№64. Locoregional therapy: a promising method for cancer treatment
- B.I. Dolgushin
In a relatively short period of existence, today interventional radiology has become an integral component of modern oncology. Interventional radiologist possesses a broad variety of highly effective minimally invasive techniques including diagnostic and therapeutical, supportive and special antineoplastic procedures. These techniques applied either alone or with other oncological treatment modalities frequently demonstrate results comparative with curative surgery. The paper presents employed in the clinical oncology interventional and hybrid techniques gaining the advantage in fields of survival, occupational and social rehabilitation and hospital costs. Consider the nature and frequency of complications, the feasibility and priority of the clinical application of IR technologies in various fields of practical oncology.
Keywords: interventional radiology, hybrid techniques, vascular/nonvascular intervention
- P.G. Tarazov
The aim of the lecture – to introduce the readers to endovascular therapy of malignant tumors as a relatively new treatment option of clinical oncology.
First pages of the article contain the actuality of interventional radiological approach as a minimally invasive method of treatment. The author mentions the main methods of endovascular intervention. Mechanisms of action and treatment effects are noticed. The role of angiographic procedures in combined management of malignant tumors is emphasized.
The most common organ for interventional treatment is the liver because liver tumors are supplied from the hepatic artery whereas the normal parenchyma receives its blood supply mainly from the portal vein. Literary data and own clinical results of arterial infusion, transcatheter chemoembolization, radioembolization in primary and metastatic liver tumors are done. The role of pre- and postoperative endovascular procedures is discussed.
Methods of intra-arterial therapy is successfully used in malignant tumors of different location such as head and neck cancer, lung tumors, breast carcinoma, gastrointestinal and genitourinary malignancies, bone and soft tissue sarcoma. The treatment results are promising especially when using combined treatment with inclusion of endovascular intervention.
It is concluded that intra-vascular intervention plays a role in the management of malignant diseases. Interventional radiology can be considered significant treatment option and should be widely used in clinical oncology.
Keywords: interventional radiology, angiography, arterial infusion, chemoembolization, radioembolization, combined treatmenty
- P.V. Balakhnin
Emergency conditions, directly or indirectly related to the cancer may be the first manifestation of oncological disease, as well as develop during of cancer diagnosis and treatment. Purpose – to consider the possibility of using a variety of interventional radiological techniques such as percutaneous drainage, percutaneous and intraluminal stenting, endovascular interventions and local therapy in the treatment of emergency conditions occurring in patients with cancer. The paper discusses the possibility of using these techniques for treatment of obstruction syndrome of hollow organs and tubular structures, perforation of hollow organs and tubular structures, compartment syndrome, bleedings, infection complications, venous thromboembolic complications and severe pain syndrome. It is concluded that interventional radiology has a wide range of effective technologies that can be used for treatment emergencies, occurring in patients at different stages of diagnosis and treatment of cancer. The information may be useful for interventional radiologists, as well as all health care professionals, participating in the combined and complex treatment of cancer patients.
Keywords: emergencies in oncology, interventional radiology, stents, percutaneous drainage, embolization, local therapy, central venous catheters, inferior vena cava filter
- V.V. Egorenkov
The isolated regional perfusion is the surgical method of treatment allowing to deliver higher doses of chemotherapeutic agents locally without systemic side effects. This method is usually used to deliver therapy to the limbs, liver, lungs or abdominal extra organic tumors. The unsatisfactory results of treatment of locally advanced and disseminated tumors define the necessity to increase overall and tumor free survival. One of the ways to improve the results is the addition of hyperthermic perfusion to surgical excision of abdominal tumors. We think that newer drugs with more anti tumor activity on local contact and treatment individualization are probably the main directions.
Keywords: isolated limb perfusion, isolated hepatic perfusion, isolated lung perfusion, intraperitoneal hyperthermic chemoperfusion
- N.V. Dengina, E.Ya. Mozerova
The following article represents the literature review on the use of two local treatment methods – stereotactic radiotherapy and local hyperthermia. The first one is considered to be the advanced technology of traditional highly precision and intensive external beam radiotherapy while the other one has almost never been applied alone but served as an excellent modifying treatment in combination with not only radiotherapy but with systemic treatment as well.
Currently the use of these two methods is recommended by international treatment guidelines for the patients with malignant tumors of various localizations.
Keywords: malignant tumors, stereotactic radiotherapy, local hyperthermia