Demchenko V. Neoadjuvant combined radiotherapy in treatment for locoregional rectal cancer.

The dissertation deals with a new methodology of treatment for the locoregional rectal cancer with the usage of intracavitary brachytherapy as an initial component for neoadjuvant chemoradiotherapy. The research proved that the developed new protocols for neoadjuvant chemoradiotherapy in rectal cancer enhance antineoplastic effect compared to the traditional chemoradiotherapy that is manifested in 23.3 % decrease of constipation frequency and 20.1 % reduced angiostaxis; favor the 20.3 % growth of the share of radical surgical procedures (including 43.2 % growth for those sphincter-preserving); cause no increase of early and late undesirable effects due to irradiation. Protocol with brachytherapy as an initial component in the complex treatment in total boost dose (TBD) of 16 Gy in 4 fractions sensitizing with fluoropyrimidine class agents causes enhanced tumor cells damage that, if compared to the traditional gamma-ray teletherapy, is revealed in the 33.8 % increased frequency of incidence of stage 4 irradiation pathomorphism, and compared to TBD 12 Gy in 3 fractions or to traditional gamma-teletherapy, allows to provide satisfactory short-term and long-term outcomes, that is demonstrated in 14.4 % decreased frequency of locoregional relapses and improvement of overall survival.