POSSIBILITIES OF THE CORRECTION OF ENDOGENOUS INTOXICATION DURING CHEMOTHERAPY IN GYNECOLOGICAL CANCER PATIENTS

Abstract

Introduction. The application of efferent therapy (extracorporeal therapy) now becomes relevant due to the individual intolerance to various drugs, side effects of a great many of drugs, which is especially important when treating onco-gynecological pathology, often accompanied by the development of endogenous intoxication. The purpose of the study is the evaluation of the state of the system of endotoxemia in gynecological cancer patients under treatment by certain types of chemotherapy with the use of extracorporeal approaches. Material and Methods. In the blood of 86 ovarian cancer patients under a neoadjuvant intraperitoneal chemotherapy conducted on protein concentrate of ascitic fluid and neoadjuvant chemotherapy with prior plasma exchange, as well as in 16 patients with cervical cancer at chemoimmunotherapy on autologous blood there were investigated indices of endogenous intoxication, reflecting the level of endotoxins and functional state of albumin. Results. Intraperitoneal chemotherapy on ascites protein concentrate obtained with the use of filtration detoxification was established to have a considerably lower toxicity as compared with the standard procedure of intraperitoneal chemotherapy. Chemotherapy conducted on autologous media with the inclusion of ronkoleukine and reaferon eliminates the toxic effects of cytostatic agents by the restoration of the functional activity of the albumin molecule. Application of plasmapheresis before neoadjuvant polychemotherapy declines the exertion in the endotoxemia system in gynecological cancer patients. Conclusion. The use of extracorporeal methods of the therapy and body fluids as a medium for cytostatics allows to decline the level of endogenous intoxication in patients with gynecological cancer.