Method of treating breast cancer

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to oncology, and may be applied in treating breast cancer. Breast is resected. Coletex-Mex textile tissue is applied for 4-7 days in 7-10 postoperative days on the postoperative scar and remained breast tissues, and changed 2 times a day. For the following 4-7 days, Coletex-D hydrogel tissue is applied and coated with Coletex-SMT textile tissue in the same regiment. The applications for 8-10 hours a day are combined with radiation teletherapy to SRD 20 Gy - 25 Gy. The radiation teletherapy is combined with the applications of Coletex gel DNA hydrogel coated with Coletex-Mex textile tissues from above changed twice a day. The radiation teletherapy is followed by the application of Coletex-SMT tissue and Coletex-Mex tissues changed every 12 hours to complete rehabilitation.

EFFECT: method provides fast healing of the postoperative wound, reduced length of the beginning of radiation and chemotherapy, minimal rate of complications and side reactions thereby improving patient's quality of life.

1 ex

 

The invention relates to medicine, namely to Oncology.

There is a method of treatment of infiltrative edematous breast cancer (Patent RF №2177349, IPC A61N 5/00, publ. 2001), including systemic and regional chemotherapy with embolization of the arteries supplying the tumor, and subsequent application of radiation therapy immediately after chemoembolization. Chemoradiation treatment on the background of the introduction of patient prednisone. Radiation therapy is carried out in a mode of secondary fractionation doses up to 3 G 5 times a week to a total dose of 45 Gy to the base of the breast and up to 33-36 Gr zone of regional lymph flow.

The disadvantage of this method is that when conducting this treatment, possible complications, due to the high risk of thrombosis. To conduct regional chemotherapy requires special equipment and trained personnel.

There is a method of treatment of advanced breast cancer with tumor ulceration of the skin (Patent RF №2176922, IPC A61N 5/00, publ. 2001), including chemotherapy 5-fluorouracil in the form of napkins "Collex-5-ftor"imposed on the region of the tumor every day 2-3 times a day, and radiation therapy to the area of the base of the breast and the area of regional lymphatic drainage. Additionally, daily entered the prednisolone 20-30 mg orally or 30 mg intramuscularly, radiation therapy was performed on the background of the action of these drugs daily for 3 Gr per day to the total focal dose of SOD 45 Gy on the basis of breast cancer and to SOD 33-36 Gr zone of regional lymph flow, after radiation therapy, the dose of prednisolone every 2-3 days was reduced by 5-10 mg, napkins "Collex-5-ftor" is replaced with "Collex-CHG" or "Collex-D" and used them to complete scarring, and 2-3 weeks after radiotherapy was performed traditional chemotherapeutic treatment.

The disadvantage of this method is the need for long-term use of prednisolone, which can have serious side effects such as gastro-intestinal tract or to be an absolute contraindication to its use in the presence of peptic ulcer or erosive gastritis patient.

The closest is a method of treating breast cancer (Patent RF №2349264, IPC AV 17/00, publ. 2009), which includes resection of breast cancer and radiation therapy to the tumor bed after surgery. 2 weeks after surgery undergo chemotherapy and 2-4 weeks for standard mode fractionation dose, do remote gamma-therapy.

The disadvantage of this method of treatment is an inadequate amount of ongoing chemotherapy treatment (1st course of chemotherapy is not enough). Respectively between courses the further chemotherapeutic treatment occurs long break of up to two months or more, that significantly reduces the effectiveness of chemotherapy treatment. The next disadvantage is the inability to comply with the terms of the treatment in the presence of residual expressed surgical inflammation, not to start a course of radiation therapy. Then the timing between courses of chemotherapy treatment more elongate.

The task of the invention is to remedy these disadvantages, the efficiency of treatment, reduction of terms of rehabilitation of patients after surgical treatment and, as a consequence, adherence to deadlines beginning of the postoperative course of radiation therapy, prevention and reduction of severity of radiation reactions in the treatment process, as well as reducing recovery time after treatment. This allows you to observe the timing of the further stages of the planned treatment.

