A CLINICAL CASE OF THE TREATMENT OF LOCALLY ADVANCED CANCER OF THE UPPER AMPULLARY RECTUM WITH NEOADJUVANT INTRAARTERIAL CHEMOINFUSION INTO THE INFERIOR MESENTERIC ARTERY IN LOCALLY ADVANCED CANCER OF THE UPPER AMPULLARY RECTUM

Zagorulko A. I., Chernyaev M. V., Kozlov D. V., Rykov S. P., Rozyyeva M.

Rectal cancer is one of the most common malignant tumors worldwide. Due to changes in the structure of the diet, the prevalence and mortality from rectal cancer are increasing year by year. In the early stages of the disease, the clinical picture is erased, in most patients the diagnosis is established at stages II and III, when the process is already locally widespread. The standard treatment for a locally common process is neoadjuvant chemoradiotherapy and total mesorectal excision followed by postoperative adjuvant chemotherapy. However, only a small proportion of patients can undergo surgical intervention with a resection boundary of R0. For those who are not suitable or do not tolerate surgery, palliative treatment is prescribed, which has an unfavorable prognosis. Intraarterial chemoinfusion is rarely used in primary rectal cancer. Due to the high risk of systemic side effects during intravenous chemotherapy and the low concentration of the chemotherapy drug acting on the tumor, we decided to change the method of administration of Oxaliplatin for rectal cancer to intra-arterial. This method has been successfully applied in the treatment of a patient with inoperable locally advanced rectal cancer in our hospital. Here we report on the first patient who underwent this method of treatment for the subsequent implementation of the technique in the management of this pathology and, more importantly, to show the safety of the method.

Keywords:oncology, inferior mesenteric artery, rectal tumor, intraarterial chemoinfusion, Oxaliplatin, X-ray endovascular intervention