Method of treating local recurrence of pancreatic cancer following radical surgery

FIELD: medicine.

SUBSTANCE: chemotherapy is conducted with using the preparations Gemzar 1000 mg/m2/30 min and Eloxatin 50 mg/m2/120 min. The chemopreparations are administered by arterial infusion cycles at least every 2 months. 1 to 4 arterial chemoinfusion cycles precede a radiation therapy, and no later than within 2 months in the same regimens - after the radiation therapy to disease progression. The radiation therapy is performed not earlier than 1 month after the first 1-4 arterial chemoinfusion cycles at a single radiation dose of 3 Gy 5 times a week to a total radiation dose of 51 Gy.

EFFECT: effective treatment with no haematological complications, reduced general toxicity and patient's satisfactory quality of life for the whole therapeutic course.

2 ex

 

The invention relates to medicine, more specifically to Oncology and radiology, and may find application in the treatment of malignant diseases.

Pancreatic cancer (PC) is the fourth cause of cancer death in the Western world with the 1-year survival rate of about 19% and 5-year - less than 5%. Global cancer statistics shows that FPW occupies the 13th place for both sexes. The global incidence rate - 10.4 in men and 7.1 for women per 100 thousand population. In Russia in 2002, we identified 13 thousand patients FPW, which was 8.2 per 100 thousand population, and these numbers, unfortunately, grow from year to year. High incidence of FPW combined with extremely low life expectancy, highlights the sad fact: the incidence is almost equal to mortality. This is associated with early metastasis in regional lymph nodes, the rapid expansion in perineurally spaces and invasion of major vessels. From FPW annually kills more than 200 people, mortality FPW occupies the 8th place among cancers. In Russia from FPW to die more than 13 thousand people a year.

At the present stage only surgical treatment gives hope for long term survival. However resectable are only 5-10% of the FPW. The only effective method of treatment of cancer golovkivs is pancreatoduodenal resection (da), mortality after which amounts to 23.7%. When a tumor is in the body and tail mud by the operation of choice is distal resection mud with splenectomy. Unfortunately, this tumor is already at the first sign of symptoms (pain, jaundice) is rarely resectable because of the distribution process. Indicators of the long survival without surgery unsatisfactory.

The low life expectancy of patients FPW associated with early metastasis and progression of the disease, after surgery, most patients will have distant metastases occur, but approximately 30% is observed isolated local recurrence.

The present invention relates to the treatment of local recurrence FPW after radical operation.

Randomized controlled trials show that adjuvant chemotherapy improves the median survival of such patients.

We know the message of Japanese scientists [Gan To Depending Ryoho 2009, Jun, 36(6): 991-4 in Japanese)] that systemic chemotherapy using Gemcitabine (Gemzar) may be effective in the treatment of local recurrence of the FPW. Later, 9 months after the implementation of the da for cancer of the head mud in a patient, according to computed tomography (CT), was detected local recurrence. CA 19-9 was 790 IU/ml Intravenous chemotherapy with Gemcitabine (1000 mg/sup> 2in 1,8 and 15 days with repetition of such courses every 28 days (the patient received 8 courses) resulted in the decrease of CA 19-9 to normal values. However, the regimen had to be adjusted every 2 weeks due to severe hematological complications: leukopenia and thrombocytopenia 2-nd degree. The patient received systemic chemotherapy in the outpatient setting within 48 months.

In the same paper there is another message about the treatment of 7 patients with local recurrence after resection method chemoradiation therapy (50 Gy three-dimensional conformal radiotherapy with concurrent systemic chemotherapy with 5-fluorouracil and Gemcitabine). Marked by the recurrence of the tumor (two out of 7 patients), as well as hematological and not hematological complications. The median survival was 14.5 months.

Closest to the present invention is a method for the treatment of local recurrence after primary resection FPW described in JOP.J. Pancreas 2006, 7(1): 34-40, taken as a prototype.

This study is devoted to the treatment of 18 patients with FPW isolated locoregional relapse. The average interval between the primary operation and diagnosis of local recurrence was 10.4 months. (range: 2.0 - 19.3 months).

