RU2188026C1 - Method for treating the renal cancer - Google Patents

Abstract

FIELD: medicine, oncourology. SUBSTANCE: it is suggested to conduct polychemotherapy course in pre- operational period according to the scheme: the 1st day - vincristine 1.4 mg/m² intravenously by jet injection; the 2nd day - 150 ml autoblood is supplemented with 70 mg/m² adriamycin, the mixture is incubated for 30 min, reinfused intravenously by drops; the 4th day - 500 mg depot-prover is injected intramuscularly; 7-10 days later it is conducted a radical nephrectomy, and 7-10 days after operation it is necessary to repeat the above-described polychemotherapy, autohemotherapy and introduction of depot-prover. The method provides to decrease toxic manifestations, complications of hormonal nature, increase relapse-free period and decrease the possibility for metastasis. EFFECT: higher efficiency of therapy. 2 ex

Description

 The invention relates to medicine, in particular to oncology, and can be used to treat patients with renal cell cancer at different stages of the tumor process by surgery and cytotoxic drugs.

The well-known "Method of treating kidney cancer of the generalized stage of the tumor process" (see book. Translatorova NI, 1993. Reference "Antitumor therapy", page 95), which consists in conducting systemic chemotherapy according to the following scheme: adriamycin - 75 mg / m ² iv - on the 1st day, vincristine - 1.4 mg / m ² iv on the 1st, 8th and 15th days; depot checker - 50 mg IM in the 1st, 8th and 15th days, followed by a repeat of the course after 4 weeks.

 The disadvantages of this method are as follows: this method is currently used to treat inoperable patients with renal cell carcinoma; the duration of treatment associated with the need for 4-5 courses of polychemotherapy (PCT), sometimes the inability to conduct a full course of treatment due to the serious condition of patients; the need for additional courses of chemotherapy; low clinical effect, high frequency of complications and toxic manifestations - nausea, vomiting, leukopenia, high cardiotoxicity; short relapse-free period, metastases and progression of the process.

 The well-known "Method of treating kidney cancer" (see the book. Garin A.M., Khlebnov A.V., Gabogari D.Z. "Reference to antitumor drug therapy", 1993, p. 49), we selected as a prototype, which consists in the use of the hormonal drug depot-proof - 500 mg IM once a week for several months. This method of treating patients with renal cell carcinoma is limited to the use of only this drug at different stages of the tumor process. Its disadvantage is the duration of the course of treatment, the absence of a pronounced clinical effect, hormonal complications associated with the drug, relapses and metastases in the early stages after treatment.

 All these disadvantages of the known methods of treating renal cell carcinoma at various stages of the spread of the tumor process require further improvement of the treatment methods.

 The aim of the invention is to increase the effectiveness of treatment, which consists in reducing toxic manifestations, hormonal and immune status disorders, increasing the disease-free period, and reducing metastasis.

This goal is achieved by the fact that in the preoperative period they conduct a course of polychemotherapy (PCT) according to the scheme: vincristine - 1.4 mg / m ² in / in the stream - day 1; 70 mg / m ^{2 of} adriamycin is added to 150 ml of the patient’s autologous blood, the mixture is incubated for 30 minutes, intravenous reinfusion is infused - day 2; 500 mg of depot-test is administered in oil - the 4th day; after 7-10 days, a radical nephrectomy is performed, and after 7-10 days after the operation, the above autohemotherapy and the introduction of a depot check are repeated.

 The invention "A method for the treatment of kidney cancer" is new, as it is unknown from the level of medicine in the field of chemotherapeutic and surgical treatment of kidney cancer in oncourology.

The novelty of the invention lies in the fact that in the preoperative period they conduct a course of polychemotherapy according to the following scheme: vincristine - 1.4 mg / m ² iv in a jet - 1 day; 70 mg / m ^{2 of} adriamycin is added to 150 ml of autologous blood, the mixture is incubated for 30 minutes, intravenous reinfusion is infused - day 2; 500 mg depot-proof in oil - the 4th day; after 7-10 days, a radical nephrectomy is performed, and after 7-10 days after the operation, the above-described polychemotherapy, autohemotherapy and the introduction of a depot test are repeated. Thus, the novelty of the invention in the use of autohemochemotherapy in combination with the hormonal preparation depot-proof in the preoperative and postoperative periods.

 The invention has an inventive step, since for a specialist urologist-oncologist it does not explicitly follow from the level of development of medicine, in particular in oncourology, in the treatment of renal cell cancer in the preoperative and postoperative periods with chemotherapeutic and hormonal agents in combination with autohemotherapy. The authors associated the reduction of toxic manifestations of polychemotherapy, hormonal and immune disorders, lengthening of the relapse-free and metastatic period with two autohemotherapy procedures.

