RU2465928C2 - Method of treating large intestine cancer metastases into liver - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely, to oncology, and can be used in complex treatment of metastases in liver, in particular of large intestine cancer. For this purpose, performed is sampling of 200 ml of blood with its further centrifuging and separation of autoleukomass. 5 ml of autoleukomass and chemical preparations are placed into the first vial, the remaining formed elements of blood, plasma and chemical preparations are placed into the second vial. Vials are incubated separately for 40 minutes at 37°C. After that transcutaneous radio-frequency thermal ablation of metastases into liver is performed under ultrasound control. When thermal ablation is finished, incubated autoleukomass with chemical preparations from the first vial is introduced into the bed of metastasis subjected to thermal destruction by means of infusion pump in electrosurgical device. Simultaneously incubated formed elements of blood, plasma with chemical preparations from the second vial are introduced intravenously by drop infusion.

EFFECT: method makes it possible to reduce frequency of tumour progressing and increase survival of patients due to combination of surgery, local intra-tissue chemical therapy and autohemochemotherapy.

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Description

The invention relates to medicine, namely to Oncology, and can be used in the complex treatment of liver metastases, in particular colon cancer.

The well-known "Method of combined treatment of metastases of colorectal cancer in the liver using adjuvant chemotherapy" (see Polyakov AN Combined treatment of metastases of colorectal cancer in the liver: Abstract. Dis. ... Cand. Medical Sciences. M., 2009). The method includes a liver resection with 2-8 weeks after chemotherapy surgery. The first course was carried out regionally in the hepatic artery, the subsequent courses - intravenously. A combination of 5-fluorouracil and leucovorin or oxaliplatin, 5-fluorouracil, leucovorin was used.

However, the frequency of side effects reaches 57.7%, the duration of the relapse-free period is negligible, and the overall survival of patients is not presented.

The well-known "Method of high-frequency thermal destruction in the treatment of metastatic liver tumors" (see Perfilov A. A. Experimental and clinical justification of high-frequency thermal destruction in the treatment of unresectable malignant primary and metastatic liver tumors: Abstract of thesis ... Candidate of Medical Science. Rostov-on Don, 2006). The method consists in the fact that patients underwent surgery and high-frequency thermal destruction of metastases in the liver using a designed apparatus. Then the patients received 5 courses of adjuvant autohemochemotherapy with 5-fluorouracil and leucovarin.

However, the high-frequency thermal destruction of liver metastases in combination with intravenous autohemochemotherapy did not improve the average life expectancy of patients.

The well-known "Method of electrolysis destruction in the treatment of metastatic liver tumors" (see Morozov AN Electrolysis destruction of malignant unresectable neoplasms of the liver: Abstract of thesis ... candidate of medical sciences. Rostov-on-Don, 2009). The method consists in the fact that patients underwent surgery and local electrolysis destruction of metastases in the liver. Then the patients received 5 courses of adjuvant autohemochemotherapy with 5-fluorouracil and leucovarin.

However, local electrolysis destruction of liver metastases in combination with intravenous autohemochemotherapy did not improve survival rates of patients; improvement of results was observed only in primary liver cancer.

The well-known "Method of surgical chemotherapy in the prevention of relapse of cancer", selected by us as a prototype (See Sidorenko Yu.S., Orlovskaya L.A., Soldatkina N.V. et al. Methods of surgical chemotherapy on autologous organisms during operations for malignant tumors of the breast and colon // Surgery, No. 10, 2006, S. 27-29). The method consists in the fact that during the operation, after removal of the tumor, for example, the mammary gland or colon, the tumor bed is infiltrated with autoplasma with chemotherapy drugs. A significant decrease in the number of local tumor relapses was shown.

However, the method is developed for the treatment of tumors of the mammary gland and colon and cannot be used in the treatment of liver metastases.

The aim of the invention is to improve the treatment of metastases in the liver of colon cancer.

This goal is achieved by the fact that 200 ml of blood is taken from patients, autoleukomassa is extracted from the blood by centrifugation, 5 ml of autoleukomassa and chemotherapeutic agents are placed in the first vial, the remaining blood cells, plasma and chemotherapy are placed in the second vial; separate incubated vials for 40 minutes at 37 ° C. Then, transdermal radiofrequency thermoablation of metastases to the liver is performed under ultrasound control, after which an incubated autoleucomass with chemotherapy from the first vial is injected through the infusion pump in the electrosurgical device into the bed of the thermo-destroyed metastasis. At the same time, incubated blood cells, plasma with chemotherapy from the second bottle are injected dropwise.

The invention “A method for the treatment of liver cancer of the colon cancer” is new, as it is unknown in the field of medicine in the treatment of liver cancer of the colon cancer.

The novelty of the invention lies in the fact that 200 ml of blood is taken from patients, autoleukomassa is extracted from the blood by centrifugation, 5 ml of autoleukomassa and chemotherapeutic agents are placed in the first vial, and the remaining blood cells, plasma and chemotherapy are placed in the second vial; separate incubated vials for 40 minutes at 37 ° C. Then, transdermal radiofrequency thermoablation of metastases to the liver is performed under ultrasound control, after which an incubated autoleucomass with chemotherapy from the first vial is injected through the infusion pump in the electrosurgical device into the bed of the thermo-destroyed metastasis. At the same time, incubated blood cells, plasma with chemotherapy from the second bottle are injected dropwise.

