Новые технологии (фотодинамическая терапия и специфическая противоопухолевая иммунотерапия) в комплексном лечении больных злокачественными астроцитарными супратенториальными опухолями. Оценка отдаленных результатов

Abstract

Background. Glial tumors are the most common tumors of the brain, with their malignant form - anaplastic astrocytoma and glioblastoma exceed 50 % and accounting for only 2 % of all tumors in adults, take fourth place in the structure of cancer mortality. Objective: To determine the effectiveness of new technologies of treatment of malignant glial tumors (photodynamic therapy and specific antitumor immunotherapy based on autologous dendritic cells). Design and Methods: We consider the results of treatment 356 patients with malignant glial tumors. Depending on the treatment, 5 groups were formed, 3 of which, in addition to standard procedures (surgery, radiotherapy, chemotherapy) photodynamic and/or immunotherapy were used. Results: when used in addition to standard methods, photodynamic therapy in patients with anaplastic astrocytoma average life expectancy and the median survival were 50.8 months and 35 months, glioblastomas - 47.9 months and 30 months, giant cell glioblastomas - 34 months and 34 months, that is higher than in the groups of patients with only standard methods of treatment. Application of 3 or more courses of immunotherapy also improves life expectancy and median survival of these patients 50.22 months and 32 months in patients with anaplastic astrocytomas, and 23.72, and 24 months in patients with glioblastomas. Conclusions: The highest average life expectancy and the median survival among patients with anaplastic astrocytomas, glioblastomas and giantcell glioblastomas in our study were achieved in patients in which treatment in addition to standard therapies (surgery, radiotherapy, chemotherapy) was added by photodynamic therapy. When managed with immunotherapy additionally to standard methods, life expectancy increased only if more than 3 courses were used.