RESUMO
AIM: To study the results of intraperitoneal chemoperfusion combined with cytoreductive procedure in patients with peritoneal pseudomyxoma. MATERIAL AND METHODS: For the period 2006--2015 seven patients with peritoneal pseudomyxoma underwent aggressive treatment using hyperthermic intraperitoneal chemoperfusion combined with cytoreductive procedure at the Department of General Oncology of N.N. Petrov Research Institute of Oncology. RESULTS: Two patients had postoperative complications. One of them died after 12 days postoperatively. Features of postoperative complications were predominantly determined by volume of cytoreduction. Advanced tumoral process caused death in 2 patients additionally. Other patients are still alive during 4--28 months after surgery. CONCLUSION: Hyperthermic intraperitoneal chemoperfusion combined with cytoreductive procedure is advisable for peritoneal pseudomyxoma to improve survival. Optimal cytoreduction should be developed in researches with large number of patients to decrease incidence of complications.
Assuntos
Procedimentos Cirúrgicos de Citorredução/métodos , Neoplasias Peritoneais , Pseudomixoma Peritoneal , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Terapia Combinada , Feminino , Humanos , Hipertermia Induzida/métodos , Infusões Parenterais/métodos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Peritoneais/mortalidade , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia , Pseudomixoma Peritoneal/mortalidade , Pseudomixoma Peritoneal/patologia , Pseudomixoma Peritoneal/cirurgia , Estudos Retrospectivos , Federação Russa , Análise de Sobrevida , Resultado do TratamentoRESUMO
Erysipelas (PB) a serious disease that is accompanied by severe complications and high lethality. The immunological investigations were carry out in 51 patients who were treated at the clinic for erysipelas with an immunomodulator application. Marked changes in the indices of phagocytic activity of monocytes (PHAM) and the cytokine profile in patients with erysipelas were note. Application in complex treatment of immunomodulator give the positive effect on the indices of PHAM.
Assuntos
Erisipela/tratamento farmacológico , Imunidade Inata/efeitos dos fármacos , Fatores Imunológicos/uso terapêutico , Monócitos/efeitos dos fármacos , Fagocitose/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Indutores da Angiogênese/uso terapêutico , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Anticoagulantes/uso terapêutico , Erisipela/sangue , Erisipela/imunologia , Erisipela/patologia , Feminino , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Interleucinas/sangue , Interleucinas/imunologia , Masculino , Pessoa de Meia-Idade , Monócitos/imunologia , Índice de Gravidade de Doença , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/imunologiaRESUMO
Experimental perfusion system and technology for normothermic and hyperthermic intraperitoneal chemoperfusion are developed for the treatment of abdominal carcinomatosis in rats with transplanted ovarian cancer. MTD of cisplatin in normothermic intraperitoneal chemoperfusion and hyperthermic perfusion are 40 and 20 mg/kg, i.e. by 10- and 5-fold higher than the dose of this cytostatic for routine intraperitoneal injection. Normothermic intraperitoneal chemoperfusion with cisplatin increases median survival time by 200% (p=0.039) in comparison with intraperitoneal injection.
Assuntos
Antineoplásicos/uso terapêutico , Cisplatino/uso terapêutico , Hipertermia Induzida/métodos , Infusões Parenterais/métodos , Neoplasias Ovarianas/tratamento farmacológico , Animais , Antineoplásicos/administração & dosagem , Linhagem Celular Tumoral , Cisplatino/administração & dosagem , Feminino , Transplante de Neoplasias , Neoplasias Peritoneais/tratamento farmacológico , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
The study or antitumor effects of dioxadet, cisplatin, melphalan, paclitaxel, mitomycin C, cyclophosphamide and gemcitabine at intraperitoneal (i.p.) and intravenous (i.v.) administration as monochemotherapy and polychemotherapy in a rat model of ascitic ovarian cancer was carried out in 244 female Wistar rats. Ovarian cancer was transplanted i.p. at a number of 1 x 10(7) tumor cells. The drugs were administered once in 48 hours after ovarian cancer transplantation i.p. or i.v. for monotherapy--in maximum tolerated doses, for i.p. polychemotherapy--in half doses from maximum tolerated doses. Antitumor effects of the treatment were estimated in increase in median survival time (MST) compared to control rats who were administered saline i.p. At i.p. administration dioxadet, cisplatin and melphalan increased MST by 79%, 88% and 144%, respectively, while at i.v. administration these drugs didn't affect MST. Mitomycin C and paclitaxel had stronger antitumor action at i.v. administration increasing MST by 152% and 81%, respectively, while at i.p. administration these drugs increased MST by 35 and 45%, respectively. Combinations dioxadet + cisplatin, dioxadet + cyclophosphamide and dioxadet + paclitaxel at i.p. administration increased MST by 305%, 277% and 133%, respectively, and had additive antitumor action compared to mono-effects of these drugs. Gemcitabine and combination dioxadet + gemcitabine at i.p. administration didn't significantly affect survival of rats with ovarian cancer. Intraperitoneal monochemotherapy and polychemotherapy could be more effective in the treatment of peritoneal carcinomatosis from ovarian cancer compared to systemic administration of the drugs.