Thus, percutaneous radiofrequency thermoablation of liver metastases, interstitial chemotherapy on autoleukomass in the bed of thermo-destroyed metastasis, intravenous on blood cells, and plasma contribute to the improvement of liver metastases treatment results.

The invention “A method for the treatment of liver metastases in the colon cancer” is industrially applicable, as it can be used in healthcare, oncological medical facilities, dispensaries, and cancer research institutes.

Examples of specific applications of the "Method for the treatment of liver metastases in colon cancer" in patients

Patient Korostylev K.M., born in 1949, medical history 987 / o, was admitted to the Department of General Oncology, RNII 09.09.09. with a diagnosis of Rectum tumor, T3N1M0, stage 3, clinical group 2, condition after rectal resection on 12/15/08, metastasis in the right lobe of the liver.

September 25, 2009, 200 ml of blood was taken from a patient, autoleukomass was extracted from the blood by centrifugation, 5 ml of autoleukomass and 5-fluorouracil 500 mg were placed in the first bottle, the remaining blood cells, plasma and oxaliplatin 100 mg were placed in the second bottle; separately incubated vials for 40 minutes at 37 ° C. Then, transdermal radiofrequency thermoablation of metastases to the liver was performed under ultrasound control, after which an incubated autoleukomass with 5-fluorouracil was introduced from the first bottle through an infusion pump in an electrosurgical device in the bed of the thermo-destroyed metastasis. At the same time, incubated blood cells, plasma with oxaliplatin from the second bottle, were injected intravenously.

The postoperative period was uneventful, without complications. The level of leukocytes, peripheral blood lymphocytes did not decrease; deviations in the biochemical analysis of blood, the general analysis of urine was not.

The patient was discharged on 09/28/09 in satisfactory condition.

When appearances at the RNII within 1 year after treatment, data for relapse and metastases were not found. The patient's condition is satisfactory.

Patient Gorshkov A.N., born in 1953, medical history 13567 / e, was admitted to the Department of General Oncology, RNII 3.11.09. with a diagnosis of Tumor of the descending colon, T3N1M0, stage 3, clinical group 2, condition after hemicolectomy on the left 02/16/2009 m / residency. Liver metastases. "

There are no complaints upon receipt.

November 5, 2009, 200 ml of blood was taken from a patient, autoleukomass was extracted from the blood by centrifugation, 5 ml of autolimacomass and 5-fluorouracil 500 mg were placed in the first bottle, the remaining blood cells, plasma and oxaliplatin 100 mg were placed in the second bottle; separately incubated vials for 40 minutes at 37 ° C. Then, transdermal radiofrequency thermoablation of metastases to the liver was performed under ultrasound control, after which an incubated autoleukomass with 5-fluorouracil from the first vial was introduced through the infusion pump in an electrosurgical device in the bed of the thermo-destroyed metastasis. At the same time, the incubated blood cells, plasma with oxaliplatin from the second bottle, were introduced intravenously dropwise.

The postoperative period was uneventful, without complications. The level of leukocytes, peripheral blood lymphocytes did not decrease; deviations in the biochemical analysis of blood, the general analysis of urine was not.

The patient was discharged 9.11.09 in satisfactory condition.

When appearances at the RNII within 8 months after treatment, data for relapse and metastases were not found. The patient's condition is satisfactory.

The proposed method treated 10 patients with colon cancer with liver metastases. The use of percutaneous radiofrequency thermoablation of liver metastases, interstitial chemotherapy on autoleukomass in the bed of thermo-degraded metastasis, intravenous on blood cells, and plasma do not cause changes in the general, biochemical analysis of blood, are characterized by low toxicity. Patients were monitored in the range from 3 months to 1 year. During the observation period, not a single case of tumor progression was detected.

The technical and economic efficiency of the “Method of treating liver metastases in the colon cancer” is that the use of the method allows to reduce the rate of tumor progression, the method is low toxic, simple to implement and allows for comprehensive treatment in a short time, reduces the length of the patient’s hospital stay and the cost of treating cancer metastases.

Claims (1)

A method of treating metastases in the liver of colon cancer, including radiofrequency ablation, chemotherapy, characterized in that 200 ml of blood is taken from patients, autoleukomassa is extracted from the blood by centrifugation, 5 ml of autoleukomassa and chemotherapy are placed in the first vial, and the remaining uniform in the second vial. blood elements, plasma and chemotherapy; separate vials are incubated for 40 min at 37 ° C; Then, transdermal radiofrequency thermoablation of metastases to the liver is performed under ultrasound control, after which the incubated autoleukomass with chemotherapeutic agents from the first vial is introduced through the infusion pump in the electrosurgical unit in the bed of the thermo-destroyed metastasis, and the incubated blood cells are injected dropwise from the second vial into the plasma, .