Role Of Lymphatic Polychemotherapy And Ehf Therapy In Treatment Of Colorectal Cancer Complicated By Carcinomatosis Of Abdominal Cavity

Abstract

Aim: to improve treatment results of colorectal cancer, complicated carcinomatosis of abdominal cavity, by associated using of endolymphatic chemotherapy (ELCT) and local extremely high frequency (EHF) therapy.Materials and methods: I-group – 21 people (33.3%) performed colostomy, then neoadjuvant systemic chemotherapy by the scheme FOLFOX-4. It was held two cycles, after two cycles their were received cytoreductive surgery;II group – 26 people (41,3%) received cytoreductive operations with early postoperative intra-abdominal chemotherapy by oxaliplatin (200 mg/m(2) at day 1 and 5-FU 650 mg/m(2) from days 1 to 4.III group – 16 people (25,4%) also performed colostomy, then used 2 courses of ELCT with local EHF therapy and all patients were received cytoreductive operations. ELCT was carried out injecting oxaliplatin-100 mg/m(2) a day during 12 hours and then 5 – FU in doze of 600 mg/m2 a day during 72 hours by the instrumentality of the dozer and LV-200 mg/m(2) (2-h intravenous infusion). During ELCT patients received local EHF therapy in abdominal cavity for an hour.Results: After chemotherapy the partial regress of tumor observed in 1st group in 4,8 % and in 3rd –37,5 %, stabilization of process noted in 28,6 and 50% cases, progressing –66,7 and 12,5% cases correspondingly to groups. Histomorphologic study of malignant foci after ELCT+EHF therapy showed reduction of specific area of parenchyma cancer cell from 57 till 39% simultaneous growth of stroma from 40 till 58% and in necrosis area – from 1,8 till 2,5%. Mitotic activity of tumor cells in the 1st group decreased (average in 22 un.), but in 3rd group it decreased until 11 units. Analysis of life span showed that in 1st group of patients 2-year survival rate was 66,7%. In 2nd group of patients 2-year survival rate was 42,3%. Сonclusion: ELCH+EHF-therapy has high clinic efficacy and promotes to decrease terms of progression of tumor process, increases life span from 0 till 24% and quality of life of the patients. ELCH+EHF-therapy brings to reduction of specific area of parenchyma in cancer cells from 57 till 39% with simultaneous growth of stroma area from 40 till 58% and necrosis area – from 1,8 till 2,5%. ELCT+EHF-therapy lowers mitotic activity of tumor cells, activates apoptosis, hemodynamic and metabolic rates.