RU2562447C1 - Method for prevention of developing radiation reactions in patients with cervical cancer - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: 1-3 hours upon completion of every radiation treatment session, the organs and tissues covered by a radiation injury area are exposed. The exposure represents a session of a magnetic laser therapy at an emission power of 9-12 mW, a frequency of 600 Hz, a wave length of 0.85-0.89 mcm and a magnetic induction of 35 mT. A therapeutic terminal unit of a magnetic laser therapeutic apparatus is placed series onto the skin of the anterior abdominal wall in the following projections: enteric loops, the ascending colon, the transverse colon, the duodenum and the stomach, the descending colon, the sigmoid colon, the urinary bladder. The exposure length is 240 seconds per each area.

EFFECT: method provides protecting the organs and tissues covered by the exposure field, ensures analgesic action, modulating immune responses, reduces muscular contractibility, and normalises arteriola diameter.

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Description

The invention relates to medicine, namely to methods of magnetic laser therapeutic effects, and can be used to prevent the development of radiation reactions.

In modern oncological practice, various methods of neutralizing organ dysfunctions and achieving the effect of tissue repair, which are in the area of radiation exposure, are known.

A known method of treating acute radiation reactions in patients with laryngeal cancer, including daily exposure to infrared laser radiation with a constant magnetic field on the irradiation area and surrounding tissues after the diagnosis of radiation reaction (RU No. 2354423). However, the known method involves exposure to infrared laser radiation with a constant magnetic field on the irradiation area and surrounding tissues after the onset of pronounced radiation reactions and cannot be used to prevent them.

There is also known a method of treating cancer patients, including radiation exposure, followed by exposure to low-intensity laser radiation of mainly the red and infrared wavelengths on tissues and organs involved in the radiation exposure zone. Exposure to low-intensity laser radiation is carried out remotely, and / or by contact, and / or intraorgan, and / or intravascular method daily after the end of radiation exposure (RU No. 2161054). In accordance with the known method for radiation injuries of hollow and / or tubular organs (stomach, bladder, etc.), laser irradiation is carried out by the intraorgan method using special rigid or flexible laser optical fibers.

The disadvantages of the known method that impede the achievement of the following technical results are: invasiveness of the procedure, which is accompanied by the risk of damage to the hollow organ when using the intraorgan or intravascular method of exposure to laser radiation, the complexity of the procedure. The use of several laser sources and various types of optical fibers makes it difficult to prevent radiation injuries of several systems simultaneously (genitourinary and digestive).

Closest to the claimed method in terms of essential features is a method of treating patients with malignant neoplasms of deep organ localization, including radiation treatment with subsequent exposure to low-intensity laser radiation on organs and tissues involved in the area of radiation injuries, which is carried out simultaneously using low-intensity radiation of two infrared lasers wavelengths of 970 nm and 1264 nm in the central zone of the projection of the focus of radiation damage on the skin. Laser exposure is carried out daily once a day, percutaneously, contact for 2-5 minutes, 50-60 minutes after the end of radiation exposure (RU No. 2226706). Adopted as a prototype.

The disadvantages of the prototype method that impede the achievement of the following technical results include the following.

It has been established that laser radiation has an anti-inflammatory effect and determines the parasympathetic state of irradiated biological tissues. However, with prolonged exposure to laser radiation (more than 14-15 sessions), the development of an organism's addiction reaction to a medical factor is possible.

At the same time, the combined effect of low-intensity laser radiation and a constant magnetic field is more energy-intensive than isolated low-intensity laser radiation. Especially this positive effect is manifested in the treatment of deeply located pathological foci.

The invention is aimed at solving the problem of preventing the development of radiation reactions in the tissues and organs involved in the radiation lesion zone in patients with cervical cancer, namely: intestines, stomach, bladder.

Using in clinical practice the proposed method allows to achieve several technical (therapeutic) results:

- protection of all organs and tissues falling into the irradiated field from the damaging effects of ionizing radiation;

- effective effect on deeply located organs due to the optimal parameters of magnetic laser therapy;

- increasing the efficiency of laser exposure due to the inclusion of a magnetic field in the treatment process, which has the following types of biological effects: analgesic effect by increasing the duration of the antinociceptive effect through the opioid-sensitive nociceptive system, modulating immune responses by increasing the number of granulopoietic cells and cells of the hematopoietic system and reducing the number bone marrow megakaryocytes;

- reduction of muscle contractility up to the development of anticonvulsant effects due to a decrease in muscle activity of Na, K and Ca ATPase;

- normalization of the diameter of arterioles due to their expansion.

