RU2183129C2 - Method for treating oncological patients - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves recording primary reflection coefficient value K1 of pathologic focus before starting treatment. Tumor dimensions are measured in plane using a ruler. Textile material containing a layer of sodium alginate, dimethyl sulfoxide and photosensibilizer agent is modulated in shape when mass proportion of the mentioned ingredients is equal to 1:1:0.3-0.5 by increasing dimensions by 1-3 cm in all directions, respectively. The so produced applicator is wetted with water or 0.9% sodium chloride solution. The applicator is applied to wound with its medicated side. Tumor reflection coefficient value K2 change is recorded. Relation of K₂≥2,5K₁ being reached, laser radiation treatment is applied with physicotechnical conditions corresponding to photosensibilizer agent applied. The laser radiation treatment is stopped when achieving K₂≥2,5K₁, relation to come true. The treatment is continued until the process no process leveling is observed or full tumor regression takes place. EFFECT: enabled ambulatory treatment; enhanced effectiveness in treatment patients with contraindications to other treatment methods.

Description

 The invention relates to medicine and can be used in the treatment of superficially located: obdigate precancer; pre-invasive and microinvasive forms of cancer; stage 1 cancer with restriction of invasion to 0.5-1.0 cm; early relapses of malignant tumors; common (primary and metastatic) malignant tumors that are resistant to chemoradiotherapy and have contraindications for surgical treatment.

 A known method of treating cancer patients, including the introduction into the patient's body of photosensitizers and laser irradiation of the pathological site (RF Patent N 2113254, IPC G 01 N 5/06, publ. 1998).

 The disadvantage of this method is the intravenous administration of photosensitizers, which leads to the accumulation of photosensitizers not only in the tumor, but also in all organs and tissues of the body, leading to general and light intoxication.

 A known method for the treatment of cancer patients, including irradiation in combination with intratumoral administration of metronidazole by applying to the tumor a textile material containing a layer of sodium alginate with metronidazole and dimethyl sulfide oxide in the mass ratio of the latter 2: 0.5-1.0, respectively (RF patent N 2089247, IPC D 61 K 31/10, publ. 1997, prototype).

 The disadvantage of this method is the inability to reuse with relapse of the tumor.

 The task posed by the authors is to eliminate these disadvantages by ensuring high selectivity of the photosensitizer entering the pathological focus along with a high concentration and a sufficient depth of penetration of the photosensitizer into the neoplasm tissue. General and light toxicity resulting from the administration of the drug is excluded, as the drug directly diffuses into the tumor and closely located intact tissues and does not enter the internal organs and tissues of the body, does not cumulate there, no time is required for its excretion.

 The problem is solved as follows.

In a method of treating cancer patients, including irradiation in combination with application of a textile material containing a layer of sodium alginate and dimethyl sulfoxide to the tumor, it is further proposed to introduce a photosensitizer into the textile material with a mass ratio of these components of 1: 1: 0.3-0.5, respectively, wherein before treatment, determine the reflection coefficient of the tumor tissue K ₁ and its linear dimensions, simulate textile material with dimensions exceeding the tumor by 1-3 cm, and after applying moistened apple to detect changes in the reflection coefficient of the tumor K ₂ and when K ₂ > 2.5 K ₁ is reached, carry out a laser irradiation session at physicotechnical parameters corresponding to the photosensitizer used, end the irradiation when K ₂ <K _{1 is} reached, and continue treatment until the process is leveled or complete tumor regression.

 Modeling of textile material eliminates the drug load on the organs and tissues of the body as a whole with a high gradient of the damaging principle directly in the pathological focus, and also makes it possible to use this technique on an outpatient basis. Monitoring the saturation of the tissue with a photosensitizer allows for laser treatment in a gentle mode and at the same time ensures high treatment efficiency.

 The method is as follows.

The patient is recorded, for example, by laser computer spectrophotometry, the primary reflection coefficient K _{1 of the} pathological focus before treatment. The ruler measures the size of the formation in the plane. According to the obtained sizes, the shape of a textile material containing sodium alginate, dimethyl sulfoxide and a photosensitizer is simulated with a mass ratio of components of 1: 1: 0.3-0.5, respectively, increasing sizes by 1-3 cm in all directions. The resulting applicator is moistened with water or a 0.9% solution of sodium chloride, imposed on the tumor with a medicinal surface. The applicator is attached to the surface of the skin or mucous membrane. For 12-48 hours in the daytime, the reflection coefficient K _{2 of the} neoplasm is periodically determined every 3 hours until the intensity coefficient of the fluorescence spectra of the photosensitizer in the pathological focus K ₂ is at least 2.5 times higher than the primary reflection coefficient K ₁ . When the conditions are met, a laser irradiation session of the pathological lesion is started at a power density of 100-250 mW / cm ² with an energy exposure of 30-350 J / cm ² per session. Physico-technical parameters are determined by the photosensitizer used. During the session, the decrease in the fluorescence activity of the photosensitizer is determined until the primary reflection coefficient K ₁ is less than or equal to the reflection coefficient K ₂ in the pathological focus after irradiation, the laser irradiation session is stopped. On the next day, the treatment regimen is repeated in the same order, and the general course of treatment is carried out until the leveling process stops or until the tumor regresses completely.

