METHOD FOR CHOOSING THE TACTICS OF CHEMORADIOTHERAPY AFTER RESECTION OF RECURRENT GLIOBLASTOMA OF THE BRAIN Russian patent published in 2023 - IPC A61N5/10 A61K39/395 A61K31/41 A61P35/00 

FIELD: medicine; oncology.

SUBSTANCE: invention can be used to select tactics for chemoradiotherapy after resection of recurrent brain glioblastoma. The method includes transmission electron microscopy of the surgical material of the brain substance at the border with the peripheral zone of glioma recurrence with the detection of pathological changes in capillaries, conducting a course of irradiation and taking temozolomide. Transmission electron microscopy reveals the presence of capillaries with a thickened basement membrane and separately located swollen astrocytes in the perivascular region, as well as intact capillaries without thickening of the basement membrane with an intact perivascular layer of astrocytes. When both types of capillaries are determined, a course of remote radiation therapy is carried out in the radiosurgery mode, while temozolomide is taken at a dose of 40–50 mg/m² for 4–6 days, daily, and the first dose is taken simultaneously with the start of radiosurgery. If one of the above types of capillaries is detected, a course of remote radiation therapy is carried out in the classical fractionation mode, chemotherapy is not carried out, while additional administration of bevacizumab 2.5 mg/kg, subcutaneously, is carried out 7 days before the start of radiation therapy, for a course of 2–3 injections with an interval of 14–21 days. In the absence of both types of capillaries, drug therapy is carried out with temozolomide at a dose of 200 mg/m² daily from day 1 to 5 of a 28-day cycle or bevacizumab at 2.5 mg/kg, subcutaneously, for a course of 2–3 injections with an interval of 14–21 day, radiation therapy is not carried out.

EFFECT: use of the invention makes it possible to increase the relapse-free life expectancy, provided that there is a minimal risk of developing radiation necrosis of the brain substance.

1 cl, 3 dwg, 6 ex