Device for treating skin mucous membrane carcinoma cases
FIELD: medical engineering.
SUBSTANCE: device has tripod bearing X-ray therapy tube having radiation source and radiographic cone. The cone has cylindrical part having flange at one end provided with fastening members to be fixable in the X-ray tube and conic part on the other end. Protective lead aperture is available on the same side with the flange. Its inlet orifice diameter is less than the outlet orifice diameter for producing divergent conic X-ray beam. A through opening is available in the cylindrical portion of the X-ray cone arranged at an angle of 45-50° to its axis with laser radiator being placeable into it.
EFFECT: enhanced effectiveness in carrying out one-stage radiation therapy and laser radiation therapy of malignant diseases.
The invention relates to medicine, namely to Oncology, and may find application in korotkoperiodnoi radiation and low-intensity laser therapy of superficial malignant tumors of the skin and mucous membranes for prevention and treatment of injuries resulting from radiation therapy, mainly malignant tumors of the maxillofacial region.
Radiation reaction is an inevitable companion of radiation therapy of tumors and are accompanied by General and local reactions to healthy skin and organs. External beam radiation is inevitably linked with local radiation reactions of the skin and mucous membranes. Among the skin reactions are its redness (erythema) and dry radiometeric. On the mucous membrane of the local radiation reaction manifested as erythema, alopecia (islet) and diffuse drain epithelitis (radioactice). All three stages usually occur when conducting remote gamma-therapy cancer of the mucous membrane of various departments of the mouth.
With the modern technology of radiation these reactions usually do not reach severe. However, the physician should be familiar with their signs and shall take all measures for their prevention and treatment.
So you know the device (see patent RU No. 2189221, publ. 2002.09.20), in which the more radical the ay reach reduce damage to healthy tissue, surrounding the pathologic lesion, treatment is not outside, but inside. This path is realized, in particular, by implantation directly into the pathologic lesion capsules with an active material.
The disadvantage of this device is the necessity of its implantation in the pathologic lesion through surgery and related complications continue treatment.
In addition, surgical intervention is undesirable in the maxillofacial region.
The main type rentgenoterapevticheskie devices used in radiation therapy, is the close-focus. Such devices are intended for irradiation with short distances pathological lesions, mainly tumors located on the body surface or mucous membrane.
The closest in technical essence and the achieved effect and is taken as a prototype is a device for the treatment of cancer of the skin and mucous membranes (see Lindenblatt L.D. and other Medical radiology (fundamentals of radiology and radiation therapy). The textbook. lit. for stud. the honey. higher education institutions. Technological support for radiation therapy. M.: Medicine, 1993, S. 523-527), containing close-focus rentgenoterapevticheskie machine ROOM-21 equipped with a tripod mounted thereon provided with a radiation source, rentgenoterapii the th tube with a set of tubes of various shapes and sizes, with the ability to limit the size of the irradiated field and the permanence of the distance from the source to the surface of the body. Irradiation is carried out from a distance of 7.5-15 see This device provides a simple and accurate guidance of the working beam irradiated on the object. In all cases, the use of radiation therapy medical complex is aimed at the destruction of tumor, preserving surrounding healthy tissues and strengthening of protective forces of an organism.
However, the known device has the disadvantage inherent in all rentgenoterapevticheskie devices for radiation exposure, namely, that as a result of intensive courses of irradiation arise radiation tissue damage.
The objective of the invention is the prevention and reduction in the incidence of local radiation injuries and the reduction of treatment time, resulting from radiation therapy.
The technical result is the creation of optimum device that allows simultaneous radiation and laser therapy of malignant tumors.
The problem is solved in that in the known device for the treatment of cancer of the skin and mucous membranes, containing the tripod attached to it is equipped with a radiation source rentgenoterapevticheskie tube with a set of tubes of various shapes and sizes, housing roentgenotherapy the second tube is additionally equipped with a cylindrical tube, supplied with one end flange, equipped with locking elements, with the possibility of fixing it in rentgenoterapevticheskie tube, and the other end of the cylindrical tube provided with a conical part, with the inner hole of the tube-side flange has a protective lead aperture, the input aperture of a smaller diameter in comparison with the outlet, in addition to the cylindrical part of the tube at an angle of 45-50° its axis is made a through hole, with the ability to accommodate laser emitter.
