Medical Radiology and Radiation Safety最新文献

{"title":"Health Effects of Onboard Radiation Accidents in the Soviet Nuclear Submarines","authors":"L.A. Ilyin, O.A. Kochetkov, A.V. Barabanova, V. Barchukov","doi":"10.33266/1024-6177-2023-68-6-42-48","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-42-48","url":null,"abstract":"Purpose: To analyze the health effects of onboard radiation accidents in the Soviet nuclear submarines. Results: Over the entire operation period of Soviet nuclear submarines, eight severe accidents occurred related to nuclear power installations. These accidents occurred in a confined space and the associated radiation situation is more complex than in other conditions; therefore, health effects of such accidents are more significant. There were two types of onboard accidents: thermal accidents (five cases) associated with a failure during heat removal from the reactor core; and accidents (three cases) caused by a partial chain reaction. The first type of accidents occurred during the route operation of nuclear submarine, and the second one – during repair work. Thermal accidents were associated with varying degrees of depressurization of the primary circuit of the reactor, which increased the gamma and beta background due to the entry into the compartment of a large amount of radioactive noble gases (hereinafter – RBGs) and radioactive aerosols. It has been shown that in the confined space of nuclear submarines, RBG isotopes (mainly 85Кr, 133Хе, 135Хе) make a significant contribution to the individual dose and the skin is a critical organ. Conclusion: An analysis of the health effects of thermal onboard accidents showed that radiation injuries were caused by external gamma- and beta-exposure, as well as the ingestion of radioactive aerosols. If accidents are accompanied by prolonged minor leaks leading to entry of RBG into the compartment, the main contribution is made by beta-exposure and the skin is a critical organ. If there is a simultaneous inflow of coolant into the compartment, combined radiation injuries are formed and, in this case, skin lesions aggravate the acute radiation sickness. In accidents induced by a partial chain reaction, the main radiation factor is external γ-n-exposure during an outbreak of a partial chain reaction, and in the case of a thermal explosion, a traumatic factor also affects a person, leading to injuries of varying severity in the victims.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621685","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}

{"title":"Effect of Radiation and Non-Radiation Factors on the ТBX21 Concentration in lysates of the Mitogen-Stimulated Mononuclear Cells","authors":"E. Kodintseva, AA Akleyev","doi":"10.33266/1024-6177-2023-68-6-55-59","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-55-59","url":null,"abstract":"Purpose: To evaluate the effect of radiation and non-radiation factors on the intracellular concentration of the ТBX21 transcription factor in peripheral blood PHA-stimulated mononuclear cells of chronically exposed residents of the Techa Riverside settlements in the long-term period after the start of exposure. Material and methods: The main group consisted of 30 people aged 67–80 years with the mean dose to the red bone marrow 867±136 mGy, to thymus and peripheral lymphoid organs 125±20 mGy. The comparison group included 10 unexposed people aged 63–82 years. The main and the comparison groups had similar sex and ethnic composition. Peripheral blood mononuclear cells were PHA-stimulated for 24 hours. Cellular lysates were normalized by total protein concentration prior to being used for ELISA test. Results: After 24 hours of incubation the median and interquartile range of the intracellular TBX21 concentration in mononuclear cells was 34.2 (6.6–86.0) pg/ml after the mitogen stimulation, and 0 (0–24.9) pg/ml – without mitogen stimulation (р=0.001). In the comparison group these values made up 24.8 (0.2–47.6) and 13.0 (0–19.2) pg/ml, respectively Conclusion: The intracellular TBX21 concentration after 24-hour mitogen stimulation did not differ statistically significantly in chronically exposed and unexposed people, as well as in people from different dose groups. Statistically significant increase in TBX21 concentration in the lysates of mononuclear cells that were PHA-stimulated for 24 hours relative to non-mitogen stimulated cells was noted in chronically exposed people with medium and high doses to the red bone marrow. No correlation was revealed between the TBX21 concentration and dose characteristics, sex, and ethnicity of the studied individuals. The results are preliminary.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621955","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}

