Морфологически определяемая гибель опухоли, как правило,
сопровождалась выраженным поражением окружающих тканей, что, несомненно, должно
иметь значение в клинической оценке полученных результатов.
Уже начиная с 3000 рад нами были отмечены очаги некробиоза
эпителиального покрова и подлежащих тканей, с резкими дегенеративными
изменениями мышц, последующим фиброзным замещением их, а также выраженная дегенерация
нервных волокон.
Заслуживают внимания наблюдавшиеся во многих случаях изменения
сосудов. Они трактуются нами как результат расстройства проницаемости
сосудистых мембран после лучевой терапии.
Изложенный материал позволяет заключить, что обнаруженные в
бластомах мягких тканей гистологические изменения после применения различных
доз ионизирующего излучения полностью нельзя считать специфичными для этого
воздействия, так как они в большей или меньшей степени наблюдаются и в
опухолевых тканях различной гистологической структуры, не подвергавшихся
радиационному воздействию.
Следует также указать на отсутствие в ряде случаев
параллелизма в повреждении окружающих тканей и опухоли при лучевой терапии.
Так, например, мы наблюдали выраженную дегенерацию мышц вплоть до некроза и
замещения их фиброзной тканью наряду со слабым поражением опухолевых клеток при
веретеноклеточных саркомах и гисто-веретеноклеточном типе злокачественных
синовиом.
Кроме телегамма-терапии, 6
больным с саркомами мягких тканей (фибросаркома —4
случая, ангиосаркома — 2) была проведена ортовольтная рентгенотерапия.
Изучение характера изменений в опухолях после электронной
терапии и сравнение их с изменениями, возникшими после телегамма-терапии, не
позволили выявить каких-либо специфических изменений в зависимости от вида
ионизирующего излучения.
Учитывая все изложенное, можно сказать, что обнаруженные нами
токсико-дистрофические и реактивно-воспалительные изменения в опухолях и в
окружающих их тканях, тормозящих митотическую активность опухолевых клеток,
оправдывают целесообразность применения комбинированного метода лечения
злокачественных опухолей мягких тканей.
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