ABSTRACT
The purpose of this paper was to increase the effectiveness of radiation therapy (RT) of local recurrence of rectal cancer (MRRPK) by setting the preferred modes and dynamic medium dose fractionation irradiation MRRPK, assessing immediate outcomes, identifying the frequency and severity of early radiation reactions during radiation therapy. The study included 60 patients with a diagnosis of "local recurrence of rectal cancer." The median age was 67 years. Terms of recurrence after surgical treatment averaged 20 months. The histological structure of the tumor was presented adenocarcinoma in 57 (95%) patients. Radiation therapy (RT) was carried out in medium or dynamic fractionation. Chemotherapy used pelleted 5-fluorouracil. In group 1 (20 patients) received palliative radiotherapy course with a fractional dose of 3 Gy to 42 Gy SOD (SDeq 51 Gy). In group 2 (20 patients) underwent a course of radiotherapy using dynamic dose fractionation: fractional dose--4, 3 and 2 Gy to 51 Gy SDeq. In the third group (20 patients) underwent combined treatment using dynamic dose fractionation: fractional dose--4, 3 and 2 Gy to 56 Gy SDeq and chemotherapy--Xeloda or ftorafur. In group 1 complete regression was achieved in 1 patient, partial regression--15, stabilization--at 3, progression--at 1, that is clinical effect was observed in 19 of 20 patients. In group 2, complete regression of the tumor was diagnosed in 3 patients, partial regression--17, therefore, 100% of patients had received clinical effect. According to follow-up, 5 patients in this group were subsequently. In the third group of complete regression of the tumor was diagnosed in 7 patients, partial regression--13, ie, 100% of patients had received clinical effect. According to follow-up, 7 patients in this group were subsequently operated. Among the radiation reaction in group 1 nausea 1 tbsp. was observed in 3 patients, radiation Recto 1-2 degree--15, radiation epithelitis 1-2 degree--4 patients; in group 2, nausea 1 degree--At 7, radiation Recto 1-2 degree--At 7, radiation epithelitis 1-2 degree--In 6 patients and 6 reactions were observed; in the third group of nausea 1st. was observed in 7 patients, radiation Recto 1-2 degree--At 9, radiation epithelitis 1-2 degree--At 8 and 3 patients reactions were observed. Thus, when irradiated in the dynamic fractionation showed less pronounced dose response as beam during treatment, and after. Increasing the total dose with the addition radiomodification increases the frequency of complete responses with acceptable toxicity. As a result of treatment in all patients achieved a significant reduction in pain, relief of bleeding.
Subject(s)
Adenocarcinoma/radiotherapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoplasm Recurrence, Local/radiotherapy , Palliative Care/methods , Radiation Injuries/diagnosis , Rectal Neoplasms/radiotherapy , Adenocarcinoma/drug therapy , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged , Aged, 80 and over , Antimetabolites, Antineoplastic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Capecitabine , Chemotherapy, Adjuvant , Deoxycytidine/administration & dosage , Deoxycytidine/analogs & derivatives , Dose Fractionation, Radiation , Dose-Response Relationship, Radiation , Female , Fluorouracil/administration & dosage , Fluorouracil/analogs & derivatives , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/drug therapy , Radiation Injuries/etiology , Radiation Injuries/prevention & control , Rectal Neoplasms/drug therapy , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Severity of Illness Index , Tegafur/administration & dosage , Treatment OutcomeABSTRACT
In 29 patients with various malignant tumors there was carried out an estimation of Thiotriazoline efficacy in the treatment of hepatotoxicity in the process of combined chemoradiation therapy. It has been showed that ten-day application of Thiotriazoline in double dose (2,5% solution intravenously by 4,0 ml twice within 24 hours and 1 tablet (100 mg) twice within 24 hours) in patients with I and II degree of hepatotoxicity at the background of combined chemoradiation therapy enabled to remove completely manifestations of cytolysis in 100% of patients, without changing regimen of chemotherapy. To normalize levels of biochemical indices of blood in III degree of hepatotoxicity, more a long intake of Thiotriazoline (about 4 weeks) was required. Regimen of chemoradiation therapy in the period of Thiotriazoline application was not changed.
Subject(s)
Chemical and Drug Induced Liver Injury/drug therapy , Chemical and Drug Induced Liver Injury/etiology , Chemoradiotherapy/adverse effects , Liver/drug effects , Liver/radiation effects , Neoplasms/therapy , Protective Agents/therapeutic use , Triazoles/therapeutic use , Adult , Aged , Brain Neoplasms/therapy , Breast Neoplasms/therapy , Chemical and Drug Induced Liver Injury/diagnosis , Drug Administration Schedule , Female , Glioma/therapy , Humans , Infusions, Intravenous , Male , Middle Aged , Protective Agents/administration & dosage , Severity of Illness Index , Treatment OutcomeABSTRACT
Effectiveness and safety of regional chemoinfusion in combination with radiation therapy in patients with breast cancer with metastases to the brain was clinically assessed. Cerebral angiography with chemoinfusion was fulfilled in six patients. The procedure could not be fulfilled completely in one patient because of transient vascular and neurological disorders. In the other five patients the regional superselective chemoinfusion was fulfilled successfully to the arteries feeding the metastatic foci in the brain with Carmustin in dosage 100 mg in combination with radiation therapy that was fulfilled in all six patients before the planned total focal dose. The incomplete response (n=5) to the treatment and stabilization of the process (n=l) were noted in six observations.
Subject(s)
Brain Neoplasms , Brain/blood supply , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/secondary , Carmustine , Infusions, Intra-Arterial/methods , Adult , Angiography , Antineoplastic Agents, Alkylating/administration & dosage , Antineoplastic Agents, Alkylating/adverse effects , Brain/pathology , Brain Neoplasms/drug therapy , Brain Neoplasms/radiotherapy , Brain Neoplasms/secondary , Carcinoma, Ductal, Breast/pathology , Carmustine/administration & dosage , Carmustine/adverse effects , Carotid Arteries/physiopathology , Catheters, Indwelling , Combined Modality Therapy , Drug Delivery Systems/methods , Endovascular Procedures , Female , Humans , Infusions, Intra-Arterial/standards , Karnofsky Performance Status , Middle Aged , Treatment OutcomeABSTRACT
Brain metastasis is an important issue in modern neurooncology. Our results of combined treatment of brain metastases are presented and available approaches to brain irradiation and chemotherapy are discussed. There is strong evidence to suggest that maximum combinations of approaches might improve treatment efficacy and extend median overall survival to as long as 6 months (p < or = 0.05).