These technical (therapeutic) results in the implementation of the invention are achieved due to the fact that, as in the known method, the prevention of radiation reactions in patients with cervical cancer is carried out by exposure to laser radiation of the infrared wavelength range on organs and tissues involved in the radiation damage zone, which carried out after radiation treatment.

A feature of the proposed method is that 1-3 hours after the end of each radiation therapy session, a magnetic laser therapy session is performed with a radiation power of 9-12 W, a frequency of 600 Hz, a magnetic induction of 35 mT, a radiation wavelength of 0.85-0 , 89 microns by sequentially placing the treatment terminal of the magnetic laser therapy device on the skin of the anterior abdominal wall in the following projections: loops of the small intestine, ascending colon, transverse colon, 12 duodenum and stomach, descending colon nerves, sigmoid colon, bladder, the duration of exposure in each zone is 240 seconds.

Disclosure of invention

The therapeutic effect of laser exposure on living tissue is significantly enhanced in a magnetic field (magnetic laser therapy) due to enhanced metabolic processes: low-intensity laser radiation acts on the biological membranes of cells, causing depolarization of cell membranes, hyperpolarization of the membrane potential, an increase in the amplitude of the action potential by 10 -15% and its rate, increases the activity of K + -Na + -ATPase, increasing the activity of ADP / ATP depending on the state of the electrochemical cell membrane gradient, activating NADH-dehydrogenase and the system of cytochromes, cytochrome oxidase; as a result of membrane changes, the intracellular system of antioxidant enzymes is included in the photoreactivation process: catalase, superoxide dismutase, glutathione peroxidase; processes of oxidative phosphorylation are enhanced.

The effectiveness of the combined magneto-laser exposure is due to the following reasons. Firstly, when interacting with laser light, the maximum transmission of electromagnetic radiation to human skin is in the range of 0.8-1.2 microns. Secondly, the mobility photoconductivity and the photomagnetoelectric effect (Kikoin-Noskov effect) arising from this interaction prepare the tissues for the perception and utilization of infrared radiation. Thirdly, a constant magnetic field, orienting dipoles in a line along a light wave collinearly, promotes the resonant effect of biostructures and enhances light absorption in the long-wavelength band. In addition, biophysical studies have shown that the longer the system of conjugated bonds in a molecule, the longer the absorption wavelength is located at a longer wavelength. It was determined that DNA molecules are characterized by a maximum spectral sensitivity in the range of 0.62 and 0.82 μm, and the oscillatory vibrations of heavy oxygen atoms with respect to the nitrogen atom in the nitro group (NO2) absorb the long-wavelength infrared light.

A session of magnetic laser support therapy is carried out 1-3 hours after the irradiation session. This time interval was chosen because radiation exposure to the tumor has already taken place and magnetic laser exposure will not affect the effects of antitumor treatment.

Use pulsed infrared sources with a power of at least 9-12 watts, a laser frequency of 600 Hz, and magnetic induction of 35 mT. The wavelength of infrared radiation from a laser or laser diodes is 0.85-0.89 microns.

The method is as follows.

The treatment terminal of the magnetic laser therapy device is successively placed in contact on the skin of the anterior abdominal wall in the projection: 1 - loops of the small intestine, 2 - ascending colon, 3 - transverse colon, 12 duodenal ulcer and stomach, 4 - descending colon, 5 - sigmoid colon, 6 - bladder. The exposure time for each zone is 240 seconds. Thus, all organs and tissues falling into the irradiated field are protected from the damaging effects of ionizing radiation. It is with such a duration of exposure that the best biological effect of low-intensity magnetic laser therapy is observed without the development of any complications associated with exposure to physical factors.

Clinical example. Patient M., 49 years old, was admitted to the Department of Radiation Therapy March 26, 2010 with a diagnosis of cervical cancer of stage IIa, vaginal version.

From the anamnesis: during a physical examination in 2009, smears were taken from the cervix, dysplasia of the III degree was detected. In November 2009, in the Moscow City Clinical Hospital No. 68, electroconization of the cervix was performed, grade III dysplasia and in situ cancer were detected. The patient turned to the Moscow Scientific Research Institute for Medical Sciences. P.A. Herzen for consultation and treatment. With a second biopsy from the walls of the vagina and curettage of the cervical canal, in situ cancer was again detected with the onset of invasion to a depth of 1 mm. Cytologically - squamous keratinizing cancer.

