[The sympathetic-adrenal and hypophyseal-adrenal systems in the preoperative irradiation of patients with cancer of the esophagus and cardia]. / Simpatiko-adrenalovaia i gipofizarno-nadpochechnikovaia sistemy pri predoperatsionnom obluchenii bol'nykh rakom pishchevoda i kardii.

A study was made of 74 patients with esophageal and cardiac cancer, Stages II and IV. The excretion of catecholamines, corticosteroids and their precursors was studied, tests with adrenalin before and after preoperative irradiation at a summary dose of 30 Gy were done. It has been shown that before the start of radiation therapy the excretion of catecholamines and corticosteroids is lowered, the reaction to adrenalin administration is negative in most patients, the phase syndrome of cardiac hypodynamics associated with disturbed function of the sympathoadrenal system was revealed. After irradiation DOPA and dopamine excretion gets still lower whereas adrenalin excretion remains at the initial reduced level, the level of noradrenalin increases but does not achieve the normal level, i. e. a predominant decrease of catecholamine synthesis is observed. Adrenalin tests after irradiation revealed the depletion of the reaction of the cardiovascular system interrelated, to a great extent, with the activity of the sympathoadrenal system. Preoperative irradiation in patients with esophageal and cardiac cancer results in an increased excretion of 17-ketosteroids (17-KS) and 17-ketogenic steroids, however 17-KS excretion does not reach the normal level. For better tolerance of irradiation and for a radiosensitization effect testenate is administered to patients before and during radiation therapy. The administration of testenate 7-10 days before the start and during radiotherapy proved to be effective which was confirmed by noticeable necrobiotic and necrotic changes of cancer cells.