Method for treating patients with colorectal cancer and with renal metastases

FIELD: medicine, oncology.

SUBSTANCE: through a catheter it is necessary to conduct prolonged polychemotherapy due to single regional intra-arterial injection of oxaliplatin at the dosage of 150 mg/sq. m into general hepatic artery as 12-h-long infusion and 5-fluorouracil at the dosage of 1000 mg/sq. m daily in the course of every course due to prolonged 120-h-long infusion. The duration of therapy - 4 courses of infusions at 28-d-long intervals. The innovation provides efficient therapy of the pathology mentioned due to increasing a single and a course dosage of anti-tumor preparations of low toxicity, at no complications that requires no hyperhydration procedures.

EFFECT: higher efficiency of therapy.

1 ex

 

The invention relates to medicine, namely to Oncology, and can be used for the treatment of colorectal cancer patients with liver metastases.

Treatment of malignant tumors is one of the most actual problems of clinical Oncology. The only method to achieve long-term survival in malignant tumors is surgical resection. At present, however, in the treatment of metastatic colorectal cancer using various schemes and methods of drug therapy.

There is a method of treatment of colorectal cancer patients with liver metastases, consisting in the use of drug therapy (D.A. the Granov, p. g Taraz, Endovascular intervention in the treatment of malignant liver tumors, St. Petersburg, Folio, 2002, s).

However, the known method is ineffective and is accompanied by severe toxic manifestations.

The closest achieved a positive result is a method of treatment of colorectal cancer patients with liver metastases, which consists in intravenous application oxaliplatin at a dose of 85 mg/m25-fluorouracil at a dose of 500 mg/m2and leucovorin at a dose of 20 mg/m2(Modern Oncology, the Results of applying oxaliplatin for colorectal cancer and other salts of the different tumors (materials ASCO) No. 2, Vol.6, 2004, s).

However, the known method is ineffective and associated with a high incidence of side effects.

The authors offer a highly effective way to reduce toxicity, increase the time and dose rate drugs without causing complications, and does not require hyperhidrotic.

A positive result of the invention is to increase efficiency.

A positive result is achieved by the fact that the oxaliplatin and 5-fluorouracil is administered intraarterially into the common hepatic artery, and oxaliplatin administered at a dose of 150 mg/m2in the form of a 12-hour continuous infusion, and 5-fluorouracil in the form of a 120-hour continuous infusion at a dose of 1000 mg/m2per day to a total dose of 6-7 g, duration of treatment consists of 4 courses of intra-arterial infusions every 28 days.

The method is as follows.

3-4 weeks after palliative operations are carried out by 4 courses of intra-arterial chemotherapy. Perform angiography to determine the anatomical variants of the hepatic artery. The catheter is installed in the common hepatic or superior mesenteric artery by the Seldinger. Under local anesthesia, aseptic conditions x-ray operation room, hold the puncture of the femoral artery. Through the lumen of the needle into the femoral artery, and then in the ORT spend a metallic conductor. After removal of the needle over the guidewire into the aorta spend angiographic catheter with a pre-contoured inner end, which perform selective catheterization of the celiac trunk and superior mesenteric artery with subsequent angiography. After carrying out angiography determine the type of the arterial supply of the liver and the source of blood supply to the metastases. The catheter is left in the artery carrying blood to the metastases. Through the catheter spend extended chemotherapy by means of a single regional intraarterial injection in the common hepatic artery oxaliplatin at a dose of 150 mg/m2in the form of a 12-hour infusion of 5-fluorouracil at a dose of 1000 mg/m2per day by continuous 120-hour infusion to a total dose of 6-7, the Treatment consists of 4 courses of prolonged intra-arterial infusion intervals over 28 days.