 Example 1

Patient K., 74 years old, medical history N 7316, 1998, was admitted to the hospital with a diagnosis of basal skin of the forehead. Locally: the tumor is round in shape, with excoriation in the center, 1.1 cm in diameter. Using laser spectrophotometry using a reference sample, the data of endogenous fluorescence in the tumor were taken, the coefficient K _{1 was} determined. A circle with a diameter of 3.5 cm was cut out of a textile material containing a layer of sodium alginate and dimethyl sulfoxide with a photosensitizer filler — photosens 2. After 24 hours, the photographic applicator was removed, the surface of the skin and tumors that were exposed to the photosensitizer were treated 3 times with 70% ethanol to remove the photosensitizer remaining on the surface and not diffused into the tissue. The reflection coefficient from the K ₂ tumor was re-taken, while its increase was 4.2 times higher than the K ₁ coefficient. A laser session was conducted on the tumor with a wavelength of 670 nm, illumination of 155 mW / cm ² , light spot diameter of 2 cm, and an energy exposure of 75 J / cm ² . The reflection coefficient K ₂ , which compared to the coefficient K _1, turned out to be 1.5 times less, was taken. Session terminated. After a night break, after 14 hours, the applicator with a photosensitizer is again applied. Treatment according to the scheme continued until the total energy exposure of 375 J / cm ² . Clinically, the tumor was completely regressed.

 Example 2

Patient S., 57 years old, medical history N 163, 1997. Was admitted to the hospital with a diagnosis of skin cancer of the left cheek. Morphology - squamous keratinizing cancer. Locally: the tumor is round in shape, measuring 1.7 cm in diameter. Similarly to that described in example 1, the coefficient K _{1 is} determined. A circle with a diameter of 4.5 cm is cut from a textile material with a photosensitizer filler — photogam. The applicator is moistened with water and the medicinal surface is applied to the tumor, fixed with adhesive tape. After 24 hours, the photographic applicator was removed, the surface of the skin and tumor that was exposed to the photosensitizer was treated 3 times with 70% ethanol to remove the photosensitizer that remained on the surface and was not diffused into the tissue. The reflection coefficient from the K ₂ tumor was measured, while an increase in the coefficient of 1.8 times was noted. A new similar applicator is again applied for 24 hours. In the control measurement of the reflection coefficient K ₂ after 48 hours, an increase of 3.2 times was noted compared with the primary coefficient. A laser irradiation session of 630 nm, an illumination of 150 mW / cm ² , a light spot diameter of 3 cm, and an energy exposure of 120 J / cm ^{2 was} performed. Reflection coefficient indicators were taken at similar measurement points, which, compared to the initial coefficients, turned out to be 5-8% less. Session terminated. After a night break, after 14 hours, the applicator with a photosensitizer is again applied. Treatment according to the scheme continued until the total energy exposure of 600 J / cm ² . The tumor regressed.

 The proposed method allows for treatment not only in hospital but also on an outpatient basis. This method is an alternative to chemotherapeutic and radiation treatment and their combination. It can be used in patients who are contraindicated in other treatment methods for health reasons.

Claims (1)

A method for the treatment of cancer patients, including irradiation in combination with application of a textile material containing a layer of sodium alginate and dimethyl sulfoxide to the tumor, characterized in that an additional photosensitizer is introduced into the textile material with a mass ratio of these components of 1: 1: 0.3-0.5, respectively , wherein before treatment determined reflection coefficient of the tissue of the tumor K ₁ and its linear dimensions, model textile material with sizes greater than 1-3 cm in the tumor and after the imposition of hydrated pplikatsii registering the change in reflection coefficient K ₂ and the tumor reaches ₂ ≥2,5K value K ₁ is performed at a laser irradiation session physico-technical parameters corresponding photosensitizer employed, on reaching the end irradiation K ₂ ≤K ₁ continue treatment until no leveling process or complete tumor regression.