Варіант лікування місцево-поширеного первинного раку грудної залози

Abstract

Вивчення ефективності схеми неоад`ювантної хіміотерапії в поєднанні з променевою терапією та радіомодифікацією (ІІ група) виявило позитивну тенденцію по показникам виживаності та рецидивування, а також задовільний стан в проявах токсичності ХТ та проявів променевих в порівнянні зі схемою запропонованою І групі. За результатами лікування в обох групах, можно сказати що віддалені результати виживаності показують на-ступне: на 36 міс. спостереження сформувалась кількість хворих, які явно показали результати лікування в І та ІІ групах. В І групі загальна вижива-ність 11 (26,19%), з них з рецидивом 4 (9,52%). В ІІ групі загальна кіль-кість хворих на 3 рік спостереження 25 (53,19%), з рецидивом 17 (36,17%). Изучение эффективности схемы неоад`ювантной химиотерапии в сочетании с лучевой терапией и радиомодификацией (II группа) выявило положительную тенденцию по показателям выживаемости и рецидивирования, а также удовлетворительное состояние в проявлениях токсичности ХТ и проявлений лучевых реакций в сравнении со схемой предложенной І группе. По результатам лечения в обеих группах, можно сказать, что отдаленные результаты выживаемости показывают следующее: на 36 мес. наблюдения: в первой группе общая выживаемость 11 (26,19%), из них с рецидивом 4 (9,52%). Во II группе общее количество больных на 3 год наблюдения 25 (53,19%), с рецидивом 17 (36,17%). The article is a fragment of the initiative research of the HSEE of Ukraine "Ukrainian Medical Stomatological Academy": "Development of methods and prevention of treatment of drug-induced lesions of internal organs" No. of state registration 0115U001087). Term of work: from 02/2015 to 02/2020. Abstract. The first place in the ranking of oncology and the most acute oncology problem is breast cancer (BC), in the vast majority of women [1,2,3,5,18]. The rate of abstinence is high, and the percentage of patients re-ceiving special therapy is 80.4%. All this indicates a low level of qualified care (Kolesnik O.O., Fedorenko Z.P., 2017). The aim of the study was the desire to study the effectiveness of various schemes of preoperative chemo-radiation therapy with radioimodification in the scheme of complex treatment of primary localized BC. The object and methods of research. For the period from 2011 to 2016, in the conditions of the Poltava Regional Clinical Oncology Center, 89 pa-tients with primary, inoperable, localized BC in the 3rd stage (T3-4N0-1M0), with compulsory verification of the process, received radiomodified chemoradiotherapy. Patients in both groups were recruited by blind randomiza-tion and divided into 2 groups. All patients were taken into work after signing, as a matter of compulsory, informed consent to the study. I (n-42) group received 2 courses of chemotherapy (CT) at standard doses of the CMF scheme. After 2 weeks of rest, patients received a course of radiation ther-apy under the radical program: on the axillary lymph nodes, parasternal supra-clavicular areas, a single focal dose (SFD) of 2.2 Gr. to a total focal dose (TFD) of 60-62 Gr. II (n-47) group of patients received 2 courses of chemotherapy (CT) at standard doses of the CAF / FAC scheme. After 2 weeks of rest, patients received a course of radiation therapy under the radical program, but in multifractional mode: on the axillary lymph nodes, parasternal supraclavicular areas, a single focal dose (SFD) of 1.1 Gr (morning) + 1.1 Gr (after 6 hours) = 2.2 Gr to the to-tal focal dose (TFD) 60-62Gr with radiomodification Tegafur (800 mg in the morning and 400 mg in the evening), which was administered in accordance with the instructions. Research results and their discussion. Analyzing 1 year of supervision, it is evident that 35 (83.3%) patients died in the I group, 7 died (16.7%). Patients who did not have a recurrence of the process at 1 year of life 25 (59.92%). In the II group, they died at 1 year - 6 (12.76%), and patients without relapsing 36 (76.59%). Comparing the result clearly that the overall survival of a reliable re-sult was not low, and the rate of recurrence is likely to speak for the benefit of Group II. During second year , another 14 patients died in Group І against 7 group II. In the I survived, 21 (50,0%) were left, of which 17 (40,47%) without relapse were against 34 (72,34%) of the live ones, of which 20 (42,55%) without relapse. Summing up our research, supervision over the results of treatment in two groups, we can say that the remote survival results show the following: For 36 months. The observation formed the number of patients who clearly showed the results of treatment in groups I and II. In group І, overall survival rate was 11 (26,19%), with relapse 4 (9,52%). In the II group, the total number of pa-tients with 3 years of observation was 25 (53,19%), with relapse of 17 (36,17%). Conclusions. The study of the effectiveness of the scheme of neoadjuvant chemotherapy in combination with radiotherapy and radiomodification (group II) showed a positive trend in survival and relapse rates as well as a satisfactory state in the manifestations of toxicity of HT and radiation manifestations com-pared with the proposed scheme for group I.