RU2286814C1 - Method for treating skin cancer and mucosal cancer - Google Patents

Abstract

FIELD: medicine, oncology.

SUBSTANCE: it is necessary to fulfill combined laser and radiation impact due to simultaneous application of laser irradiation for tumoral focus and cancerocidal dosage of roentgenological beams upon low-energetic equipment from the distance of about 7-10 cm at dosage power being 1 Gy/min up to maximal dosage of about 58-62 Gy for about 0.4-3.0 min. Moreover, laser impact should be carried out for 3 min at average power of radiation being 2.4 mW, wave length of 0.662 mcm. The method prevents the onset and the development of radiation-induced lesions in tissue and organs involved into area of radiation impact.

EFFECT: higher efficiency of therapy.

2 cl, 3 ex

Description

The invention relates to medicine, namely to oncology, and can be used in close-focus radiation and low-intensity laser therapy of superficially located malignant neoplasms of the skin and mucous membranes for the prevention and treatment of injuries resulting from radiation therapy.

Over the past decade (see Gusev L.I. et al. Clinical studies of the effectiveness of low-intensity laser radiation in oncology. BULLETIN of the Russian Cancer Research Center named after N.N. Blokhin RAMS, No. 2/2003, p. 36-41) application of low-intensity Laser radiation (LLLT) has taken a strong position as a highly effective way to treat and prevent many diseases and pathological conditions. Received and published data on the positive results of the treatment of LLLT of postoperative complications in cancer patients with various localizations, both in adults and in children. The effectiveness of LLLT in early radiation reactions of varying severity is proved. In addition, it was shown that laser radiation stimulates the body's reactivity in oncopathology.

A known method of treating cancer of the skin and mucous membranes (see Patent RU No. 2088285 according to class A 61 N 5/06, claimed., Publ. 27.08.97,), including a joint alternating low-intensity laser radiation and after 6-25 min - radiation exposure.

The disadvantage of this method is the low reliability of the method, because when it is used, although the organism’s reactivity is stimulated during oncopathology, however, taking into account the different possibilities of the cancer patient’s organism, having different ages and varying degrees of disease neglect, the use of this sequence does not allow to achieve the effect of a significant reduction in the frequency and depth of local radiation injuries and a reduction in the time of their healing.

In addition, only a tumor is subjected to laser exposure without affecting the tissues and organs involved in the radiation exposure zone, which also does not allow to achieve the effect of preventing the occurrence and treatment of radiation injuries.

The closest in technical essence and the achieved effect to the claimed method and selected as a prototype is a method of treating cancer of the skin and mucous membranes (see patent RU No. 2161054 according to class A 61 N 5/067, filed July 10, 1998, publ. December 27, 2000), including radiation exposure, followed by exposure to low-intensity laser radiation on tissues and organs involved in the radiation exposure zone. Laser exposure is carried out by radiation, mainly of the red and infrared wavelength ranges of 0.63 and / or 0.89 microns in continuous or pulsed mode at a power of 0.3-25.0 mW and the total energy recruited per session, comprising 0.1- 55.0 J by remote and / or contact (and / or intraorgan and / or intravascular) means together with gamma radiation.

The disadvantage of this method, as well as in the analogue, is the low reliability of the method, because exposure to laser radiation is carried out only after 30-40 minutes after the end of radiation exposure, which does not help to prevent the occurrence of radiation damage, but is used primarily for the treatment of adverse reactions resulting from previous radiation exposure.

The objective of the invention is to increase the reliability of the method by preventing the occurrence of radiation damage.

The technical result is the creation of an optimal method that allows you to achieve the effect of preventing the occurrence of radiation complications of tissues and organs involved in the radiation zone by simultaneous radiation exposure with low-intensity laser radiation.

The task is carried out by the fact that in the known method for the treatment of cancer of the skin and mucous membranes, including a combined radiation exposure with low-intensity laser radiation on the tissues and organs involved in the radiation exposure zone, according to the invention, the combined laser and radiation exposure is performed by simultaneously applying a synchronous laser to the tumor focus irradiation and a concertocidal dose of x-rays in the installation from a distance of 7-10 cm with a dose rate of 1 Gy / min to a dose maximum of 58-62 Gy for from 0.4-3.0 min, is performed simultaneously laser irradiation for 3 minutes with an average power of 2.4 mW, a wavelength of 0.662 microns.