Assuntos
Antineoplásicos/administração & dosagem , Infusões Parenterais , Neoplasias Ovarianas/tratamento farmacológico , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Cisplatino/administração & dosagem , Ciclofosfamida/administração & dosagem , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Feminino , Infusões Intravenosas , Dose Máxima Tolerável , Melfalan/administração & dosagem , Mitomicina/administração & dosagem , Neoplasias Ovarianas/patologia , Paclitaxel/administração & dosagem , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/secundário , Ratos , Ratos Wistar , Triazinas/administração & dosagem , GencitabinaRESUMO
A comparative study of safety and efficacy of normothermic and hyperthermic intraperitoneal chemoperfusion (IPEC and HIPEC) with cisplatin and dioxadet was carried out in 143 female Wistar rats. Ovarian cancer was inoculated intraperitoneally (i.p.). In 48 hours after ovarian cancer inoculation the drugs were administered i.p. or IPEC and HIPEC with the drugs were performed using maximum tolerated doses (MTD). Content of cisplatin was determined in the perfusate and blood plasma during HIPEC with the drug. The leukocyte count was measured using veterinary hematologic analyzer in peripheral blood of rats at different time points after HIPEC with dioxadet. Efficacy of the treatment was estimated in increase in median survival time (MST). During HIPEC cisplatin was accumulated in the abdominal cavity in a considerable amount with minimal systemic absorption. HIPEC with dioxadet didn't significantly affect the leukocyte count in peripheral blood while i.p. administration of dioxadet suppressed leukopoiesis. MST of rats after IPEC with cisplatin was 37.5 days which was significantly higher compared to MST after i.p. administration of cisplatin (19.5 days, p = 0.037). HIPEC with dioxadet was the most effective regimen of treatment with MST of rats reaching 49 days which was significantly higher compared to MST after HIPEC with cisplatin (25.5 days, p = 0.002).
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/terapia , Quimioterapia do Câncer por Perfusão Regional , Hipertermia Induzida , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Neoplasias Peritoneais/terapia , Animais , Carcinoma/tratamento farmacológico , Carcinoma/cirurgia , Cisplatino/administração & dosagem , Feminino , Período Intraoperatório , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/cirurgia , Cavidade Peritoneal , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/cirurgia , Ratos , Ratos Wistar , Análise de Sobrevida , Triazinas/administração & dosagemRESUMO
Gemcitabine is known to exert a therapeutic effect on brain tumors despite the limited permeability of the blood-brain barrier (BBB). In our experimental research single intraperitoneal (i.p.) injection of gemcitabine 25 mg/kg provided increase in median survival of mice with intracranially transplanted Ehrlich carcinoma by 41-89% (p < 0.001). In this experimental model i.p. administration of gemcitabine (permeability of the BBB of less than 10%), carmustine (good permeability of the BBB), cyclophosphamide (poor permeability of the BBB) and cisplatin (doesn't penetrate through the BBB) increased median survival of mice by 88% (p < 0.001), 59% (p = 0.001), 35% (p = 0.005) and 18% (p = 0.302) respectively. Considering strong correlation between antitumor activity of the drugs (carmustine, cyclophosphamide and cisplatin) and their permeability of the BBB, efficacy of gemcitabine in intracranial tumors could be due to its wide range of therapeutic doses.
Assuntos
Antimetabólitos Antineoplásicos/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Barreira Hematoencefálica , Neoplasias Encefálicas/tratamento farmacológico , Carcinoma de Ehrlich/tratamento farmacológico , Desoxicitidina/análogos & derivados , Animais , Antimetabólitos Antineoplásicos/administração & dosagem , Barreira Hematoencefálica/efeitos dos fármacos , Barreira Hematoencefálica/metabolismo , Neoplasias Encefálicas/etiologia , Carmustina/administração & dosagem , Cisplatino/administração & dosagem , Ciclofosfamida/administração & dosagem , Desoxicitidina/administração & dosagem , Desoxicitidina/farmacologia , Injeções Intraperitoneais , Masculino , Camundongos , Transplante de Neoplasias , GencitabinaRESUMO
The data of literature on possibility of the use of perfusion technologies in combined treatment for malignant tumors of different sites are presented. Possible complications during hyperthermic chemoperfusion are discussed and the effectiveness of this method is analyzed.
Assuntos
Quimioterapia do Câncer por Perfusão Regional/métodos , Hipertermia Induzida , Neoplasias/tratamento farmacológico , Feminino , Humanos , Hipertermia Induzida/efeitos adversos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Melanoma/tratamento farmacológico , Neoplasias/patologia , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Pleurais/tratamento farmacológico , Neoplasias Pleurais/secundário , Sarcoma/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Gástricas/tratamento farmacológico , Resultado do TratamentoRESUMO
A systematic review of the studies where HIPEC combined with cytoreductive surgery was used in patients with primary advanced ovarian cancer was performed to understand is there a role for this treatment modality not only in recurrent but in primary advanced ovarian cancer. The results are controversial but there is a strong trend for improvement of the long-term outcomes of patients with primary advanced ovarian cancer after HIPEC.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia do Câncer por Perfusão Regional , Procedimentos Cirúrgicos de Citorredução/métodos , Hipertermia Induzida/métodos , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/terapia , Terapia Combinada , Feminino , Humanos , Metanálise como Assunto , Prognóstico , Taxa de SobrevidaRESUMO
The results of organ-saving treatment for 84 children with closed transcapsular spleen rupture were studied. Criteria for the stipulation of differential curative tactics were present. Twenty-five children were treated conservatively. In 57 patients, different endosurgical manipulations were done. Laparotomy was done in 5 patients, including 3 patients who primarily had endosurgical treatment. Long-term results were studied for 29 children. The followup period was from 3 months to 4 years. Investigators showed that recommended tactics helped save organs in > 90% of children with transcapular splenic injuries. The possibility of restoring splenic structure and functional activity and preventing hyposplenism was proven by orthotopic saving of injured spleens.