreatitis complicated with retroperitoneal phlegmon and decrease the number of complications as a result of local anesthesia.

EFFECT: higher efficiency of drainage.

2 dwg, 1 ex

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