OPTION FOR TREATING LOCALLY ADVANCED PRIMARY BREAST CANCER

Bashtan V. P., Zhukova T. O., Mukovoz O. E., Litvinenko V. E., Aipert V. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The first place in the ranking of oncology and the most acute oncology problem is breast cancer (BC), in the vast majority of women. The rate of abstinence is high, and the percentage of patients receiving special therapy is 80.4%. All this indicates a low level of qualified care (Kolesnik O.O., Fedorenko Z.P., 2017). The aim of the study was the desire to study the effectiveness of various schemes of preoperative chemoradiation therapy with radiomodification in the scheme of complex treatment of primary localized BC. The object and methods of research. For the period from 2011 to 2016, in the conditions of the Poltava Regional Clinical Oncology Center, 89 patients with primary, inoperable, localized BC in the 3rd stage (T3-4N0-1M0), with compulsory verification of the process, received radiomodified chemoradiotherapy. Patients in both groups were recruited by blind randomization and divided into 2 groups. All patients were taken into work after signing, as a matter of compulsory, informed consent to the study. I (n-42) group received 2 courses of chemotherapy (CT) at standard doses of the CMF scheme. After 2 weeks of rest, patients received a course of radiation therapy under the radical program: on the axillary lymph nodes, parasternal supraclavicular areas, a single focal dose (SFD) of 2.2 Gr. to a total focal dose (TFD) of 60-62 Gr. II (n-47) group of patients received 2 courses of chemotherapy (CT) at standard doses of the CAF/FAC scheme. After 2 weeks of rest, patients received a course of radiation therapy under the radical program, but in multifractional mode: on the axillary lymph nodes, parasternal supraclavicular areas, a single focal dose (SFD) of 1.1 Gr (morning) + 1.1 Gr (after 6 hours) = 2.2 Gr to the total focal dose (TFD) 60-62Gr with radiomodification Tegafur (800 mg in the morning and 400 mg in the evening), which was administered in accordance with the instructions. Research results and their discussion. Analyzing 1 year of supervision, it is evident that 35 (83.3%) patients died in the I group, 7 died (16.7%). Patients who did not have a recurrence of the process at 1 year of life 25 (59.92%). In the II group, they died at 1 year – 6 (12.76%), and patients without relapsing 36 (76.59%). Comparing the result clearly that the overall survival of a reliable result was not low, and the rate of recurrence is likely to speak for the benefit of Group II. During second year, another 14 patients died in Group І against 7 group II. In the I survived, 21 (50,0%) were left, of which 17 (40,47%) without relapse were against 34 (72,34%) of the live ones, of which 20 (42,55%) without relapse. Summing up our research, supervision over the results of treatment in two groups, we can say that the remote survival results show the following: for 36 months. The observation formed the number of patients who clearly showed the results of treatment in groups I and II. In group І, overall survival rate was 11 (26,19%), with relapse 4 (9,52%). In the II group, the total number of patients with 3 years of observation was 25 (53,19%), with relapse of 17 (36,17%). Conclusions. The study of the effectiveness of the scheme of neoadjuvant chemotherapy in combination with radiotherapy and radiomodification (group II) showed a positive trend in survival and relapse rates as well as a satisfactory state in the manifestations of toxicity of HT and radiation manifestations compared with the proposed scheme for group I.

neoadjuvant chemotherapy, primary inoperable breast cancer, breast, multifractionation, radiomodification

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«Bulletin of problems biology and medicine» Issue 3 (145), 2018 year, 84-87 pages, index UDK 618.19-006-03

10.29254/2077-4214-2018-3-1-145-84-87