Studies on the sources of patent and scientific and medical information showed that the present invention is unknown and should not be explicitly studied material, i.e., meets the criteria of "novelty" and "inventive step".
The invention can find application in the treatment of cancer patients, in particular in radiation therapy, with the possibility of prevention of the complications of radiation through the use of this device, manufactured at the enterprises of this kind, both domestic and foreign industry, therefore, "industrially applicable".
Additional supply of housing rentgenoterapevticheskie head cylindrical tube provided at one end with a flange, equipped with fixing the elements, with the possibility of fixing it in rentgenoterapevticheskie tube, and the other end is a cylindrical tube provided with a conical part, the total length of which allows to maintain the constant distance from the radiation source to the surface of the body, thus the cone reduces to a specified dimension of the outer diameter of the tube.
The interior hole of the tube-side flange protective lead aperture, the input aperture of a smaller diameter in comparison with the outlet, allows you to generate a diverging conical beam of x-rays.
Execution in the cylindrical part of the tube at an angle of 45-50° its axis through holes with the ability to accommodate laser emitter allows simultaneous radiation and laser therapy of malignant tumors, while it is found experimentally that specified in the range of 45 to 50° the angle of the holes and the protective material of the laser emitter prevent lateral leakage radiation.
Thus, the set of essential features allows you to achieve a technical result, namely, creating an optimal device allowing simultaneous radiation and laser therapy of malignant tumors.
The present invention explains the I drawings, where
- Fig 1 is a perspective view from above of the device shown in a perspective view;
- Fig 2 is a General side view.
Device for the treatment of cancer of the skin and mucous membranes contains a tripod mounted thereon provided with a radiation source rentgenoterapevticheskie tube, which is equipped with the ability to limit the size of the irradiated field tubes of various sizes (not shown), while rentgenoterapevticheskie tube equipped with a tube 1 made in the form of a cylinder 2, provided at one end with a flange 3, are equipped with locking elements 4, with the possibility of fixing it in rentgenoterapevticheskie tube, and the other end of the cylinder 2 has a conical part 5. The internal bore of the cylinder 2 from the side of the flange 3 has a protective lead aperture 6 with the inlet 7 with the possibility of formation of a divergent conical beam of x-rays on the exit hole 8. In addition, on the side of the cylinder 2 at an angle of 45-50° its axis is a through hole with the ability to accommodate the sleeve 9 with a through hole 10, is equipped with a laser emitter (not shown).
Set the length of the side walls of the tube 1 and the diameter of the outlet 8 depend on the shape and height of the tumor and, in addition, the length of the tube provides a constant distance of the long-term equilibrium radiation to the surface of the body, and the diameter of the outlet 8 limits the size of the irradiated field.
It was established experimentally that the specified diameter of the through hole 10 of the sleeve 9, is installed with a tilt angle equal to 45-50° to the axis of the tube 1, allows you to create a field irradiation with low-intensity laser blocking on the calculated value of field x-ray emitter, with no side leakage x-ray radiation through the opening 10, which together protect healthy skin from radiation complications.
Device for the treatment of cancer of the skin and mucous membranes are used as follows.
Depending on the shape and height of the patient's tumor pick up an extra tube 1 to rentgenoterapevticheskie tube. In hole 10 is injected laser emitter and initially irradiated tumor laser beam. After 30-50 seconds and include produce irradiation her rentgenoterapevticheskie tube during the time required to obtain a therapeutic dose, for example of 3.7 Gy. After disabling x-ray irradiation through 30-50 sec disable laser irradiation.
The advantage of the proposed simultaneous x - ray and lasermouse compared to x-ray irradiation of the prototype is to prevent and reduce the frequency of local radiation injuries and reduction of terms of treatment result in damage to the Oia laser radiation.