Clinical example:

Patient K., 56 years old were treated in the Department of Coloproctology from April 2002 with a diagnosis of multiple Primary system synchronous cancer: cancer of the descending of the Department of colon T4N1M1G3cancer of the transverse colon T1H0M1cancer rectosigmoidal connection T3N1M1, mnozhestvennye MTS in the liver. G/d of poorly differentiated adenocarcinoma with invasion in the br is geico colon, metastasis in a single lymph node. 26.04.04 held obstructive extended left hemicolectomy, nadalina resection of the rectum. The surface area of the patient's body was 1.4 m2. After 4 weeks patients received 1 cycle of chemotherapy: oxaliplatin at a dose of 210 mg on the first day in 12-hour infusion intraarterially and 5-fluorouracil at a dose of 1000 mg/m2a day that is administered to the patient in the form of a continuous 120-hour infusion, which was performed through a catheter in the common hepatic artery by the Seldinger. All patients received 4 courses of chemotherapy every 28 days. At follow-up by ultrasound, computed tomography and angiography of the liver was determined by regression of a significant part of the metastatic foci.

By the present method treated 17 patients (11 men and 6 women aged 42 to 69 years). All patients had multiple metastases in the liver. The treatment was performed according to the claimed method and the efficiency was: complete regression of the tumor in 4 patients, partial - 11 and stabilization - 2 patients. The progression was not observed a single patient. The duration of remission ranged from 12 to 18 months.

During treatment showed the following complications: nausea/vomiting - in 13 patients, gastroenteritis - 4, neuropathy, manifested by numbness of the fingers, the EV of the hand, to reduce the sensitivity to 5 patients. Showed complete lack of hematological complications, marked elevation of hepatic transaminases.

Thus, the inventive method has a high efficiency by reducing the toxicity, complications.

The method of treatment of colorectal cancer patients with liver metastases by chemotherapy, which consists in the introduction oxaliplatin and 5-fluorouracil, wherein the oxaliplatin and 5-fluorouracil is administered intraarterially into the common hepatic artery, and oxaliplatin administered at a dose of 150 mg/m2in the form of a 12-hour continuous infusion, and 5-fluorouracil in the form of a 120-hour continuous infusion at a dose of 1000 mg/m2per day to a total dose of 6-7 g, duration of treatment consists of 4 courses of intra-arterial infusions every 28 days.



 

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4 cl, 4 dwg, 7 ex

FIELD: medicine, oncology.

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3 ex

FIELD: medicine, oncology.

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1 cl, 6 dwg, 1 ex

FIELD: medicine, oncology.

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2 ex

FIELD: medicine, biotechnology.

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28 cl, 7 ex, 7 dwg

FIELD: biotechnology.

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3 cl, 18 ex, 4 tbl

FIELD: medicine, oncology, pharmacy.

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9 cl, 1 dwg, 4 tbl, 6 ex

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5 cl, 17 tbl, 112 ex

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16 cl, 32 ex

FIELD: medicine, in particular angiogenesis prophylaxis and treatment.

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5 cl

FIELD: organic chemistry, medicine, pharmacy.

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EFFECT: valuable medicinal properties of compounds and pharmaceutical compositions.

27 cl, 1 tbl, 199 ex

FIELD: organic chemistry of natural compounds, medicine, pharmacy.

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EFFECT: valuable medicinal properties of compounds and pharmaceutical composition.

30 cl, 1 tbl, 69 ex

FIELD: medicine.

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EFFECT: enhanced effectiveness of treatment; reduced risk of postoperative complications; increased immune activity.

FIELD: medicine.

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2 cl

FIELD: medicine, oncology.

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EFFECT: higher efficiency of therapy.

1 ex

FIELD: pharmaceutical industry, in particular agent having cytostatic and apoptosis-inducing activity.

SUBSTANCE: claimed agent represents β-Asparagine, obtained by extraction of ground burdock roots having specific particle size with heated water in specific raw materials/extractant ratio; decoction, extract separation, concentration up to dry residue in concentrate, filtering, and double recrystallization.

EFFECT: agent with high cytostatic and apoptosis-inducing (anti-tumor) activity.

5 dwg, 2 tbl

FIELD: medicine, oncology.

