Start of section
Production, amateur
Radio amateurs
Aircraft model, rocket-model
Useful, entertaining 		Stealth Master
Electronics
Physics
Technologies
Inventions 		Secrets of the cosmos
Secrets of the Earth
Secrets of the Ocean
Tricks
Map of section
Start
Forum
Use of the site materials is allowed subject to the link (for websites - hyperlinks)

Navigation: =>

Home / Patent catalog / Catalog section / Back /

ONCOLOGY AND RADIOLOGY
INVENTION
Patent of the Russian Federation RU2286724

METHOD FOR CARRYING OUT INTRASTAT FOR BRACHYSTERAPY OF CANCER OF THE ESOPHAGUS

The name of the inventor: Konstantin G. Utin (RU); Vazhenin Andrey Vladimirovich (RU); Vaganov Nikolay Viktorovich (RU)
The name of the patent holder: the state educational institution of higher professional education "Chelyabinsk State Medical Academy" of the Ministry of Health of Russia (RU)
Address for correspondence: 454092, Chelyabinsk, ul. Vorovsky, 64, ChGMA
Date of commencement of the patent: 2005.03.09

The invention relates to medicine, in particular to radiation oncology, and can be used in combined radiation treatment in patients with esophageal cancer or stomach cancer with transition to the esophagus III-IV stage, complicated by stenosis of 2-4 degree. The technical result is the possibility of conducting intracavitary radiation treatment in patients with tumor stenosis of the esophagus 2-4 degrees, achieving a good dilatation effect after dissection-expansion of tumor tissue, without serious complications such as bleeding, perforation. Essence of the method: simultaneously dissect the tumor wall at six equidistant points by no more than 1-2 mm in one session in each direction. The number of sessions is set depending on the effect of achieving a diameter of the lumen of stenosis of not less than 8-9 mm.

DESCRIPTION OF THE INVENTION

The invention relates to medicine, in particular to radiation oncology, and can be used in combined radiation treatment in patients with esophageal cancer or stomach cancer with transition to the esophagus III-IV stage, complicated by stenosis of 2-4 degree.

Combined radiation therapy has several advantages over remote irradiation in reducing the radiation load on normal tissues, especially when relapses, when external irradiation has exhausted its capabilities [3, 4]. A sufficient number of authors use this method for palliative purposes in combination with endosurgical dilatation methods [5, 6].

The simplest way to restore the passage of food through the esophagus, as well as the introduction of intrastat for the supply of radioactive sources to the tumor during brachytherapy, is that it can not be performed with full and extended stenosis, and in cases of incomplete stenosis it temporarily improves the passage of the esophagus. Due to carrying out an intrastat "blind" way it is often fraught with such complications as perforation of the esophagus wall, profuse bleeding with all the ensuing consequences.

Some methods of bougie (on a string-conductor, under the control of vision) reduce the probability of its perforation, but do not eliminate the danger of bleeding from a bougie-damaged tumor. In addition, with visual monitoring, only the upper pole of the tumor can be observed, which does not help reduce the likelihood of complications. Unfortunately, the effect of using the method of boogering stenosing tumors of the esophagus is short, and the risk of complications is high [1].

Dilatation with hydro-, air-balloons or stents and is not an effective method due to possible complications and is not always feasible, there is a risk of rupture of the esophagus, the occurrence of profuse bleeding. But it is a valuable addition to two serious palliative procedures - intubation and tumor destruction [1, 2].

In this regard, the search for the least traumatic and safest methods that allow the use of intracavitary brachytherapy is an urgent task [1].

The aim, to achieve which the claimed invention is directed, is to ensure the safe conduct of Intrastat for brachytherapy.

The technical result is the possibility of conducting intracavitary radiation treatment in patients with tumor stenosis of the esophagus 2-4 degrees, achieving a good dilatation effect after dissection-expansion of tumor tissue, without serious complications such as bleeding, perforation.

This goal is achieved due to the fact that in the claimed method the esophageal stenosis expansion is carried out simultaneously with the dissection of the tumor wall at six equidistant points under visual control, no more than 1-2 mm in one session in each direction. The number of sessions is set so that eventually the diameter of the lumen of the stenosis is not less than 8-9 mm. After this, and under visual control, intrastat is established in the esophagus at the tumor level, and then intracavitary irradiation is performed.

Studies carried out on patent and scientific and technical information sources have shown that this method of carrying intrastat into tumor stenosis in patients with esophageal cancer with a view to preparing for intracavitary irradiation is not known and should not be explicitly studied from the state of the art; Corresponds to the criterion of "novelty".

