Лучшие радиологи, отзывы
По вашему запросу найдено 22 врача
Элиягу Гез
63 года /
доктор /
Общий стаж 29 лет
Заведует радиотерапевтическим отделением, специализируется на лучевой терапии, урологической и клинической онкологии.
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Амихай Меирович
60 лет /
Старший терапевт онкологического отделения /
Общий стаж 39 лет
Доктор Меирович один из пионеров, внедривших инновационный метод лучевой терапии — брахитерапию — в израильскую медицину.
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Отто Роллманн
64 года /
доктор медицинских наук /
Общий стаж 41 год
Заведует отделением радиологии, специализируется на диагностике и выявлении онкологических заболеваний.
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Рэне Шапот
54 года /
Профессор /
Общий стаж 24 года
Выдающийся специалист-радиолог, возглавляет отделение радиологии и нейрорадиологии.
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Андреас Козировский
59 лет /
Доктор медицинских наук /
Общий стаж 38 лет
Высококвалифицированный онколог, специализирующийся на лечении онкологических заболеваний на разных стадиях.
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Мы работаем напрямую с ведущими клиниками
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Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
Высокий профессионализм. Врачи-радиологи за границей – это профессионалы высокого уровня. Пациент может узнать сведения об опыте и квалификации медика на сайте клиники, в которой он работает.
Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
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["description"]=>
string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
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Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
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string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
Высокий профессионализм. Врачи-радиологи за границей – это профессионалы высокого уровня. Пациент может узнать сведения об опыте и квалификации медика на сайте клиники, в которой он работает.
Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
"
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string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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string(1323) "Преимущества радиолечения за границей
Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
Высокий профессионализм. Врачи-радиологи за границей – это профессионалы высокого уровня. Пациент может узнать сведения об опыте и квалификации медика на сайте клиники, в которой он работает.
Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
"
["description"]=>
string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,7128)
[4]=>
array(0) {
}
[5]=>
int(5472248)
}
[16]=>
array(6) {
[0]=>
string(296) "SELECT `speciality`.*, COUNT(DISTINCT doctor.id) AS count FROM `speciality` LEFT JOIN `doctor_to_speciality` ON `speciality`.`id` = `doctor_to_speciality`.`speciality_id` LEFT JOIN `doctor` ON `doctor_to_speciality`.`doctor_id` = `doctor`.`id` WHERE `doctor`.`public`=1 GROUP BY `speciality`.`id`"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,7129)
[4]=>
array(0) {
}
[5]=>
int(5473896)
}
[17]=>
array(6) {
[0]=>
string(296) "SELECT `speciality`.*, COUNT(DISTINCT doctor.id) AS count FROM `speciality` LEFT JOIN `doctor_to_speciality` ON `speciality`.`id` = `doctor_to_speciality`.`speciality_id` LEFT JOIN `doctor` ON `doctor_to_speciality`.`doctor_id` = `doctor`.`id` WHERE `doctor`.`public`=1 GROUP BY `speciality`.`id`"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,717)
[4]=>
array(0) {
}
[5]=>
int(5517328)
}
[18]=>
array(6) {
[0]=>
string(281) "SELECT * FROM `doctor_to_speciality` WHERE `speciality_id` IN (5, 6, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 44, 45, 47, 48, 49, 50, 51, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65)"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,7175)
[4]=>
array(0) {
}
[5]=>
int(5991328)
}
[19]=>
array(6) {
[0]=>
string(281) "SELECT * FROM `doctor_to_speciality` WHERE `speciality_id` IN (5, 6, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 44, 45, 47, 48, 49, 50, 51, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65)"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,7175)
[4]=>
array(0) {
}
[5]=>
int(5978392)
}
[20]=>
array(6) {
[0]=>
string(281) "SELECT * FROM `doctor_to_speciality` WHERE `speciality_id` IN (5, 6, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 44, 45, 47, 48, 49, 50, 51, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65)"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,7279)
[4]=>
array(0) {
}
[5]=>
int(6907872)
}
[21]=>
array(6) {
[0]=>
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[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,7292)
[4]=>
array(0) {
}
[5]=>
int(7664608)
}
[22]=>
array(6) {
[0]=>
string(9090) "SELECT * FROM `doctor` WHERE (`doctor`.`public`=1) AND (`id` IN ('3', '77', '6', '68', '43', '56', '69', '44', '19', '75', '61', '62', '30', '35', '23', '36', '76', '24', '18', '70', '38', '25', '57', '45', '53', '52', '63', '78', '13', '54', '64', '37', '71', '9', '26', '58', '65', '218', '31', '80', '32', '66', '21', '34', '33', '27', '17', '15', '12', '67', '47', '48', '46', '20', '74', '59', '79', '40', '51', '29', '42', '41', '216', '14', '55', '16', '39', '81', '50', '215', '49', '73', '28', '82', '83', '84', '85', '86', '87', '88', '89', '91', '92', '93', '94', '95', '96', '97', '1102', '99', '100', '101', '102', '103', '104', '105', '106', '107', '108', '110', '111', '112', '113', '114', '115', '116', '117', '118', '119', '120', '121', '122', '123', '124', '125', '126', '127', '128', '129', '130', '131', '132', '133', '134', '135', '109', '136', '138', '139', '140', '142', '141', '143', '144', '145', '146', '153', '154', '155', '156', '157', '158', '147', '148', 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'1276', '1280', '1282', '1283', '1284', '1285', '1286', '1287', '1278', '1281', '1288', '1289', '1290', '1291'))"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,7293)
[4]=>
array(0) {
}
[5]=>
int(7356904)
}
[23]=>
array(6) {
[0]=>
string(9090) "SELECT * FROM `doctor` WHERE (`doctor`.`public`=1) AND (`id` IN ('3', '77', '6', '68', '43', '56', '69', '44', '19', '75', '61', '62', '30', '35', '23', '36', '76', '24', '18', '70', '38', '25', '57', '45', '53', '52', '63', '78', '13', '54', '64', '37', '71', '9', '26', '58', '65', '218', '31', '80', '32', '66', '21', '34', '33', '27', '17', '15', '12', '67', '47', '48', '46', '20', '74', '59', '79', '40', '51', '29', '42', '41', '216', '14', '55', '16', '39', '81', '50', '215', '49', '73', '28', '82', '83', '84', '85', '86', '87', '88', '89', '91', '92', '93', '94', '95', '96', '97', '1102', '99', '100', '101', '102', '103', '104', '105', '106', '107', '108', '110', '111', '112', '113', '114', '115', '116', '117', '118', '119', '120', '121', '122', '123', '124', '125', '126', '127', '128', '129', '130', '131', '132', '133', '134', '135', '109', '136', '138', '139', '140', '142', '141', '143', '144', '145', '146', '153', '154', '155', '156', '157', '158', '147', '148', '149', '150', '151', '152', '137', '159', '160', '161', '162', '163', '164', '165', '166', '167', '168', '169', '170', '171', '1101', '1100', '179', '180', '181', '182', '183', '184', '185', '186', '187', '188', '189', '190', '191', '192', '193', '194', '195', '196', '197', '198', '199', '200', '22', '201', '202', '203', '204', '205', '206', '207', '303', '209', '210', '211', '1167', '213', '214', '220', '221', '222', '223', '224', '225', '226', '227', '228', '229', '230', '231', '232', '233', '234', '235', '236', '237', '238', '239', '240', '241', '242', '243', '244', '245', '246', '247', '248', '249', '250', '251', '252', '253', '254', '255', '256', '257', '258', '259', '260', '261', '262', '263', '264', '265', '266', '267', '268', '269', '270', '271', '272', '273', '274', '275', '276', '277', '278', '279', '280', '281', '282', '283', '284', '285', '286', '287', '288', '289', '290', '291', '292', '293', '294', '295', '296', '297', '298', '299', '300', '301', '302', '304', '305', 