For this purpose, the method of treating breast cancer, including resection of breast cancer and radiation therapy after surgery for 7-10 day post-surgical scar and the remaining breast tissue to hold within 4-7 days of the application wipes "Collex-Mex on a textile backing with change it 2 times a day. In the next 4-7 days should be application hydrogel napkins "Collex-D"to the Yu top covered with a cloth textile based "Collex-SMC" in the same mode. Then simultaneously with the holding of sessions of remote radiation therapy to SOD 20-25 Gy to continue this application mode 8-10 hours a day. Next, simultaneously with the continuation of remote radiation therapy proposed to carry out the application of the hydrogel material "Collex-gel-DNA, which are covered with cloth textile based "Collex-Mex with change 2 times per day. After completion of the course of radiation remote therapy recommended application napkins "Collex-SMC and Collex-Mex, alternating every 12 hours up to full rehabilitation.

The proposed method allows for more quickly to stop post-operative swelling of the tissues, helps in the healing of postoperative wounds and reduce the time before the start of radiation therapy, as well as to undertake a course of radiation therapy without interruption due to a decrease in the intensity of radiation reactions and accelerate the rehabilitation of the patient. In this regard, reduced time to initiation of chemotherapy. Sharing hydrogel and textile napkins improves the mass transfer of the drug into the damaged tissue to achieve joint action of drugs and possible traumas of appliciable, use a moistened textile and hydrogel applications reduces soreness dressings, making them the safest. All this pozvolyayushchii outcomes and quality of life.

The method is as follows.

Patients diagnosed with breast cancer in most cases shows segmental or complete resection of the breast. After the initial scarring 7-10 days after surgery postoperative scar and the remaining breast tissue causing the tissue "Collex-Mex with Mexidol on a textile backing with change it 2 times a day for 4-7 days.

5-8 days start to apply hydrogel napkin "Collex-D" with Dimexidum, which are covered with cloth textile based "Collex-SMC" with urea for 4-7 days with change 2 times per day.

On 8-14 day begin postoperative course of radiation therapy to the remaining breast tissue in mode unconventional fractionation with GENUS - 2,5 Gr. During radiation treatment, daily continue to use the same application (napkin "Collex-D" with Dimexidum, which are covered with cloth textile based "Collex-SMC" with urea) mode 8-10 hours a day to take stock of 20 Gy To 25 Gy.

Remote radiation therapy continue with the RACE - 2,5 Gr and SOD - 50 Grams or SOD - 45 Gr and then boost on the fabric postoperative scar GENUS - 2,8 Gr 3 session energy of the electron beam of 4 MeV to SOD - 53,4 Gr. At the same time hold the applique material hydro is spruce "Collex-gel-DNA", which are covered with cloth textile based "Collex-Mex with change 2 times per day. This allows you to stop radiation reaction and undergo irradiation without interruption.

After completion of the course of radiation treatment applications napkins "Collex-SMC and napkins "Collex-Mex, alternating every 12 hours up to full rehabilitation.

Example.

Clinical diagnosis: Cancer of the right mammary gland II And Art., T2N0M0. Condition during multimodality treatment (surgery: radical resection of the right breast with the plastic fragment latissimus from, 13.04.11).

The 1st stage of the operation: radical resection of the right breast with the plastic fragment latissimus from 13.04.11,

In the second stage the recommended postoperative radiation therapy to the remaining tissue of the right breast with subsequent courses of polychemotherapy according to the scheme CAF.

Clinically admission: large Breasts, the 5th dimension bra. Postoperative scar breast swollen right, the sutures were removed after one in the outer quadrants of the breast rocky density, sedentary, with multiple subcutaneous hemorrhages. The scar multiple brown.

The patient is scheduled on day 8 after surgery applications with cloth Collex-Mex on textile the basis change it 2 times a day, during the day napkins were specialise according to the instructions. The treatment was carried out for 7 days. On the 5th day of applications was made by predlozena 3D SKT markup breast cancer. After 7 days expressed positive dynamics in the form of a resolution subcutaneous hemorrhages 75%complete healing of the scar, reducing edema of the mammary gland.

