RU2383371C1 - Installation for treatment of skin tumours while performing photodynamic therapy sessions - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: installation contains controlling light dose source of laser radiation, whose light conductor is fastened on support, and device for protection of healthy skin from laser irradiation, fastened with possibility of fixation in definite position, via transitional device, on frontal holder. Device for protection made in form of three parallel flat discs, having general central axis, external discs being rigidly connected to each other on perimetre with formation of blind cavity and with transitional device. Internal disc has smaller than external discs diametre, is fastened on general central axis with possibility of rotation and is divided into equal sectors, in each of which through opening of definite diametre is made. In each of external discs coaxially one above another there is opening in form of sector, whose central angle equals central angle of internal disc sector.

EFFECT: increasing efficiency of treatment of any parts of head and neck due to reliable fixation of device for protection of healthy skin from irradiation above tumour.

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Description

The invention relates to medicine, namely to devices used in the treatment of skin tumors using a laser, and can be used in the treatment of basal cell skin cancer or squamous skin cancer.

For the treatment of skin tumors, photodynamic therapy (PDT) is performed, for which a photosensitizer (PS) is administered intravenously, and after a certain time (sufficient for PS to enter the tumor cells), skin tumors are irradiated with a laser, for example, Innova-200 or Atkus-2 ( EF Stranadko, N. A. Markichev, M. V. Ryabov “Photodynamic therapy in the treatment of malignant neoplasms of various localizations”, M. - 2002, p. 4-7). As practice has shown, in the course of photodynamic therapy of skin tumors, in some cases, unwanted hyperemia and edema of healthy skin around the tumor occur, which leads to difficult treatment and undesirable complications.

A known installation for the treatment of skin tumors, consisting of a laser source installed with the ability to regulate laser radiation on the tumor area, devices for fixing the fiber and protective dark paper with a hole in the center to protect healthy skin (E.F. Stranadko, T.A. Astrakhankin "Photodynamic therapy of skin cancer", M. - 1999, p.7). In this installation, improvised means with a hole in the center or pieces of black paper with a hole in the center cut to the size of the laser light spot (prototype) are used as devices for protecting healthy skin.

A disadvantage of the known installation is the low effectiveness of the treatment, due to the lack of fixation of protective devices in a stationary state on the skin relative to tumors located in different areas of the head, neck and periorbital region.

The technical result of the invention is an increase in the number of areas of exposure while increasing the effectiveness of treatment by eliminating the possibility of damage to healthy skin adjacent to the tumor area.

The specified technical result is achieved by the fact that in the known apparatus for treating skin tumors during photodynamic therapy sessions containing a light dose regulating laser radiation source, the light guide of which is mounted on a tripod, and a device for protecting healthy skin from laser radiation, according to the invention, a device for protecting healthy skin from laser radiation is fixed with the possibility of fixing in a predetermined position through an adapter on the frontal holder and is made in the form of three parallel flat disks having a common central axis, while the outer disks are rigidly interconnected around the perimeter with the formation of a blind cavity and with a transition device, the inner disk is made of a smaller diameter with respect to the outer disks, mounted on a common central axis with the possibility of rotation and divided into equal sectors, in each of which a through hole of a given diameter is made, and in each of the outer disks, a hole is made coaxially above each other in the form of a sector whose central angle is equal to the price eral corner of the inner disk sector.

Figure 1 presents a block diagram of an installation for the treatment of skin tumors during PDT sessions;

figure 2 - a device for protecting healthy skin during PDT sessions of skin tumors (disassembled - three disks);

figure 3 - a device for protecting healthy skin during PDT sessions of skin tumors (General view, connected through an adapter to the frontal holder);

figure 4 - a device for protecting healthy skin during PDT sessions of skin tumors (view aa of figure 3).

Installation for the treatment of skin tumors contains a laser 1 on a stand 2. The optical fiber 3 is mounted on the panel of the laser 1 and on a tripod 4 for fixing the optical fiber in front of the irradiated focus on the skin. As a laser 1, any industrially produced laser for PDT can be used (for example, Atkus-2 or Innova-200). The device 5 for protecting healthy skin from laser radiation is fixed above the tumor using the frontal holder 6 and the transition device 7 at a distance of at least 5 mm from the tumor.