SUBSTANCE: method involves carrying out lumbal puncture to a patient in post-operative period, subarachnoid space is catheterized, and 5 ml of liquor is removed followed by incubation of liquor with nimustine taken in the dose 5 mg in vitro at temperature 38°C for 30 min, and liquor is administrated into subarachnoid space through catheter. Procedure is carried out 2 times with interval for 7 days. Since the second day after onset of this procedure distant gamma-therapy on bed of removed tumor is carried out up to the total focus dose 60 Gr. Method provides stable remission, decreasing toxicity of chemopreparation, frequency of adverse by-side effects and significant reducing the cost of chemotherapy. Invention can be used in carrying out the adjuvant chemoradiation therapy of brain malignant glial tumors.

EFFECT: improved method of chemoradiation therapy, enhanced effectiveness of method.

1 ex

FIELD: medicine, oncology, gynecology.

SUBSTANCE: method involves trepanopuncture of flank bone wing, aspiration of bone marrow suspension in the amount 150-200 ml followed by incubation of suspension with chemopreparations cisplatin and cyclophosphan at temperature 37°C for 40 min in doses above therapeutic ones. Doxorubicin is not incubated with bone marrow suspension and chemopreparations are administrated separately by intravenous route, by drops in indicated order in day when the bone marrow suspension has been taken, and this procedure is repeated with interval for 3-4 weeks but totally 4 times per one treatment course. Proposed method provides attaining the stable anti-tumor effect up to the complete tumor regression in this category of patients showing high tolerance to chemotherapy, and in practical absence of adverse toxic responses. Invention can be used in treatment of patients with relapses of ovary and uterus body cancer in case absence effectiveness of other methods of treatment or in case of their low effectiveness.

EFFECT: improved method of treatment.

2 ex

FIELD: medicine, oncology.

SUBSTANCE: method involves administration of bleomycin and erythropoietin simultaneously in patients. Invention can be used for decreasing pulmonary cytotoxicity in patients treated with bleomycin. Invention provides improving functioning lung in patients of this category.

EFFECT: valuable medicinal properties of erythropoietin.

4 cl, 2 dwg, 2 ex

FIELD: medicine, oncology, pharmacology, pharmacy.

SUBSTANCE: invention relates to methods and medicinal formulations used in antitumor treatment and enhancing oral biological availability of taxanes. Method involves administration of taxane in combination with agent enhancing biological availability of taxane in oral administration in subject wherein concentrations of taxane attain levels of therapeutic activity in subject. Ketoconazol representing inhibitor of cytochrome P-450 is used as agent enhancing oral biological availability of taxane. Invention provides enhancing bioavailability of taxane in its oral administration in subject in subtherapeutic doses that results to decreasing toxicity of treatment.

EFFECT: improved and valuable medicinal properties of drug.

33 cl, 42 dwg, 10 tbl, 12 ex

FIELD: medical engineering.

SUBSTANCE: system is usable for introducing liquid medication to the patient in performing his/her physical condition monitoring, that is, the liquid is introduced under expired air control with given component under observation. The monitoring system has interface unit, the infusion pump unit, and capnographic unit. The infusion pump unit is used for introducing liquid medication to the patient, including anesthetizing, anesthetizing or somnifacient drugs introduction. Capnographic unit allows controlling air, exhaled by the patient, in particular, final flux and reflux levels of carbon dioxide gas content in expired air and frequency of breath. Capnographic unit giving instructions to the interface unit that final flux and reflux level of carbon dioxide gas content in expired air and frequency of breath have reached the values violating certain reference values stored in memory, the interface unit starts producing visual and acoustic alarm signals and controls infusion pump unit operation by modifying air flow or by switching-off the pump unit. In controllable anesthesia application cases, the interface unit can block bolus dozes of anesthetizing drug supplied to patient under control until they will be repeatedly set by qualified medical personnel or until measured capnographic sizes will return to their normal variation range. The interface unit also has communication ports, which the interface unit can use for submitting signals to external devices to warn the medical personnel.

EFFECT: enabled quality of liquid drugs introduction.

41 cl, 16 dwg

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