Patients received 3-D conformal radiation therapy with SOD 45 Gy in 25 fractions of 1.8 Gy/day. Concurrent chemotherapy was used with either C is erevnum the introduction of 5-FU, partly in combination with gemcitabine or Gemzar and Cisplatin. Separately systemic chemotherapy with gemcitabine and cisplatin was some patients before and after chemoradiation therapy.

In 17 of 18 patients radiotherapy was used in the prescribed dose. Had severe hematologic toxicity. Leukopenia 3rd degree was four patients (22,2%) and 4th degree - one patient (5.6 percent), thrombocytopenia 3-th and 4-th degree was four patients (22,2%) and one patient (5.6 percent), respectively. Of the 16 patients noted six (37.5%) of the full and six (37.5%) of partial remission, four (25,0%) stabilization of tumor growth. The median relapse-free survival was calculated from the start chemo / radiotherapy and $ 14.7 (range: 8.4-21.0) months. 7 (28,9%) patients were identified another local recurrence, and 11 (61,1%) distant metastases.

From the above studies it can be concluded that chemoradiation therapy may be effective treatment for patients with local recurrence after primary surgery about FPW. However, along with the traditional clinical criteria for evaluating the effectiveness of treatment (immediate effect, disease-free survival), which is the dignity of the prototype method and does not differ from the results in drugdiscovery, one of the reliable evaluation criteria should be the quality of life of patients and communication with possible correlation of quality of life with survival rates.

But the presence of serious complications, such as hematologic toxicity (22.1% of patients, leukopenia and thrombocytopenia 3rd degree and even at 5.6% - 4th degree), as well as the identification of 7 patients (28,9%) local recurrence is the shortcomings of the prototype method.

The technical result of the present invention is to reduce the number of complications by developing tactics chemoradiation treatment of local recurrence FPW after radical surgery, providing patients a satisfactory quality of life.

This result is achieved by the fact that the treatment is carried out by means of chemo / radiotherapy, with chemotherapy performed by arterial chemoinfusion cycles with intervals between them of not less than 2 months with the use of Gemzar 1000 mg/m2/30 min and eloxatine 50 mg/m /120 min, from 1 to 4 cycles of arterial chemoinfusion done before radiation therapy (RT) and no later than 2 months in the same modes - after LT to disease progression, and LT is carried out not earlier than 1 month after the first 1-4-x cycles of arterial chemoinfusion with a single focal dose (ROD) 3 Gr 5 times a week up to a total focal dose (SOD) 51 Gr.

Perform arterial chemoinfusion before and after LT cycles for 2.5 hours each can significantly reduce the overall toxicity of chemotherapy, and the use of Gemzar and Eloxatin, as shown by our observations, without reducing cytotoxic effects, not causes in patients with hematological and not hematological complications and continued growth of local recurrence. It also allows you to exclude from the regimens of systemic chemotherapy, which is known to be less effective, but is accompanied by a large number of complications.

Exercise cycles arterial chemoinfusion at intervals of not less than 2 months between them makes it possible to perform the puncture of the femoral artery by the Seldinger when conducting each procedure angiography, hepatopancreatobiliary zone, providing targeted delivery of chemotherapeutic agents, as well as allowing the patient to recover after a cycle of chemotherapy, providing them with a satisfactory quality of life during treatment, what was the main purpose of the present invention.

Holding LT (conformal) between cycles of arterial chemoinfusion enhances the cytotoxic effect on the tumor, and the use of medium fraction with a single dose of 3 Gy to ODS 51 G (which we found empirically), ekvivalentnoi Gr conventional fractionation for linear-quadratic model for α/β 2.5 G) contributes to further enhancing the effects of ionizing radiation on the tumor.

Thus, the proposed method is the past and clinically tested to date, 7 patients the treatment of this difficult group of patients without hematological complications and continued growth of local recurrence, providing them with a satisfactory quality of life during treatment.

The essence of the method is illustrated by examples.

