{"title":"УСКОРЕННЫЕ РЕЖИМЫ АДЪЮВАНТНОЙ ЛУЧЕВОЙ ТЕРАПИИ В ЛЕЧЕНИИ РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ","authors":"Г. В. Афонин, Ю. А. Рагулин, Игорь Гулидов","doi":"10.17709/2409-2231-2017-4-3-6","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-6","url":null,"abstract":"Treatment of breast cancer (BC) is a complex multidisciplinary problem. Often, radiation therapy is an obligatory component of treatment of breast cancer patients. Numerous large randomized trials have proved the efficacy of adjuvant radiotherapy in both the standard fractionation regimen in a single focal dose of 2 Gy to a total focal dose of 50 Gy for 25 fractions and in modes of hypofractionation using radiation exposure at a larger daily dose with a reduction in the total treatment time. The presented review summarizes the data of the largest studies on the modes of hypofractionation of postoperative radiotherapy for breast cancer. Most of the studies comparing the standard mode of fractionation of postoperative radiotherapy with the modes of hypofractionation showed comparable results for the main oncological parameters with similar tolerability, frequency of complications and good cosmetic results. It also shows the economic feasibility of applying accelerated regimes in everyday practice. Despite the fact that radiotherapy in the mode of hypofractionation has already become the standard of treatment and is recommended for use by the largest European and American cancer associations, indications for its conduct, the criteria for selection in the studies and the range of recommended single focal doses differ. The obtained results do not give an opportunity to confidently judge the advantage of one or another regime. It is necessary to determine the factors of a favorable and unfavorable prognosis, to clarify the indications for the use of various radiotherapy techniques. Therefore, questions about the optimal mode of hypo-fractionation of adjuvant radiotherapy, the timing of its initiation and the criteria for selecting patients for this type of therapy as part of the comprehensive treatment of breast cancer have not yet been fully resolved. Also open is the choice of optimal single and total doses of radiation, its combination with drug therapy.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115598629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Д. М. Дубовиченко, М. Ю. Вальков, А. А. Карпунов, А. Ю. Панкратьева
{"title":"ПОПУЛЯЦИОННАЯ ОЦЕНКА ДИНАМИКИ ЗАБОЛЕВАЕМОСТИ И СТАДИЙНОЙ СТРУКТУРЫ РАКА ПРЯМОЙ КИШКИ В УСЛОВИЯХ РЕАЛИЗАЦИИ МЕРОПРИЯТИЙ НАЦИОНАЛЬНОГО ПРОЕКТА «ЗДОРОВЬЕ» И ДИСПАНСЕРИЗАЦИИ ОПРЕДЕЛЕННЫХ ГРУПП ВЗРОСЛОГО НАСЕЛЕНИЯ В АРХАНГЕЛЬСКОЙ ОБЛАСТИ (ИТОГИ ПРЕДВАРИТЕЛЬНОГО ИССЛЕДОВАНИЯ)","authors":"Д. М. Дубовиченко, М. Ю. Вальков, А. А. Карпунов, А. Ю. Панкратьева","doi":"10.17709/2409-2231-2017-4-3-3","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-3","url":null,"abstract":"Objective . Assessment of the rectal cancer (RC) incidence and stage structure trends in the Arkhangelsk region (AR), Russia before and after implementation of national programs for health system reforming based on population data of the Arkhangelsk Regional Cancer Registry (ARCR) over the period 2000–2015. Materials and methods . Anonymized data on all cases of RC (C19.0‑C21.0) in the AR in 2000–2015 were extracted from the database of the ARCR. Over the study period, 3721 cases of the RC were selected. Age-standardized (ASR) RC incidence rate was calculated. Population number and its age distribution were taken from the Regional Bureau of Statistics, Arkhangelskstat. Time trends were analyzed using segmented regression. Results . Over the period, an incidence (ASR) of RC in AR increased from 11.5 to 14.2 per 100000. The incidence rates in the male population were higher than in women: 20.3 vs 12.6 in 2015. The growing trend of male incidence was stable. The ASR of RC incidence in female increased significantly by 4.6% per year in 2011–2015. RC ASRs for both urban and rural populations were growing, 12.3 and 20.4 per 100000 in 2015, respectively. StagesI, II, III and IV were established in 14%, 50%, 9% and 21% of cases, however, the stage I in urban residents was detected 4% more often. The proportion of stage I non-significantly varied from 10.6% to 13.3% in 2000–2015. After the introduction of the National Project “Health”, the proportion of the stage IV non-significantly decreased by 5.4% per year, same after the introduction of the All-national Dispensarization it non-significantly increased by 5.4% per year. Conclusion . Implementation of national programs for health system reforming didn’t provide significant improvement in earlier detection of RC. Introduction of national screening programs is necessary. A higher incidence rates among males and rural population require detailed analysis.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115716243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