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'449', '450', '451', '452', '453', '454', '455', '456', '457', '458', '459', '460', '461', '462', '463', '464', '465', '466', '467', '468', '469', '470', '471', '472', '473', '474', '475', '476', '477', '478', '479', '480', '481', '482', '483', '484', '486', '487', '488', '489', '490', '491', '492', '493', '494', '495', '496', '497', '498', '499', '500', '501', '502', '503', '504', '505', '506', '507', '508', '509', '511', '512', '513', '514', '515', '516', '517', '518', '519', '520', '521', '522', '523', '524', '525', '526', '527', '528', '529', '530', '531', '532', '533', '534', '535', '536', '537', '544', '538', '539', '540', '541', '542', '543', '545', '546', '547', '548', '549', '550', '551', '552', '553', '554', '555', '556', '562', '557', '558', '559', '560', '561', '563', '564', '565', '566', '567', '568', '569', '570', '571', '572', '573', '574', '575', '576', '577', '578', '579', '580', '581', '582', '583', '586', '587', '588', '589', '590', '591', '592', '593', '594', '595', 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'880', '881', '882', '883', '884', '885', '886', '887', '888', '889', '890', '891', '892', '893', '894', '895', '896', '897', '60', '899', '900', '901', '902', '903', '904', '905', '906', '907', '908', '909', '910', '911', '912', '913', '914', '915', '916', '917', '918', '919', '920', '921', '922', '923', '924', '925', '926', '927', '928', '929', '930', '931', '932', '933', '934', '935', '936', '937', '938', '939', '940', '941', '943', '944', '945', '946', '947', '1046', '949', '950', '951', '952', '953', '954', '955', '956', '957', '958', '959', '960', '961', '962', '90', '942', '72', '964', '965', '966', '967', '968', '969', '1014', '1015', '971', '972', '973', '974', '975', '976', '977', '978', '979', '980', '981', '982', '983', '984', '985', '986', '987', '988', '989', '990', '991', '992', '993', '994', '995', '996', '997', '998', '999', '1000', '1001', '1002', '1003', '1004', '1005', '1006', '1007', '1008', '1009', '1010', '1011', '1012', '1013', '808', '1016', '1017', '1018', '1019', '1020', '1021', '1022', '1023', '1024', '1025', '1026', '1027', '1028', '1029', '1030', '1031', '1032', '1033', '1035', '1036', '1037', '1038', '1039', '1040', '1041', '1042', '1043', '1044', '1045', '1047', '1048', '1049', '1050', '1078', '1051', '1052', '1053', '1054', '1055', '1056', '1057', '1058', '1059', '1060', '1061', '1062', '1063', '1064', '1065', '1066', '1067', '1068', '1069', '1070', '1071', '1072', '1073', '1074', '1075', '1076', '1077', '1079', '1080', '1081', '1082', '1083', '1084', '1085', '1086', '1087', '1088', '1089', '1090', '1091', '1092', '1093', '1094', '1095', '1096', '1097', '1098', '1099', '1103', '1104', '1105', '1106', '1107', '1108', '1109', '1110', '1111', '1112', '1113', '1114', '1115', '1116', '1117', '1118', '1119', '1120', '1121', '1122', '1123', '1124', '1125', '1126', '1127', '1128', '1129', '1130', '1132', '1133', '1134', '1135', '1136', '1137', '1138', '1139', '1140', '1141', '1142', '1143', '1144', '1145', '1146', '1147', '1148', '1149', '1150', '1151', '1152', '1153', '1154', '1155', '1156', '1157', '1158', '1159', '1160', '1161', '1162', '1163', '1164', '1165', '1166', '1168', '1169', '1170', '1171', '1172', '1173', '1174', '1175', '1176', '1177', '1178', '1179', '1180', '1181', '1182', '1183', '1184', '1185', '1186', '1187', '1188', '1189', '1190', '1191', '1192', '1193', '1194', '1195', '1196', '1197', '1198', '1199', '1200', '1201', '1202', '1203', '1204', '1205', '1206', '1207', '1208', '1209', '1210', '1211', '1212', '1213', '1214', '1215', '1216', '1217', '1218', '1219', '1220', '1221', '1222', '1223', '1224', '1225', '1226', '1227', '1228', '1229', '1230', '1231', '1232', '1233', '1234', '1235', '1236', '1237', '1238', '1239', '1240', '1241', '1242', '1243', '1244', '1245', '1246', '1247', '1248', '1249', '1250', '1251', '1252', '1253', '1254', '1255', '1256', '1257', '1258', '1259', '1260', '1261', '1262', '1263', '1264', '1265', '1266', '1267', '1268', '1269', '1270', '1271', '1272', '1273', '1274', '1275', '1276', '1280', '1282', '1283', '1284', '1285', '1286', '1287', '1278', '1281', '1288', '1289', '1290', '1291'))"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,735)
[4]=>
array(0) {
}
[5]=>
int(12871752)
}
[24]=>
array(6) {
[0]=>
string(607) "SELECT `country`.*, COUNT(DISTINCT doctor.id) AS count FROM `country` LEFT JOIN `city` ON `country`.`id` = `city`.`country_id` LEFT JOIN `clinic` ON `city`.`id` = `clinic`.`city_id` LEFT JOIN `doctor_to_clinic` ON `clinic`.`id` = `doctor_to_clinic`.`clinic_id` LEFT JOIN `doctor` ON `doctor_to_clinic`.`doctor_id` = `doctor`.`id` LEFT JOIN `doctor_to_speciality` ON `doctor`.`id` = `doctor_to_speciality`.`doctor_id` LEFT JOIN `speciality` ON `doctor_to_speciality`.`speciality_id` = `speciality`.`id` WHERE (`country`.`public`=1) AND (`speciality`.`id`=37) AND (`doctor`.`public`=1) GROUP BY `country`.`id`"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8049)
[4]=>
array(0) {
}
[5]=>
int(24998384)
}
[25]=>
array(6) {
[0]=>
string(607) "SELECT `country`.*, COUNT(DISTINCT doctor.id) AS count FROM `country` LEFT JOIN `city` ON `country`.`id` = `city`.`country_id` LEFT JOIN `clinic` ON `city`.`id` = `clinic`.`city_id` LEFT JOIN `doctor_to_clinic` ON `clinic`.`id` = `doctor_to_clinic`.`clinic_id` LEFT JOIN `doctor` ON `doctor_to_clinic`.`doctor_id` = `doctor`.`id` LEFT JOIN `doctor_to_speciality` ON `doctor`.`id` = `doctor_to_speciality`.`doctor_id` LEFT JOIN `speciality` ON `doctor_to_speciality`.`speciality_id` = `speciality`.`id` WHERE (`country`.`public`=1) AND (`speciality`.`id`=37) AND (`doctor`.`public`=1) GROUP BY `country`.`id`"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8049)
[4]=>
array(0) {
}
[5]=>
int(25000080)
}
[26]=>
array(6) {
[0]=>
string(607) "SELECT `country`.*, COUNT(DISTINCT doctor.id) AS count FROM `country` LEFT JOIN `city` ON `country`.`id` = `city`.`country_id` LEFT JOIN `clinic` ON `city`.`id` = `clinic`.`city_id` LEFT JOIN `doctor_to_clinic` ON `clinic`.`id` = `doctor_to_clinic`.`clinic_id` LEFT JOIN `doctor` ON `doctor_to_clinic`.`doctor_id` = `doctor`.`id` LEFT JOIN `doctor_to_speciality` ON `doctor`.`id` = `doctor_to_speciality`.`doctor_id` LEFT JOIN `speciality` ON `doctor_to_speciality`.`speciality_id` = `speciality`.`id` WHERE (`country`.`public`=1) AND (`speciality`.`id`=37) AND (`doctor`.`public`=1) GROUP BY `country`.`id`"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8697)
[4]=>
array(0) {
}
[5]=>
int(25086536)
}
[27]=>
array(6) {
[0]=>
string(57) "SELECT * FROM `city` WHERE `country_id` IN (5, 6, 11, 12)"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8725)
[4]=>
array(0) {
}
[5]=>
int(25198712)
}
[28]=>
array(6) {
[0]=>
string(57) "SELECT * FROM `city` WHERE `country_id` IN (5, 6, 11, 12)"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8725)
[4]=>
array(0) {
}
[5]=>
int(25199040)
}
[29]=>
array(6) {
[0]=>
string(57) "SELECT * FROM `city` WHERE `country_id` IN (5, 6, 11, 12)"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8732)
[4]=>
array(0) {
}
[5]=>
int(25434520)
}
[30]=>
array(6) {
[0]=>
string(373) "SELECT * FROM `clinic` WHERE `city_id` IN (11, 10, 8, 9, 12, 13, 14, 15, 16, 17, 18, 19, 21, 86, 98, 113, 114, 115, 116, 146, 151, 153, 22, 23, 24, 25, 26, 27, 28, 29, 30, 42, 43, 44, 46, 48, 51, 52, 57, 58, 81, 84, 85, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 165, 82, 163, 79, 80, 87, 88, 131)"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8746)
[4]=>
array(0) {
}
[5]=>
int(26077936)
}
[31]=>
array(6) {
[0]=>
string(373) "SELECT * FROM `clinic` WHERE `city_id` IN (11, 10, 8, 9, 12, 13, 14, 15, 16, 17, 18, 19, 21, 86, 98, 113, 114, 115, 116, 146, 151, 153, 22, 23, 24, 25, 26, 27, 28, 29, 30, 42, 43, 44, 46, 48, 51, 52, 57, 58, 81, 84, 85, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 165, 82, 163, 79, 80, 87, 88, 131)"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8746)
[4]=>
array(0) {
}
[5]=>
int(26060304)
}
[32]=>
array(6) {
[0]=>
string(373) "SELECT * FROM `clinic` WHERE `city_id` IN (11, 10, 8, 9, 12, 13, 14, 15, 16, 17, 18, 19, 21, 86, 98, 113, 114, 115, 116, 146, 151, 153, 22, 23, 24, 25, 26, 27, 28, 29, 30, 42, 43, 44, 46, 48, 51, 52, 57, 58, 81, 84, 85, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 165, 82, 163, 79, 80, 87, 88, 131)"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,883)
[4]=>
array(0) {
}
[5]=>
int(28251880)
}
[33]=>
array(6) {
[0]=>
string(1068) "SELECT * FROM `doctor_to_clinic` WHERE `clinic_id` IN (5, 6, 19, 21, 22, 24, 26, 165, 325, 327, 339, 340, 341, 343, 12, 25, 301, 306, 309, 9, 11, 307, 311, 8, 16, 231, 236, 297, 300, 308, 323, 7, 296, 14, 15, 324, 18, 13, 322, 10, 20, 23, 269, 298, 36, 37, 41, 45, 52, 54, 59, 65, 67, 73, 79, 40, 43, 53, 56, 57, 63, 64, 74, 232, 235, 305, 38, 55, 58, 60, 66, 125, 130, 160, 206, 200, 203, 210, 220, 221, 242, 314, 48, 47, 46, 50, 51, 72, 68, 71, 208, 49, 157, 243, 371, 42, 196, 44, 61, 209, 217, 228, 70, 62, 69, 282, 162, 161, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 254, 255, 256, 257, 258, 259, 261, 266, 283, 284, 289, 293, 316, 355, 356, 357, 358, 359, 360, 361, 362, 363, 366, 367, 313, 152, 153, 251, 252, 132, 163, 212, 222, 223, 342, 133, 134, 135, 136, 372, 275, 290, 304, 370, 364, 365, 373, 155, 158, 191, 154, 159, 166, 164, 194, 195, 197, 280, 287, 198, 199, 201, 202, 204, 205, 207, 211, 234, 213, 214, 215, 237, 238, 239, 299, 241, 216, 219, 276, 224, 225, 192, 193, 218, 226, 227, 229, 240, 260, 17, 321, 328, 374)"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8917)