{"title":"Effective Doses of Children During X-Ray Diagnostic Examinations: A Literary Review","authors":"I. Shatskiy, P. Druzhinina, Y. Kapyrina, M.V. Osipov","doi":"10.33266/1024-6177-2023-68-6-27-41","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-27-41","url":null,"abstract":"Radiation diagnostics methods are widely used not only for the diagnosis of adult patients, but also in pediatrics. Children are the most radiosensitive group of the population, with a higher risk of developing long-term effects of ionizing radiation than adults. Therefore, control of exposure levels of pediatric patients is a priority. Nowadays, many publications have been devoted to the issues of radiation safety of children in foreign countries. There is no reliable information of diagnostic exposure levels of children in the Russian Federation. In domestic publications, these issues are considered insufficiently. Foreign and domestic publications of children exposure levels during X-ray, interventional and computed tomography examinations (CT-examinations) were analyzed. First of all, publications containing a quantitative characteristic of exposure levels in terms of effective dose (ED) were considered. Effective doses presented in the publications were recalculated in accordance with the division of age groups adopted in the Russian Federation for the convenience of comparing the values with each other: 0‒0.5; 0.5‒3; 3‒8; 8‒13; 13–18 years old. This study presents the average of weighted effective doses for children of all age groups for different types of radiography, interventional and CT-examinations. According to publications the average weighted effective doses of children on average for all types of X-ray diagnostics are lower in the Russian Federation than in foreign countries. To ensure the radiation protection of children in the Russian Federation during radiography, interventional and CT-examinations, it is necessary to increase the reliability of information of children exposure levels, by improving the systems for collecting data, monitoring and accounting of individual patient doses, and raising the level of awareness of specialists.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138622811","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}

{"title":"Unified Information System of The Urcrm of Fmba of Russia","authors":"V.S. Nikiforov, V.A. Krivoshchapov, N.V. Startsev","doi":"10.33266/1024-6177-2023-68-6-13-19","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-13-19","url":null,"abstract":"A great amount of scientific information on the effect of radiation on the human body in various fields of knowledge from genetics and molecular biology to radiation epidemiology has been accumulated over a long-term period of activity of the URCRM of the FMBA of Russia. To get the best out of the use of numerous registers and databases maintained in the URCRM and to make interdisciplinary research possible, a Unified Information System was created, which consists of two parts: information complex REGISTR and complex Storage. The creation of the Storage complex makes it possible to ensure the safety of scientific data obtained in the departments of the URCRM, as well as methods/techniques elaborated to obtain them. The development of the REGISTR complex, the creation of new functionality in it, have significantly increased the use of information resources, which allows for strategic planning of new research. The paper describes in detail the basic functionality of the Unified Information System. The technical aspect of the usage of the REGISTR complex is presented. An example of the use of the Selections Constructor for planning of the study performed in the Laboratory of Molecular and Cellular Radiobiology of the URCRM of the FMBA of Russia is given. Keywords: unified information system, the Register complex, the Storage complex, personal data protection, prospects for the development of the REGISTER complex For citation: Nikiforov VS, Krivoshchapov VA, Startsev NV. Unified Information System of The Urcrm of Fmba of Russia. Medical Radiology and Radiation Safety. 2023;68(6):13–19. (In Russian). DOI:10.33266/1024-6177-2023-68-6-13-19","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138626227","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}

{"title":"Analysis of Vβ-Segment Diversity of T-Cell Receptor in Residents of the Techa Riverside Villages Chronically Exposed to Radiation in the Long-Term Period","authors":"A. Kotikova, E. Blinova, A. Akleyev","doi":"10.33266/1024-6177-2023-68-6-49-54","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-49-54","url":null,"abstract":"Purpose: Study the repertoire of the T-cell receptor in persons chronically exposed to radiation in the long-term period. Material and methods: The study involved 48 people, who were divided into two groups: a group of exposed persons – 31 individuals with the average accumulated dose to red bone marrow (RBM) of 981±130 mGy, and a comparison group – 17 individuals, the average accumulated dose to RBM was 25.3±5.91 mGy. The study groups did not differ significantly in age, gender and ethnicity. The repertoire of Vβ-segments of the T-cell receptor of the peripheral blood T-lymphocytes of exposed persons was analyzed by flow cytometry method. 24 Vβ-segments of the T-cell receptor were studied. Statistical processing of the obtained data was carried out using the Wilcoxon signed-rank test, and a direct description of Vβ-segment repertoire of the T-cell receptor was performed using the Lorenz curve and the Gini-TCR index. Results: The study revealed a statistically significant increase in the number of Vβ3 and Vβ5.2 T-cell receptor segments in exposed individuals relative to the comparison group (p=0.03 and p=0.003, respectively). It was also shown that the distribution of the Vβ-segments of the T-cell receptor is uneven in both study groups. However, there was no significant difference between the repertoires of the T-cell receptor of the studied groups by the Gini-TCR index (p=0.14).","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621271","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}