On the 8th day the application was continued under the scheme: hydrogel napkin "Collex-D" with Dimexidum covered with cloth textile based "Collex-SMC" with urea with change 2 times per day.

On the 12th day was initiated postoperative radiation therapy to the remaining breast tissue, the apparatus of the Terratron, gamma radiation in terms of conformal radiation, with the GENUS - 2,5 Gr and SOD - 25 Gr. While simultaneously held the same application in the exposure mode 8-10 hours per day. At the dose of 25 Gy, the patient developed poorly defined epidermic 1-St degree.

Further, since the 23 day, the irradiation was continued until the SOD 53,4 Gr. At the same time was appointed applique material hydrogel "Collex-gel-DNA, which are covered with cloth textile based "Collex-Mex with change 2 times per day.

Radiation therapy is not interrupted. In this combination the application was performed daily until the end of treatment

By the end of the irradiation of the patient revealed the development in the submammary fold wet epidermitis (II degree) (mammary glands large size).

The patient after radiation therapy were recommended applications under the scheme: napkins "Collex-SMC" with urea and napkins "Collex-Mex with Mexidol, alternating every 12 hours.

At the control examination on the 17th day full resolution wet epidermitis. All radiation areas of residual hyperpigmentation weak degree.

The rehabilitation period was 17 days.

Patient referred for further chemotherapy treatment.

In a study on the use of textile and hydrogel napkins included 32 patients with a diagnosis of breast cancer. The average age of patients was 49 years. The use of applications has allowed us: first, to reduce the period of rehabilitation in the postoperative period up to 4-5 weeks (which corresponds to the recommended timing for the start of radiation therapy in combined modality treatment plan after performing the surgical phase of treatment). Before these terms were at best 8-9 weeks. Secondly, all patients postoperative radiation therapy carried out without interruption. In addition, it significantly delay the timing of the beam d is of capabilities during treatment: the first signs of radiation reaction on the part of the skin and breast tissue developed only on SOD - 40-42,5 Gr. Earlier this dose level was 22.5-27,5 Gr.

At 31,25% (10 patients) development of radiation reactions during treatment and early postradiation period (the first 7-10 days after treatment) was not recorded.

Have to 58.1% of the patients showed development of epidermic mild degree, which was docked in 3-5 days.

The holds 18.52% of the patients showed development of radiation reactions (skin erythema moderate severity) on SOD - 40-42,5 Gy, which was maintained for 5-7 days after the treatment, during the next 3-7 days was stopped. Thus, the rehabilitation period after radiation treatment was 8-14 days. Previously, he was equal to 21-28 days.

And only 8,33% (3 patients) on the 3rd day after the end of radiation therapy showed development limited wet epidermitis in the submammary fold (with larger Breasts). The period of full rehabilitation of these patients was 17-21 day against 35-42 days without using the proposed method.

The use of textile and hydrogel napkins radiation therapy in combined modality treatment plan in patients with breast cancer is allowed to increase its effectiveness criteria the immediate and distant effects with minimal incidence of complications and adverse reactions, improving the quality of W is FDI.

A method of treating breast cancer, including resection of the mammary gland and external beam irradiation, characterized in that after the surgery 7-10 days for postoperative scar and the remaining breast tissue should be performed within 4-7 days of the application wipes "Collex-Mex on a textile backing with change it 2 times a day, in the next 4-7 days of conducting the application hydrogel napkins "Collex-D", which are covered with cloth textile based "Collex-SMC" in the same mode, and then simultaneously with the holding of sessions of remote radiation therapy to SOD 20-25gr continue this application mode for 8-10 hours a day, then simultaneously with the continuation of remote radiation treatment is the application of the hydrogel material "Collex-gel-DNA, which are covered with cloth textile based "Collex-Mex with change 2 times per day, and after a course of radiation treatment applications napkins "Collex-SMC and napkins "Collex-Mex, alternating every 12 h until full rehabilitation.



 

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1 ex

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1 ex

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2 ex

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