[4]=>
array(0) {
}
[5]=>
int(30897584)
}
[34]=>
array(6) {
[0]=>
string(1068) "SELECT * FROM `doctor_to_clinic` WHERE `clinic_id` IN (5, 6, 19, 21, 22, 24, 26, 165, 325, 327, 339, 340, 341, 343, 12, 25, 301, 306, 309, 9, 11, 307, 311, 8, 16, 231, 236, 297, 300, 308, 323, 7, 296, 14, 15, 324, 18, 13, 322, 10, 20, 23, 269, 298, 36, 37, 41, 45, 52, 54, 59, 65, 67, 73, 79, 40, 43, 53, 56, 57, 63, 64, 74, 232, 235, 305, 38, 55, 58, 60, 66, 125, 130, 160, 206, 200, 203, 210, 220, 221, 242, 314, 48, 47, 46, 50, 51, 72, 68, 71, 208, 49, 157, 243, 371, 42, 196, 44, 61, 209, 217, 228, 70, 62, 69, 282, 162, 161, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 254, 255, 256, 257, 258, 259, 261, 266, 283, 284, 289, 293, 316, 355, 356, 357, 358, 359, 360, 361, 362, 363, 366, 367, 313, 152, 153, 251, 252, 132, 163, 212, 222, 223, 342, 133, 134, 135, 136, 372, 275, 290, 304, 370, 364, 365, 373, 155, 158, 191, 154, 159, 166, 164, 194, 195, 197, 280, 287, 198, 199, 201, 202, 204, 205, 207, 211, 234, 213, 214, 215, 237, 238, 239, 299, 241, 216, 219, 276, 224, 225, 192, 193, 218, 226, 227, 229, 240, 260, 17, 321, 328, 374)"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,8917)
[4]=>
array(0) {
}
[5]=>
int(30845032)
}
[35]=>
array(6) {
[0]=>
string(1068) "SELECT * FROM `doctor_to_clinic` WHERE `clinic_id` IN (5, 6, 19, 21, 22, 24, 26, 165, 325, 327, 339, 340, 341, 343, 12, 25, 301, 306, 309, 9, 11, 307, 311, 8, 16, 231, 236, 297, 300, 308, 323, 7, 296, 14, 15, 324, 18, 13, 322, 10, 20, 23, 269, 298, 36, 37, 41, 45, 52, 54, 59, 65, 67, 73, 79, 40, 43, 53, 56, 57, 63, 64, 74, 232, 235, 305, 38, 55, 58, 60, 66, 125, 130, 160, 206, 200, 203, 210, 220, 221, 242, 314, 48, 47, 46, 50, 51, 72, 68, 71, 208, 49, 157, 243, 371, 42, 196, 44, 61, 209, 217, 228, 70, 62, 69, 282, 162, 161, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 254, 255, 256, 257, 258, 259, 261, 266, 283, 284, 289, 293, 316, 355, 356, 357, 358, 359, 360, 361, 362, 363, 366, 367, 313, 152, 153, 251, 252, 132, 163, 212, 222, 223, 342, 133, 134, 135, 136, 372, 275, 290, 304, 370, 364, 365, 373, 155, 158, 191, 154, 159, 166, 164, 194, 195, 197, 280, 287, 198, 199, 201, 202, 204, 205, 207, 211, 234, 213, 214, 215, 237, 238, 239, 299, 241, 216, 219, 276, 224, 225, 192, 193, 218, 226, 227, 229, 240, 260, 17, 321, 328, 374)"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,9098)
[4]=>
array(0) {
}
[5]=>
int(31522024)
}
[36]=>
array(6) {
[0]=>
string(5498) "SELECT * FROM `doctor` WHERE (`doctor`.`public`=1) AND (`id` IN (3, 19, 6, 18, 17, 9, 16, 15, 12, 13, 14, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 39, 38, 40, 41, 42, 43, 44, 45, 46, 47, 37, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 87, 88, 82, 83, 84, 85, 86, 98, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 303, 209, 210, 211, 213, 214, 215, 216, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, 286, 287, 288, 289, 290, 291, 292, 293, 294, 295, 296, 297, 298, 299, 300, 301, 302, 304, 305, 306, 307, 308, 309, 310, 311, 312, 313, 314, 315, 316, 317, 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 332, 333, 334, 335, 373, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, 395, 396, 397, 398, 399, 400, 401, 402, 403, 404, 405, 406, 407, 408, 409, 410, 411, 412, 413, 414, 415, 416, 417, 431, 432, 433, 434, 435, 436, 437, 438, 439, 440, 441, 442, 443, 444, 445, 446, 447, 448, 449, 450, 451, 452, 453, 454, 455, 456, 457, 458, 459, 460, 461, 462, 463, 464, 465, 466, 467, 468, 469, 470, 471, 472, 473, 474, 475, 476, 477, 478, 479, 480, 481, 482, 483, 484, 492, 486, 487, 488, 489, 490, 491, 493, 494, 495, 496, 497, 498, 499, 500, 501, 502, 503, 504, 505, 506, 507, 508, 509, 511, 512, 513, 514, 515, 516, 517, 518, 519, 520, 521, 522, 523, 524, 525, 526, 527, 528, 532, 534, 535, 536, 537, 538, 539, 540, 541, 542, 543, 544, 545, 546, 547, 548, 549, 550, 551, 552, 553, 554, 555, 556, 557, 558, 559, 560, 561, 562, 563, 564, 565, 566, 567, 568, 569, 570, 571, 572, 573, 574, 575, 576, 577, 578, 579, 580, 581, 582, 583, 586, 587, 588, 589, 590, 591, 592, 593, 594, 595, 596, 597, 598, 599, 600, 601, 602, 603, 604, 605, 606, 607, 608, 609, 610, 611, 612, 613, 614, 615, 616, 617, 618, 619, 620, 621, 622, 623, 624, 625, 626, 627, 628, 629, 630, 631, 632, 633, 634, 635, 636, 637, 638, 639, 640, 641, 642, 643, 644, 645, 646, 647, 648, 649, 650, 651, 652, 653, 655, 656, 657, 658, 659, 660, 661, 662, 663, 664, 665, 666, 668, 667, 669, 670, 671, 672, 673, 674, 675, 676, 677, 678, 679, 680, 681, 682, 683, 684, 685, 686, 687, 688, 689, 690, 691, 692, 693, 694, 695, 696, 697, 698, 699, 700, 701, 702, 703, 704, 705, 706, 707, 708, 709, 710, 711, 712, 713, 714, 715, 716, 717, 718, 719, 720, 721, 722, 723, 724, 725, 726, 727, 728, 729, 730, 731, 732, 733, 734, 735, 736, 737, 738, 739, 740, 741, 742, 743, 744, 745, 746, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 1288, 760, 761, 762, 763, 764, 765, 766, 767, 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 802, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 823, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 965, 899, 900, 901, 902, 903, 904, 905, 906, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 923, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 937, 938, 939, 940, 941, 943, 946, 947, 1272, 949, 950, 951, 952, 953, 955, 954, 956, 957, 958, 959, 960, 961, 962, 945, 964, 966, 967, 968, 969, 971, 972, 973, 974, 975, 977, 976, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1078, 944, 654, 942, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1043, 1044, 1045, 1287, 1286, 1285, 1284, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1080, 1081, 1082, 1083, 1079, 1283, 1282, 1281, 1091, 1280, 1279, 1278, 1277, 1096, 1097, 1098, 1119, 1120, 1121, 1122, 1123, 1124, 1136, 1137, 1138, 1140, 1141, 1143, 1144, 1145, 1146, 1147, 1149, 1153, 1154, 1155, 1156, 1157, 1158, 1159, 1162, 1163, 1164, 1165, 1166, 1168, 1169, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1273, 1274, 1275, 1276, 1289, 1290, 1291))"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,9162)
[4]=>
array(0) {
}
[5]=>
int(32317256)
}
[37]=>
array(6) {
[0]=>
string(5498) "SELECT * FROM `doctor` WHERE (`doctor`.`public`=1) AND (`id` IN (3, 19, 6, 18, 17, 9, 16, 15, 12, 13, 14, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 39, 38, 40, 41, 42, 43, 44, 45, 46, 47, 37, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 87, 88, 82, 83, 84, 85, 86, 98, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 303, 209, 210, 211, 213, 214, 215, 216, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, 286, 287, 288, 289, 290, 291, 292, 293, 294, 295, 296, 297, 298, 299, 300, 301, 302, 304, 305, 306, 307, 308, 309, 310, 311, 312, 313, 314, 315, 316, 317, 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 332, 333, 334, 335, 373, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, 395, 396, 397, 398, 399, 400, 401, 402, 403, 404, 405, 406, 407, 408, 409, 410, 411, 412, 413, 414, 415, 416, 417, 431, 432, 433, 434, 435, 436, 437, 438, 439, 440, 441, 442, 443, 444, 445, 446, 447, 448, 449, 450, 451, 452, 453, 454, 455, 456, 457, 458, 459, 460, 461, 462, 463, 464, 465, 466, 467, 468, 469, 470, 471, 472, 473, 474, 475, 476, 477, 478, 479, 480, 481, 482, 483, 484, 492, 486, 487, 488, 489, 490, 491, 493, 494, 495, 496, 497, 498, 499, 500, 501, 502, 503, 504, 505, 506, 507, 508, 509, 511, 512, 513, 514, 515, 516, 517, 518, 519, 520, 521, 522, 523, 524, 525, 526, 527, 528, 532, 534, 535, 536, 537, 538, 539, 540, 541, 542, 543, 544, 545, 546, 547, 548, 549, 550, 551, 552, 553, 554, 555, 556, 557, 558, 559, 560, 561, 562, 563, 564, 565, 566, 567, 568, 569, 570, 571, 572, 573, 574, 575, 576, 577, 578, 579, 580, 581, 582, 583, 586, 587, 588, 589, 590, 591, 592, 593, 594, 595, 596, 597, 598, 599, 600, 601, 602, 603, 604, 605, 606, 607, 608, 609, 610, 611, 612, 613, 614, 615, 616, 617, 618, 619, 620, 621, 622, 623, 624, 625, 626, 627, 628, 629, 630, 631, 632, 633, 634, 635, 636, 637, 638, 639, 640, 641, 642, 643, 644, 645, 646, 647, 648, 649, 650, 651, 652, 653, 655, 656, 657, 658, 659, 660, 661, 662, 663, 664, 665, 666, 668, 667, 669, 670, 671, 672, 673, 674, 675, 676, 677, 678, 679, 680, 681, 682, 683, 684, 685, 686, 687, 688, 689, 690, 691, 692, 693, 694, 695, 696, 697, 698, 