С. А. Ягубов, Б. С. Аманджолов, Ф. В. Доненко, Ю. И. Должикова, Н. В. Малахова
{"title":"ВЛИЯНИЕ МЕТРОНИДАЗОЛА НА БИОЛОГИЧЕСКОЕ ДЕЙСТВИЕ ДОКСОРУБИЦИНА","authors":"С. А. Ягубов, Б. С. Аманджолов, Ф. В. Доненко, Ю. И. Должикова, Н. В. Малахова","doi":"10.17709/2409-2231-2017-4-3-2","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-2","url":null,"abstract":"Purpose . Investigation of the effect of the Metronizatol on the biological effect of Doxirubicin. Materials and methods . The studies were performed in the CBA/Lac males and C57Bl/6 females mice grafted with melanoma B16 and mucinous ovarian cancer CaO‑1. Metronidazole and Doxorubicin were used in the work. The antitumor effect was assessed by tumor volume and inhibition of tumor growth. Results . The data obtained indicate that Metronidazole used in oncologic practice for the treatment and prevention of infectious complications, and as a radiosensitizer, can enhance the antitumor effect of Doxorubicin, but this effect is accompanied by a significant increase of the cytostatic toxicity. These effects are leveled by increasing the interval between injections of Metronidazole and Doxorubicin up to 4 hours. Conclusion . The enhancement of the antitumor activity of Doxorubicin under the influence of Metronidazole depends on the interval between the administration of these drugs. When Metronidazole is used in cancer patients, the possibility of enhancing the toxic effect of cytostatics should be considered when they are simultaneously exposed. Patients receiving chemotherapy should be administered antitumor drugs no earlier than 4 hours after exposure to Metronidazole.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123191836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Г. А. Паньшин, Н. В. Харченко, С М Милюков, Тимур Раисович Измайлов
{"title":"Гипофракционирование при радиотерапевтическом лечении инфильтративных глиом низкой степени злокачественности who grade II","authors":"Г. А. Паньшин, Н. В. Харченко, С М Милюков, Тимур Раисович Измайлов","doi":"10.21294/1814-4861-2017-16-4-11-18","DOIUrl":"https://doi.org/10.21294/1814-4861-2017-16-4-11-18","url":null,"abstract":"The purpose of the study was to develop more effective fractionation regimens and radiation therapy programs in the treatment of infiltrative low-grade gliomas (WHO grade II). Material and methods. The study included 53 patients with morphologically verified supratentorial infiltrative low-grade gliomas (WHO grade II). Diffuse astrocytoma was diagnosed in 35 (66 %) patients, oligoastrocytoma in 7 (13 %) patients and oligodendroglioma in 11 (21 %) patients. Results. The overall survival (OS) was influenced by fractionated radiotherapy regimens (conventionally fractionated versus hypofractionated radiotherapy) (p=0.000) and type of radiotherapy (3D conformal versus 2D radiotherapy) (p=0.023). Multivariate analysis showed a statistically significant difference between the equivalent total dose (LQ-model) and OS (p=0.068). Risk factors proposed by the Association of Russian oncologists (р=0.947) and the extent of surgical excision (р=0.423) had no significant impact on the overall survival. Conclusion. Conventionally fractionated radiation therapy (2 Gy per fraction daily) significantly improved the OS compared to hypofractionated radiotherapy (3 Gy per fraction daily). The value of α/β ratio=6.8 Gy can be used to calculate the total dose using a linear-quadratic model.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131532734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
А. Д. Зикиряходжаев, Мария Александровна Фролова, Елена Александровна Рассказова, Е. В. Глазкова
{"title":"ЛЕЧЕНИЕ ТРОЙНОГО НЕГАТИВНОГО ПОДТИПА РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ","authors":"А. Д. Зикиряходжаев, Мария Александровна Фролова, Елена Александровна Рассказова, Е. В. Глазкова","doi":"10.17650/1994-4098-2017-13-2-20-26","DOIUrl":"https://doi.org/10.17650/1994-4098-2017-13-2-20-26","url":null,"abstract":"The rate of triple-negative breast cancer is 10–24 %, and in recent years it’s one of the most studied subtypes of breast cancer due to its clinical aggressiveness and a small number of molecular targets. The study objective is to evaluate effectiveness of different NAPCT regimens including their dependence on the presence of mutations in the ВRСА 1, 2, СHEK2 genes. Materials and methods . The study included 40 female patients with triple-negative breast cancer. The patients were monitored from 2012 to 2016; surgical treatment was performed at the P.A. