METHOD FOR COMBINED TREATMENT OF LOCALLY ADVANCED FORMS OF CERVICAL CANCER IIB-IIIB (T2B-T3BN0(1)M0) STAGES

摘要

FIELD: pharmaceuticals. ;SUBSTANCE: invention relates to the field of pharmaceuticals, namely to a method for combined treatment of locally advanced forms of cervical cancer IIB-IIIB (T2b-T3bN0(1)M0) stages. The method includes the first stage of treatment, during which 2 courses of neoadjuvant polychemotherapy are carried out with an interval of 21 days: intravenous administration of paclitaxel and cisplatin in certain doses in the form of a 3-hour infusion with previous premedication, as well as 30 minutes before the administration of paclitaxel, intramuscular administration of dexamethasone or intra-arterial administration of cisplatin at a certain dose, alternately in the right and left uterine arteries and the next day, intravenous administration of paclitaxel is performed in the form of a 3-hour infusion with previous premedication, as well as 30 minutes before the administration of paclitaxel intramuscular administration of dexamethasone, 21 days after the last course of chemotherapy, combined chemoradiation therapy is carried out: distance - 3D conformal radiation therapy or intensity-modulated radiation therapy (IMRT), or volumetric modulated arc therapy - VMAT of the small pelvis and areas of regional metastasis. The total boost dose is 46-50 Gy. The fractionation mode is 2 Gy daily 5 times per week. Moreover, during remote irradiation as a radiomodification - cisplatin is administered at a certain dose, at 4-5 weeks of irradiation on days free from remote irradiation, brachytherapy is performed in 4 fractions of 7 Gy to the total boost dose equivalent of 30 Gy, total doses from the course combined radiation therapy are: in t. A 80-90 Gy, in t. B 60 Gy, and the volume of irradiation directly includes the primary tumor, the parametric region, sacro-uterine ligaments, the optimal distance from the edge of the primary tumor is not less than 3 cm, taking into account the level of tumor lesions of the vagina, the group of pelvic lymph nodes, as well as all other regional lymph nodes.;EFFECT: invention improves efficiency of treatment of patients with locally advanced cervical cancer by increasing the overall and disease-free survival rates, as well as improving the quality of life.;1 cl, 2 ex