699, 700, 701, 702, 703, 704, 705, 706, 707, 708, 709, 710, 711, 712, 713, 714, 715, 716, 717, 718, 719, 720, 721, 722, 723, 724, 725, 726, 727, 728, 729, 730, 731, 732, 733, 734, 735, 736, 737, 738, 739, 740, 741, 742, 743, 744, 745, 746, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 1288, 760, 761, 762, 763, 764, 765, 766, 767, 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 802, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 823, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 965, 899, 900, 901, 902, 903, 904, 905, 906, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 923, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 937, 938, 939, 940, 941, 943, 946, 947, 1272, 949, 950, 951, 952, 953, 955, 954, 956, 957, 958, 959, 960, 961, 962, 945, 964, 966, 967, 968, 969, 971, 972, 973, 974, 975, 977, 976, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1078, 944, 654, 942, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1043, 1044, 1045, 1287, 1286, 1285, 1284, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1080, 1081, 1082, 1083, 1079, 1283, 1282, 1281, 1091, 1280, 1279, 1278, 1277, 1096, 1097, 1098, 1119, 1120, 1121, 1122, 1123, 1124, 1136, 1137, 1138, 1140, 1141, 1143, 1144, 1145, 1146, 1147, 1149, 1153, 1154, 1155, 1156, 1157, 1158, 1159, 1162, 1163, 1164, 1165, 1166, 1168, 1169, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1273, 1274, 1275, 1276, 1289, 1290, 1291))"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,9163)
[4]=>
array(0) {
}
[5]=>
int(32062352)
}
[38]=>
array(6) {
[0]=>
string(5498) "SELECT * FROM `doctor` WHERE (`doctor`.`public`=1) AND (`id` IN (3, 19, 6, 18, 17, 9, 16, 15, 12, 13, 14, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 39, 38, 40, 41, 42, 43, 44, 45, 46, 47, 37, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 87, 88, 82, 83, 84, 85, 86, 98, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 303, 209, 210, 211, 213, 214, 215, 216, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, 286, 287, 288, 289, 290, 291, 292, 293, 294, 295, 296, 297, 298, 299, 300, 301, 302, 304, 305, 306, 307, 308, 309, 310, 311, 312, 313, 314, 315, 316, 317, 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 332, 333, 334, 335, 373, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, 395, 396, 397, 398, 399, 400, 401, 402, 403, 404, 405, 406, 407, 408, 409, 410, 411, 412, 413, 414, 415, 416, 417, 431, 432, 433, 434, 435, 436, 437, 438, 439, 440, 441, 442, 443, 444, 445, 446, 447, 448, 449, 450, 451, 452, 453, 454, 455, 456, 457, 458, 459, 460, 461, 462, 463, 464, 465, 466, 467, 468, 469, 470, 471, 472, 473, 474, 475, 476, 477, 478, 479, 480, 481, 482, 483, 484, 492, 486, 487, 488, 489, 490, 491, 493, 494, 495, 496, 497, 498, 499, 500, 501, 502, 503, 504, 505, 506, 507, 508, 509, 511, 512, 513, 514, 515, 516, 517, 518, 519, 520, 521, 522, 523, 524, 525, 526, 527, 528, 532, 534, 535, 536, 537, 538, 539, 540, 541, 542, 543, 544, 545, 546, 547, 548, 549, 550, 551, 552, 553, 554, 555, 556, 557, 558, 559, 560, 561, 562, 563, 564, 565, 566, 567, 568, 569, 570, 571, 572, 573, 574, 575, 576, 577, 578, 579, 580, 581, 582, 583, 586, 587, 588, 589, 590, 591, 592, 593, 594, 595, 596, 597, 598, 599, 600, 601, 602, 603, 604, 605, 606, 607, 608, 609, 610, 611, 612, 613, 614, 615, 616, 617, 618, 619, 620, 621, 622, 623, 624, 625, 626, 627, 628, 629, 630, 631, 632, 633, 634, 635, 636, 637, 638, 639, 640, 641, 642, 643, 644, 645, 646, 647, 648, 649, 650, 651, 652, 653, 655, 656, 657, 658, 659, 660, 661, 662, 663, 664, 665, 666, 668, 667, 669, 670, 671, 672, 673, 674, 675, 676, 677, 678, 679, 680, 681, 682, 683, 684, 685, 686, 687, 688, 689, 690, 691, 692, 693, 694, 695, 696, 697, 698, 699, 700, 701, 702, 703, 704, 705, 706, 707, 708, 709, 710, 711, 712, 713, 714, 715, 716, 717, 718, 719, 720, 721, 722, 723, 724, 725, 726, 727, 728, 729, 730, 731, 732, 733, 734, 735, 736, 737, 738, 739, 740, 741, 742, 743, 744, 745, 746, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 1288, 760, 761, 762, 763, 764, 765, 766, 767, 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 802, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 823, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 965, 899, 900, 901, 902, 903, 904, 905, 906, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 923, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 937, 938, 939, 940, 941, 943, 946, 947, 1272, 949, 950, 951, 952, 953, 955, 954, 956, 957, 958, 959, 960, 961, 962, 945, 964, 966, 967, 968, 969, 971, 972, 973, 974, 975, 977, 976, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1078, 944, 654, 942, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1043, 1044, 1045, 1287, 1286, 1285, 1284, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1080, 1081, 1082, 1083, 1079, 1283, 1282, 1281, 1091, 1280, 1279, 1278, 1277, 1096, 1097, 1098, 1119, 1120, 1121, 1122, 1123, 1124, 1136, 1137, 1138, 1140, 1141, 1143, 1144, 1145, 1146, 1147, 1149, 1153, 1154, 1155, 1156, 1157, 1158, 1159, 1162, 1163, 1164, 1165, 1166, 1168, 1169, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1273, 1274, 1275, 1276, 1289, 1290, 1291))"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639162,9365)
[4]=>
array(0) {
}
[5]=>
int(36670928)
}
[39]=>
array(6) {
[0]=>
string(5297) "SELECT * FROM `doctor_to_speciality` WHERE `doctor_id` IN (19, 6, 18, 17, 9, 16, 15, 12, 13, 14, 20, 21, 22, 23, 3, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 215, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 100, 109, 101, 108, 107, 102, 105, 106, 104, 103, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 1176, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 303, 209, 210, 1078, 211, 213, 214, 216, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 306, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, 286, 287, 288, 289, 290, 291, 292, 293, 294, 295, 296, 297, 298, 299, 301, 300, 302, 304, 305, 1277, 307, 308, 309, 310, 311, 312, 313, 314, 315, 316, 317, 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 332, 333, 334, 335, 373, 374, 375, 376, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, 395, 396, 397, 398, 399, 400, 401, 402, 403, 404, 482, 405, 406, 407, 408, 409, 410, 411, 412, 413, 414, 415, 416, 417, 431, 432, 433, 434, 435, 436, 437, 438, 439, 440, 441, 845, 442, 443, 444, 445, 446, 447, 448, 449, 450, 451, 452, 481, 455, 456, 457, 458, 459, 460, 461, 462, 463, 464, 465, 466, 467, 468, 469, 470, 471, 472, 473, 474, 475, 476, 477, 478, 479, 480, 483, 484, 486, 487, 488, 489, 490, 491, 492, 493, 494, 495, 496, 497, 498, 499, 500, 501, 502, 503, 504, 505, 506, 507, 508, 509, 511, 512, 513, 514, 515, 516, 517, 518, 519, 520, 521, 522, 523, 524, 525, 526, 1141, 527, 528, 532, 534, 535, 536, 537, 538, 539, 540, 541, 542, 543, 544, 545, 546, 547, 548, 549, 550, 551, 552, 553, 554, 555, 556, 557, 558, 559, 560, 561, 562, 563, 564, 565, 566, 567, 568, 569, 570, 571, 572, 573, 574, 575, 576, 577, 578, 579, 580, 581, 582, 583, 586, 587, 588, 589, 590, 591, 592, 593, 594, 595, 596, 597, 598, 599, 600, 601, 602, 603, 604, 605, 606, 607, 608, 609, 610, 611, 612, 613, 614, 615, 616, 617, 618, 619, 620, 624, 621, 622, 623, 625, 626, 627, 628, 629, 630, 631, 632, 633, 634, 635, 636, 637, 638, 639, 647, 649, 650, 651, 653, 654, 655, 656, 658, 659, 660, 661, 662, 663, 664, 665, 674, 675, 676, 677, 678, 679, 680, 681, 682, 683, 684, 685, 686, 687, 688, 689, 690, 691, 692, 693, 694, 695, 696, 697, 698, 699, 700, 701, 702, 703, 704, 705, 706, 707, 708, 709, 710, 711, 712, 713, 714, 715, 716, 717, 718, 719, 720, 721, 722, 723, 724, 725, 726, 727, 728, 729, 730, 731, 732, 733, 734, 735, 736, 737, 738, 739, 740, 741, 742, 743, 744, 745, 746, 747, 748, 749, 750, 751, 752, 753, 754, 767, 769, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 802, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 823, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 939, 876, 877, 878, 879, 880, 881, 882, 883, 884, 943, 885, 886, 887, 888, 889, 890, 942, 891, 892, 893, 894, 895, 1016, 896, 940, 897, 938, 899, 900, 901, 902, 903, 904, 905, 906, 907, 908, 909, 910, 937, 911, 912, 913, 914, 936, 915, 916, 917, 918, 935, 919, 920, 921, 922, 923, 924, 925, 941, 926, 927, 928, 929, 930, 931, 932, 933, 934, 944, 945, 946, 947, 949, 950, 951, 952, 953, 954, 955, 956, 957, 959, 958, 960, 961, 962, 964, 965, 966, 967, 968, 969, 971, 972, 973, 974, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1031, 1030, 1017, 1018, 1172, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1154, 1040, 1041, 1042, 1043, 1044, 1045, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1159, 1162, 1163, 1164, 1165, 1166, 1168, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1079, 1080, 1081, 1082, 1083, 1091, 1096, 1097, 1098, 1158, 1119, 1120, 1121, 1122, 1123, 1124, 1136, 1137, 1138, 1182, 1140, 1143, 1144, 1145, 1146, 1147, 1155, 1149, 1190, 1153, 1157, 1156, 1171, 1169, 1173, 1174, 1175, 1177, 1178, 1179, 1180, 1181, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1191, 1192, 1193, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291)"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0086)