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center, Ministry of Health of Russia. Median patient age was 45.9 (31–69) years. All patients received neoadjuvant polychemotherapy (NAPCT) per different regimens. Then the patients underwent surgery of different volume (from radical mastectomies to resections), and in 25 % of cases reconstructive breast surgery was performed. In 5 patients with BRCA1, – 2 mutations, prophylactic subcutaneous mastectomy with immediate reconstruction with an implant was performed; 2 patients refused prophylactic mastectomy; in 1 patient with СНЕК2 mutation, metachronous multiple primary breast cancer was diagnosed, previously she didn»t undergo prophylactic mastectomy, and 6 years later cancer in the second breast was diagnosed. Results. The study included 11 patients under 40 (27.5 %), 4 (50 %) of them in the group with mutations in ВRCA1, -2, CHEK2. The study demonstrated high effectiveness of NAPCT regimens per the АС + Т scheme and weekly injections of doxorubicin 25 mg/m 2 , cisplatin 30 mg/m 2 , and paclitaxel 100 mg/m 2 . Grade IV treatment pathomorphosis for NAPCT per АС + Т scheme was achieved in 50.0 ± 7.9 % cases, for intensified regimen – in 62.5 ± 12.5 % cases. Median follow-up duration for this patient group was 22.1 months, and during this time disease progression was observed in 3 patients: in the 1st patient continued growth on the thoracic wall and brain metastases were diagnosed, in the 2nd patient – lung and supraclavicular lymph nodes metastases, in the 3rd patient – metastases in the cerebellum. In all of these patients, grade IV treatment pathomorphosis wasn»t achieved. Conclusions. The study demonstrated high effectiveness of NAPCT in patients with triple-negative breast cancer of different stages: objective response rate was 90.0 ± 4.7 %, grade IV treatment pathomorphosis was 50.0 ± 7.9 %. Grade IV treatment pathomorphosis for NAPCT per АС + Т scheme was achieved in 50.0 ± 7.9 % cases, for intensified regimen – in 62.5 ± 12.5 % cases. Rate of grade IV treatment pathomorphosis was higher in patients with hereditary form of the disease (62.5 ± 18.3 %) compared to the group with sporadic breast cancer (46.9 ± 8.8 %), р >0.05. In all patients, 2-year disease-free survival was 92.5 %, 2-year overall survival was 95 %.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127769685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Array А. Рассказова, Array Д. Зикиряходжаев, Array К. Сарибекян
{"title":"ОНКОПЛАСТИЧЕСКАЯ РЕЗЕКЦИЯ МОЛОЧНОЙ ЖЕЛЕЗЫ СКОЛЬЗЯЩИМ ДЕРМОГЛАНДУЛЯРНЫМ ЛОСКУТОМ С Z-ОБРАЗНЫМ РАЗРЕЗОМ","authors":"Array А. Рассказова, Array Д. Зикиряходжаев, Array К. Сарибекян","doi":"10.17709/2409-2231-2017-4-2-9","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-2-9","url":null,"abstract":"Oncoplastic resections are a radical surgical treatment for breast cancer, as well as a method for the rehabilitation of patients, since operations are classified as organ preserving. When the tumor node is localized in the upper-inner quadrant of the breast, it is difficult to achieve good aesthetic results. One of the solutions to the problem is the use of a sliding flap with a Z-shaped incision. In P. Hertsen MORI from 2014 to 2016, the operation with the use of a sliding flap was performed in 13 patients. The prevalence of the process, patients were distributed as follows: ТisN0 М0–1, Т1N0 М0–7, Т2N0 М0–3, Т1N1 М0–2 .Molecular subtypes distribution was the following — luminal type A— 8, luminal type B — 3, triple-negative subtype — 1 patient. Localization of the tumor site in the breast: the upper-internal quadrant — 9, upper — 1, lowerinner quadrant — 3 .The upper Zshaped flap was used in 10 patients, the lower Zshaped flap in 3 cases. Postoperative period in all patients was without com plications. The wound healed by primary intention in all patients. Cosmetic effect was good. The observation period is from 6 months to 2 years, the median is 1.1 years. Data for local recurrence and distant metastases were not detected. 2 patients had only surgical treatment, in the remaining 8 cases, radiation therapy with or without drug therapy. In all cases the operation is performed on one breast, correction of the second breast was not required.The article presents the clinical observation of patients with oncoplastic resection of the Zshaped flap, a detailed procedure of the operation.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127100701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Array С. Кызласов, Array М. Сокольщик, Н. А. Гончаров, Array В. Поройский, В. А. Сергеев, Array И. Володин, Array А. Кисилева, М. Забелин
