METHOD FOR TREATMENT OF ANAL CANCER WITH SKIN TRANSITION

摘要

FIELD: medicine.;SUBSTANCE: method includes two induction courses of polychemotherapy (PCT) according to the scheme: mitomycin C 10 mg/m² intravenously sprayed on days 1 and 29 and 5-fluorouracil 1000 mg/m² per day by continuous infusion on days 1-4 and 29-32. Three weeks after the second course of PCT, the primary focus and regional lymph nodes are exposed to external radiation of 2.4 Gy daily, 5 fractions per week till the cumulative dose of 44 isoGr, 17 irradiation sessions. At that, during 15 irradiation sessions, a sonodynamic therapy session is performed 2 hours before the start of irradiation, for which an "extempore" formulated mixture containing 5 mg of hydrogel napkin "Coletex SP-1" with propolis based on sodium alginate and 100 mg of gemcitabine is delivered to the perianal area skin. After application of the medicinal mixture, a radiator is fed to the lesion focus and a medium frequency ultrasound treatment session is performed at a frequency of 0.88 MHz, I = 1.0 Bm/cm², exposure time 10 min. On days free from irradiation, no sonodynamic chemotherapy sessions are performed, while 15 procedures of sonodynamic exposure are performed for the entire course of external exposure. The total dose of gemcitabine for the external exposure course is 1500 mg. After the course of irradiation, a break in treatment for 2-3 weeks is performed. Then a course of endovaginal brachytherapy with a fraction dose of 3 Gy with irradiation frequency one day until a cumulative dose of 15 Gy is conducted. On days of irradiation, 2 hours before the irradiation session, a sonodynamic therapy session is performed. For this purpose, the above-mentioned "extempore" composed mixture is introduced into the anus region. Immediately after its delivery, , the radiator is fed to the focal point of the lesion and a medium frequency ultrasonic exposure session is conducted at a frequency of 0.88 MHz, I=1.0 Bm/cm², exposure time is 10 min. In days free from irradiation, no sonodynamic chemotherapy sessions are performed. A total of 5 procedures are performed for the course of intracavitary irradiation. The total dose of gemcitabine for the course of combined radiation treatment is 2000 mg, total cumulative dose at the primary focus is 61 isoGr.;EFFECT: improved effectiveness of radiation treatment, quality of life of patients with locally advanced anal cancer with transition to the skin, its complete regression.;1 ex, 1 tbl