[4]=>
array(0) {
}
[5]=>
int(49549072)
}
[40]=>
array(6) {
[0]=>
string(5297) "SELECT * FROM `doctor_to_speciality` WHERE `doctor_id` IN (19, 6, 18, 17, 9, 16, 15, 12, 13, 14, 20, 21, 22, 23, 3, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 215, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 100, 109, 101, 108, 107, 102, 105, 106, 104, 103, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 1176, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 303, 209, 210, 1078, 211, 213, 214, 216, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 306, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, 286, 287, 288, 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[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0088)
[4]=>
array(0) {
}
[5]=>
int(49296536)
}
[41]=>
array(6) {
[0]=>
string(5297) "SELECT * FROM `doctor_to_speciality` WHERE `doctor_id` IN (19, 6, 18, 17, 9, 16, 15, 12, 13, 14, 20, 21, 22, 23, 3, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 215, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 100, 109, 101, 108, 107, 102, 105, 106, 104, 103, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 1176, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 303, 209, 210, 1078, 211, 213, 214, 216, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 306, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, 286, 287, 288, 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1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291)"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0493)
[4]=>
array(0) {
}
[5]=>
int(50071992)
}
[42]=>
array(6) {
[0]=>
string(366) "SELECT * FROM `speciality` WHERE `id` IN ('23', '9', '5', '7', '6', '11', '12', '13', '14', '16', '15', '17', '18', '19', '41', '21', '20', '44', '22', '24', '26', '25', '27', '29', '38', '30', '8', '37', '39', '32', '42', '45', '47', '28', '48', '60', '49', '50', '54', '51', '57', '34', '55', '58', '56', '53', '36', '40', '33', '59', '61', '63', '64', '62', '65')"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0499)
[4]=>
array(0) {
}
[5]=>
int(49872184)
}
[43]=>
array(6) {
[0]=>
string(366) "SELECT * FROM `speciality` WHERE `id` IN ('23', '9', '5', '7', '6', '11', '12', '13', '14', '16', '15', '17', '18', '19', '41', '21', '20', '44', '22', '24', '26', '25', '27', '29', '38', '30', '8', '37', '39', '32', '42', '45', '47', '28', '48', '60', '49', '50', '54', '51', '57', '34', '55', '58', '56', '53', '36', '40', '33', '59', '61', '63', '64', '62', '65')"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0499)
[4]=>
array(0) {
}
[5]=>
int(49859448)
}
[44]=>
array(6) {
[0]=>
string(366) "SELECT * FROM `speciality` WHERE `id` IN ('23', '9', '5', '7', '6', '11', '12', '13', '14', '16', '15', '17', '18', '19', '41', '21', '20', '44', '22', '24', '26', '25', '27', '29', '38', '30', '8', '37', '39', '32', '42', '45', '47', '28', '48', '60', '49', '50', '54', '51', '57', '34', '55', '58', '56', '53', '36', '40', '33', '59', '61', '63', '64', '62', '65')"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0517)
[4]=>
array(0) {
}
[5]=>
int(49900056)
}
[45]=>
array(6) {
[0]=>
string(56) "SELECT * FROM `seo_item` WHERE `url`='/doctors/radiolog'"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0685)
[4]=>
array(0) {
}
[5]=>
int(47747096)
}
[46]=>
array(6) {
[0]=>
string(56) "SELECT * FROM `seo_item` WHERE `url`='/doctors/radiolog'"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0685)
[4]=>
array(0) {
}
[5]=>
int(47748168)
}
[47]=>
array(6) {
[0]=>
string(56) "SELECT * FROM `seo_item` WHERE `url`='/doctors/radiolog'"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,089)
[4]=>
array(0) {
}
[5]=>
int(47749016)
}
[48]=>
array(6) {
[0]=>
string(54) "SELECT * FROM `params` WHERE `name`='settings.view.ru'"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0973)
[4]=>
array(0) {
}
[5]=>
int(48464480)
}
[49]=>
array(6) {
[0]=>
string(54) "SELECT * FROM `params` WHERE `name`='settings.view.ru'"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0973)
[4]=>
array(0) {
}
[5]=>
int(48465552)
}
[50]=>
array(6) {
[0]=>
string(54) "SELECT * FROM `params` WHERE `name`='settings.view.ru'"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0975)
[4]=>
array(0) {
}
[5]=>
int(48466960)
}
[51]=>
array(6) {
[0]=>
string(47) "SELECT * FROM `branch` WHERE `speciality_id`=37"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0991)
[4]=>
array(0) {
}
[5]=>
int(48662208)
}
[52]=>
array(6) {
[0]=>
string(47) "SELECT * FROM `branch` WHERE `speciality_id`=37"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,0991)
[4]=>
array(0) {
}
[5]=>
int(48663288)
}
[53]=>
array(6) {
[0]=>
string(47) "SELECT * FROM `branch` WHERE `speciality_id`=37"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,1106)
[4]=>
array(0) {
}
[5]=>
int(48690032)
}
[54]=>
array(6) {
[0]=>
string(88) "SELECT * FROM `doctor_to_speciality` WHERE (`speciality_id`=37) AND (`speciality_id`=37)"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,1126)
[4]=>
array(0) {
}
[5]=>
int(48800920)
}
[55]=>
array(6) {
[0]=>
string(88) "SELECT * FROM `doctor_to_speciality` WHERE (`speciality_id`=37) AND (`speciality_id`=37)"
[1]=>
int(80)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,1126)
[4]=>
array(0) {
}
[5]=>
int(48801824)
}
[56]=>
array(6) {
[0]=>
string(88) "SELECT * FROM `doctor_to_speciality` WHERE (`speciality_id`=37) AND (`speciality_id`=37)"
[1]=>
int(96)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,1127)
[4]=>
array(0) {
}
[5]=>
int(48814240)
}
[57]=>
array(6) {
[0]=>
string(254) "SELECT * FROM `doctor` WHERE (`doctor`.`public`=1) AND (`id` IN ('109', '168', '205', '310', '397', '441', '442', '450', '609', '693', '826', '843', '850', '851', '852', '854', '943', '944', '1123', '1158', '1159', '1214')) ORDER BY `rating` DESC LIMIT 8"
[1]=>
int(4)
[2]=>
string(21) "yii\db\Command::query"
[3]=>
float(1711639163,1128)
[4]=>
array(0) {
}
[5]=>
int(48817528)
}
[58]=>
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string(1323) "Преимущества радиолечения за границей
Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
Высокий профессионализм. Врачи-радиологи за границей – это профессионалы высокого уровня. Пациент может узнать сведения об опыте и квалификации медика на сайте клиники, в которой он работает.
Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
"
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string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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string(1323) "Преимущества радиолечения за границей
Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
Высокий профессионализм. Врачи-радиологи за границей – это профессионалы высокого уровня. Пациент может узнать сведения об опыте и квалификации медика на сайте клиники, в которой он работает.
Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
"
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string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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NULL
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object(yii\web\UrlRule)#33 (16) {
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NULL
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object(yii\web\UrlRule)#34 (16) {
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array(0) {
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object(yii\web\UrlRule)#35 (16) {
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NULL
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string(8) "//"
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NULL
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array(1) {
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string(35) "#^privacy\-policy|terms\-of\-use$#u"
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array(0) {
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object(yii\web\UrlRule)#36 (16) {
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string(23) "///"
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string(55) "#^(?Ppartner)/(?P[^\/]+)/index$#u"
["_paramRules":"yii\web\UrlRule":private]=>
array(0) {
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array(2) {
