168 research outputs found
Time-resolved EPR study of radicals from 2,2-dimethoxy-2-phenylacetophenone in ethylene glycol after flash photolysis
The dynamic behaviour of transient free radicals generated by laser pulse photolysis (with Ξ» = 351 nm) of 2,2-dimethoxy-2-phenylacetophenone (DMPA) in ethylene glycol solutions have been studied by time-resolved EPR at room temperature. A main result of the study is a suitable evaluation method for radical systems with CIDEP in the case of very close hyperfine lines and hence with a overlap of several signals. The evaluation of single EPR time-profile signals requires in this case to take in account also the influence of the near resonance positions, what successfully has been done. The formation and decay of the two spin polarized radicals, 7,7-dimethoxy-benzyl (R1) and benzoyl radical (R2), has been observed. For R1 the relaxation time T2 was determined with a good accuracy and the rate constants k1 and k2 were estimated by fitting the time evolution of the EPR signal at resonance and near resonance positions of the field using the Bloch equations and direct Fourier transform analysis. Radicals from DMPA in the high viscous solvent ethylene glycol have been proved to be an excellent model system for this study however the treatment is applicable also for other systems. Β© 2002 Elsevier Science B.V. All rights reserved
Accelerated Recovery Protocol in Extended Combined and Single-Stage Surgery for Pelvic Cancer
Introduction. The study aimed to evaluate a routine accelerated recovery management in patients with extended combined pelvic surgery.Materials and methods. We surveyed the records and outcomes in various oncological patients following the accelerated recovery protocol after a routine extended combined pelvic surgery at the Moscow City Oncology Hospital No. 1 during 2018β2020.Results and discussion. Locally advanced tumours comprised 37 (75.5 %) cases, and the remaining 12 (24.5 %) were nonpelvic resections due to metastasis. Radical surgery was achieved in 41 (83.7 %) cases, while the other 8 (16.3 %) were symptomatic due to the emerged complications of intestinal permeability disruption, bleeding, urinary obstruction, paracancrotic abscess, internal fistulae or pain syndrome. Postoperative complications were evaluated in the Clavien-Dindo classification.Conclusion. The results obtained suggest the feasibility of an accelerated recovery protocol-based practice in extended combined pelvic surgery
Time-resolved ESR studies on transient radicals photogenerated in solutions of melamine in ethylene glycol
Chemically Induced Dynamic Electron Polarization (CIDEP) spectra of transient radicals generated by laser pulse with Ξ» = 248 nm in solutions of melamine in ethylene glycol have been studied by means of time-resolved (TR) ESR at room temperature. The main products are radicals of the solvent molecules formed through abstraction of hydrogen from ethylene glycol by excited melamine molecules and a melamine radical with attached hydrogen atom on melamine. Parameters obtained from well resolved TR ESR spectra coincide with parameters of radical of ethylene glycol HOC{radical dot}HCH2OH and methylol {radical dot}CH2OH, and an unresolved ESR spectrum was attributed to the melamine radical. The electron spin polarization results from the radical pair mechanism (RPM) involving S-T0 mixing (ST0M) and additionally from a small part of triplet mechanism (TM). In order to establish the possible structure and nature of melamine radical quantum-chemical calculations by the DFT B3LYP method using several different basis sets have been done. The reaction pathway and mechanisms of alcohol and melamine radicals formation are proposed and supported by DFT calculations within B3LYP and CIS(D) methods. Melamine and ethylene glycol free radicals relaxation time T2 was estimated as 1.5 and 0.5 ΞΌs, respectively. Β© 2005 Elsevier B.V. All rights reserved