{"title":"ОДНОМОМЕНТНАЯ ИМПЛАНТАЦИЯ ИСКУССТВЕННОГО СФИНКТЕРА МОЧЕВОГО ПУЗЫРЯ И ПЕНИЛЬНОГО ПРОТЕЗА КАК МЕТОД КОРРЕКЦИИ ЭРЕКТИЛЬНОЙ ДИСФУНКЦИИ И МОЧЕВОЙ ИНКОНТИНЕНЦИИ","authors":"Array С. Кызласов, Array М. Сокольщик, Н. А. Гончаров, Array В. Поройский, В. А. Сергеев, Array И. Володин, Array А. Кисилева, М. Забелин","doi":"10.17709/2409-2231-2017-4-2-10","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-2-10","url":null,"abstract":"This article provides a clinical example of the simultaneous implantation of an artificial sphincter of the bladder and a triple-component prosthesis of the penis, which allows almost completely to rehabilitate a patient with total incontinence and erectile dysfunction after laparoscopic radical prostatectom y for prostate cancer. The urgency of writing this article was a high incidence of prostate cancer, which has no tendency to decrease.It should be noted that when choosing the optimal method for treating prostate cancer, it is necessary to take into account the stage of the disease development, the patient’s age, concomitant diseases, possible complications, test results, and the wishes of the patient. In the stages of prostate cancer T1T2, radical prostatectomy in any of its embodiments, openly laparoscopically or with the help of a robot is a routine operation, at stage T3, in order to achieve an acceptable result, it is necessary not only sufficient surgical technique, but the correct preoperative preparation (the use of hormone therapy).One of the frequent complications of radical prostatectomy at stage T3 is urinary incontinence and erectile dysfunction, which is caused by the need for more “aggressive” techniques, the frequency of which reaches, in the opinion of different authors, 30 to 90%. With incontinence after a radical prostatectomy of moderate and severe degree, the implantation of an artificial urethral sphincter remains the preferred method of treatment. Artificial sphincter allows you to fully control the process of retention of urine and urination. Note that the restoration of potency after surgery is a very difficult problem. After the operation, one of the methods of preserving the erectile function is the early administration of 5fosofodiesterase inhibitors, but their reception does not always allow to maintain the erectile function, in this case, patients can be rehabilitated by penile implantation. The installation of a three-component phalloprosthesis or artificial sphincter separately is already a routine operation, but simultaneous treatment of two com plications and sim ultaneous im plantation of two prostheses is a rarity.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130867461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
В. В. Соколов, Дмитрий Викторович Соколов, Л. В. Телегина, Андрей Леонидович Николаев, Андрей Павлович Кирюхин, Ю. Л. Кудрявцева
{"title":"Новые технологии в криохирургии при эндоскопическом лечении опухолей дыхательных путей","authors":"В. В. Соколов, Дмитрий Викторович Соколов, Л. В. Телегина, Андрей Леонидович Николаев, Андрей Павлович Кирюхин, Ю. Л. Кудрявцева","doi":"10.17709/2409-2231-2017-4-2-4","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-2-4","url":null,"abstract":"The article presents the history of the development of the cryosurgery method from antiquity to the present day, materials of the clinical use of cryosurgery for endoscopic diagnosis and treatment of tumors of respiratory tract at the present stage, features of modern equipment for cryosurgery. Also the article presents the first clinical experience of using cryorecanalization in stenosing tumors of the tracheobronchial tree inRussiawith the help of the medical device of the latest generation ERBECRYO 2. Three clinical examples of cryorecanalization are given. Preliminary results of clinical studies show that, in comparison with cryosurgery on older devices, cryorecanalization using the latest generation of m edical eq uipment and a new cryosondond model is an effective method of recanalization to restore airway patency, which can be used in combination with electrodestruction, argon-plasma And laser coagulation.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130274164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Array М. Сольх, Array И. Андрюхин, О. А. Макаров, Array В. Федченков
