No abstract

A new combined photoultrasonic (CPUS) technology for the treatment of infected wounds is suggested. The CPUS principal operation is based on the topical application of a photosensitizer followed by light irradiation in combination with low frequency ultrasonic (US) treatment of wounds. In CPUS, two methods -photodynamic (PDT) and ultrasonic therapies supplement each other beneficially and in conjunction provide a significant effect of deep suppurative inflammatory wounds treatment. The main advantages of the new technology are the combined application of an antibiotic solution and photodynamic therapy to destroy antibiotic-resistant microorganisms, an effective mixing of a photosensitizer in the wound, the US enhancement of photosensitizer impregnation into the membranes of bacteria, the US clearing of wound surface from necrotic products, an increased effective light dose exposure in the whole volume of the deep wound when the light does not penetrate totally inside the wound, an additional bactericidal effect under the US impact, and the combined effect of CPUS activation of the immune system. The parameters of the developed CPUS therapy are as follows: the frequency of US oscillations is 26,5 kHz, the US tip elongation is 40±20 microns, an aluminum disulfonated phtalocyanine photosensitizer dissolved in a physiological solution, a photomatrix LEDs array with 660±10 nm used as a radiation source, light intensity from 0,5 to 10 mW/cm2, and the exposed surface is up to 1500 cm2. The experiments were carried out with 70 male chinchilla rabbits. The dynamics and character of wounds healing were studied by analyzing of clinical pathomorphological and histochemical data of the biopsy material and capillaroscopy of wounds edges. The experimental data on the animals model have demonstrated a high efficiency ofthe combined CPUS therapy.

The further development of new method of phototherapy based on using of light-emitting diodes (LED) arrays has been presented. LEDs array distribution in side of cylindrical surface, covering pathology region, was used for treatment group of patients with an affected peripheral nervous system. The main group consisted of patients with humeral plexopathy -one of possible neurological manifestation of postmastectomic syndrome as result of breast cancer radical treatment.This disease was accompanied also some another peripheral nervous system diseases: diabetic polyneuropathy, compression ischemic mononeuropathy, festering wounds and others. The phototherapeutic method is just directed on improvement of patient's conditions in combination with other traditional methods of treatment. The main parameters of photomatrix therapeutic system: wavelength -660 urn, line width -no more than 20 nm, intensity of radiation on the surface of edema -0.5-3 mW/cm2 (in dependence of apparatuses type). To control and study efficiency of phototreatment ultrasonic dopplerography, thermography, electromyography and viscosimetry have been used.The method oftreatment consists in illumination of affected region with exposition of 15-20 mm, during 10 everyday procedures. We have obtained following results of this study: stable analgesic effect was revealed, increase of muscle strength and decrease of pathological tissue volume were marked. These phenomenons were confirmed by statistically proved amelioration of such parameters as: electroneuromiogram on affected nerve, viscosity of plasma, blood flow velocity in main arteries and gradient of temperature distribution.

Показан современный подход в лечении этих больных в виде применения таргетной терапии в неоадъювантном режиме с учетом биологического профиля опухоли. Это позволяет улучшить качество жизни, оптимизировать послеоперационную реабилитацию и психо-социальную адаптацию больных.Ключевые слова: орофарингеальный рак (oropharynx cancer), таргетная терапия (targeted therapy), качество жизни (quality of life).Контактная информация: Л. З. Вельшер -д.м.н., проф., руководитель онкологического центра департамента здравоохранения ОАО «РЖД», заслуженный врач РФ, зав. кафедрой онкологии и лучевой терапии МГМСУ им. А. И. Евдокимова. А. А. Космынин -ассистент кафедры онкологии и лучевой терапии МГМСУ

Presented herein is a clinical study comprising 48 patients (42 men and 6 women) of working age (40–70 years), all of whom are suffering from locally advanced oropharyngeal cancer. A modern approach is applied to treat these patients,i.e., neoadjuvant targeted therapy, taking into account the biological profile of the tumor. The use of gefitinib causes an antitumor effect in 90.5% of cases as opposed to 56.5% when no drug is applied.