Staren'kyj V. Modification of radiation therapy in non-small cell lung cancer.

This dissertation deals with a topical problem of medical science – increase of efficiency of Non-Small Cell Lung Cancer (NSCLC) radiation therapy. The paper is based on clinicoinstrumental, X-ray, spiral computer tomography, and endoscopic findings for 548 patients, who received treatment with various variants of radiation and chemoradiation therapy with Taxotere, Etoposide and Cisplatin. High results of NSCLC therapy have been reported for combining the accelerated irradiation mode with chemomodification, with positive effect having reached 77,6-82,1 % and being higher at all stages as compared to similar indices for conventional therapy, including that with chemomodification. In the same groups, late results in all indices excelled the respective parameters for conventional therapy and accelerated irradiation without chemomodification (life time, 1-, 2-, 3-year survivability). The limiting factors at implementation of methods with accelerated irradiation mode have been radioreactions of the 3rd degree of severity: esophagitis, pneumonitis, and in combination with chemomodification – additionally, nausea and vomiting, neutropenia, thrombocytopenia, nephropathy, and mucositis. Studies of metabolism of the main component of apoptosis signaling of sphingolipid metabolite – ceramide – have found out that radiochemomodification is accompanied with significant production intensification and increase of ceramide content, both in the patients’ blood serum and in tumor tissues, which, according to ultrasonic findings, was correlated with apoptosis intensification in tumor cells. A positive clinicoroentgenologic presentation of a primary site regression is accompanied with decrease of CEA, NSE, bombesin level and increase of R-substance level. With the advance of oncologic process, increase of CEA, NSE bombesin level and decrease of P-substance level by more than 30% is observed 1-1,5 months in advance of clinicoinstrumental confirmation.