{"title":"Brachytherapy of Malignant Neoplasms of the Cervix Uteri: Current Status of the Problem (Literature Review)","authors":"A.A. Zavyalov, A.N. Solodova, A.I. Tyryshkin, E.V. Kryakvina","doi":"10.33266/1024-6177-2023-68-6-99-105","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-99-105","url":null,"abstract":"Purpose: To conduct a search and generalization of literature data to assess the relevance and prospects for the development of brachytherapy in the treatment of cervical cancer. Material and methods: Scientific sources were searched in PubMed / Medline for the following key words: «cervical cancer», «radiotherapy», «brachytherapy». The time horizon covered 2016–2023. Using a time filter, the most relevant and innovative research papers on cervical cancer brachytherapy were selected. Results: Modern radiology provides specialists with a wide range of methods, one of which is brachytherapy (BT). Brachytherapy is a promising direction in the treatment of cervical cancer, however, its use is largely limited and continues to gradually progressively decline around the world. The reasons associated with this are different: the complex technical component of this technique, the high requirements for the training of BT specialists, the high cost of treatment, and others. However, it should be noted that most of the current data demonstrate the high efficacy of BT in the complex therapy of cervical cancer. Therefore, research is ongoing to increase the involvement of BT in the treatment strategy for cervical cancer. Thus, many authors emphasize that the rates of primary complete remission and 5-year cancer-specific survival were significantly higher in patients treated with BT than in those who were treated with EBRT instead of BT (92.5 % versus 73.3 % and 68. 5 % versus 35.4 % respectively). Modern technical developments in the field of BT are also interesting, for example, the use of 3D printing methods. New applicators make it possible to increase the conformity of the conducted BT. The presented methodology also provides an opportunity for better training of specialists in the field of BT. An important aspect of the spread of BT and radiological treatment in general, and along with it the dynamics of the main indicators of survival, is still the socioeconomic factor. Thus, there are direct correlations between the total income of a country and the degree of prevalence of BT in it. Some countries are almost completely deprived of the possibility of using BT methods in health care. In general, brachytherapy is actively developing, opening up new horizons in the treatment of malignant neoplasms of cervical cancer.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138624033","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}

{"title":"Comparison of Photon and Neutron Radiation Dosimetric Systems Used in Organizations of Rosatom State Corporation for Control in A Planned Exposure Situation","authors":"O.A. Kochetkov, E.Yu. Tarasova, S.M. Shinkarev, E.A. Rumyantsev","doi":"10.33266/1024-6177-2023-68-6-118-124","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-118-124","url":null,"abstract":"Purpose: Using the example of reviewing and discussing the results of comparison tests of dosimetric systems of gamma and neutron radiation used in organizations of the State Corporation “Rosatom”, to assess the current state of reliability of monitoring the planned exposure of workers in fields of mixed gamma-neutron radiation using the considered dosimetric systems in order to produce recommendations for corrective actions to ensure a unified approach to conduct individual dosimetric control of external exposure. Results: All measuring instruments for individual dose equivalent of photon and neutron radiation, presented in comparison tests, comply with up-to-date requirements for individual dosimetric control systems. All measuring instruments confirmed their measuring capabilities, showed satisfactory quality of measurement results and the absence of a systematic bias in the measurement results. Analysis of the results of measuring the individual dose equivalent of neutron radiation showed that problems affecting the quality of the results obtained were identified in the considered instruments of measuring personal dose equivalent. The following factors might be the sources of problems: lack of knowledge about the real characteristics of radiation fields (spectral characteristics, radiation direction, etc.) at workplaces; insufficient research of the method used for measuring neutron radiation under real conditions (technical and metrological characteristics and features of the individual dosimeters used); failure to take into account the weighing coefficients for neutrons of various energies when measuring instruments are calibrated and when real measurements are conducted. Conclusion: It is necessary to organize and conduct investigations of the metrological characteristics of the measuring instrument that are used under conditions typical for a specific radiation object. After finishing these experimental studies, it is recommended to test the methodology with an analysis of the compliance of the accuracy indicators with the requirements of the relevant guidelines. In order to solve the problem of a lack of knowledge about the real characteristics of radiation fields, radiation safety services of organizations are recommended to organize and conduct research aimed at studying such characteristics using radiometric and spectrometric methods, experimental modeling of the process of personnel exposure using anthropomorphic phantoms and determining correction factors for the individual dosimeters used.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138612165","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}