Ultrasound of the small pelvis and abdominal cavity: the liver is not enlarged, the contour is smooth, without focal formations. The kidneys are located typically, of normal size and structure, the CLS is not expanded, there are no calculi. In the abdominal cavity and retroperitoneal space, additional formations are not visualized. The uterus of fuzzy smooth contours 48 × 47 × 52 mm, m-echo 6 mm, linear. The cervix with a fuzzy smooth contour of 38 × 35 × 44 mm, is clearly diffuse heterogeneous due to increased echogenicity and multiple anechogenic inclusions, partially passes to the region of the internal pharynx. The front wall of the vagina in the area of the arch and the right side wall of the hypoechoic structure due to an infiltrate of 23 × 8 × 22 mm. In the inguinal regions, the altered lymph nodes are not visualized.

MRI of the pelvic organs: uterine body 55 × 50 × 57 mm, with smooth and clear contours, the uterine cavity is not expanded, not deformed. The cervix is 36 × 31 × 29 mm, with clear contours, cysts from 2 to 12 mm are detected paracervically and in the vaginal portion. Diffuse thickening of the vaginal arches up to 6-7 mm is noted. Parametries are free. The ovaries are not structurally altered. The bladder and visualized parts of the colon without visible pathological changes. In the pelvic cavity, altered lymph nodes were not detected.

Tumor marker SCC - 2.1 ng / ml (normal - <1.5 ng / ml).

She was hospitalized in the radiology department for radiation therapy.

On admission: the vagina is free. The cervix is shortened, the mucous membrane is brightly hyperemic, especially its right half, is rough. In the upper third of the vagina, along the front and right walls, areas of hyperemic and clumpy mucosa are visualized. On the back wall - areas of hyperemia alternate with areas of leukoplakia. Palpation of the vaginal mucosa without infiltration of underlying tissues. The cervix during palpation is not enlarged, it is dense in both portions. The body of the uterus is not enlarged, the parameters are free.

The patient from 04/06/2010, the initiation of combined radiation therapy. The resulting total focal doses: t.A. - 75.0 Gy; So. B - 52.5 Gy, vagina - 55.0 Gy, bladder - 51.0 Gy, rectum - 56.0 Gy.

From the 1st day of radiation therapy, the patient underwent magnetic-laser support therapy according to the developed technique on the Milta-F-8-01 apparatus. 1 hour after the end of each radiation therapy session by sequentially placing the treatment terminal of the magnetic laser therapy device on the skin of the anterior abdominal wall in the following projections: 1 - loops of the small intestine, 2 - ascending colon, 3 - transverse colon, 12 duodenal ulcer and the stomach, 4 - the descending colon, 5 - the sigmoid colon, 6 - the bladder, the duration of exposure in each zone was 240 seconds. The following parameters were used: pulsed infrared source with a power of 9-12 W, laser frequency 600 Hz, magnetic induction 35 mT. The wavelength of the infrared radiation of the laser and laser diodes is 0.89 microns. The course of treatment was 15 sessions. Complications associated with conducting magnetic laser therapy escort were not observed.

Throughout the course of radiation therapy, not a single radiation reaction was observed.

At discharge: the vagina is free, the cervix is not determined, the external pharynx is retracted, in the right arch, with thick membranous epithelitis around the m on the mucosa of the right arch. The mucous in / 3 of the vagina on the remaining walls is hyperemic, slightly granular in the left arch. Palpation in the area of the right arch seal in the form of fibrosis. The cervix is small but moderately dense. The body of the uterus is not enlarged, deflected to the left, the parametria are free.

The patient was discharged in satisfactory condition under the supervision of an oncologist at the place of residence. Radiation therapy did not affect the patient's ability to work, who began to work in the early stages after treatment. The observation period was 48 months. Currently, the patient is fully rehabilitated, with no signs of relapse or disease progression.

Thus, this clinical example shows the feasibility of using magnetic laser support therapy as a prophylaxis of radiation reactions. Despite the large values of the summed doses of ionizing radiation, reactions from critical organs were not observed. The treatment was carried out in the planned volume. The absence of recurrence and progression of the disease during the observation indicates that the magnetic laser therapy of the accompaniment does not adversely affect overall and relapse-free survival, allowing patients to remain able to work.

Claims (1)

A method for preventing the development of radiation reactions in patients with cervical cancer, including exposure to laser radiation of the infrared wavelength range on organs and tissues involved in the radiation damage zone, which is carried out after radiation treatment, characterized in that 1-3 hours after the end of each radiation session Therapies perform a session of magnetic laser therapy with a radiation power of 9-12 W, a frequency of 600 Hz, a radiation wavelength of 0.85-0.89 microns and a magnetic induction of 35 mT, by sequentially placing the treatment terminal at boron of magnetic laser therapy is contacted on the skin of the anterior abdominal wall in the following projections: loops of the small intestine, ascending colon, transverse colon, 12 duodenum and stomach, descending colon, sigmoid colon, bladder, the duration of exposure in each zone is 240 seconds.