Open AccessAPPLICATION OF PHOTODYNAMIC THERAPY IN COMPLEX TREATMENT OF PATIENTS WITH MALIGNANT NEOPLASMS OF PANCREAS AND BILIAR TRACT. REVIEW
Author(s) -
A.Е. Tseimakh,
Цеймах А. Е,
А. Ф. Лазарев,
Лазарев А. Ф,
V.А. Kurtukov,
Куртуков В. А,
M.E. Tseimakh,
Цеймах М. Е,
Ia. N. Shoykhet,
Шойхет Я. Н
Publication year - 2018
Publication title -
rossijskij onkologičeskij žurnal
Language(s) - English
Resource type - Journals
eISSN - 2412-9119
pISSN - 1028-9984
DOI - 10.18821/1028-9984-2018-23-3-6-134-142
Subject(s) - medicine , malignancy , radiation therapy , pancreatic cancer , cancer , radical surgery , pancreas , head of pancreas , oncology , surgery , general surgery
Data from the global oncology statistics shows that pancreatic cancer is at the 4th place in the world for mortality in men and women, having the lowest five-year life expectancy among gastrointestinal tumors with an average median survival of no more than 6 months. Along with it, malignant neoplasms of the biliary tract are rare in the frequency of occurrence of the nosological group of diseases, which, however, are on the second place in terms of the level of malignancy among the neoplasms of the liver. Both nosologies in the vast majority are not subject to radical treatment, being the object of palliative treatment due to late diagnosis. Despite the establishment of new medical technologies, the main method of treating of these nosologies remains surgical. However, at the time of detection and diagnosis less than 20% of patients have a resectable process, and, moreover, even patients with a resectable tumor are often not subjected to radical surgical treatment due to dissemination of the tumor at the time of surgery, which reduces the postoperative five-year survival of this cancer: 25-30% in patients without metastases to regional lymph nodes and about 10% in patients with metastases to regional lymph nodes. Due to the low efficiency of the surgical method, there are searched new methods of complex treatment, new drugs and chemotherapy regimens, as well as radiotherapy regimens, however, with the improvement of methods for diagnosing cancer in the past 20-25 years, neither the prognosis nor survival of patients nor the percentage of early diagnosis of cancer of the pancreas did not significantly improve. A new and promising method for the treatment of malignant neoplasms of the pancreas and the biliary tract is photodynamic therapy, the undoubted advantage of which is low toxicity, selective effect only on cancer cells at the fundamental level, contributing depending on the duration of exposure to their autophagy, apoptosis or necrosis. And, although PDT has drawbacks connected with side effects of PDT, such as gastrointestinal bleeding, obstruction of the duodenum and hemorrhagic pancreonecrosis, and with insufficient knowledge and lack of clear recommendations, but the PDT method is certainly a promising method in both radical and in palliative complex therapy of malignant neoplasms of the pancreas and biliary tract, which requires further study.