{"title":"УЛУЧШЕНИЕ РЕЗУЛЬТАТОВ ЛЕЧЕНИЯ БОЛЬНЫХ С КОНКРЕМЕНТАМИ МОЧЕТОЧНИКА ПОСЛЕ КОНТАКТНОЙ УРЕТЕРОЛИТОТРИПСИИ","authors":"Array М. Сольх, Array И. Андрюхин, О. А. Макаров, Array В. Федченков","doi":"10.17709/2409-2231-2017-4-2-1","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-2-1","url":null,"abstract":"Purpose. Im proving the results of treatment of patients with ureteral stones and reducing the dam aging effects of contact lithotripsy. Materials and methods . In this study, 48 patients were examined aged 20 to 63 years. All patients admitted to the urology department with diagnoses: urolithiasis, calculus of the ureter. In all cases contact ureterolithotripsy with stenting of the upper urinary tract were performed. The patients were divided into two groups: main and control. 25 patients (52 .1%) were included into the main group, which in the postoperative period, we used low-level laser therapy (L-therapy). 23 patients were included in a control group (47.9%) who did not receive low-laser therapy. Laboratory tests and ultrasound with Doppler renal blood vessels scan were performed on admission, on the first day after the operation and on the 5-th day of hospitalization. Low-intensity laser therapy was performed within 5 days after contact ureterolithotripsy on projection of placement of stone and kidney projection by series for 5 minutes. Results . All patients admitted to the hospital, were spared from ureteral stones. In the main group during the treatment with L-therapy a decrease in the level of beta-2 microglobulin to normal was observed. (4.8 ± 0.1 mg/l on the first day. On the 5th day 2 .3 + 0.1 mg/l). In the control group during the treatment without the use of L-therapy, the average level of beta-2 microglobulin decreased but did not reach normal levels. (5.5 ± 0.1 mg/l on the first day. On the 5th day 3,2 ±0, l mg/l).Resistance index in the study group decreased compared to the control. In the control group, cases of acute pyelonephritis were observed. The average hospital stay for patients of the main group (6 days) was less than in the control group (6 .5 + days). Conclusion. The use of laser therapy in the treatment of patients who did undergo ureterolithotripsy can reduce the length of stay of the patient in the hospital and reduce the risk of acute pyelonephritis in the postoperative period. Also it can reduce the damaging effect of lithotripsy on the renal tissues.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125332914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
А. A. Рерберг, А. А. Костин, А. А. Бойко, Е. А. Новикова, Н. Волченко, О. A. Чулкова, Л. A. Демидова, Г. A. Хохриков, Д. Сидоров, А. Геворкян
{"title":"НЕОАДЪЮВАНТНАЯ КОМБИНИРОВАННАЯ ХИМИОТЕРАПИЯ У БОЛЬНОЙ РАКОМ ШЕЙКИ МАТКИ IIIB СТАДИИ С ИСПОЛЬЗОВАНИЕМ ВНУТРИАРТЕРИАЛЬНОГО ВВЕДЕНИЯ ПРЕПАРАТОВ ПЛАТИНЫ","authors":"А. A. Рерберг, А. А. Костин, А. А. Бойко, Е. А. Новикова, Н. Волченко, О. A. Чулкова, Л. A. Демидова, Г. A. Хохриков, Д. Сидоров, А. Геворкян","doi":"10.17709/2409-2231-2017-4-2-8","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-2-8","url":null,"abstract":"The main treatment for cervical cancer are surgery, radiation and combined (surgery + radiotherapy), the role of chemotherapy in this localization is studied less fully. In recent years the new possibilities of chemotherapy, including neoadjuvant intraarterial chemotherapy, are explored. Theoretical prerequisites for this are the best drug delivery to the tumor by blood vessels, undamaged due to radiation therapy and surgery. This paper describes a clinical case of a patient with primary inoperable cervical cancer. As an alternative to preoperativ e radiotherapy the patient was proposed neoadjuv ant com bination chemotherapy with the use of regional administration of platinum drugs and systemic administration of drugs of taxan series as a stage of preparation for further surgical treatment. According to the prevalence of the tumor process patient underwent 2 courses of neoadjuv ant chemotherapy by a method of superselective intra-arterial administration of cisplatin and paclitaxel intravenously. According to a comprehensive examination after treatment data for the presence of tumor was absent. During the second stage the patient underwent surgical treatment in the volume of nerve-sparing radical hysterectomy with appendages. The next step, according to the histological form of the tumor, stage of disease, was the radiotherapy in the postoperative period on the pelv ic area and routes of lym ph drainage. The patient underwent external beam radiotherapy to the pelvic area of FD = 20 Gr, intracavitary gamma-therapy and external beam radiation on the area of parametrial and lymphopenia FD = 50 Gr.The patient passed the control examinations every 3 months. According to a comprehensive survey a year after the start of treatment — there is no data for the presence of recurrence and spread of tumor process.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"292 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117328323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}