In addition, laser irradiation can block radiation exposure at the beginning and end of irradiation for 30-50 s, while simultaneous laser x-ray therapy can be carried out daily for 15-20 days.

Studies conducted on the sources of patent and medical information have shown that the proposed method is not known and does not follow explicitly from the material studied, i.e. meets the criteria of "novelty" and "inventive step".

The proposed method can find application in the treatment of cancer patients, in particular, close-focus radiation and low-intensity laser therapy of superficially located malignant neoplasms of the skin and mucous membranes, with the possibility of preventing radiation complications, by using installations made by domestic or foreign industry, therefore, the method meets the criterion of "industrial applicability"

The use in the method of combined laser and radiation exposure by simultaneously applying simultaneous laser irradiation and a carcinocidal dose of x-rays to the tumor site allows not only to completely remove the tumor, but also to prevent or reduce the incidence of unwanted radiation reactions and complications.

Irradiation from a distance of 7-10 cm with a dose rate of 1 Gy / min to a dose max of 58-62 Gy for a duration of 0.4-3.0 minutes, with simultaneous laser exposure for 3 minutes with an average radiation power of 2.4 mW, 0.662 μm wavelength avoids severe radiation damage.

In addition, laser irradiation covers radiation exposure at the beginning and end of irradiation for 30-50 s, which allows not only to prevent radiation complications, but also to consolidate the achieved result, and simultaneous laser therapy daily, for example, for 15-20 days, does not only a complete cure for a malignant tumor, but also prevents possible radiation damage.

The method is carried out on an improved close-focus X-ray therapeutic device RUM-21, equipped with an additional removable cylindrical nozzle in the form of a tube with a through hole made in its lateral part at an angle of 45-50 ° to the axis, with the possibility of placing a laser emitter in it (low-intensity laser fiber).

A protective application is made from the lead rubber or lead sheet on the surface of the patient’s skin and a hole is cut out in the shape of the tumor, which should be 5 mm wider than the tumor. Depending on the shape and height of the tumor, the patient selects an additional removable nozzle to the x-ray tube. A low-intensity laser fiber is introduced into the through hole and the tumor is initially irradiated with a laser beam. After 0.3-0.5 minutes, an X-ray therapy device is connected and a combined laser and radiation exposure is performed by simultaneously applying a synchronous laser exposure to the tumor site with an average radiation power of 2.4 mW, a wavelength of 0.662 μm, and a concertocidal dose of X-rays from a distance of 7 10 cm with a dose rate of 1 Gy / min to a maximum dose of 58-62 Gy for a duration of 0.4-3.0 minutes. After shutting down the X-ray irradiation, after 0.3-0.5 minutes the laser irradiation is switched off, i.e. laser irradiation covers radiation exposure at the beginning and end of irradiation for 30-50 s. Laser X-ray therapy is carried out daily for 15-25 days.

Example 1

Patient Tipakov Ivan Elizarovich.

Diagnosis: "Basal cell carcinoma of the skin of the nasal dorsum."

Since September, a bleeding formation appeared on the skin of the nasal bridge, which began to gradually increase in size. I went to the polyclinic OOD. Cytologically: basal cell cancer No. 1481. On December 1, a course of close-focus x-ray therapy was started on the advanced apparatus RUM-21, genus 3.7 Gy daily. The exposure time is 40 s. The size of the lesion is 0.7 × 0.6 cm. The filter is 0.5 mm. AI, S (tube outlet area) = 2 sq. Cm. At the same time, laser irradiation was carried out for 3 min through the opening of a cylindrical tube with a radiation power of 2.2 mW, with a wavelength of 0.662 μm.

By the end of the course of treatment, after adjusting the dose to the primary tumor, an SOD of 55.5 Gy, complete clinical resorption was noted. There were no reactions from the skin throughout the course of treatment. Directly with this method of treatment, a subjectively patient noted a feeling of warmth and slight tingling in the area of contact of the device with the skin in the irradiation zone. There were no general reactions.

