BASIC TREATMENT METHODS
The center performs more than 12 thousand complex operations per year. State Institution "Republican Scientific and Practical Center of Oncology and Medical Radiology named after NN Alexandrov" is a single scientific, medical and educational complex. It consists of 4 scientific departments and 10 scientific laboratories, 20 inpatient and 11 diagnostic departments. The Department of Oncology BelMAPO operates on the basis of the Center. The number of employees is 2034, doctors - 444, of which 189 are of the highest category and 117 of the first, 24 doctors and 74 candidates of medical and biological sciences, 11 professors and a corresponding member of the National Academy of Sciences of Belarus. The clinic of the Center examines and receives treatment for more than 19,000 cancer patients per year.
What is radiation therapy?
Radiation therapy (x-ray therapy, telegammotherapy, electron therapy, neutron therapy, etc.) is the use of a special type of energy of electromagnetic radiation or beams of elementary nuclear particles that can kill tumor cells or inhibit their growth and division.
Some healthy cells that fall into the irradiation zone are also damaged, but most of them are able to recover. Tumor cells divide faster than the surrounding healthy cells. Therefore, radiation affects them more destructively. It is these differences that determine the effectiveness of radiation therapy for cancer.
What types of cancer are radiation therapy used for?
Radiation therapy is used to treat a variety of cancers. Currently, more than half of cancer patients are successfully treated with radiation.
Irradiation can be used as an independent treatment method. Sometimes LT is performed before surgery to reduce the size of the tumor or after it to destroy the remaining cancer cells. Quite often, doctors use radiation together with anticancer drugs (chemotherapy) to destroy the tumor.
Even patients with the non-operable tumor, RT can reduce its size, relieve pain and improve the general condition.
How is the treatment:
Usually, the course of treatment lasts 4-7 weeks. In some cases, when radiation therapy is carried out before surgery to reduce the size of the tumor or to alleviate the condition of the patient, the duration of the course is 2-3 weeks.
Typically, radiation therapy sessions are carried out 5 times a week. Sometimes, in order to protect normal tissues in the irradiation zone, the daily dose is divided into 2-3 sessions. A two-day break at the end of the week allows healthy tissues to recover.
The decision on the total radiation dose and number of sessions is made by the radiologist based on the size and location of the tumor, its type, general condition of the patient and other types of treatment.
The main indications for the use of general high-frequency hyperthermia:
• Far-reaching and generalized forms of malignant neoplasms, in which traditional methods of treatment are ineffective or seemingly hopeless;
• Unresectable forms of tumors in order to transfer them as a result of regression into a resectable state;
• Non-radical or conditionally radical surgical interventions;
• Malignant neoplasms, which in the course of treatment developed resistance to cytostatic therapy (chemo- and radioresistant tumors). What nosological forms of malignant tumors can be treated using common high-frequency hyperthermia?
• Soft tissue sarcomas (stage III / IV, relapses and metastases after radical treatment);
• Skin melanoma (stage III / IV, relapses and metastases after radical treatment);
• Bone sarcomas (stage III / IV, relapses and metastases after radical treatment);
• Renal cell carcinoma in the presence of distant and regional metastases);
• Breast cancer (with distant metastases);
• Non-organ tumors of the retroperitoneal space;
• Unresectable cervical cancer;
• Chemoresistant ovarian tumors. What are the benefits of using common high-frequency hyperthermia? The use of general high-frequency hyperthermia in the treatment of patients with malignant pathology allows you to:
• Increase the antitumor efficacy of radiation therapy and chemotherapy;
• Increase the life expectancy of patients and improve its quality;
• Transfer inoperable tumors to an operable state and reduce the volume of surgery;
• Reduce the incidence of local recurrence of the tumor and the risk of distant metastases;
• Increase the frequency of stabilization of the tumor process and achieve clinical remission (in the late stages of the disease).
What is photodynamic therapy (PDT)?
PDT is a method of treating precancerous diseases and malignant tumors, based on the introduction of a special drug (photosensitizer) into the patient's body and the subsequent irradiation of pathological tissues with a laser. What is a photosensitizer? A photosensitizer is a drug that is injected intravenously into the patient's body and is activated by laser radiation. How does PDT work? After the photosensitizer is introduced into the patient's body and activated by laser radiation in pathological cells and tissues, reactions are triggered, the result of which is a violation of the blood supply to the pathological tissues and their subsequent destruction and death. What are the benefits of using photodynamic therapy?