 The invention is not obvious, not following from the level of modern medicine, it is not known in the world, nor in the CIS and Russia medical literature.

 The invention "A method for the treatment of kidney cancer" is industrially applicable and can be used in healthcare in research oncological institutes, oncology dispensaries and other medical institutions involved in the treatment of renal cell cancer.

A "method of treating kidney cancer" is performed as follows: patients with kidney cancer in the preoperative period undergo a course of polychemotherapy according to the scheme: vincristine - 1.4 mg / m ² in / in stream - day 1; on the 2nd day, the patient’s blood is taken in a special bottle with glugicir in the amount of 150 ml, adriamycin is added to the bottle with blood and glugicir at a rate of 70 mg / m ² , the mixture is incubated in an thermostat at t = 36.5-37 ^o C within 30 minutes, followed by reinfusion intravenously, drip; on the 4th day, a depot prover is administered - 500 mg - intramuscularly. 7-10 days after administration, surgery is performed - radical nephrectomy. On the 7-10th day after the operation, the course of preoperative polychemotherapy is repeated according to the above scheme and methodology: vincristine - 1.4 mg / m ² iv / jet - 1 day; adriamycin 70 mg / m ² on previously taken autologous blood in a special vial with glugicir - blood volume - 150 ml, followed by incubation in an thermostat at t = 36.5-37 ^o C for 30 minutes, and intravenous drip reinfusion - 2nd day and a depot check in / m 500 mg - the 4th day.

 Examples of specific performance of the "Method of treating kidney cancer."

 An example of a specific application of the "Method for the treatment of kidney cancer" 1.

Patient S., 14268 / k was admitted to the Department of Oncourology with complaints of hyperthermia - up to 38 ^o C in the evenings for 2 months, general weakness, weight loss. After the examination, DS was put: tumor of the left kidney T3N1M0, gr. II. According to ultrasound: in the n / pole of the left kidney, a tuberous formation of 8.7 • 6.0 • 8.0 cm in the upper part of the mesogastrium is paraaortally 2 lymph nodes 2.8 and 3.0 cm.

 The patient received preoperative AGCT. When ultrasound control: a tumor of 8.7 • 6.2 cm, retroperitoneal lymph nodes are not located. Then a radical nephrectomy was performed on the left. Intraoperatively: the vascular pedicle is infiltrated by a tumor. GA 557899-902 moderately differentiated renal cell carcinoma, clear cell variant with foci of necrosis, with the capsule sprouting. There is no cancer in the regional lymph nodes.

 On the 12th day after the operation, a second course of AGCT was performed.

 Discharged in clinical group III. The follow-up period was 5 months. There is no data for relapse and the presence of distant metastases.

 Clinical application example 2.

 Patient C. 2392 / l was admitted to the oncourological department of the RNII with complaints of pain in the lumbar region, which were stopped by the use of non-narcotic analgesics (baralgin 4-5). First noted the appearance of pain 2 months ago after a road injury. When examining according to ultrasound: on the right on the front surface of the lower pole is a volumetric formation with clear contours with a diameter of 56 mm. The patient underwent a non-adjuvant course of AGHT. Clinical effect - the pain syndrome was stopped, the patient refused to take analgesics. At control ultrasound: volumetric education 5.8 • 5.3 cm, on the 10th day the patient underwent radical nephrectomy on the right. GA 566397-98 moderately differentiated renal cell carcinoma, clear cell variant without capsule invasion. Macro drug: kidney 7 • 5 • 5 cm, tumor node 3 cm in diameter in the lower pole. Postoperative period without features. On the 10th day - an adjuvant course of AGHT. Discharged in clinical group III. The observation period was 8 months. There is no data for relapse.

 In both cases, no toxic effect of polychemotherapy on bone marrow cells was observed. According to the immunogram, inhibition of immunity was not noted.

 The technical and economic effectiveness of the "Method for the treatment of kidney cancer" lies in the fact that the application of the method increases the effectiveness of treatment, reduces toxic manifestations, complications of hormonal imbalance, increases the relapse-free period, and reduces the incidence of distant metastases.

 A method of treatment is available, the course of treatment, despite some duration, is well tolerated by patients, can be widely used in oncology in various medical institutions.

Claims (1)

A method of treating kidney cancer, including polychemotherapy, an operation characterized in that in the preoperative period, a course of polychemotherapy is carried out according to the following scheme: vincristine - 1.4 mg / m ² iv / jet - 1 day; 70 mg / m ^{2 of} adriamycin is added to 150 ml of autologous blood, the mixture is incubated for 30 minutes, intravenous reinfusion is infused - day 2; 500 mg of depot-test is administered in oil - the 4th day; after 7-10 days, a radical nephrectomy is performed, and after 7-10 days after the operation, the above-described polychemotherapy, autohemotherapy and the introduction of a depot test are repeated.