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CNS Tumor in Proton Therapy


Mahmud Sitawi, 9 years old. epidemoma.


A thin boy with glasses, a little shy, rang the bell - and the people in white coats gathered around him smiled and clapped their hands. The loud sound of a real ship's bell filled the hall of the MIBS Proton Therapy Center and marked the end of nine-year-old Mahmud Sitawi's one-and-a-half month treatment.


Mahmud is one of the dozens of foreign patients of the Medical Institute. Berezin Sergey (MIBS), whose total number exceeded 50 people. At the end of 2017, St. In the first proton therapy clinic in the Russian Federation and CIS countries, opened in St. Petersburg, patients from dozens of cities and countries were treated within two years. Adults and children with cancer come here not only from all over Russia, but also from Belarus, Kazakhstan, Uzbekistan, Kyrgyzstan, Georgia, Ukraine and the Baltic countries. The list of patients from far abroad is also growing: on the virtual map of the MIBS Center - Israel, Kuwait, Palestine, Bulgaria, Canada, Australia.


They come on their own, both by learning on the Internet and on the advice of charities and insurance organizations. Mahmud, for example, is part of the MIBS collaboration with the largest Israeli health insurance fund, Clalit Health Service, and the Hadassah Medical Center in Jerusalem. She became the third patient referred to the St. Petersburg proton centre. There is no proton therapy in Israel yet, the decision to build a modern high-tech center was made just the other day by the country's government. By the way, in cases where protons are clearly preferred over photons (traditional radiation therapy), residents of the country are forced to go abroad.


“I was told that the best thing for Mahmud would be proton therapy. We started looking for centers all over the world: in the USA and Europe… But our Israeli doctor is in St. He said there was a new proton therapy center in St. Petersburg and advised me to apply here. I went through all the information about the MIBS center and realized that it is a good place for treatment,” says Toffik Sitawi, the boy's father.


For Mahmoud, proton therapy is indeed the optimal choice. Protons, heavily charged particles, deliver almost the entire radiation dose to the target due to their physical properties; they almost do not irradiate healthy tissues and organs in the tumor path and they certainly do not carry radiation outside of it. Because of this property of protons, the side effects of radiation therapy are much less pronounced and less likely to occur. In addition, proton therapy does not affect intellectual and mental development and does not cause radio-induced cancers to occur 10-15 years after the end of treatment, so proton irradiation is considered the best radiotherapy option for children with cancer in the world. . In addition, in case of recurrence of the disease, proton therapy allows patients to go through a second course,


Both of these reasons—young age and exposure to radiation in past years—are included in Mahmud Sitawi's story.


For the first time, Mahmud was diagnosed with cancer ten days before his first birthday - an epidemic of the fourth ventricle of the brain. In Israel, the boy was successfully operated on and underwent complex therapy, including radiation therapy. All went well for eight years: Mahmud grew up in a friendly family with his older sister and younger brother and felt absolutely healthy. But during the passage of the next control MRI study, a new tumor was found on the left side of the head... The treatment entered a new cycle: surgeries, again in an Israeli clinic. And again, according to the protocol, "rays" were needed.


"When Mahmud was operated on, it turned out to be a recurrence of the previous tumor - it had been scanned. Therefore, craniospinal irradiation was required. This is a fairly large amount of radiation, and accordingly, the less dose the tissue receives, the easier the child will recover and the fewer complications he will face. In this case, proton therapy has an advantage because the dose is only delivered to the target, the target structure, and the surrounding structures are not irradiated,” explains oncologist Natalia Martynova, MIBS radiotherapist.


Proton therapy needed to be completed as soon as possible, because parents spent less than a month choosing a medical institution for their son. “I talked to many experts and looked at the vast amount of information on the internet. We got a lot of advice from different people. But I made a decision with my heart. My wife and I decided that we would be treated in Russia, Mahmud himself also wanted to come here, see your country, ”says the boy's father.


After seven weeks at the MIBS Proton Therapy Center, Toffik Sitawi is confident it was the right decision. There is only one claim to treatment in Russia - air. "It's a little colder here than in Israel, but we're used to it," Toffik smiles.


"Now we see that we made the right decision. For many reasons: advanced technology, the latest equipment, experienced and helpful doctors and nurses. The staff always welcome us with a smile. They are like family to us and Mahmoud felt very comfortable," says the boy's father.


Mahmoud endured fairly easily, without the unpleasant side effects sometimes associated with radiation therapy. And on the last day of treatment, after a significant blow to the bell, the boy walked around the Center and gave a red rose to everyone who helped him fight the disease - doctors, operators, administrators.


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