EXAMPLE 1. Patient A., 38 years. Was admitted to the hospital fsbi MCRT health Ministry 23.11.11. was diagnosed with Cancer of the pancreatic head T3N1M0. After the da (16.03.11 year). Local recurrence. From the anamnesis: considers himself ill since September 2010, when there has been a sharp weight loss of 15 kg in 3 months. When surveyed in the St. Petersburg state medical University n.a. Pavlov (ultrasound, computed tomography - CT) revealed a tumor in the pancreatic head.

10.03.11, the tumor marker CA 19-9 179 IU/ml

16.03.11, the patient underwent surgery: Pelorosaurus pancreatoduodenal resection (da), splenectomy.

Histological examination: usernotification adenocarcinoma.

In a satisfactory condition the patient was discharged under the supervision of the district oncologist. Outpatient performed ultrasound, abdominal CT, according to which signs of disease progression was not.

Tumor marker CA 19-9 in the norm.

Since October 2011, weakness, pain in rhna abdomen, irregular bowel movements.

02.11.11, ultrasound: the pathological formation of up to 40 mm in diameter in the projection of the remaining part of the mud.

The patient was referred for further evaluation and treatment in the clinic of the fgbi MCRT.

Upon receipt 23.11.2011, complaints of recurrent discomfort in the epigastric region, an unstable chair. Objectively: the patient is in satisfactory condition, the Constitution normostenichesky, height is 173 cm, weight 64 kg

The skin is clean, peripheral lymph nodes are not enlarged. Borders of the heart is within normal limits, heart rate (HR) 81 /min, heart sounds clear, rhythmic. Chest right shape symmetrically involved in breathing, breathing hard, no wheezing. The abdomen is soft, moderately painful in the epigastric region, the liver is at the edge of the costal arch, the spleen is not enlarged. The kidneys are not palpable. Physiological functions unchanged.

Survey data:

24.11.11, Clinical blood analysis: Hemoglobin 134 g/l, Erythrocytes was 4.02×1012/l, Platelets 357×109/l, Leukocyte count of 8.1×109/HP

Tumor marker CA 19-9 287 IU/ml

25.11.11, CT: in the area of operations include education 53×38×42 mm - local recurrence.

29.11.11, Diagnostic angiography hepatopancreatobiliary zone under local anesthesia 20 ml of 1%lidocaine solution made a puncture of the right femoral artery by the Seldinger. Katya is ur Hook 5 F alternately installed in the upper mesenteric artery, the celiac trunk. Made 2 series of shots. On angiograms anatomy typical for hepatic-pancreaticoduodenal area corresponds surgery (da): missing gastroduodenal and splenic artery. In the projection of the subhepatic space is hypervascular pathological education up to 40 mm in diameter, containing tumor vessels, usurious verabreichung artery. The trunk of the portal vein narrowed externally to 4 mm, the left and right branches are passable. Verhneberegovaya Vienna is passable.

After diagnostic angiography performed regional chemotherapy: chemoinfusion in the celiac trunk drugs Gemzar 1000 mg/m2(within 30 min) and Eloxatin 50 mg/m2(120 min). The procedure satisfactorily, had no complaints. 02.12.11, (on the 3rd day after regional chemotherapy) in a satisfactory condition the patient was discharged from the hospital with a recommendation to come to subsequent treatment at the end of January.

30.01.12 was Held the second cycle regional chemotherapy: chemoinfusion in the celiac trunk drugs Gemzar 1000 mg/m2(within 30 min) and Eloxatin 50 mg/m (120 min). The condition of the patient after the procedure is satisfactory, no complaints were filed, discharged 02.02.12, (on the 3rd day).

When hospitalization 02.04.12, patients received a third cycle arterial chemoinfusion in the same modes. Health is th satisfactory, without complaint.

Discharged 06.04.12,

On admission the patient 04.06.12 oncomarkers CA 19-9 132 IU/ml

Clinical blood analysis: Hemoglobin 120 g/l, Erythrocytes 4,43×1012/l, Platelets 329×109/l, Leukocytes of 7.97×109/l, Neutrophils 48,7%, Lymphocytes And 30.0%, Monocytes 13,8%, Eosinophils 4.9%, Basophils 2,6%.

