Androgens should be included in complex treatment. Androgens are prescribed for a long time, depending on the individual tolerance of the patients (up to 5-7 g): testosterone progsonate (1 ml of 5% solution 2 times a week), testenate (1 ml of 10% solution 1 time per week), Sustanon-250 (1 ml 2 times a month). Anabolic substances are prescribed: methandrostenolone (nerobol), phenobolin (nerobolil), retabolil.
Turning off the pituitary function in advanced stages of the disease in some cases can slow down tumor growth and also lead to a more or less lasting improvement. Irradiation of the pituitary gland is also indicated after radical surgery as an additional therapeutic factor.
Irradiation is carried out from two temporal fields 4 cm2 in size, with a skin focus distance of 30 cm. The daily dose to the focus is 200 rad on both sides. The total dose is 4000-8000 rad.
No complications associated directly with radiation were observed. Later, there may be transient baldness of the temporal regions.
Radiation therapy is usually used as an additional effect after radical prophylactic operations and after non-radical operations in order to eliminate residual tumor masses and small disseminates along the pelvic peritoneum (dissemination of the tumor outside the pelvic area is a contraindication to radiation therapy).
Radiation therapy is carried out by external irradiation from 4-8 fields using x-ray machines or by means of gamma sources (“Ray”, “ROCUS”) or by introducing radioactive drugs into the uterine cavity and into the vaginal vaults, by introducing liquid isotopes such as radioactive gold (Au198 ) into the cavity of the peritoneum and pleura (70-150 mCi in 0.25% solution of novocaine). A combination of radiation exposure, for example, external exposure and local applications of radium or Co60, is possible.
The most common method of external x-ray therapy is considered to be irradiation with wide fields with the capture of the zone of recurrent metastases. According to this technique, the anterior abdominal wall is divided into 4 equal parts: two below the navel and two above. The upper border of the fields passes at the level of the base of the xiphoid process, the lower – along the lower edge of the pubic bone. The dimensions of the fields are 10 X 15 cm. The distance between the fields is 2 cm. 4 fields are also irradiated from the back, respectively, to the fields of the anterior abdominal wall. A single dose on the field is 250 rad, the total -2500 rad.
Telegammotherapy is carried out in the same fields as x-ray therapy. The focal skin distance is 35-60 cm. The field sizes are 6 X 15 cm. The total dose on the field (point B) is up to 3000-3500 rad.
Due to the effectiveness of chemotherapy as an additional treatment method, postoperative radiation therapy in the form of X-ray therapy on the parametric region on both sides in primary patients is currently almost not used.
Telegammotherapy can be recommended as a preventive measure after radical surgery, while combining it with Co60 applications. Telegammotherapy after non-radical surgery is not recommended.
Targeted telegammotherapy is advisable for single metastases or relapses in the rectal uterine cavity or parametria.