Complex formation, chemical exchange, species structure, and stereoselective effects in the copper(II)- L/DL-histidine systems
The formation of copper(ii) complexes with l- and dl-histidine (HisH) has been studied by means of pH-potentiometry and spectrophotometry over a wide range of pH (2-14), ligand-to-metal ratio (1:1-15:1), and temperature (15-55Β°C) in aqueous solutions with 1.0 mol dm -3 KNO 3 as background. Formation constants and spectral characteristics of 13 complex types were found. Fine stereoselective effects have been detected with preferential coordination of two ligands with identical configuration in Cu(His)(HisH) + and opposite configuration in Cu(His) 2. The stereoselective effect for Cu(His)(HisH) + is explained by hydrogen bond formation between the carboxyl and imidazolyl groups of neighboring ligands at cis-arrangement of amino groups (3N eq-form). The opposite sign of stereoselective effect for Cu(His) 2 is derived from favourable axial coordination of the imidazole group in meso-form with cis-structure (3N eqN ax-form). A significant tetrahedral distortion was revealed for the first time in the prevalent cis-isomer of the Cu(l-His) 2 4N eq-form. These findings were confirmed by EPR data and DFT computations at the B3LYP/TZVP level. The prevalence of cis-isomers for these complexes has been assigned to the rather strong trans effect of the amino groups. The structures of other detected complexes are briefly discussed on the basis of spectroscopic data. Chemical exchange reactions in the copper(ii)- l/dl-hishidine systems have been investigated by the NMR relaxation of water protons. A unique proton exchange reaction with short-term proton dissociation from the coordinated imidazolyl group catalyzed by hydroxide ion was characterised for the first time. The discovered enantioselective effects in the ligand exchange reactions between Cu(His) 2 and HisH or His - species were attributed to the associative substitution mechanism. Β© 2012 The Royal Society of Chemistry
Electron spin resonance study of radicals generated in cellulose/N- methylmorpholine solutions after flash photolysis at 77 K
The processes of radical formation in N-methylmorpholine-N-oxide monohydrate (NMMO) and cellulose/NMMO solutions were studied by ESR at 77 K under high-power UV (Ξ» = 248 nm) excimer laser flash photolysis. Radicals mainly generated were attributed to the nitroxide type radicals -CH 2-NO.-CH2- and -CH2-NO .-CH3 at the first step and methyl .CH 3 and formyl .CHO radicals at the second step of the photoreaction. Kinetic studies of these radicals revealed that formation and recombination rates of the radicals depend on the cellulose concentration in cellulose/NMMO solutions and the concentration of additional ingredients, e.g. Fe(II) and propyl gallate. Even at frozen state temperature, acceleration or quenching of radical reaction processes was found. The proposed scheme of UV light-induced NMMO degradation during irradiation based on ESR data correlates well with independently obtained results based on high-performance liquid chromatography (HPLC). The analysis of degradation products by HPLC, e.g. aminoethanol and acetaldehyde, supports the assumption concerning a radical-initiated ring opening of NMMO. Copyright Β© 2006 John Wiley & Sons, Ltd