Biochemical analysis of blood glucose 5.2 mmol/l, total protein 69 g/l, total bilirubin 6.3 µmol/l, ALT 24 U/l, ACT 23 U/l, amylase 52 U/l

CT: pathological education in the projection of the remaining mud decreased in size: 38×38×45 mm

06.06.12, Diagnostic angiography hepatopancreatobiliary zone: hypervascular pathological education in the projection of the subhepatic space has increased in size from 40 mm to 45 mm in diameter. Conducted regional chemotherapy: chemoinfusion in the celiac trunk drugs Gemzar 1000 mg/m2(within 30 min) and Eloxatin 50 mg/m2(120 min). After the procedure, no complaints, treatment satisfactorily. 11.06.12, the patient was discharged from the hospital for 1 month.

05.07.12, hospitalization in the radiotherapy Department.

The marked increase in the level of tumor marker CA 19-9: 201 IU/ml

Clinical blood analysis: Hemoglobin 121 g/l Erythrocytes 3.88×1012/l, Platelets 422×109/l, Leukocytes 8.31×109/HP

Ultrasound: a solid education in the liver are not defined. Around the celiac trunk has a Hypo is johannae education h mm (increased in size).

With 09.07.12 was started conformal LT. Clinical extent of exposure (CTV) included the tumor (relapse) PJ (GTV) indented 0.5-1.0 cm, pancreatoduodenal and celiac lymph nodes. The planned volume (PTV) included the CTV indented 0.5-1 see Planning was carried out on the system 3 In the planning of the Precise PLAN. The treatment was carried out on the machine Elekta Precise in multi-field static mode. Single dose (GENUS) - 3 Gy, total dose (SOD) - 51 Gy (equivalent to 61 Gy conventional fractionation for linear-quadratic model for α/β 2.5 Gy). Treatment the patient underwent satisfactory, complaints of nausea, epigastric discomfort, weakness. Special treatment is not required.

The clinical analysis of blood 13.07.12, (in the middle of the course LT) Hemoglobin 116 g/l Erythrocytes 3.7×1012/l, Platelets 240×109/l Leukocytes 3.8×109/HP

The clinical analysis of blood 02.08.12, (after LT): Hemoglobin 114 g/l, Erythrocytes-3.67×1012/l, Platelets 200×109/l, Leukocytes 3.5×109/HP Leukopenia and thrombocytopenia 1-St degree.

Biochemical analysis of blood glucose to 4.16 mmol/l, total protein 62 g/l, total bilirubin 5.6 µmol/l, ALT 19 U/l, ACT 23 U/l, amylase 40 U/L. a

The patient was discharged 03.08.12, with a recommendation to come for treatment after 2 months.

28.09.12, the patient was hospitalized at the clinic for examination and further treatment. The state will satisfy the lnoe, no complaints.

Clinical blood analysis: Hemoglobin 122 g/l Erythrocytes 4.01×1012/l, Platelets 340×109/l, Leukocytes 4.8×109/HP

Tumor marker 140 IU/ml

CT: pathological education decreased in size to 35 mm in diameter.

01.10.12 was started arterial chemoinfusion: 3 cycle chemoinfusion in the celiac trunk with the use of Gemzar 1 g/m2(within 30 min) and Eloxatin 50 mg/m2(120 min): 01.10.12,, 05.12.12,, 08.02.13,

Arterial chemoinfusion patient endured satisfactorily, complaints were on a small nausea, weakness, but they were short and soon after discharge took place. With each new patient to the clinic was conducted blood tests (they were close to the norm), was determined by the tumor marker CA 19-9 (its size ranged from 140 to 100 U/ml), 1 semi-annually performed CT-the size of the nidus in the area of operation have changed slightly, remaining in the range of 30-40 mm, the continued growth of local recurrence and distant metastases were noted.

At the time of discharge from the hospital 12.02.13, the patient's condition is satisfactory, marked stabilization of local recurrence in the area of operation, without distant metastases.

At present, the patient continues to be - he lives within 16 months from the start of treatment and is in satisfactory condition.

