RU2211716C2 - Method for treating malignant nasopharyngeal tumors - Google Patents

Abstract

FIELD: medicine, oncology. SUBSTANCE: it is suggested to conduct radical course of radiation therapy due to braking radiation of betatron at 25 Mev for 7-8 min from two contrary lateral fields of 6x8 cm size, single focal dosage is 2 g, daily, 5 times weekly, total focal dosage is 60-70 g, therapy course lasts for 6-7 wk and, also, inject cisplatin as radiosensitizer at the dosage of 30 mg/sq. m, once weekly, on the 3d or 4th d after radiation therapy, intravenously, by drops, at the background of hyperhydration during the whole period of irradiation course. The suggested method enables to decrease frequency of general and local radiation reactions, radiation lesions of healthy tissues and vital organs. EFFECT: higher efficiency of therapy.

Description

 The invention relates to medicine, specifically to otorhinolaryngology, and relates to methods for treating malignant neoplasms of the nasopharynx.

 The closest (prototype) is a method of treating malignant neoplasms of the nasopharynx by irradiation on the gamma-therapeutic unit "Rokus" (Pavlov A.S., Stiop L.D., 1985). Irradiation is carried out according to the standard method: a single focal dose of 2 Gy daily, 5 times a week, the total focal dose - 60-70 Gy. The course of exposure is 6-7 weeks.

 However, with the known method there is a large number of acute general and local radiation reactions, a high frequency of radiation damage to normal tissues and vital organs, the frequency of complete tumor regression is insufficient.

 The problem solved by this invention is to reduce the frequency of acute general and local radiation reactions, radiation damage to normal tissues and vital organs, increasing the effectiveness of treatment results.

The problem is solved by a method of treating malignant tumors of the nasopharynx, which consists in conducting a radical course of radiation therapy with inhibitory radiation of a 25 MeV betatron from two oncoming lateral fields measuring 6 x 8 cm by 2 Gy daily, 5 times a week, the duration of the irradiation session is 7-8 minutes, total focal dose - 60-70 Gy and the introduction of cisplatin as a radiosensitizer at a dose of 30 mg / m ² , 1 time per week (on the 3-4th day after radiation therapy), intravenously, drip, against the background of hyperhydration, throughout irradiation rate Nia. The duration of treatment is 6-7 weeks.

New in the invention is that radiation therapy is carried out by inhibitory radiation of a 25 MeV betatron for 7-8 minutes, cisplatin is administered as a radiosensitizer at a dose of 30 mg / m ² intravenously, drip, 1 time per week on the 3-4th day after conducting radiation therapy throughout the course of exposure.

 The authors did not find in the literature they analyzed these distinguishing features.

 This technical solution passed clinical trials at the Oncology Research Institute of the Tomsk Scientific Center SB RAMS.

 Thus, this technical solution meets the criteria of the invention: "novelty", "inventive step" and "industrially applicable".

 The positive effect of this invention is to reduce the frequency of acute general and local radiation reactions, radiation injuries of normal tissues and vital organs, increase the effectiveness of treatment results - is achieved due to experimentally and clinically determined sequences and radiation therapy regimens of inhibitory radiation of 25 MeV betatron and cisplatin. The use of bremsstrahlung allows to achieve the optimal effect of irradiation of the affected organ, since a well-focused beam penetrates 4.5-5 cm (unlike the prototype, where scattering occurs), and also due to the fact that the maximum dose of radiation falls on the center of the tumor and due to the same patency through bone and soft tissue structures. The introduction of cisplatin as a radiosensitizer during the entire course of irradiation made it possible to strengthen the effect of radiation therapy and increase the effectiveness of radiation exposure to tumor tissue without increasing a single focal dose of radiation. Effective, but low doses of cisplatin were experimentally selected. The use of low doses of cisplatin allowed avoiding the side effects characteristic of therapeutic doses of this cytostatic and achieving a radiosensitizing effect in combination with radiation therapy. Cisplatin in sub-therapeutic doses, in addition to the direct cytostatic effect, inhibits the repair of sub- and potentially fatal post-radiation injuries, thereby increasing the degree of tumor resorption.

To achieve a positive effect, it is necessary to adhere to the following treatment regimen: daily, 5 times a week, a radiation therapy session is performed with inhibitory radiation of a 25 MeV betatron from two opposite side fields 6 x 8 cm in size, a single focal dose is 2 Gy, the duration of the irradiation session is 7 -8 minutes, the total focal dose of 60-70 Gy and cisplatin is administered as a radiosensitizer at a dose of 30 mg / m ² , 1 time per week, on the 3-4th day after radiation therapy, intravenously, drip, against the background of hyperhydration, throughout the course and exposure. The duration of treatment is 6-7 weeks.

The method is as follows: the patient is prescribed a radical course of radiation therapy with inhibitory radiation of a 25 MeV betatron from two oncoming lateral fields measuring 6 x 8 cm, a single focal dose of 2 Gy, daily, 5 times a week, the duration of the irradiation session is 7-8 minutes, total the focal dose is 60-70 Gy and cisplatin is administered as a radiosensitizer in a dose of 30 mg / m ² , 1 time per week, on the 3-4th day after radiation therapy, intravenously, drip, against the background of hyperhydration, throughout the course exposure. The course of treatment is 6-7 weeks.

Example. Patient D., 51 years old. Medical history 122893. Diagnosis: Nasopharyngeal cancer T ₃ N ₀ M ₀ . Histology 1395-96; transitional cell carcinoma. The tumor occupied the dome of the nasopharynx, spreading to the mouth of the auditory tubes and the upper parts of the choanas.

 C 27.1l. 00 g. To 01/17/01 received a radical course of radiation therapy with inhibitory radiation of a 25 MeV betatron from two opposite side fields measuring 6 x 8 cm, a single focal dose - 2 Gy, daily, 5 times a week, the duration of the irradiation session is 7-8 minutes, the total focal dose to the nasopharynx was 66 Gy. During the entire course of radiation therapy, cisplatin was administered as a radiosensitizer at a dose of 60 mg, intravenously, drip, 1 time per week, on the 3rd day after radiation therapy, against the background of hyperhydration. The duration of treatment was 6.5 weeks. During control epipharyngoscopy, there are no signs of tumor growth in the nasopharynx (complete regression has come). Immediately after discharge, the patient began his previous work. At the control examination two months after the end of treatment, there are no signs of tumor growth.

 Thus, the present invention allows due to new significant features to achieve a new positive effect of reducing the frequency of acute general and local radiation reactions, radiation injuries of normal tissues and vital organs, increasing the effectiveness of treatment results.

Claims (1)

A method for the treatment of malignant tumors of the nasopharynx, which consists in carrying out a radical course of radiation therapy with two opposite side fields measuring 6x8 cm, a single focal dose - 2 Gy, daily, 5 times a week, the total focal dose - 60 - 70 Gy, the course of treatment is 6-7 weeks, characterized in that radiation therapy is carried out by inhibitory radiation of a 25 MeV betatron for 7-8 minutes and cisplatin is administered as a radiosensitizer at a dose of 30 mg / m ² , 1 time per week, on the 3-4th day after radiation therapy , intravenously, drip, against the background of hyperhydrate tion, during the entire course of exposure.