• organ-saving treatment method;
• minimal toxicity to normal tissues;
• a slight risk of severe pain;
• minor systemic effects;
• lack of mechanisms of primary and acquired resistance;
• the possibility of outpatient treatment;
• the possibility of combination with other methods of treatment;
• ease of use for multiple lesions;
• good cosmetic results;
• reasonable prices.
Alexander V. Prokhorov
Areas of scientific interest: diagnosis and treatment of tumors of the abdominal cavity, hepatopancreatodunal zone, cell immunotherapy in the treatment of malignant neoplasms
Medical experience since 1981
Published 212 scientific works; 5 patents.
THE ANTI-TUMOR VACCINE
INDICATIONS FOR IMMUNOTHERAPY
An effective way to combat tumor cells remaining after radical treatment and creating a threat of relapse of the disease is to activate the patient's own immune system. Modern methods of personalized cell-mediated immunotherapy are using the patient’s own immune cells programmed to attack and destroy cancer cells. The main task of activating the antitumor immunity of a patient is performed by his own dendritic cells (DC), which are the specialized and most powerful antigen-presenting cells, and with the help of which one can initiate a directed immune response against the tumor. Immunotherapy is indicated for patients with chemoresistant solid tumors (cancer of the stomach, pancreas, breast, bladder, lungs, etc.) Usually - after a radical surgery and standard postoperative treatment (chemoradiotherapy).
SAFETY & BENEFITS
The course introduction of an antitumor vaccine allows stabilization of the oncological process and the timing of subsequent lines of chemotherapy, and also often increases the disease-free period, and, in general, life expectancy. The clinical effect of one course of immunotherapy (5 doses) is manifested by stabilization of the tumor process (in 40 - 50% of cases), sometimes with partial or full regression (5 - 15%), and can last, on average, from 3 months to a year or more . The maximum clinical effect of DC can be expected if it is carried out continuously in the adjuvant mode after removal of the primary lesion (after surgery) in order to prevent tumor recurrence and to destroy invisible micrometastases. Clinical studies on the use of DCs for the treatment of malignant neoplasms have been conducted in leading medical centers in the world for more than 20 years, and the results of most of them are encouraging - the safety of using DCs, activation of the immune system, and significant clinical effect have been proved. There is a likelihood of low efficiency of DCs when using standardized synthetic tumor-associated antigens for their production, the expression of which by the tumor is not confirmed by immunohistochemical data. That is why an immunohistochemical analysis is highly desirable. It is proved that the use of autologous DCs is completely safe, does not cause allergic, toxic reactions, does not suppress immunity and does not stimulate tumor growth. Direct administration of the vaccine can be accompanied by a short-term (1-2 days) increase in body temperature up to 38 ° C, redness and swelling of the injection site, which do not require medical attention and pass on their own.
Stage 1 - COMPREHENSIVE CHECK-UP
To develop treatment tactics and determine the vaccination schedule, a specialist oncologist of the Department of Regenerative Medicine and Cell Therapy carries out all the diagnosis procedures and compulsory examinations.
Stage 2 - BIOMATERIAL SAMPLING
The biomaterial for obtaining CELL PRODUCT based on Dendritic Cells is peripheral venous blood (50-100 ml). The biomaterial extraction is a routine medical manipulation. From a single volume of blood, 1 dose of the vaccine is produced. The number of dendritic cells is determined by the number of native monocytes in the patient’s biomaterial - with their low content in the blood, the number of DCs will also be low.
Stage 3 - BIOMATERIAL PRODUCTION
Monocytes isolated from blood are “loaded” with tumor antigens in the laboratory, which allows to obtain mature dendritic cells that can activate the immune response. Individual antigenic tumor antigens (tumor lysates), as well as synthetic standardized tumor-associated antigens, are used as the antigenic material for creating the vaccine.
Stage 4 - BIOMATERIAL TRANSPLANTATION
An antitumor vaccine based on DC is administered by a course of 5 therapeutic doses. The administration of the vaccine (1-2 ml) is a routine medical manipulation, performed subcutaneously in the shoulder or forearm, is performed on an outpatient basis in a treatment room.
Immediately after vaccination, the patient is observed for 1 to 2 hours in a ward.
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