ΠΠ΅ΡΠ²ΠΈΡΠ½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ D3-Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΠΈ ΠΏΡΠΈ Ρ ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΡΠ°ΠΊΠ° ΠΏΡΠ°Π²ΠΎΠΉ ΠΎΠ±ΠΎΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ
Introduction. Despite recent significant progress in chemotherapy treatment of primary non-metastatic cancer of the right half of the segmented intestine, surgery remains the primary method of treatment. Radical surgery includes removal of the tumour within the healthy tissues and regional lymph glands. Considering localisation of the primary tumour in the right half of the segmented intestine, hemicolectomy is typically performed on the right side. W. Hohenberger et al. have formulated a new concept of radical surgical treatment of the segmented intestine, consisting of the following components: complete mesocolic excision, early ligation of the lymphovascular pedicle and lymph dissection in the D3 volume.Purpose of the research: to analyse the early results of surgical treatment of cancer in the right half of the segmented intestine in the volume of the right-side hemicolectomy with D3 lymph node dissection depending on the method of surgical treatment.Materials and methods. At the premises of the Surgical Department No. 3 of the Republican Oncologic Dispensary (city of Ufa) a retrospective analysis of data of 59 patients was performed following right-side hemicolectomy using complete mesocolic excision, ligation lymphovascular pedicles and lymph node dissection in the D3 volume. Depending on the surgical access, all patients were divided into two main groups: group I (48 patients)Β β surgeries were performed using open method; group II (11 patients)Β β using laparoscopy.Results and discussion. Table 2 shows that the surgery performed with laparoscopy takes longer. However, statistically it results in significantly less blood loss. Patients who underwent open surgery were characterised by a longer stay in hospital. One of the effectiveness criteria is the number of removed lymph glands not differing for either group.Conclusion. Extended lymph dissection in the D3 volume for segmented intestine on the right side during cancer is a possible and safe method in case of laparoscopic and open procedures.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΠ΅ΡΠΌΠΎΡΡΡ Π½Π° Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΏΡΠΎΠ³ΡΠ΅ΡΡ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π² ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π³ΠΎΠ΄Ρ, Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠ³ΠΎ Π½Π΅ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° ΠΏΡΠ°Π²ΠΎΠΉ ΠΏΠΎΠ»ΠΎΠ²ΠΈΠ½Ρ ΠΎΠ±ΠΎΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΌΠ΅ΡΠΎΠ΄ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ. Π Π°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ΅ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎ Π²ΠΊΠ»ΡΡΠ°Π΅Ρ Π² ΡΠ΅Π±Ρ ΡΠ΄Π°Π»Π΅Π½ΠΈΠ΅ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Π² ΠΏΡΠ΅Π΄Π΅Π»Π°Ρ
Π·Π΄ΠΎΡΠΎΠ²ΡΡ
ΡΠΊΠ°Π½Π΅ΠΉ ΠΈ ΡΠ΅Π³ΠΈΠΎΠ½Π°ΡΠ½ΡΡ
Π»ΠΈΠΌΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ·Π»ΠΎΠ². Π ΡΡΠ»ΠΎΠ²ΠΈΡΡ
Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Π² ΠΏΡΠ°Π²ΠΎΠΉ ΠΏΠΎΠ»ΠΎΠ²ΠΈΠ½Π΅ ΠΎΠ±ΠΎΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ ΡΡΠ°Π΄ΠΈΡΠΈΠΎΠ½Π½ΠΎ Π²ΡΠΏΠΎΠ»Π½ΡΠ΅ΡΡΡ Π³Π΅ΠΌΠΈΠΊΠΎΠ»ΡΠΊΡΠΎΠΌΠΈΡ ΡΠΏΡΠ°Π²Π°. W. Hohenberger ΠΈ Π΄Ρ. ΡΡΠΎΡΠΌΡΠ»ΠΈΡΠΎΠ²Π°Π»ΠΈ Π½ΠΎΠ²ΡΡ ΠΊΠΎΠ½ΡΠ΅ΠΏΡΠΈΡ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΎΠ±ΠΎΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ, ΡΠΎΡΡΠΎΡΡΡΡ ΠΈΠ· ΡΠ»Π΅Π΄ΡΡΡΠΈΡ
ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠΎΠ²: ΠΏΠΎΠ»Π½Π°Ρ ΠΌΠ΅Π·ΠΎΠΊΠΎΠ»ΠΎΠ½ΡΠΊΡΠΎΠΌΠΈΡ, ΡΠ°Π½Π½Π΅Π΅ Π»ΠΈΠ³ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π»ΠΈΠΌΡΠΎΠ²Π°ΡΠΊΡΠ»ΡΡΠ½ΠΎΠΉ Π½ΠΎΠΆΠΊΠΈ ΠΈ Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΡ Π² ΠΎΠ±ΡΠ΅ΠΌΠ΅ D3.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΏΡΠΎΠ²Π΅ΡΡΠΈ Π°Π½Π°Π»ΠΈΠ· ΡΠ°Π½Π½ΠΈΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ°ΠΊΠ° ΠΏΡΠ°Π²ΠΎΠΉ ΠΏΠΎΠ»ΠΎΠ²ΠΈΠ½Ρ ΠΎΠ±ΠΎΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ Π² ΠΎΠ±ΡΠ΅ΠΌΠ΅ ΠΏΡΠ°Π²ΠΎΡΡΠΎΡΠΎΠ½Π½Π΅ΠΉ Π³Π΅ΠΌΠΈΠΊΠΎΠ»ΡΠΊΡΠΎΠΌΠΈΠΈ Ρ D3-Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΠ΅ΠΉ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΠΌΠ΅ΡΠΎΠ΄Π° ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ° Π±Π°Π·Π΅ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡ β 3 Π Π΅ΡΠΏΡΠ±Π»ΠΈΠΊΠ°Π½ΡΠΊΠΎΠ³ΠΎ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π΄ΠΈΡΠΏΠ°Π½ΡΠ΅ΡΠ° (Π³.Β Π£ΡΠ°) ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Π΄Π°Π½Π½ΡΡ
59 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎΡΠ»Π΅ ΠΏΡΠ°Π²ΠΎΡΡΠΎΡΠΎΠ½Π½Π΅ΠΉ Π³Π΅ΠΌΠΈΠΊΠΎΠ»ΡΠΊΡΠΎΠΌΠΈΠΈ ΠΏΠΎ ΡΠ΅Ρ
Π½ΠΈΠΊΠ΅ complete mesocolic excision Π»ΠΈΠ³ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π»ΠΈΠΌΡΠΎΠ²Π°ΡΠΊΡΠ»ΡΡΠ½ΠΎΠΉ Π½ΠΎΠΆΠΊΠΈ ΠΈ Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΠ΅ΠΉ Π² ΠΎΠ±ΡΠ΅ΠΌΠ΅ D3. Π Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π΄ΠΎΡΡΡΠΏΠ° Π²ΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Π±ΡΠ»ΠΈ ΡΠ°Π·Π΄Π΅Π»Π΅Π½Ρ Π½Π° Π΄Π²Π΅ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ Π³ΡΡΠΏΠΏΡ: I Π³ΡΡΠΏΠΏΠ° (48Β ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²) β ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ ΠΎΡΠΊΡΡΡΡΠΌ ΡΠΏΠΎΡΠΎΠ±ΠΎΠΌ ΠΈ II Π³ΡΡΠΏΠΏΠ° (11 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²)Β β Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΏΠΎΡΠΎΠ±ΠΎΠΌ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. ΠΠ· Π΄Π°Π½Π½ΡΡ
ΡΠ°Π±Π»ΠΈΡΡ 2 Π²ΠΈΠ΄Π½ΠΎ, ΡΡΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎ, Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π½ΠΎΠ΅ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈ, ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅ΡΡΡ Π±ΠΎΠ»Π΅Π΅ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠΌ. ΠΠ΄Π½Π°ΠΊΠΎ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π»ΠΎΡΡ ΠΌΠ΅Π½ΡΡΠ΅ΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠ΅ΠΉ. ΠΠ°ΡΠΈΠ΅Π½ΡΡ, ΠΏΠΎΠ΄Π²Π΅ΡΠ³ΡΠΈΠ΅ΡΡ ΠΎΡΠΊΡΡΡΠΎΠΉ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ, Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΠΎΠ²Π°Π»ΠΈΡΡ Π±ΠΎΠ»Π΅Π΅ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠΌ ΠΏΡΠ΅Π±ΡΠ²Π°Π½ΠΈΠ΅ΠΌ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ΅. ΠΠ΄ΠΈΠ½ ΠΈΠ· ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈΒ β ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΡΠ΄Π°Π»Π΅Π½Π½ΡΡ
Π»ΠΈΠΌΡΠΎΡΠ·Π»ΠΎΠ²Β β Π½Π΅ ΡΠ°Π·Π»ΠΈΡΠ°Π»ΡΡ Π΄Π»Ρ ΠΎΠ±Π΅ΠΈΡ
Π³ΡΡΠΏΠΏ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π Π°ΡΡΠΈΡΠ΅Π½Π½Π°Ρ Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΡ Π² ΠΎΠ±ΡΠ΅ΠΌΠ΅ D3 ΠΏΡΠΈ ΡΠ°ΠΊΠ΅ ΠΎΠ±ΠΎΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ ΡΠΏΡΠ°Π²Π° ΡΠ²Π»ΡΠ΅ΡΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΠΌ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π² ΡΠ»ΡΡΠ°Π΅ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΊΠ°ΠΊ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΡ
, ΡΠ°ΠΊ ΠΈ ΠΎΡΠΊΡΡΡΡΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²
ΠΠΏΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΡΠ΅ΡΠ΅ΠΎΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΡΡΠ΅Π²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΡΠΈ ΠΎΠ»ΠΈΠ³ΠΎΠΌΠ΅ΡΠ°ΡΡΠ°Π·Π°Ρ ΠΊΠΎΠ»ΠΎΡΠ΅ΠΊΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° Π² ΠΏΠ΅ΡΠ΅Π½ΠΈ
Introduction: The problem of treating patients with unresectable liver metastases of colon cancer is currently far f rom being solved. One possible approach is the use of stereotactic body radiotherapy.The purpose of this study was to evaluate the immediate and long-term results of stereotactic radiotherapy in patients with colorectal cancer and oligometastatic liver metastases.Methods: This study was designed as a retro-prospective, open-label, controlled, non-randomized clinical trial. We assessed one-year local control, one-year overall survival, progression-free survival, and toxicity in 60 patients with oligometastatic liver disease from colorectal cancer who underwent stereotactic body radiotherapy, with median dose of 54 Gy.Results: The median follow-up was 20,1 months. One-year local control (LC) was 73,7 % (95 % CI = 62,7β86,6 %). Oneyear overall survival (OS) was 92,8 % (95 % CI = 86,3β99,9 %), one-year progression-free survival (PFS) was 31,3 % (95 % CI = 21,1β46,4 %) with a median of 8,1 months. Grade β₯ 3 toxicity was not noted. No cases of radiation-induced liver failure were observed. Radiation dose (HR = 0.88, 95 % CI = 0.81β0.95, p = 0.00087), metastasis size (HR = 1.51, 95 % CI = 1.07β2.12, p = 0.01858) and their number (HR = 1.8, 95 % CI = 1.01β3.22, p = 0.04669) are significant risk factors for LC. Metastasis size > 3 cm is a significant risk factor for LC (HR = 5.5, 95 % CI = 1.7β17.9, p = 0.005) and OS (HR = 3.8, 95 % CI = 1.3β11.7, p = 0.02).Conclusion: Stereotactic body radiotherapy is an effective and safe method of providing local control of oligometastatic liver metastases in colorectal cancer as part of a combined treatment approach. Further studies are required to individualize the indications for this treatment method.ΠΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅: ΠΡΠΎΠ±Π»Π΅ΠΌΠ° Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Π½Π΅ΡΠ΅Π·Π΅ΠΊΡΠ°Π±Π΅Π»ΡΠ½ΡΠΌΠΈ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·Π°ΠΌΠΈ ΡΠ°ΠΊΠ° ΡΠΎΠ»ΡΡΠΎΠΉ ΠΊΠΈΡΠΊΠΈ Π² ΠΏΠ΅ΡΠ΅Π½ΠΈ Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ Π΄Π°Π»Π΅ΠΊΠ° ΠΎΡ ΡΠ΅ΡΠ΅Π½ΠΈΡ. ΠΠ΄ΠΈΠ½ ΠΈΠ· Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΡ
ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ΠΎΠ² β ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΡΠ΅ΡΠ΅ΠΎΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΡΡΠ΅Π²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΡΠ΅Π½ΠΊΠ° Π½Π΅ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΈ ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΡΠ΅ΡΠ΅ΠΎΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΡΡΠ΅Π²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ°ΠΊΠ° ΡΠΎΠ»ΡΡΠΎΠΉ ΠΊΠΈΡΠΊΠΈ Ρ ΠΎΠ»ΠΈΠ³ΠΎΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠ΅ΡΠ΅Π½ΠΈ.