Device for the treatment of cancer of the skin and mucous membranes, containing tripod mounted thereon provided with a radiation source rentgenoterapevticheskie tube, equipped with a tube, wherein the tube is made in the form of a cylindrical part provided at one end with a flange, equipped with locking elements, with the possibility of fixing it in rentgenoterapevticheskie tube, and the other end is tapered part, with the side flange hole of the tube has a protective lead aperture, the input aperture of smaller diameter than the hole, with the possibility of forming a diverging conical beam of x-rays, and in the cylindrical part of the tube at an angle of 45-50° its axis is made a through hole, with the ability to accommodate laser emitter.
FIELD: technology for orientation of x-ray emitter relatively to the object.
SUBSTANCE: laser localizer additionally comprises optical pattern, consisting of 4 groups of identical transparent and nontransparent bars with width t and height H, bars of each group are turned in pattern plane by 45° relatively to bars of adjacent groups and positioned symmetrically to laser axis, pattern is mounted on laser axis perpendicularly to it, in front of the pattern between it and the first deflector on the laser axis perpendicularly to it a nontransparent screen is mounted for screening laser rays of highest diffraction orders, screen having one central aperture for passage of laser rays of zero diffraction order and eight apertures for passage of laser rays, diffracted into ±1 diffraction order, which are positioned on the screen at certain diameter with 45° interval from each other and spatially combined with position of corresponding diffraction maximums of ±1 order in pattern plane.
EFFECT: defined area of the object being x-rayed, simplified procedure for determining center of the zone.
FIELD: positioning radiator with respect to object.
SUBSTANCE: additionally introduced in positioner is rotor in the form of hollow cylinder revolving at frequency f ≥ 20 Hz whose axis of revolution is aligned with laser axis; rotor is disposed between first reflector and laser; optical raster in the form of combination of transparent and nontransparent bars of width t and height H is set on rotor butt-end disposed closer to laser; bar width is chosen from condition t = λ/sin(α/2, where λ is laser beam wavelength; α is X-radiator ray angle; bar height is chosen from relation H ≤ d, where d is laser beam diameter; mounted on other end of rotor is mask with central hole and two symmetrically disposed holes spaced apart through distance D; rotor length B on laser axis is found from expression B=kd/tg(α/2), where k = 1 - 2 is process coefficient and diametric line connecting centers of mask holes is perpendicular to direction of raster bars; distance A between raster and center of first reflector along lather axis equals distance from this center to X-ray tube focus on X-ray beam axis. Such positioner enables X-raying of object area as well as determination of center of this area.
EFFECT: enlarged functional capabilities and facilitated determination of distance from radiator to object.
1 cl, 4 dwg
FIELD: positioning radiator with respect to object.
SUBSTANCE: newly introduced in proposed positioner are optical wedge installed on laser optical axis for rotation relative to this axis at frequency f ≥ 10 Hz and at distance A from intersection point of X-ray beam and laser axes that equals distance from this point to X-radiator focus; drive for rotating optical wedge; first beam splitter installed on laser optical axis between optical wedge and first butt-end of laser at distance C > A from center of first reflector and at angle β < 45° to laser axis perpendicular to plane formed by laser and X-ray beam axes; second beam splitter made of plexiglas and installed on X-ray beam axis past first reflector at distance B from its center perpendicular to plane formed by X-ray beam and laser axes at angle γ to X-ray beam axis. Distances B and C as well as angles β and γ are interrelated by equations γ = 45° - β and β=c·tg(2β); optical wedge parameters (angle at θ vortex, ray deviation angle δ, and wedge material refractive index) are interrelated by equations δ = θ(n - 1) and δ = α/2, where α is X-radiation angle. This positioner enables estimation of X-rayed object area and also determination of center of this area.
EFFECT: enlarged functional capabilities, facilitated determination of distance from radiator to object.
1 cl, 4 dwg
FIELD: radiator positioning to object.
SUBSTANCE: newly introduced in proposed laser positioner are beam splitter disposed on laser axis between first reflector and first butt-end of laser at angle of 45 deg. to it axis, as well as third reflector disposed on axis drawn between point of intersection of beam splitter reflecting surface and laser axis perpendicular to this axis; beam splitter and third reflector are rigidly intercoupled and mounted on revolving flange whose axis is aligned with laser axis; it is set in rotary motion by means of motor drive, for instance that of frictional type, at frequency f ≥ 10 Hz mounted on positioner housing; reflecting surface of third reflector is tilted through angle β = 45° + α/4 to laser axis, where α is X-ray radiator angle of radiation; distance C between centers of beam splitter and third reflector is correlated with distance B along laser axis from center of first reflector to that of beam splitter by equation C=(A-B)·tg(α/2), where A is distance from X-ray radiator focus to first reflector center. This positioner incorporates provision for estimating X-rayed area of object and also for determining center of this area.