{"title":"Comparison of Radiation and Chemical Toxicity of Uranium Compounds on The Basis of Calculation by New Icrp Biokinetic Models","authors":"A.A. Molokanov, N. Potsyapun, E.Yu. Maksimova, Yu. E. Kvacheva","doi":"10.33266/1024-6177-2023-68-6-20-26","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-20-26","url":null,"abstract":"Purpose: Harmonization and improvement of the system for regulating the internal radiation exposure of workers and the basic requirements for ensuring radiation safety, taking into account the application of new international requirements and recommendations. Material and methods: The article presents a comparison of the radiation and chemical toxicity of uranium compounds, obtained on the basis of calculating the levels of inhalation intake and committed effective dose depending on the types of compounds F, M, F/M and M/S in the AMAD range from 0.3 to 20 μm for typical isotopic compositions of natural (NU), depleted (DU), low enriched (LEU) and highly enriched (HEU) uranium, which lead to the maximum permissible concentration of uranium in the kidneys. The calculations were carried out using new ICRP biokinetic models, which give more physiologically realistic representations of uptake and retention in organs and tissues, and excretion. Results: The dynamics of uranium activity in the kidneys was calculated for constant chronic inhalation intake over a 50-year period and for acute intake. It was shown that in case of chronic intake, the rate of accumulation of uranium in the kidneys, expressed in relative units, does not depend on the AMAD in the range from 0.3 to 20 μm and slightly depends on the types of compounds F, F/M, M and M/S, which include almost all chemical compounds of uranium. In case of acute intake, there is a rapid, within 1–3 days, an increase of uranium in the kidneys to a maximum value and then a gradual decrease to a value of 20 % of the maximum value in 20–60 days, depending on the type of compound F, M, F/M, M/S and AMAD in a wide range of values from 0.3 to 20 µm. To compare the radiation and chemical toxicity of uranium, the values of the committed effective dose were calculated, which is formed after intake of uranium aerosols of the types F, M, F/M and M/S and AMADs from 0.3 to 20 µm in an amount that creates the maximum concentration of uranium in the kidneys 0.3 µg/g for chronic intake and 3 µg/g for acute intake. The values of uranium intake per year in milligrams, which form the maximum concentration of uranium in the kidneys of 0.3 µg/g, in case of constant chronic intake of uranium aerosols, as well as the values of uranium intake in milligrams, which form the maximum concentration of uranium in the kidneys of 3 μg/g after a single intake of uranium aerosols in both case of the types F, M, F/M and M/S and AMAD in the range from 0.3 to 20 µm were calculated, which are evidently independent of the considered isotopic composition of the uranium. Conclusion: It is shown that chemical toxicity prevails over radiation toxicity for the types of uranium compounds F and F/M for all considered uranium isotopic composition, except for HEU; for the type of compound M it is the same for mixtures of NU and DU, and for the type M/S radiation toxicity prevails for all considered uranium isotopic composition. In case of chronic in","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138614950","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}