The use of dilatations of tumor stenosis by means of bougie with the use of bougie of various modifications, electrosurgical and laser dilatation, the use of endoprosthetics are known in medicine, but due to the presence in the method of distinctive actions, it can be concluded that the claimed method corresponds to the inventive level.

THE PROPOSED METHOD OF TREATMENT IS FOLLOWED AS FOLLOWS:

A patient with a tumor stenosis of the esophagus is injected into his lumen with a fibrogastroscope and the location of the proximal pole of the tumor is determined under visual control. Then, through the instrumental channel of the fibrogastroscope, a cutting instrument is brought to the tumor by means of which the tumor wall is visually inspected under the visual control of the fibrogastroscope, gradually moving the cutting instrument along the entire length of the tumor. Dissection of the tumor wall is performed at a depth of 1-2 mm, no less than in six equidistant directions along the lumen of the esophagus. Such sessions are repeated 1-2 days before reaching the diameter of the lumen of the esophagus 8-9 mm, which is established with fibrogastroscopy. After reaching this value, the intrastat is injected into the esophagus lumen on the level of the tumor and brachytherapy is performed.

The claimed method of carrying out intrastat was applied in 19 patients with stenosing esophageal cancer of II-IV stage and 2-4 degree of stenosis (7-0 mm), after the first stage of remote radiation therapy. In all cases, the exact introduction of Intrastat was achieved, not accompanied by any complications.

We give clinical examples of the use of the claimed method

Example 1
Patient S., esophageal cancer complicated by stenosis of the third degree (lumen of the esophagus was 5 mm). The patient received remote gamma-therapy in a dynamic fractionation mode. After the end of the remote irradiation with endoscopic control, the tumor did not allow the introduction of intrastat for intracavitary brachytherapy. There were 4 sessions of dissection - expansion of tumor stenosis in 10 days. Interventions were conducted after 48 hours. The clearance after these manipulations became 8-9 mm. Patient S. was injected through Intrastat with further intracavitary radiation treatment.

Example 2
Patient M., stenosing esophageal cancer, continued tumor growth after distant gamma therapy. The proposed method conducted 8 sessions within 18 days. The lumen of the esophagus at the site of stenosis became 8-9 mm, which allowed to pass through the tumor intrastat for brachytherapy.

Example 3
Patient R. Stenosis of esophageal anastomosis of 2-3 degrees (5-7 mm). After three sessions of endosurgical dissection-expansion according to the proposed method, the lumen of the esophagus was enlarged to 8-9 mm, which allowed to enter intrastat without complications and to apply intracavitary brachytherapy with good antitumor effect.

Thus, the use of the claimed method provides for the safe administration of Intrastat for brachytherapy.

INFORMATION SOURCES

1. Vazhenin A.V. The experience of using combined radiation therapy in patients with esophageal cancer / AVVazhenin, TMSharabura, MVVasilchenko and others // Rengenoradiology of the XXI century. Problems and hopes ...: Tez. Doc. VIII all-Russia. Congress of roentgenologists and radiologists. - Chelyabinsk - M., 2001. - P.89.

2. Yu. P. Kuvshinov. Endoscopic surgery of tumor and postoperative stenoses in patients with esophageal and stomach cancer / Yu.P. Kuvshinov, BK Poddubny, ON Stylidi, etc. // Contemporary. oncology. - 2000. - T.2, №3. - P.72-78.

3. Skobelkin OK Palliative treatment of esophageal cancer: current trends / O.K. Skobelkin, ZA Topchiashvili, M.Yu. Telnykh and others // Ros. honey. Journal. - 1996. - T.4, №7. - FROM.

4. Cusumano A, et al. Push-through intubation: Effective palliation in 409 patients with cancer of the esophagus and cardia. Ann. Thorac. Surg. 1992; 55: patients with cancer of the esophagus and cardia. Ann. Thorac. Surg. 1992; 55: 70-264.

5. Fleischer D. Endoscopic treatment of upper gastrointestinal tumors. In: Jensen DM, Brunetand JM, eds., Medical laser endoscopy. Dordrecht: Kluwer, 1990: 163-76.

6. Leung JT Brachytherapy in oesophageal carcinoma / JTLeung, R.Kuan // Australas. Radiol. - 1995. - Vol.39, N.4. - P.375-378.

CLAIM

The method of carrying out intrastat for brachytherapy of esophageal cancer, including expansion of the lumen of tumor stenosis under visual control, characterized in that simultaneously dissecting the tumor wall in six equidistant directions along the lumen of the esophagus, and dissecting no more than 1-2 mm in one session in each direction, To a depth of 1-2 mm, the number of sessions is set until the diameter of the lumen of the stenosis is not less than 8-9 mm.

print version
Date of publication 06.01.2007gg