The experience of polyradiomodification with the use of ozone-oxygen mixture in complex treatment of the squamous cell cervical cancer

Abstract

Aim. To improve the results of complex treatment of stage IIb squamous cell cervical cancer. Methods. 53 patients with stage IIb squamous cell cervical cancer were included. All patients underwent combined radiotherapy (teletherapy plus brachytherapy) and were treated with intravenous cisplatin followed by hysterectomy by Wertheim. As a pre-surgical treatment 31 patients (main group) underwent rectal insufflations of ozone-oxygen mixture as a radio modifier. The original method and machine pulse oxymetry of the tumor tissue oxygenation were used. 22 (41.5%) who were included in the control group underwent combined chemoradiotherapy without use of ozone-oxygen mixture. A comparative analysis of tumor tissue post-treatment pathomorphism, chemoradiotherapy side effects rate and post-surgical complications rate was performed in both of the groups. Results. All complications were transient and could be easily managed symptomatically. Hence, there was a tendency of side effects rate and complications rate decrease in the main group. Cystitis as a complication of radiotherapy was observed in 1 (3%) patient of the main group and in 2 (9%) of the control group, proctitis - in 5 (16%) patients of the main group and in 4 (18%) patients of the control group. Leukocytopenia (I-II degree) as the most frequent hematological chemotherapy complication was registered in 7 (22%) patients of the main group and in 17 (72.2%) patients of the control group. Flu-like syndrome was observed in 1 (3%) patient of the main group and in 2 (9%) patients of the control group. There were no grade III and IV toxicity events. Proposed pre-surgical chemoradiotherapy of the localized stage IIb cervical cancer with an ozone-oxygen mixture as a radio modifier was characterized by high (grade IV) tumor tissue post-treatment pathomorphism level reaching 44.8%. Conclusion. The use of rectal insufflations of ozone-oxygen mixture allowed to decrease the rate of chemotherapy and radiotherapy complications, but the difference was not statistically significant. To increase the power of the study, more subjects are needed to be recruited with a longer follow-up.