EFFECT: enlarged functional capabilities and facilitated determination of radiator-to-object distance.
1 cl, 1 dwg
FIELD: roentgen diagnostics and therapy in medicine and various processes including flaw detection and scientific research.
SUBSTANCE: proposed X-ray pulse generator has X-ray tube effective surface area of whose point cathode and anode is not over 10-6 m2 and preset cathode-to-anode distance is minimum, 10-3 m; it also has high-voltage pulse generator whose heavy-current high-voltage pulse shaper is made in the form of heavy-current high-voltage vacuum or gas-discharge switching unit incorporating electrode that controls switching unit triggering and is provided with additional high-voltage filter inserted in its circuit. Linear size of X-ray radiator focal spot is 0.1-0.5 mm. X-ray quanta energy can be regulated between 20 and 150 keV; X-ray pulse length is about 10-8 to 10-6 s.
EFFECT: reduced size of X-ray tube.
1 cl, 1 dwg
FIELD: roentgen engineering; producing roentgenograms, for instance in medicine.
SUBSTANCE: proposed X-ray source module has X-ray tube incorporating body, cathode and anode assemblies, as well as generator unit incorporating high-rating voltage divider whose high-voltage lead is connected to one of tube assemblies; X-ray tube body is made in the form of metal cylinder accommodating sectionalized cylindrical high-voltage insulator. One of its ends is connected through vacuum-tight joint to one of body ends and other end mounts cathode assembly. Anode assembly is disposed on other end of body and is made in the form of anode tube brought outside the body that carries target on its loose end. Generator unit is disposed inside cylindrical high-voltage insulator whose inner space is filled with oil. Side surface of insulator functions as high-rating voltage divider.
EFFECT: reduced mass and size of module.
1 cl, 1 dwg
FIELD: mechanical engineering; radiation method of inspection of materials and items.
SUBSTANCE: centering mount has housing inside which the laser is disposed as well as first reflector mounted onto axis of laser in front of exit window of X-ray radiator is the point where axis of laser crosses axis of X-ray beam, second reflector mounted onto axis of laser outside the projection of exit window of X-ray reflector for rotation relatively axis being perpendicular to plane formed by axes of laser beam and X-ray. Device also has aids for indicating focal length made in form of pointer provided with scale fixed onto housing of centering mount. Flat collimated laser beam forming system is mounted in front of laser. Laser beam propagates along plane being parallel to vertical plane crossing longitudinal axis of X-ray radiator. The axis is at the same time perpendicular to vertical plane crossing axis of X-ray beam. The second reflector is mounted at the exit of system at laser axis. Beam splitter is mounted between first and second reflectors. In front of the beam splitter there is the second semiconductor laser which is mounted onto axis being perpendicular to axis of laser to cross its point of crossing with beam splitter.
EFFECT: improved precision of measurements; simplified application.
FIELD: medicine, oncology.
SUBSTANCE: in pre-surgical period in the 1st, 3d, 5th d of a 5-d-long irradiation course it is necessary to carry out a seance of distance gamma-therapy at single focal dosage (SFD) being 5 Gy at the background of a double intake of capecytabin at its daily dosage of 1.5 g/sq. m body surface. In the 2nd and 4th d at the background of a double intake of capecytabin at the same dosage, one should intrarectally introduce metronidasol at the rate of 10 g/sq. m body surface and after a 6-h-long exposure one should carry out a seance of distance gamma-therapy at SFD being 5 Gy. Moreover, metronidasol should be introduced as a composite mixture at the following ratios of the ingredients, weight%: metronidasol 12-22; sodium alginate 4-6; dimethyl sulfoxide 2; distilled water - up to 100. The innovation provides taking antilogarithms of the effect of radiomodifiers of different direction at the background of radiation therapy and, thus, the absence of locoregional relapses for the period of 2 yr, the decrease in the onset of distant metastases and the increased frequency in achieving radial pathomorphosis of degree III in the tumor.