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object(yii\web\UrlRule)#37 (16) {
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NULL
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string(6) "action"
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string(32) "////"
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string(71) "#^(?Ppartner)/(?P[^\/]+)/(?P[^\/]+)$#u"
["_paramRules":"yii\web\UrlRule":private]=>
array(0) {
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["_routeParams":"yii\web\UrlRule":private]=>
array(3) {
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object(yii\web\UrlRule)#38 (16) {
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NULL
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array(0) {
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NULL
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NULL
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bool(true)
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NULL
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int(2)
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array(0) {
}
["_template":"yii\web\UrlRule":private]=>
string(11) "/countries/"
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NULL
["_paramRules":"yii\web\UrlRule":private]=>
array(0) {
}
["_routeParams":"yii\web\UrlRule":private]=>
array(0) {
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}
[9]=>
object(yii\web\UrlRule)#39 (16) {
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NULL
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array(0) {
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NULL
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NULL
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NULL
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bool(true)
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NULL
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int(2)
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array(0) {
}
["_template":"yii\web\UrlRule":private]=>
string(9) "/clinics/"
["_routeRule":"yii\web\UrlRule":private]=>
NULL
["_paramRules":"yii\web\UrlRule":private]=>
array(0) {
}
["_routeParams":"yii\web\UrlRule":private]=>
array(0) {
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}
[10]=>
object(yii\web\UrlRule)#40 (16) {
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string(14) "#^illnesses$#u"
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NULL
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array(0) {
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NULL
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NULL
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bool(true)
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NULL
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int(2)
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array(0) {
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["_template":"yii\web\UrlRule":private]=>
string(11) "/illnesses/"
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NULL
["_paramRules":"yii\web\UrlRule":private]=>
array(0) {
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["_routeParams":"yii\web\UrlRule":private]=>
array(0) {
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}
[11]=>
object(yii\web\UrlRule)#41 (16) {
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string(12) "certificates"
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NULL
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array(0) {
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NULL
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bool(true)
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array(0) {
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["_template":"yii\web\UrlRule":private]=>
string(14) "/certificates/"
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NULL
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array(0) {
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["_routeParams":"yii\web\UrlRule":private]=>
array(0) {
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object(yii\web\UrlRule)#42 (16) {
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string(39) "#^certificates/(?P[^\/]+)$#u"
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NULL
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NULL
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array(1) {
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string(0) ""
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array(0) {
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object(yii\web\UrlRule)#43 (16) {
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string(28) "/blog/tags//"
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NULL
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array(1) {
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["_routeParams":"yii\web\UrlRule":private]=>
array(0) {
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object(yii\web\UrlRule)#44 (16) {
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string(9) "blog/tags"
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NULL
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array(0) {
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array(0) {
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object(yii\web\UrlRule)#45 (16) {
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NULL
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object(yii\web\UrlRule)#47 (16) {
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object(yii\web\UrlRule)#49 (16) {
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object(app\components\CountryUrlRule)#52 (0) {
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object(app\components\DiseaseUrlRule)#54 (0) {
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object(app\components\BranchUrlRule)#55 (0) {
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object(app\components\ClinicUrlRule)#56 (0) {
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string(5) "MULTI"
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string(6) "OBJECT"
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string(4) "ROLE"
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string(4) "SAVE"
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string(13) "SCRIPT EXISTS"
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string(12) "SCRIPT FLUSH"
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string(11) "SCRIPT KILL"
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string(11) "SCRIPT LOAD"
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string(10) "SDIFFSTORE"
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string(6) "SELECT"
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string(5) "SETEX"
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string(8) "SETRANGE"
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string(8) "SHUTDOWN"
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string(6) "SINTER"
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string(11) "SINTERSTORE"
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string(9) "SISMEMBER"
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string(7) "SLAVEOF"
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string(7) "SLOWLOG"
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string(8) "SMEMBERS"
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string(5) "SMOVE"
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string(4) "SORT"
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string(4) "SPOP"
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string(11) "SRANDMEMBER"
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string(4) "SREM"
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string(9) "SUBSCRIBE"
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string(6) "SWAPDB"
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string(4) "SYNC"
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string(4) "TIME"
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string(5) "TOUCH"
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string(4) "TYPE"
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string(7) "UNWATCH"
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string(4) "WAIT"
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string(5) "WATCH"
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string(5) "ZCARD"
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string(6) "ZCOUNT"
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string(7) "ZINCRBY"
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string(11) "ZINTERSTORE"
