METHOD OF THE TREATMENT OF PRIMARY GLIOBLASTOMA OF THE BRAIN Russian patent published in 2023 - IPC A61N5/10 A61K31/41 A61K39/395 A61K35/00 

FIELD: medicine; oncology.

SUBSTANCE: invention can be used in the treatment of primary glioblastoma of the brain. The method includes conducting an MRI study after surgery, radiation therapy, chemotherapy with temozolomide. As an MRI study, an ASL perfusion MRI is performed. If foci of hyperperfusion are not detected in the area of the wall of the postoperative cyst or foci of hyperperfusion with a diameter of less than 25 mm are detected, the radiation therapy is performed up to SOD 60 Gy, chemotherapy with temozolomide is performed after completion of 6 cycles. If the diameter of one of the identified foci is equal to or greater than 25 mm, the radiation therapy is performed in the hypofractionation mode of 3.5 Gy to SOD 35 Gy, followed by a single irradiation of up to 10 Gy to the identified hyperperfusion focus, the diameter of which is equal to or greater than 25 mm, while chemotherapy with temozolomide is performed from the first day of radiation therapy at a daily dose of 100 mg/m², and after the completion of radiation therapy, an additional 12 cycles of chemotherapy with temozolomide are carried out according to the scheme of 250 mg/m² daily during the first 5 days of the cycle with a break for 30 days. If two or more foci of hyperperfusion are detected, the diameter of which is equal to or greater than 25 mm, radiation therapy is performed in the hypofractionation mode of 3.5 Gy to SOD-45.5 Gy while taking temozolomide from the first day of radiation therapy at a daily dose of 100 mg/m², and after completion of radiation therapy, 6 cycles of chemotherapy with temozolomide are carried out according to the scheme of 250 mg/m² daily for the first 5 days of the cycle with a break of 30 days, after which immunotherapy with pembrolizumab is performed at a dose of 400 mg once every 4 weeks for 6 months.

EFFECT: use of the invention makes it possible to identify patients with residual glioblastoma, which is characterized by high radioresistance, to personally form an adjuvant therapy plan for such patients, including the appointment of a more strenuous course of chemotherapy, radiation therapy, including, in combination with additional single irradiation of a radioresistant focus, to apply immunotherapy in some of them which provides a significant reduction in the time interval required for irradiation, and significant increase in the duration and quality of life.

1 cl, 6 ex