With a follow-up of up to 4 months. The tumor did not recur.

Example 2

Patient Krivoshchapov Victor Stepanovich.

Diagnosis: "Skin cancer of the right cheek T1N0M0"

Over the past 2 years, the presence of education on the skin of the right cheek has been noted. I went to the polyclinic OOD. Histologically: squamous non-keratinized cancer No. 5997-99.

Irradiation was carried out on an advanced close-focus apparatus RUM-21, ROD 5.6 Gy daily. The exposure time is 1 min 50 sec. The size of the outbreak is 0.8 × 0.6 cm. The filter is 1.2 mm. Al, S = 3 sq. Cm with simultaneous laser exposure for 3 min with an average radiation power of 2.4 mW, a wavelength of 0.662 μm.

By the end of the course of treatment, after the dose was adjusted to the primary tumor, SOD 67 Gy, a marked regression of the tumor was observed. There were no reactions from the skin throughout the course of treatment. Directly with this method of treatment, a subjectively patient noted a feeling of warmth and light tingling in the area of contact of the tube of the apparatus with the skin. No general reactions were noted.

At observation periods of up to 3 months, tumor growth was not observed.

Example 3. Patient Shkurkin Valery Ivanovich. Diagnosis: Basal cell cancer of the forehead skin T1N0M0 "

From youth, he notes the presence of an education on the skin of the forehead. Within a year, it began to bother - itching appeared. I went to the polyclinic OOD.

Diagnosis: "Basal cell cancer of the forehead skin T1N0M0"

From youth, he notes the presence of an education on the skin of the forehead. Within a year, it began to bother - itching appeared. I went to the polyclinic OOD. Cytologically: Bazalioma No. 989.

On November 22, a course of x-ray therapy was started on an advanced close-focus apparatus RUM-21, genus 3.7 Gy daily. The exposure time is 40 s, the focus size is 1.2 × 1.4 cm. The filter is 0.5 mm, Al, S = 2 cm2, with simultaneous laser exposure for 3 min with an average radiation power of 2.2 mW at the end of the fiber, wavelength of 0.662 microns.

By the end of the course of treatment, after adjusting the dose to the primary tumor with an SOD of 55.8 Gy, a complete regression of the tumor was observed. There were no reactions from the skin throughout the course of treatment. Directly with this treatment technique, the subjectively patient noted a feeling of warmth and slight tingling in the area of radiation.

With a follow-up of up to 6 months. tumor growth did not resume.

Simultaneous simultaneous radiation and laser therapy was performed for 10 patients with basal squamous cell carcinoma of the skin. All patients achieved complete tumor regression, and the absence of radiation reactions of the skin was noted as an advantage.

Thus, in comparison with the prototype, the simultaneous introduction of a carcinoid dose of x-rays and synchronous laser irradiation to a skin tumor helps to increase the effectiveness of treatment (tumor cells die 20% faster than exposure time) in the absence or significant decrease in the severity of radiation reactions and is safe for patients.

Claims (3)

1. A method of treating cancer of the skin and mucous membranes, comprising a combined radiation exposure with low-intensity laser radiation on the tissues and organs involved in the radiation exposure zone, characterized in that the combined laser and radiation exposure produce simultaneous laser radiation exposure to the tumor site and a carcinocidal dose of x-rays in a low-energy installation from a distance of 7-10 cm with a dose rate of 1 Gy / min to a dose of 58-62 Gy for a duration of 0.4-3.0 minutes, while simultaneously conducting laser e exposure for 3 minutes with an average power of 2.4 mW, a wavelength of 0.662 microns. 2. A method for the treatment of cancer of the skin and mucous membranes according to claim 1, characterized in that the laser irradiation blocks the radiation exposure at the beginning and end of irradiation for 30-50 s. 3. A method of treating cancer of the skin and mucous membranes according to claim 1, characterized in that the simultaneous laser x-ray therapy is carried out daily for 15-20 days.