EXAMPLE 2. the Aulnay J., 65. Was admitted to the hospital fsbi MCRT health Ministry 02.02.12. was diagnosed with Cancer of the body of the pancreas T4N1M0 after resection of the body and tail mud (10.06.11,) Histology: well-differentiated adenocarcinoma.

During outpatient treatment, 20.01.11 (after 7 months after surgery) performed abdominal ultrasound: in the area of operations FPW has education up to 45 mm in diameter - local recurrence.

Patient referred for treatment in the clinic of the fgbi RRC RCT.

Upon receipt 02.02.12, complaints of discomfort in the left hypochondrium. 03.02.12, Tumor marker CA 19-9 419 IU/ml

CT: in the projection zone operation has tuberous education size 37×46 mm - local recurrence.

06.02.12, Diagnostic angiography performed analogously to example 1. On angiograms: none of the splenic artery and vein (status after resection of the body and tail of the pancreas (10.06.11 year). Determined by thrombosis of the portal vein in the place of its confluence of the superior mesenteric vein. Filling v.porte is extended the retroperitoneal collaterals. The contours of the superior mesenteric, common hepatic and gastroduodenal arteries smooth all over, without usuali.

Conducted regional chemotherapy: chemoinfusion in the celiac trunk drugs Gemzar 1000 mg/m2(within 30 min) and Eloxatin 50 mg/m2(120 min). After the procedure, the complaint is and weakness, the nausea.

10.02.12, in satisfactory condition have been discharged on the 4th day after regional hemionus).

08.03.12 was hospitalized at the clinic for a routine check.

The patient's condition was satisfactory, no complaints.

Clinical blood analysis: Hemoglobin 124 g/l, Erythrocytes-3,59×1012/l, Platelets 249×109/l, Leukocytes of 6.45×109/HP

Biochemical analysis of blood glucose 8,01 mmol/l, total protein 72 g/l, total bilirubin 4.9 µmol/l, ALT 12 U/l, ACT 15 U/l, amylase 31 U/l

The marked increase in the level of tumor marker: 430 IU/ml

CT 09.03.12, the size of education at the surgical site 42×50 mm, distant metastases were not found.

In connection with the progression started conformal LT.

With 12.03.12, 03.04.12, radiation therapy analogously to example 1. Satisfactorily, complaints of nausea, weakness.

04.04.12, Clinical blood analysis: Hemoglobin 118 g/l, Erythrocytes of 3.46×1012/l, Platelets 207×109/l, Leukocytes to 3.52×109/l-leukopenia and thrombocytopenia 1-St degree. Special treatment is not required.

The patient in a satisfactory condition discharged 05.04.12,

04.06.12, upon admission of the patient to hold a series of regional chemotherapy: chemoinfusion in the celiac trunk of Gemzar 1000 mg/m2(within 30 min) and Eloxatin 50 mg/m2- 120 minutes

The condition of the patient satis is instrumental, complaints of nausea, weakness, occasional pain in the upper abdomen.

09.08.12 was hospitalized at the clinic for further treatment.

The patient's condition is satisfactory, abdomen soft, no pain.

10.08.12, Tumor marker CA 19-9 296 IU/ml

Abdominal CT: education in the field of pancreas size 31×39 mm Marked stabilization of the process.

15.10.12, 18.12.12, conducted a similar cycles regionen chemotherapy in the same mode. Moved without complications, clinical biochemical analyses in norm.

Tumor marker decreased to 180 IU/ml

Decided to continue treatment.

20.02.13, conducted a similar cycle of chemotherapy.

The patient noted nausea, mild epigastric pain.

He was discharged in satisfactory condition 25.02.13,

27.02.13, the patient performed abdominal CT. According to the study, the size of the education in the area of operations h m (decreased), distant metastases were not found.

Tumor marker - 152 IU/ml

The patient was discharged in good condition, having lived to the present time without continued growth of local recurrence and distant metastases for more than 12 months. Recommended hospitalization in April 2013 for further treatment.

