Objectification of the effectiveness of osteopathic correction of the consequences of polychemotherapy during the accompanying therapy in the postoperative period in children with malignant neoplasms of the musculoskeletal system

Abstract

Introduction.Cancer is the second leading cause of death in the world. WHO predicts that the incidence of cancer will grow from 14 million in 2012 to 22 million in the following decades. It is impossible to achieve an adequate effect in the medicamentous treatment of malignant tumors without the use of accompanying therapy. The search and use of new methods of correction of complications arising in children during polychemotherapy will not only signifi cantly reduce the lethality of this category of patients, but also signifi cantly intensify specifi c therapy and thereby increase the percentage of complete remissions and event-free survivals.Goal of research— to assess the effectiveness of osteopathic treatment in eliminating the side effects of adjuvant PCT in children in the postoperative period.Materials and methods. 42 children aged 6–16 years with a history of malignant neoplasm of the musculoskeletal system took part in the research. At the time of the study they were undergoing adjuvant PCT after the radical surgery. Patients were divided into two equal and comparable in all parameters groups (the main group and the control one) by method of blind selection. Patients of the experimental group (21 patients) underwent osteopathic correction according to the standard protocol with the frequency 1 session per 7–14 days. In order to assess the severity of PCT complications, a number of non-specifi c indicators from the toxicity criteria proposed by the International Society of Pediatric Oncologists (laboratory markers of hematological toxicity and clinical manifestations of gastrointestinal toxicity) were used. The osteopathic status was assessed in accordance with the recommendations «Osteopathic Diagnostics of Somatic Dysfunctions» with limitations in active tests because of the severity of the condition and postural problems related to the short time period after surgical treatment (tumor resection, endoprosthetics). The indices for each PCT course were calculated separately. Patients were included in the study during the start of the next course of PCT. The duration of each patient′s observation was at least 21 days, which corresponds to the time between two subsequent courses of PCT.Results.In this group of patients, osteopathic correction led to the elimination of global biomechanical dysfunctions, a decrease in the absolute number of global and regional somatic dysfunctions, and a change in the structure of regional dysfunctions. It has been established that osteopathic support does not signifi cantly affect the intensity of hematological toxicity in PCT (the severity of leukocytopenia, anemia, thrombocytopenia). However, it leads to a signifi cant decrease in such manifestations of gastroenterological toxicity as emetogenic syndrome and abdominal pain.Conclusion.The reasonable use of individual osteopathic correction in the course of accompanying therapy can reduce the intensity of intoxication and improve the quality of life of patients during PCT courses.