The device 5 for protecting healthy skin from laser radiation consists of three plastic flat disks: external 8, 9 and internal 10. The external disks 8 and 9 are rigidly connected (adhesive joint) around the perimeter of a flat strip 11 of plastic with the formation of a blind cavity. The inner disk 10 is mounted on a common axis 12 common to all three disks and is made of a smaller diameter than the diameters of the disks 8 and 9, which makes it possible to rotate it using a handle inside this cavity. The inner disk 10 is divided into five equal sectors with a central angle of 72 °. In each sector, a hole 13 of different diameters (10, 15, 20, 25, 30 mm) was made. The outer discs 8 and 9 have identically cut sectors 14 arranged coaxially one above the other. The central angle of the sector of the disk 10 is equal to the central angle of the sectors 14 of the disks 8 and 9. The diameters of the holes 13 of the inner disk 10 are selected based on the size range of the most common areas of the skin affected by the tumor. The centers of these holes are located as close as possible to the axis of the disk 10 for maximum protection of healthy skin from laser radiation. The overall dimensions of the outer disks 8, 9, as an option, are 120 mm in diameter, the inner disk 10 is 118 mm, the thickness of the disks 8, 9, 10 is 1 mm, the distance between the outer disks is 2 mm. The outer disks 8 and 9, forming a blind cavity, are connected to the adapter 7 by the rod 15 (Fig.3).

The frontal holder 6 is made in the form of a plastic tape 650 mm long, 25 mm wide, 3 mm thick, which has a latch (without pos.) For fixing around the circumference of the patient's head in accordance with its size. On the frontal holder 6 there is placed a plastic plate moved along it with a metal hinge (without pos.) Connected to the adapter 7, which consists of two metal plates, through which a screw with a wide head passes through the central hole for the convenience of fixing the metal hinge of the plastic plate of the frontal holder 6 and the metal hinge of the rod 15, rigidly connected with the disks 8 and 9 of the device for protecting healthy skin from radiation (figure 3).

Installation for the treatment of skin tumors operates as follows.

Example. Patient K., aged 64, was diagnosed with a solid basal cell carcinoma of the right cheek. Tumor diameter 10 mm, height 4 mm. The patient is injected with an intravenous photosensitizer, after 2 hours a light guide 3 is inserted, which is fixed in a tripod 4 over the tumor. A device 5 is mounted above this tumor to protect healthy skin from radiation, using a transition device 7 connected to the frontal holder 6 so that the laser beam passes through sectors 14 of disks 8 and 9. The inner disk 10 is turned with a handle on the axis 12, leading the hole 13, having a diameter of 20 mm (from the condition that the minimum excess of the diameter of the tumor is 10 mm). Set the dose of laser light and turn on the laser 1. The exposure time to the tumor is set to 8.5 minutes, after which the laser 1 is turned off automatically. After a photodynamic therapy session, the frontal holder 6 is removed from the patient along with a device for protecting healthy skin from laser radiation.

At the end of the session, the patient did not complain. When observing the patient for a month after treatment, there were no complaints, the dose of light exposure was sufficient, the hemorrhagic scab in the lesion focussed with the formation of a tender scar, there were no complications in the form of hyperemia and edema of healthy skin around the tumor.

The proposed installation was used in the treatment of 52 patients with basal cell and squamous cell carcinomas. No complications were found after treatment.

Thus, the use of the invention will increase the effectiveness of the treatment of skin cancers, eliminating the complications associated with the defeat of healthy skin around the tumor and the displacement of the protective devices of the skin relative to the tumor during photodynamic therapy.

Claims (1)

An apparatus for treating skin tumors during photodynamic therapy sessions, comprising a laser dose regulating light dose, a light guide of which is mounted on a tripod, and a device for protecting healthy skin from laser radiation, characterized in that the device for protecting healthy skin from laser radiation is fixed with the possibility fixing in a predetermined position, through the adapter, on the frontal holder and is made in the form of three parallel flat disks having a common central axis, with the outer disks are rigidly interconnected around the perimeter with the formation of a blind cavity and - with a transition device, the inner disk is made of a smaller diameter with respect to the outer disks, mounted on a common central axis with the possibility of rotation and divided into equal sectors, each of which is made through a hole of a given diameter, and in each of the outer disks coaxially above each other, a hole is made in the form of a sector, the central angle of which is equal to the central angle of the sector of the internal disk.

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