To date, the proposed method were treated 7 patients with local recurrence in the Le radical surgery FPW, of these, six have been completed da, with three live from 10 to 16 months and continue to occur, three died: one in 8 months, two - 12 months. Only one patient was performed (example 2) distal resection mud with splenectomy, which, to our surprise, lives without distant metastases for more than 12 months. As we noted above, such tumors at the first sign of their manifestation to be irresectable and very quickly metastasize.

The proposed method is compared with the known has a significant advantage in that the patients during treatment, do not have serious hematological complications. A single patient we have not noted leukopenia and thrombocytopenia above the 1st degree, and it did not require additional treatment and interruption or termination of treatment. Also in the process of treating a single patient was not continued growth of local recurrence and four of the seven patients were not detected distant metastases.

Thus, the proposed method is developed and tested in clinical conditions of the treatment, providing patients a satisfactory quality of life that distinguishes it from all known methods of treatment for this difficult group of patients.

The method developed in the Department of interventional radiology in collaboration with the Department of the m clinical radiology and was clinically tested in 7 patients with a positive result.

A method for the treatment of local recurrence FPW after radical surgery through chemo therapy, wherein the chemotherapy is carried out by arterial chemoinfusion cycles with an interval between them of not less than 2 months with the use of Gemzar 1000 mg/m2/30 min and eloxatine 50 mg/m2/120 min, from 1 to 4 cycles of arterial chemoinfusion done before radiation therapy and not later than 2 months in the same modes - after radiation to the progression of the disease, and radiation therapy is carried out not earlier than 1 month after the first 1-4-x cycles of arterial chemoinfusion with a single focal dose of 3 Gy 5 times a week up to a total focal dose of 51 Gy.



 

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9 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: invention relates to physiotherapeutic devices. Device contains case with optically transparent surface, magnetic conductor and radiator. In case located are: light emitter, made in form of powerful three-colour RBG LED, and electromagnetic emitter, made in form of coil, connected to power unit via control means. Magnetic conductor is made in form of stepped cylinder, and radiator is made in form of thick-walled cup from heat-conducting material. Radiator is installed in cylinder of magnetic conductor of larger diameter, connected with internal surface of case, cylinder of magnetic conductor of smaller diameter is connected with internal surface of coil, LED is installed on radiator.

EFFECT: application of invention ensures improvement of treatment quality due to increase of depth of magnetic field impact and increase of light radiation power.

5 cl, 1 dwg

FIELD: medicine.

SUBSTANCE: 30-60 minutes after the following fraction of radical irradiation on the 1st, 3rd and 5th day of each week for the whole period of irradiation, the preparation Molixan® 60 mg (2 ml) is introduced intramuscularly to the patient.

EFFECT: higher efficacy and safety of the chemotherapy ensured by relieving the manifestations of oral mucositis.

4 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely therapeutic dentistry and may be used for treating destructive forms of chronic periodontitis. That is ensured by administering a therapeutic preparation into a root canal. A sonic phoresis of the therapeutic preparation Beresh plus drops is preceded by coating the skin surrounding a causative tooth with a therapeutic mixture containing the preparation Beresh plus drops, 10% calcium gluconate and Vaseline oil. Thereafter, an emitter is used to process the area. The sonic phoresis is followed by a root canal obturation with calcium hydroxide. That is combined with administering ascorbic acid in a daily dose of 50-100 mg and the preparation Beresh plus drops 1 drop per 2 kg of body weight a day orally. The therapeutic course is 5-8 procedures.

EFFECT: invention enables arresting the inflammatory process in the aggressive lesion, reducing the number of complications and aggravations ensured by accelerating the repair processes in the apical aggressive lesion.

2 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to - physiotherapy. Pressure pulse frequency is pre-measured. Patient's acoustic and/or visual organs are exposed to sound and/or light pulses at pre-set frequency. For the first 100-300 seconds of the exposure, the sound and/or light pulses are supplied at constant conditions of frequency corresponding to the pre-measured pulse frequency; then for 900-1100 seconds of the exposure, the pulses are supplied at variable conditions with gradually varying frequency and rhythm of the sound and/or light pulses.

