In the department of coloproctology of NORC MH RUz 17 patients with disseminated forms of colorectal cancer was made the study of oncogenes and complex treatment by 2 protocols using FOLFOX4 regime and FOLFIRI regime. In second protocol there used 2 sessions of endolymphatical polychemotherapy FOLFOX4 regime against EHFhyperthermia. All patients were performed additional investigations directed to study the presence of multiple drug resistance in them where definition of р53, bcl2 oncogene expression. In our observations we followed resistance to FOLFOX4 scheme in 4 patients, and to FOLFIRI scheme in 2 cases. In our studies hyperexpression of oncoproteine р53 was correlated with the effect of conducted therapy whereas hyperexpr, Navruzov S. N., Abdujapparov S. B., Pulatov D. A., Islamov H. D., Matniyazova Sh. Ya., Akbarov E. T., and Literatura
Pseudomyxoma peritonei je vzácný klinický syndrom; nádorový proces, pro který je charakteristické hromadění mucinózního ascitu a peritoneálních implantátů v břišní dutině. Primárním zdrojem je téměř vždy low grade mucinózní tumor apendixu. Jedná se o pomalu progredující, nízce agresivní, ale smrtící onemocnění s častými recidivami. Optimálním léčebným postupem je kompletní chirurgická cytoredukce (CRS) v kombinaci s peroperačně aplikovanou intraperitoneální hypertermickou chemoterapií (HIPEC) – tzv. Sugarbakerova metoda., Pseudomyxoma peritonei (PMP) is an uncommon clinical syndrome characterized by the slow and progressive accumulation of peritoneal implants and mucinous ascites, intraabdominal gelatinous collection (jelly belly). PMP is reported to originate from the low grade appendiceal mucinous neoplasm. Pseudomyxoma peritonei often recurs after treatment and may eventually cause death by abdominal visceral dysfunction via compression with mucinous ascites. Cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy comprising hyperthermic intraperitoneal chemotherapy (HIPEC) with or without postoperative intraperitoneal chemotherapy (EPIC) has been regarded as the standard of care in specialized centers. It is often referred to as the „Sugerbaker procedure“. Conventionally, PMP is considered resistant to systemic chemotherapy. Even though complete cytoreduction is associated with prolonged overall survival, recurrence of disease is common and multiple operations are frequently required. Patients may enjoy sustained period of remission, free of symptoms, but long – term disease free survival is distinctly uncommon. The pathologic subtype remains the dominant factor in survival. Patients should be centralized to improve survival by a combination of surgical experience and adequate patient selection., Roman Kocián, and Literatura
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. Igroup 21 people (33.3%) performed colostomy, then neoadjuvant systemic chemotherapy by the scheme FOLFOX4. 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 intraabdominal chemotherapy by oxaliplatin (200 mg/m(2) at day 1 and 5FU 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 oxaliplatin100 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 LV200 mg/m(2) (2h intravenous infusion). During ELCT patients received local EHF therapy in abdominal cavity for an hour. 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 2year survival rate was 66,7%. In 2nd group of patients 2year survival rate was 42,3%. ELCH+EHFtherapy 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+EHFtherapy 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+EHFtherapy lowers mitotic activity of tumor cells, activates apoptosis, hemodynamic and metabolic rates., Akbarov E.T., Navruzov S.N., Abdujapparov S.B., Islamov H.D., and Literatura