[Pilot study of oncological safety of extracorporeal shock wave therapy for post-mastectomy lymphedema in patients with breast cancer]. / Pilotnoe issledovanie onkologicheskoi bezopasnosti ekstrakorporal'noi udarno-volnovoi terapii postmastektomicheskoi limfedemy u bol'nykh rakom molochnoi zhelezy.

PURPOSE OF THE STUDY: Studying the long-term results of extracorporeal shock wave therapy (ESWT) in patients with breast cancer (BC) to obtain preliminary data on the oncological safety of the method, necessary for planning further extensive studies. MATERIAL AND METHODS: The pilot study included 18 women aged 45 to 70 years (mean age 55.6 years) with breast cancer of stages I-IIIA (stage I - in 4 cases, stage IIA - in 8 cases, stage IIIA - in 6 cases) and postmastectomy lymphedema. 11 (61%) patients received complex treatment, 7 (39%) patients received combined treatment. ESWT from the MasterPuls MP200 apparatus was performed with a radial shock wave on the axillary region on the side of the surgical operation using a dynamic technique: R-SW applicator with a standard D20-S nozzle, penetration depth 50 mm, pressure 2-2.5 bar, pulse frequency 8-10 Hz, 2000-4000 pulses each session, 1 time per week, 5 procedures in 1 course. RESULTS: After a course of ESWT, the average decrease in the volume of the edematous upper limb for the entire group of patients was 41.8±4.6% (p<0.05) with the effect maintained for 3 years. During 3 years of observation, none of the patients developed breast cancer progression - ESWT did not have a negative effect on the course of breast cancer and did not worsen oncological parameters. CONCLUSION: Obtained data can serve as a basis for well-organized cohort studies of the expediency of using shock wave therapy in oncology rehabilitation of patients.

[Shock wave therapy in oncology: in vitro, in vivo, rehabilitation]. / Udarno-volnovaya terapiya v onkologii: in vitro, in vivo, reabilitatsiya.

Extracorporeal shock wave therapy (ESWT) is a relatively new branch of physiotherapy. PURPOSE OF THE STUDY: Conduct an analytical review of the available literature data on the use of ESWT in oncology. MATERIAL AND METHODS: A review was conducted, including data from electronic databases: Scopus, Web of Science, MedLine, World Health Organization, The Cochrane Central Register of Controlled Trials, ScienceDirect, US National Library of Medicine National Institutes of Health, PubMed, Google Scholar, elibrary, CyberLeninka, disserCat. RESULTS AND CONCLUSION: The study of ESWT in oncology is carried out in two directions: 1) impact on the tumor with the aim of its disintegration, inhibition of growth, enhancement of the action of radiation and/or chemotherapy; 2) rehabilitation of cancer patients. Shock waves in vitro and in vivo significantly reduce the viability and activate apoptosis of cell lines of osteosarcoma, cancer of the stomach, colon, rectum, bladder, breast, urothelial cancer of the upper urinary tract, adenocarcinoma of the cervix, Burkitt's lymphoma, sarcoma, anaplastic thyroid cancer glands, glioblastoma multiforme. Shock waves also sensitize tumor cells for adjuvant chemotherapy and increase its antitumor activity. The lack of a stimulating effect on a number of malignant tumors in this physical factor makes it possible to conduct ESWT studies in the rehabilitation of cancer patients. The data obtained by a number of authors indicate the clinical efficacy of ESWT in the rehabilitation of patients with erectile dysfunction after radical prostatectomy, with postmastectomy lymphedema of the upper limb, with myofascial pain syndrome after cervical lymph node dissection due to malignant neoplasms of the head and neck, with peripheral polyneuropathy induced by cytostatics. However, in order to develop indications and contraindications for the appointment of ESWT in the rehabilitation of cancer patients, it is not enough just to evaluate its clinical effectiveness; currently absent scientific studies with long-term follow-up of patients who received this method of physiotherapy are needed.