[Immediate results of combined therapy for local recurrences of rectal cancer].

The purpose of this paper was to increase the effectiveness of radiation therapy (RT) of local recurrence of rectal cancer (MRRPK) by setting the preferred modes and dynamic medium dose fractionation irradiation MRRPK, assessing immediate outcomes, identifying the frequency and severity of early radiation reactions during radiation therapy. The study included 60 patients with a diagnosis of "local recurrence of rectal cancer." The median age was 67 years. Terms of recurrence after surgical treatment averaged 20 months. The histological structure of the tumor was presented adenocarcinoma in 57 (95%) patients. Radiation therapy (RT) was carried out in medium or dynamic fractionation. Chemotherapy used pelleted 5-fluorouracil. In group 1 (20 patients) received palliative radiotherapy course with a fractional dose of 3 Gy to 42 Gy SOD (SDeq 51 Gy). In group 2 (20 patients) underwent a course of radiotherapy using dynamic dose fractionation: fractional dose--4, 3 and 2 Gy to 51 Gy SDeq. In the third group (20 patients) underwent combined treatment using dynamic dose fractionation: fractional dose--4, 3 and 2 Gy to 56 Gy SDeq and chemotherapy--Xeloda or ftorafur. In group 1 complete regression was achieved in 1 patient, partial regression--15, stabilization--at 3, progression--at 1, that is clinical effect was observed in 19 of 20 patients. In group 2, complete regression of the tumor was diagnosed in 3 patients, partial regression--17, therefore, 100% of patients had received clinical effect. According to follow-up, 5 patients in this group were subsequently. In the third group of complete regression of the tumor was diagnosed in 7 patients, partial regression--13, ie, 100% of patients had received clinical effect. According to follow-up, 7 patients in this group were subsequently operated. Among the radiation reaction in group 1 nausea 1 tbsp. was observed in 3 patients, radiation Recto 1-2 degree--15, radiation epithelitis 1-2 degree--4 patients; in group 2, nausea 1 degree--At 7, radiation Recto 1-2 degree--At 7, radiation epithelitis 1-2 degree--In 6 patients and 6 reactions were observed; in the third group of nausea 1st. was observed in 7 patients, radiation Recto 1-2 degree--At 9, radiation epithelitis 1-2 degree--At 8 and 3 patients reactions were observed. Thus, when irradiated in the dynamic fractionation showed less pronounced dose response as beam during treatment, and after. Increasing the total dose with the addition radiomodification increases the frequency of complete responses with acceptable toxicity. As a result of treatment in all patients achieved a significant reduction in pain, relief of bleeding.