EFFECT: method enables the non-invasive effect on heart rate and rhythm.

5 ex, 5 tbl, 11 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely oncology and concerns treating locally advanced vaginal cancer. For this purpose, the therapy is staged. The first stage involves the chemotherapeutic course that provides administering cisplatin 100 mg/m and doxorubicine 30 mg/m2 intravenously drop-by-drop; the gamma-ray teletherapy covering a primary centre in a dose of 20 Gy is followed by two fractions 2.5 Gy of the intracavitary Co60 therapy every 5 hours twice a week; in the middle of the 5-hour period, platidiam 5 mg dissolved in saline solution 1.0 ml is introduced into surface layers of the tumour which is exposed to ultrasound of frequency 880 kHz and intensity 0.4 Wt/cm2 through the licensed dimexide gel tissue for 5 minutes; the therapy requires the gamma-ray teletherapy covering the lymphatic nodes alternated with 10-11 sessions of the intracavitary Co60 therapy in total to reach a total dose of the primary centre exposure of 70-75 Gy, of the lymphatic nodes exposure of 40 Gy.

EFFECT: specified integrated therapy provides the effective treatment and prevention of the recurrences also ensured by using the chemotherapy combined with the ultrasonic exposure that promotes the deeper chemopreparation penetration into tumour tissues.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, more specifically to oncology and radiology. The method involves the local radiation therapy sessions in a dynamic dose fractionation mode. Additionally, 3 times a week the local radiation therapy session is immediately followed by subtotal irradiation of the upper body from a suprasternal notch to a diaphragm. Thereafter, 21-28 days after the local radiation therapy completed, min. 4 cycles of the chemotherapy with each cycle combined with subtotal irradiation of the upper body from the suprasternal notch to the diaphragm 3 times a week.

EFFECT: method enables reducing a risk of developing a local recurrence of the tumour and metastases to 10,7% as compared to the previously known methods (15%), as well as a severity of complications with achieving the complete objective response to the treatment in 35,7% of the patients, and the partial response - in 46,42%.

1 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to ophthalmology. Method includes wound suturing. In immediate postoperative period after wound suturing procedure of cornea collagen crosslinking is performed. Procedure is carried out with power density of UV-irradiation on cornea surface 2.5 mW/cm2. Duration of exposure is 15-20 minutes. In the procedure soft contact lens from hydro gel or silicone-hydrogel with through cut is applied. Cut in form and length corresponds to sutured wound.

EFFECT: method ensures restoring architectonics, strength, transparency of cornea and, as a result, prevention of scarry astigmatism and absence of damage to internal eye membranes.

2 ex

FIELD: medicine.

SUBSTANCE: 20 minutes before radiation in the UV chamber, an infusion of nettle, birch, plantain and oak leaves, tansy blossom taken in 1:1:1:1:1 are introduced orally into laboratory animals daily at a rate of 5 ml/kg of body weight.

EFFECT: method enables providing a manifested actoprotective and antioxidant effect on the exposed animals that gives reason to recommend the above agent to increase the non-specific body resistance with underlying pro-oxidant factors.

5 tbl

FIELD: medicine.

SUBSTANCE: method involves teletherapy combined with a local electromagnetic hyperthermia, chemotherapy with cisplatin and bleomycin, metronidazole as an ingredient of a composite mixture introduced through rectum. Teletherapy is conducted with using a continuous course of 3D and IMRT planning with photons 6-18 MeV covering the tumour and regional metastases in a single basic dose of 1.6 to 1.8 Gy daily 5 times a week, 27-30 fractions, in a total radiation dose of 48.0-48.6 Gy. At the same time, the tumour is exposed to teletherapy with using a simultaneous integrated boost in a single basic dose of 2.0 to 2.2 Gy, 27-30 fractions, in a total radiation dose of 59.4-60.0 Gy.

EFFECT: method enables reducing a radiation exposure, a teletherapeutic dose on the surrounding critical structure, saving the time and conducting a fewer sessions of teletherapy, ensuring lower intensity and the number of toxic reactions, the total length of treatment, eliminating early recurrences.

2 ex

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