{"title":"Radionuclide Diagnosis of Sentinel Lymph Nodes in Breast cancer with a Radiopharmaceutical Based on Technetium-99m Labeled Gamma Aluminum Oxide","authors":"A.A. Medvedeva, A.N. Rуbina, R.V. Zeltchan, O.D. Bragina, A.V. Doroshenko, E.Iu. Garbukov, N.A. Tarabanovskaya, L.A. Tashireva, V.I. Chernov","doi":"10.33266/1024-6177-2023-68-5-88-95","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-5-88-95","url":null,"abstract":"Аim: To analyze the results of radionuclide diagnostics of sentinel lymph nodes (SLN) in patients with breast cancer (BC) with the radiotracer Sentiscan, 99mTc (manufacturer “MedicorPharma-Ural”) using the multimodal SPECT/CT at the stage of visualization. Material and methods: The study was retrospective, it included 48 patients with BC with clinical stage T2-3N0M0, who underwent radionuclide diagnostics of SLN and SPECT/CT was performed at the imaging stage. The images were evaluated visually, the intensity of the radiotracer accumulation in the lymph nodes (LN) was analyzed, SUVmax was used as a quantitative parameter. Intraoperative detection of SLN with subsequent histological examination was also carried out with the calculation of the level of the radiotracer accumulation. Results: On tomoscintigrams, LNs were visualized in 43 patients out of 48, intraoperatively ‒ in 46 cases, in 2 patients, accumulation of the radiotracer in the LN projection was noted neither according to SPECT/CT, nor intraoperatively. When analyzing the intensity of the radiotracer accumulation according to SPECT/CT data, a rather large scatter of SUVmax‒35 [10‒104]. Sentinel were considered LNs with the level of the radiotracer accumulation in them of at least 10 % of the most intense node. According to SPECT/CT data, 165 lymph nodes were identified, the average number of lymph nodes detected in one patient was 2 [1‒3], the maximum number was 6 lymph nodes. In all patients, the lymph nodes were determined in the projection of the 1st level, in 25 cases ‒ in the projection of other zones of regional lymphatic outflow. The total number of lymph nodes removed during surgery was n=247, on average 3 [2‒5] lymph nodes were removed in one patient, with a maximum of 8 nodes. Conclusion: The sensitivity of radionuclide diagnostics of SLN with Sentiscan, 99mTc was 89.6 % according to SPECT/CT and 95.8 % according to the results of intraoperative detection. The use of multimodal imaging provides information on the exact anatomical localization of the lymph nodes. In the absence of scintigraphic visualization of the radiotracer redistribution in the lymphatic collector, intraoperative detection does not lose its relevance.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135963804","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}

{"title":"Thermoradiochemotherapy in the Combined Treatment of Rectal Cancer","authors":"D.A. Plaskeeva, A.I. Konovalov, Zh.A. Startseva, S.G. Afanasyev","doi":"10.33266/1024-6177-2023-68-5-77-81","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-5-77-81","url":null,"abstract":"Currently, the treatment of rectal cancer requires a multidisciplinary approach. So the combined method of treatment, including chemoradiotherapy and the surgical stage, has proven itself reliably. However, the desired results that significantly increase the rates of relapse-free and metastatic survival have not yet been achieved. The use of radio modifiers makes it possible to enhance radiation exposure without increasing the total focal dose. One of the universal radio modifiers is local hyperthermia. Purpose: To develop a method of thermoradiochemotherapy in the combined treatment of distal rectal cancer and evaluate its effectiveness. Material and methods: This work is based on the analysis of the results of treatment of 141 patients with morphologically confirmed locally advanced distal rectal cancer. In accordance with the objectives of the study, all patients were divided into 2 groups. In the combined treatment of 75 patients, the first stage was performed chemoradiotherapy (CLT) in combination with local hyperthermia (LH). Local hyperthermia was not used in the treatment of 66 patients. Results: Long-term results of complex treatment of patients with an independent course of chemoradiotherapy/thermochemoradiotherapy (dynamic observation group) and after surgical treatment are presented. One – year relapse-free survival in the group with an independent course of TRHT was 96.7 %, in the CLT group – 79.3 % (p=0.024). There was a significant increase in three–year relapse-free survival – 93.3 % versus 76.7 % in the control (p=0.041). Among patients who underwent surgical treatment at the second stage, the study of one-year relapse-free survival did not reveal statistical significance. Three – year relapse-free survival in patients with TRHT compared with the CLT group was 96.2 % versus 86.0 % (p=0.038). The effectiveness of thermoradiochemotherapy in patients of this category was evaluated. The tolerability of treatment in all patients is satisfactory. Among all radiation reactions, the most frequently observed phenomena of radiation epidermitis I–II art. in the projection of irradiation fields (Table 1). Acute radiation reactions were reversible and did not have a negative effect on the subsequent stages of treatment. Treatment for all patients (n=141) was implemented in full.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135963809","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}