EFFECT: higher efficiency of therapy.
FIELD: medicine, oncology.
SUBSTANCE: the present innovation deals with treating patients at not small cell nonoperable pulmonary carcinoma. It is necessary to introduce chemopreparations incubated with a patient's body automedium and carry out radiation therapy. Moreover, medullary iliac suspension should be incubated with chemopreparations in a thermostat at 37°C for 30 min and reinfused for a patient intravenously by drop technique. In 2 wk one should carry out radiation therapy at the mode of accelerated hyperfractioning per 1.3 Gy per 2 fractions daily at a 4-h-long interval between fractions during 2 wk daily. It is important to carry out 3 such cycles that combine the introduction of chemopreparations upon medullary suspension and radiation therapy, at a 2-wk-long interval, the difference being in the mode of radiation therapy only. So, in the course of the second cycle a single dosage of irradiation corresponds to 1.2 Gy twice daily at a 4-h-long interval during 2 wk. During the third cycle - per 1.1 Gy daily at a 4-h-long interval for 2 wk. The innovation enables to improve final results and quality of life in such patients; decrease side manifestations of anti-tumor therapy at inspecific stimulation of immune status with the elements of medullary suspension.
EFFECT: higher efficiency of therapy.
FIELD: veterinary medicine.
SUBSTANCE: method involves restoring disturbed hemostasis system parameters, reducing harmful radiation action upon hematosis system. Animal pelvis zone is exposed to low intensity broadband electromagnetic radiation in millimetric bandwidth with wavelength equal to 3.8-5.6 mm, specific noise power of 1.2 mcW/cm2 and specific noise spectrum frequency distribution inhomogeneity equal to ±3 dB during 7 days beginning from the first experiment day.
EFFECT: enhanced effectiveness of treatment.
2 dwg, 3 tbl
SUBSTANCE: method involves exposing hypothalamus area to alternating magnetic field in ultra-low frequency bandwidth and operation field to permanent magnetic field in postoperative period in combination with adjuvant chemo radiation therapy in ablatable central nerve system tumor cases. The hypothalamus area is treated in the same way and the tumor is treated with permanent magnetic field in applying palliative chemo radiation therapy in nonablatable central nerve system tumor cases.
EFFECT: reduced risk of adverse side effects; reduced tumor size; prolonged survival period.
FIELD: experimental medicine; radiology.
SUBSTANCE: method of physical-biological preventive measures of radiation sickness can be used at rats. 20-300 days before radiating rats with lethal doses, prophylactic gamma-ray radiation is applied to rats in dose of 0,5-1 Gr. 5-10 days radiation with lethal doses, 10% solution of phyto-medication named eracond is given to rats in dosage of 5,0-7,5 ml/kg.
EFFECT: method provides 50-80% probability of survival of animals due to formation of increased radiology resistance during long period of time.
2 tbl, 1 ex
SUBSTANCE: method involves introducing Capecitabin on the background of preoperational irradiation as radio modifier at a dose of 1650 mg/m2 divided into 2 portions given 2 h before exposure and 12 h after the exposure.
EFFECT: prevented local relapse occurrence; prolonged survival period.
2 dwg, 9 tbl
FIELD: medicine, oncology.
SUBSTANCE: the present innovation deals with treating patients in case of skin melanoma stage III. For this purpose blood plasma should be incubated with the following chemopreparations: cisplatin 30 mg, metotrexate 5 mg, cyclophosphan 600 mg in a thermostat at 37°C for 30 min and in pre-surgical period it is necessary to inject it for a patient into subcutaneous fatty fiber due to paracenteses from 4 sides under the focus of malignant growth. During the same day it is important to star gamma-therapy at the dosage of 2.4 Gy daily for 5 d, then comes 1-d-long interval and the same order of procedures should be continued twice more. In 2 d one should carry out operation in the volume of wide dissecting the primary focus at regional lymphadenectomy. In 2 wk after operation - with the same preparations and at the same dosages 5 times every other week. During the next 2 yr it is necessary to carry out analogous adjuvant autohemochemotherapy once/3 mo. Application of the complex therapy suggested enables to achieve higher percentage of tumor regression, increase duration and improve quality of life.
