ABSTRACT
Radiation therapy for malignant tumors of the female genital area, even with the use of modern radiotherapy equipment and dosimetric planning, causes the development of local radiation changes. An approach involving methodsof general and local exposure is used in their treatment. One of the most promising directions is the creation of optimal combinations of medicines (in the form of ointments, gels, aerosols, suppositories, etc.), which have a therapeutic effect on the inflammatory process. The article reflects the clinical course and stage of occurrence of late radiation reactions of the skin, vaginal/cervix mucosa, bladder, and intestines, as well as the features of their treatment.Literary data and own practical experience in the treatment of radiation complications are presented. Whenreviewing the topic under study, it could be concluded that the leading cause of the development of local radiationdamage is the errors in the planning and implementation of radiation therapy, when high absorbed doses thatexceed the tolerance of healthy tissues are used. Another reason for this is the poor accounting for dose distribution of ionizing radiation in tissues, the presence of concomitant diseases in patients, and the underestimation ofthe long-term effects of radiation.
Subject(s)
Cystitis/pathology , Radiation Injuries/pathology , Radiodermatitis/pathology , Urogenital Neoplasms/radiotherapy , Cervix Uteri/pathology , Cervix Uteri/radiation effects , Cystitis/etiology , Cystitis/prevention & control , Dose-Response Relationship, Radiation , Female , Humans , Intestines/pathology , Intestines/radiation effects , Radiation Dosage , Radiation Injuries/etiology , Radiation Injuries/prevention & control , Radiation, Ionizing , Radiodermatitis/etiology , Radiodermatitis/prevention & control , Skin/pathology , Skin/radiation effects , Time Factors , Urinary Bladder/pathology , Urinary Bladder/radiation effects , Urogenital Neoplasms/pathology , Vagina/pathology , Vagina/radiation effectsSubject(s)
Contrast Media , Magnetic Resonance Imaging/methods , Animals , Contrast Media/administration & dosage , Contrast Media/adverse effects , Contrast Media/chemistry , Drug Administration Routes , Gadolinium/administration & dosage , Gadolinium/adverse effects , Gadolinium/chemistry , Gadolinium DTPA , Heterocyclic Compounds/administration & dosage , Heterocyclic Compounds/adverse effects , Heterocyclic Compounds/chemistry , Humans , Meglumine/administration & dosage , Meglumine/adverse effects , Meglumine/chemistry , Organometallic Compounds/administration & dosage , Organometallic Compounds/adverse effects , Organometallic Compounds/chemistry , Pentetic Acid/administration & dosage , Pentetic Acid/adverse effects , Pentetic Acid/analogs & derivatives , Pentetic Acid/chemistry , SafetyABSTRACT
The paper provides the analysis of treatment outcomes in 199 patients with local renal carcinoma. The highest effects were achieved in radical surgery followed by general hyperthermia with hyperglycemia and adriamycin chemotherapy. This approach allows to prolong the survival to 5 years in 94.3 +/- 5.5% of patients with renal carcinoma and tumor occlusion in the veins as well as in 60.9 +/- 10.4% of patients with metastases to the regional lymph nodes. These results are significantly better than in surgical and combined treatment including radiation. Preoperative large-fraction radiotherapy (14 Gy) significantly increases 5-year survival of renal cancer patients with tumor thrombus in the renal vein or inferior vena cava from 26.9 +/- 12.0 to 63.5 +/- 13.5% (p < 0.05). Additional postoperative radiotherapy in 2Gy fractions to total dose 40 Gy fails to affect survival of the above patients. Combined treatment using preoperative large-fraction (14 Gy) and postoperative radiation in routine fractions (40 Gy) significantly improves 5-year survival against surgical treatment (22.2 +/- 7.1 and 5.4 +/- 3.8%, respectively) in patients with renal carcinoma metastasizing to regional lymph nodes. Large-fraction preoperative radiotherapy only in these patients adds little to the treatment efficacy.