ΠΠ΅ΡΠΎΠ΄Ρ: ΠΠ°Π½Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΊΠ°ΠΊ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΎΡΠΊΡΡΡΠΎΠ΅ ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΠΎΠ΅ Π½Π΅ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅. ΠΠ΄Π½ΠΎΠ³ΠΎΠ΄ΠΈΡΠ½ΡΠΉ Π»ΠΎΠΊΠ°Π»ΡΠ½ΡΠΉ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ, ΠΎΠ΄Π½ΠΎΠ³ΠΎΠ΄ΠΈΡΠ½Π°Ρ ΠΎΠ±ΡΠ°Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ, Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ Π±Π΅Π· ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΡ Π±ΡΠ»ΠΈ ΠΎΡΠ΅Π½Π΅Π½Ρ Ρ 60 Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΠΎΠ»ΠΈΠ³ΠΎΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠ΅ΡΠ΅Π½ΠΈ Π½Π° ΡΠΎΠ½Π΅ ΠΊΠΎΠ»ΠΎΡΠ΅ΠΊΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ°, ΠΊΠΎΡΠΎΡΡΠΌ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»Π°ΡΡ ΡΡΠ΅ΡΠ΅ΠΎΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π»ΡΡΠ΅Π²Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ, ΠΌΠ΅Π΄ΠΈΠ°Π½Π° ΡΡΠΌΠΌΠ°ΡΠ½ΠΎΠΉ ΠΎΡΠ°Π³ΠΎΠ²ΠΎΠΉ Π΄ΠΎΠ·Ρ 54 ΠΡ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: ΠΠ΅Π΄ΠΈΠ°Π½Π° Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 20,1 ΠΌΠ΅Ρ. ΠΠ΄Π½ΠΎΠ³ΠΎΠ΄ΠΈΡΠ½ΡΠΉ Π»ΠΎΠΊΠ°Π»ΡΠ½ΡΠΉ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ (ΠΠ) Π΄ΠΎΡΡΠΈΠ³ 73,7 % (95 %ΠΠ = 62,7β86,6 %). ΠΠ΄Π½ΠΎΠ³ΠΎΠ΄ΠΈΡΠ½Π°Ρ ΠΎΠ±ΡΠ°Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ (ΠΠ) ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 92,8 % (95 % ΠΠ = 86,3β99,9 %), ΠΎΠ΄Π½ΠΎΠ³ΠΎΠ΄ΠΈΡΠ½Π°Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ Π±Π΅Π· ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ (ΠΠΠ) β 31,3 % (95 %ΠΠ = 21,1β46,4 %) Ρ ΠΌΠ΅Π΄ΠΈΠ°Π½ΠΎΠΉ 8,1 ΠΌΠ΅Ρ. Π’ΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΠΈ 3 ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΠΈ Π²ΡΡΠ΅ Π½Π΅ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ. Π‘Π»ΡΡΠ°Π΅Π² ΡΠ°Π΄ΠΈΠ°ΡΠΈΠΎΠ½Π½ΠΎ ΠΈΠ½Π΄ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΏΠ΅ΡΠ΅Π½ΠΎΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ Π½Π΅ Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΎΡΡ. ΠΡΠ»ΠΎ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π΄ΠΎΠ·Π° ΠΎΠ±Π»ΡΡΠ΅Π½ΠΈΡ (HR = 0,88, 95 % ΠΠ = 0,81β0,95, p = 0,00087), ΡΠ°Π·ΠΌΠ΅Ρ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² (HR = 1,51, 95 % ΠΠ = 1,07β2,12, Ρ = 0,01858) ΠΈ ΠΈΡ
ΡΠΈΡΠ»ΠΎ (HR = 1,8 95 % ΠΠ = 1,01β3,22, Ρ = 0,04669) ΡΠ²Π»ΡΡΡΡΡ Π·Π½Π°ΡΠΈΠΌΡΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΡΠΈΡΠΊΠ° Π΄Π»Ρ ΠΠ. Π Π°Π·ΠΌΠ΅Ρ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² > 3 ΡΠΌ ΡΠ²Π»ΡΠ΅ΡΡΡ Π·Π½Π°ΡΠΈΠΌΡΠΌ ΡΠ°ΠΊΡΠΎΡΠΎΠΌ ΡΠΈΡΠΊΠ° ΠΏΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ Π»ΠΎΠΊΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ (HR = 5.5, 95 % ΠΠ = 1.7β17.9, p = 0.005) ΠΈ ΠΠ (HR = 3.8, 95 % ΠΠ = 1.3β11.7, p = 0.02).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅: Π‘ΡΠ΅ΡΠ΅ΠΎΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π»ΡΡΠ΅Π²Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ β ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΡΠΉ ΠΌΠ΅ΡΠΎΠ΄ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ Π»ΠΎΠΊΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ Π½Π°Π΄ ΠΎΠ»ΠΈΠ³ΠΎΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠ΅ΡΠ΅Π½ΠΈ ΠΏΡΠΈ ΠΊΠΎΠ»ΠΎΡΠ΅ΠΊΡΠ°Π»ΡΠ½ΠΎΠΌ ΡΠ°ΠΊΠ΅ Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° ΠΊ Π»Π΅ΡΠ΅Π½ΠΈΡ. Π’ΡΠ΅Π±ΡΠ΅ΡΡΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π΄Π»Ρ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠΉ ΠΊ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΎΠ΄Π° Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ Π΅Π³ΠΎ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΠ³ΠΈΠΈ.
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