EFFECT: higher efficiency of therapy.
SUBSTANCE: method involves intravenously introducing chlorine row photosensitizer in pharmaceutical water-soluble dosage form at a dose of 0.7-1.05 mg/kg during 10 min. Fluorescent spectral diagnostic analysis of chlorine row photosensitizer accumulation is carried out in intraocular neoplasm in 1 h after having finished introduction. Neoplasm fluorescence being observed on the background of surrounding tissue, chlorine row photosensitizer in pharmaceutical liposome dosage form is introduced as intravenous bolus dose of 0.3-0.45 mg/kg. 10-15 min later after having finished the injection, laser radiation is applied tumor periphery is irradiated all over the whole tumor perimeter in transpupillary mode in laser radiation fields using wavelength of 670 nm with power density of 60-80 J/cm2 with neighboring fields overlapping over 5% of area. Then the whole neoplasm surface is irradiated in transpupillary mode in laser radiation fields using wavelength of 662 nm with power density of 100-120 J/cm2 with neighboring fields overlapping over 5% of area. Irradiation is carried out in circle moving from periphery towards the center. When calculating superficial ophthalmoapplicator dose in brachytherapy, initial tumor thickness is to be reduced by 4 mm.
EFFECT: enhanced effectiveness of treatment; reduced superficial ophthalmoapplicator dose; reduced risk of complications caused by radiation.
SUBSTANCE: method involves carrying out brachytherapy. Chlorine row photosensitizer is introduced in pharmaceutical water-soluble dosage form at a dose of 0.7-1.05 mg/kg during 10 min. Fluorescent spectral diagnostic analysis of chlorine row photosensitizer accumulation is carried out in intraocular neoplasm in 1 h after having finished introduction. Neoplasm fluorescence being observed on the background of surrounding tissue, chlorine row photosensitizer in pharmaceutical liposome dosage form is introduced as intravenous bolus dose of 0.3-0.45 mg/kg. 10-15 min later after having finished the injection, laser radiation is applied tumor periphery is irradiated all over the whole tumor perimeter in transpupillary mode in laser radiation fields using wavelength of 670 nm with power density of 60-80 J/cm2 with neighboring fields overlapping over 5% of area. Then the whole neoplasm surface is irradiated in transpupillary mode in laser radiation fields using wavelength of 662 nm with power density of 100-120 J/cm2 with neighboring fields overlapping over 5% of area. Irradiation is carried out in circle moving from periphery towards the center. When calculating superficial ophthalmoapplicator dose in brachytherapy, initial tumor thickness is to be reduced by 4 mm.
EFFECT: enhanced effectiveness in achieving complete or partial intraocular neoplasm regress; retained eye as organ without metastatic complications; reduced risk of complications caused by radiation.
FIELD: medicine, oncology.
SUBSTANCE: method involves carrying out the preliminary catheterization of larynx artery and the following intra-arterial chemotherapy by administration of cisplatin as 6 h infusion of 80-100 ml of 0.0025% solution from 1-st to 4-th day of treatment in the total dose 100 mg/m2, 5-fluorouracil as 3 h infusion of 20 ml of 5% solution from 5-th to 7-th day of treatment in the total dose 3 g. After termination of chemotherapy in 2-3 weeks after arresting adverse reactions in tumor regression above 50% the larynx resection is carried out and in regression less 50% - laryngoectomy. In 3-4 weeks after surgery operation the distance radiation therapy is carried out in a single irradiation dose 2.0 Gr in irradiation regimen 5 times per a week and in the total dose 40-46 Gr in laryngoectomy and 60-66 Gr in organ-retaining surgery operation depending on the stage of the primary process. Method provides the functional rehabilitation of patients and decreasing expression and amount of total complications of complex therapy based on step-by-step carrying out the treatment. Invention can be used in treatment of patients with locally spread squamous larynx cancer.
EFFECT: improved method of treatment.