Belozor N. Optimization of chemoradiation treatment for non-small cell lung cancer.

The thesis is devoted to the study of the effectiveness of non-standard chemoradiation treatment of non-small cell lung cancer stage IIIA-IIIB, the study of clinical indices and biological markers with the objective to predict and monitor the efficacy of the anticancer therapy. As a result of the study of 121 patients it has been shown that accelerated hyperfractionation radiotherapy with cisplatin and etoposide modification significantly increases the rate of positive response up to the 67,8-74,2 %, and provides increased median of the overall and disease-free survival. The positive prognostic factors for survival in non-standard modes of fractionation are based at the general condition of the patient (Karnofsky Grade less 70 %) and the degree of tumor regression 50 % and more. CYFRA 21-1 has high test performance and the dynamics of marker expression correlates with high frequency of positive responses (96,6 %), so it is advisable to recommend CYFRA 21-1 to assess the effectiveness of treatment. The definite increase in activity of Zn2+-dependent SM-ase is established after chemoradiotherapy with etoposide by 2.9 times, with cisplatin - by 2.5 times, which are accompanied by positive clinical findings in 74,6 % of cases. Significant bond between a baseline enzyme and the dynamics of its activity with positive treatment results enables us to use the marker as a predictor and a prognostic factor, for monitoring the effectiveness of radiation therapy with cisplatin or etoposide modification.