METHOD FOR INTEGRATED TREATMENT OF LOCALLY ADVANCED THORACIC OESOPHAGEAL CARCINOMA

摘要

FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, oncology. It involves 3-5 sessions of argon-plasma recanalisation of a tumour stenosis area at power 60-70 Wt, duration of each application max. 5 sec, argon supply rate 2.0-2.2 l/min, every 3-5 days. It is followed by 3 sessions of endoluminal brachytherapy of single radiation dose 7 Gy, once a week, total radiation dose 21 Gy. An endostate is placed so that to enable the source moving at the distance covering the tumour and the oesophageal wall above and below the tumour by 2-3 cm. It is combined with 2 cycles of chemotherapy according to the schedule: cisplatin 75 mg/m intravenously on the 1st day, 5- fluorouracil 1000 mg/m2 daily, continuous intravenous infusion on the 1st-5th days. The first session of brachytherapy is combined with the beginning of chemotherapy. The next course of polychemotherapy follows in 28 days. A tumour regression degree is estimated to consider a possibility of the surgical management to the extent of sub-total esophagectomy accompanied by three-zone lymphodissection and single-step repair with a wide gastric graft. ^ EFFECT: method enables higher resectability and radicality of the surgical management ensured by downsizing the initial tumour. ^ 2 ex