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string(9) "ZLEXCOUNT"
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string(6) "ZRANGE"
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string(11) "ZRANGEBYLEX"
[182]=>
string(14) "ZREVRANGEBYLEX"
[183]=>
string(13) "ZRANGEBYSCORE"
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string(5) "ZRANK"
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string(4) "ZREM"
[186]=>
string(14) "ZREMRANGEBYLEX"
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string(15) "ZREMRANGEBYRANK"
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string(16) "ZREMRANGEBYSCORE"
[189]=>
string(9) "ZREVRANGE"
[190]=>
string(16) "ZREVRANGEBYSCORE"
[191]=>
string(8) "ZREVRANK"
[192]=>
string(6) "ZSCORE"
[193]=>
string(11) "ZUNIONSTORE"
[194]=>
string(4) "SCAN"
[195]=>
string(5) "SSCAN"
[196]=>
string(5) "HSCAN"
[197]=>
string(5) "ZSCAN"
}
["_socket":"yii\redis\Connection":private]=>
resource(55) of type (stream)
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array(0) {
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string(0) ""
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NULL
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string(18) "https://docland.ru"
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array(7) {
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object(app\components\DoctorUrlRule)#50 (0) {
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object(app\components\SpecialityUrlRule)#51 (0) {
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object(app\components\CountryUrlRule)#52 (0) {
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object(app\components\CityUrlRule)#53 (0) {
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object(app\components\DiseaseUrlRule)#54 (0) {
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object(app\components\ClinicUrlRule)#56 (0) {
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object(app\components\SpecialityUrlRule)#51 (0) {
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object(app\components\CountryUrlRule)#52 (0) {
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object(app\components\CityUrlRule)#53 (0) {
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object(app\components\DiseaseUrlRule)#54 (0) {
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object(app\components\CountryUrlRule)#52 (0) {
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object(app\components\CityUrlRule)#53 (0) {
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object(app\components\DiseaseUrlRule)#54 (0) {
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NULL
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array(7) {
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object(app\components\DoctorUrlRule)#50 (0) {
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object(app\components\SpecialityUrlRule)#51 (0) {
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object(app\components\CountryUrlRule)#52 (0) {
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[3]=>
object(app\components\CityUrlRule)#53 (0) {
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[4]=>
object(app\components\DiseaseUrlRule)#54 (0) {
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object(app\components\BranchUrlRule)#55 (0) {
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[6]=>
object(app\components\ClinicUrlRule)#56 (0) {
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["sitemap/doctors?"]=>
array(7) {
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object(app\components\DoctorUrlRule)#50 (0) {
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[1]=>
object(app\components\SpecialityUrlRule)#51 (0) {
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[2]=>
object(app\components\CountryUrlRule)#52 (0) {
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[3]=>
object(app\components\CityUrlRule)#53 (0) {
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[4]=>
object(app\components\DiseaseUrlRule)#54 (0) {
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[5]=>
object(app\components\BranchUrlRule)#55 (0) {
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[6]=>
object(app\components\ClinicUrlRule)#56 (0) {
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}
["sitemap/clinics?"]=>
array(7) {
[0]=>
object(app\components\DoctorUrlRule)#50 (0) {
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[1]=>
object(app\components\SpecialityUrlRule)#51 (0) {
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[2]=>
object(app\components\CountryUrlRule)#52 (0) {
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[3]=>
object(app\components\CityUrlRule)#53 (0) {
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[4]=>
object(app\components\DiseaseUrlRule)#54 (0) {
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[5]=>
object(app\components\BranchUrlRule)#55 (0) {
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[6]=>
object(app\components\ClinicUrlRule)#56 (0) {
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}
["sitemap/branches?"]=>
array(7) {
[0]=>
object(app\components\DoctorUrlRule)#50 (0) {
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object(app\components\SpecialityUrlRule)#51 (0) {
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object(app\components\CountryUrlRule)#52 (0) {
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[3]=>
object(app\components\CityUrlRule)#53 (0) {
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[4]=>
object(app\components\DiseaseUrlRule)#54 (0) {
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[5]=>
object(app\components\BranchUrlRule)#55 (0) {
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[6]=>
object(app\components\ClinicUrlRule)#56 (0) {
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}
["sitemap/illnesses?"]=>
array(7) {
[0]=>
object(app\components\DoctorUrlRule)#50 (0) {
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[1]=>
object(app\components\SpecialityUrlRule)#51 (0) {
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[2]=>
object(app\components\CountryUrlRule)#52 (0) {
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[3]=>
object(app\components\CityUrlRule)#53 (0) {
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[4]=>
object(app\components\DiseaseUrlRule)#54 (0) {
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[5]=>
object(app\components\BranchUrlRule)#55 (0) {
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[6]=>
object(app\components\ClinicUrlRule)#56 (0) {
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["favorite?"]=>
array(7) {
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object(app\components\DoctorUrlRule)#50 (0) {
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[1]=>
object(app\components\SpecialityUrlRule)#51 (0) {
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[2]=>
object(app\components\CountryUrlRule)#52 (0) {
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[3]=>
object(app\components\CityUrlRule)#53 (0) {
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[4]=>
object(app\components\DiseaseUrlRule)#54 (0) {
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[5]=>
object(app\components\BranchUrlRule)#55 (0) {
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object(app\components\ClinicUrlRule)#56 (0) {
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array(1) {
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object(yii\web\UrlRule)#35 (16) {
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}
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string(8) "//"
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NULL
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}
["_routeParams":"yii\web\UrlRule":private]=>
array(0) {
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["about"]=>
string(1323) "Преимущества радиолечения за границей
Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
Высокий профессионализм. Врачи-радиологи за границей – это профессионалы высокого уровня. Пациент может узнать сведения об опыте и квалификации медика на сайте клиники, в которой он работает.
Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
"
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string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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string(1323) "Преимущества радиолечения за границей
Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
Высокий профессионализм. Врачи-радиологи за границей – это профессионалы высокого уровня. Пациент может узнать сведения об опыте и квалификации медика на сайте клиники, в которой он работает.
Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
"
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string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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string(15) "seo_description"
}
["languages"]=>
array(1) {
[0]=>
string(2) "en"
}
["defaultLanguage"]=>
string(2) "ru"
["tableName"]=>
string(11) "lang_branch"
["langClassName"]=>
string(21) "app\models\BranchLang"
["langClassSuffix"]=>
string(4) "Lang"
["langForeignKey"]=>
string(9) "branch_id"
["languageField"]=>
string(8) "language"
["forceDelete"]=>
bool(true)
["currentLanguage"]=>
string(2) "ru"
["langAttributes":"app\components\MultilingualBehavior":private]=>
array(0) {
}
["owner"]=>
*RECURSION*
}
[1]=>
object(yii\behaviors\TimestampBehavior)#7722 (7) {
["createdAtAttribute"]=>
string(10) "created_at"
["updatedAtAttribute"]=>
string(10) "updated_at"
["value"]=>
object(Closure)#7724 (1) {
["this"]=>
*RECURSION*
}
["attributes"]=>
array(2) {
["beforeInsert"]=>
array(2) {
[0]=>
string(10) "created_at"
[1]=>
string(10) "updated_at"
}
["beforeUpdate"]=>
string(10) "updated_at"
}
["skipUpdateOnClean"]=>
bool(true)
["preserveNonEmptyValues"]=>
bool(false)
["owner"]=>
*RECURSION*
}
}
}
}
}
["_relationsDependencies":"yii\db\BaseActiveRecord":private]=>
array(1) {
["id"]=>
array(1) {
["branches"]=>
string(8) "branches"
}
}
["_errors":"yii\base\Model":private]=>
NULL
["_validators":"yii\base\Model":private]=>
NULL
["_scenario":"yii\base\Model":private]=>
string(7) "default"
["_events":"yii\base\Component":private]=>
array(5) {
["afterFind"]=>
array(1) {
[0]=>
array(2) {
[0]=>
array(2) {
[0]=>
object(app\components\MultilingualBehavior)#71 (12) {
["attributes"]=>
array(5) {
[0]=>
string(5) "title"
[1]=>
string(4) "link"
[2]=>
string(12) "plural_title"
[3]=>
string(14) "genitive_title"
[4]=>
string(21) "genitive_plural_title"
}
["languages"]=>
array(1) {
[0]=>
string(2) "en"
}
["defaultLanguage"]=>
string(2) "ru"
["tableName"]=>
string(15) "lang_speciality"
["langClassName"]=>
string(25) "app\models\SpecialityLang"
["langClassSuffix"]=>
string(4) "Lang"
["langForeignKey"]=>
string(13) "speciality_id"
["languageField"]=>
string(8) "language"
["forceDelete"]=>
bool(true)
["currentLanguage"]=>
string(2) "ru"
["langAttributes":"app\components\MultilingualBehavior":private]=>
array(0) {
}
["owner"]=>
*RECURSION*
}
[1]=>
string(9) "afterFind"
}
[1]=>
NULL
}
}
["afterUpdate"]=>
array(1) {
[0]=>
array(2) {
[0]=>
array(2) {
[0]=>
object(app\components\MultilingualBehavior)#71 (12) {
["attributes"]=>
array(5) {
[0]=>
string(5) "title"
[1]=>
string(4) "link"
[2]=>
string(12) "plural_title"
[3]=>
string(14) "genitive_title"
[4]=>
string(21) "genitive_plural_title"
}
["languages"]=>
array(1) {
[0]=>
string(2) "en"
}
["defaultLanguage"]=>
string(2) "ru"
["tableName"]=>
string(15) "lang_speciality"
["langClassName"]=>
string(25) "app\models\SpecialityLang"
["langClassSuffix"]=>
string(4) "Lang"
["langForeignKey"]=>
string(13) "speciality_id"
["languageField"]=>
string(8) "language"
["forceDelete"]=>
bool(true)
["currentLanguage"]=>
string(2) "ru"
["langAttributes":"app\components\MultilingualBehavior":private]=>
array(0) {
}
["owner"]=>
*RECURSION*
}
[1]=>
string(11) "afterUpdate"
}
[1]=>
NULL
}
}
["afterInsert"]=>
array(1) {
[0]=>
array(2) {
[0]=>
array(2) {
[0]=>
object(app\components\MultilingualBehavior)#71 (12) {
["attributes"]=>
array(5) {
[0]=>
string(5) "title"
[1]=>
string(4) "link"
[2]=>
string(12) "plural_title"
[3]=>
string(14) "genitive_title"
[4]=>
string(21) "genitive_plural_title"
}
["languages"]=>
array(1) {
[0]=>
string(2) "en"
}
["defaultLanguage"]=>
string(2) "ru"
["tableName"]=>
string(15) "lang_speciality"
["langClassName"]=>
string(25) "app\models\SpecialityLang"
["langClassSuffix"]=>
string(4) "Lang"
["langForeignKey"]=>
string(13) "speciality_id"
["languageField"]=>
string(8) "language"
["forceDelete"]=>
bool(true)
["currentLanguage"]=>
string(2) "ru"
["langAttributes":"app\components\MultilingualBehavior":private]=>
array(0) {
}
["owner"]=>
*RECURSION*
}
[1]=>
string(11) "afterInsert"
}
[1]=>
NULL
}
}
["afterDelete"]=>
array(1) {
[0]=>
array(2) {
[0]=>
array(2) {
[0]=>
object(app\components\MultilingualBehavior)#71 (12) {
["attributes"]=>
array(5) {
[0]=>
string(5) "title"
[1]=>
string(4) "link"
[2]=>
string(12) "plural_title"
[3]=>
string(14) "genitive_title"
[4]=>
string(21) "genitive_plural_title"
}
["languages"]=>
array(1) {
[0]=>
string(2) "en"
}
["defaultLanguage"]=>
string(2) "ru"
["tableName"]=>
string(15) "lang_speciality"
["langClassName"]=>
string(25) "app\models\SpecialityLang"
["langClassSuffix"]=>
string(4) "Lang"
["langForeignKey"]=>
string(13) "speciality_id"
["languageField"]=>
string(8) "language"
["forceDelete"]=>
bool(true)
["currentLanguage"]=>
string(2) "ru"
["langAttributes":"app\components\MultilingualBehavior":private]=>
array(0) {
}
["owner"]=>
*RECURSION*
}
[1]=>
string(11) "afterDelete"
}
[1]=>
NULL
}
}
["beforeValidate"]=>
array(1) {
[0]=>
array(2) {
[0]=>
array(2) {
[0]=>
object(app\components\MultilingualBehavior)#71 (12) {
["attributes"]=>
array(5) {
[0]=>
string(5) "title"
[1]=>
string(4) "link"
[2]=>
string(12) "plural_title"
[3]=>
string(14) "genitive_title"
[4]=>
string(21) "genitive_plural_title"
}
["languages"]=>
array(1) {
[0]=>
string(2) "en"
}
["defaultLanguage"]=>
string(2) "ru"
["tableName"]=>
string(15) "lang_speciality"
["langClassName"]=>
string(25) "app\models\SpecialityLang"
["langClassSuffix"]=>
string(4) "Lang"
["langForeignKey"]=>
string(13) "speciality_id"
["languageField"]=>
string(8) "language"
["forceDelete"]=>
bool(true)
["currentLanguage"]=>
string(2) "ru"
["langAttributes":"app\components\MultilingualBehavior":private]=>
array(0) {
}
["owner"]=>
*RECURSION*
}
[1]=>
string(14) "beforeValidate"
}
[1]=>
NULL
}
}
}
["_eventWildcards":"yii\base\Component":private]=>
array(0) {
}
["_behaviors":"yii\base\Component":private]=>
array(1) {
[0]=>
object(app\components\MultilingualBehavior)#71 (12) {
["attributes"]=>
array(5) {
[0]=>
string(5) "title"
[1]=>
string(4) "link"
[2]=>
string(12) "plural_title"
[3]=>
string(14) "genitive_title"
[4]=>
string(21) "genitive_plural_title"
}
["languages"]=>
array(1) {
[0]=>
string(2) "en"
}
["defaultLanguage"]=>
string(2) "ru"
["tableName"]=>
string(15) "lang_speciality"
["langClassName"]=>
string(25) "app\models\SpecialityLang"
["langClassSuffix"]=>
string(4) "Lang"
["langForeignKey"]=>
string(13) "speciality_id"
["languageField"]=>
string(8) "language"
["forceDelete"]=>
bool(true)
["currentLanguage"]=>
string(2) "ru"
["langAttributes":"app\components\MultilingualBehavior":private]=>
array(0) {
}
["owner"]=>
*RECURSION*
}
}
}
["country"]=>
NULL
["_events":"yii\base\Component":private]=>
array(0) {
}
["_eventWildcards":"yii\base\Component":private]=>
array(0) {
}
["_behaviors":"yii\base\Component":private]=>
NULL
}
["doctorSearch"]=>
object(app\components\search\DoctorSearch)#91 (3) {
["_events":"yii\base\Component":private]=>
array(0) {
}
["_eventWildcards":"yii\base\Component":private]=>
array(0) {
}
["_behaviors":"yii\base\Component":private]=>
NULL
}
["i18n"]=>
object(yii\i18n\I18N)#5204 (5) {
["translations"]=>
array(5) {
["app*"]=>
object(app\components\CustomMessageSource)#7762 (8) {
["basePath"]=>
string(13) "@app/messages"
["fileMap"]=>
NULL
["forceTranslation"]=>
bool(false)
["sourceLanguage"]=>
string(2) "ru"
["_messages":"yii\i18n\MessageSource":private]=>
array(0) {
}
["_events":"yii\base\Component":private]=>
array(0) {
}
["_eventWildcards":"yii\base\Component":private]=>
array(0) {
}
["_behaviors":"yii\base\Component":private]=>
NULL
}
["seo*"]=>
object(app\components\CustomMessageSource)#5206 (8) {
["basePath"]=>
string(13) "@app/messages"
["fileMap"]=>
NULL
["forceTranslation"]=>
bool(false)
["sourceLanguage"]=>
string(2) "ru"
["_messages":"yii\i18n\MessageSource":private]=>
array(0) {
}
["_events":"yii\base\Component":private]=>
array(0) {
}
["_eventWildcards":"yii\base\Component":private]=>
array(0) {
}
["_behaviors":"yii\base\Component":private]=>
NULL
}
["yii"]=>
object(yii\i18n\PhpMessageSource)#7719 (8) {
["basePath"]=>
string(13) "@yii/messages"
["fileMap"]=>
NULL
["forceTranslation"]=>
bool(false)
["sourceLanguage"]=>
string(5) "en-US"
["_messages":"yii\i18n\MessageSource":private]=>
array(1) {
["ru/yii"]=>
array(118) {
[""{attribute}" does not support operator "{operator}"."]=>
string(74) ""{attribute}" не поддерживает оператор "{operator}"."
["Condition for "{attribute}" should be either a value or valid operator specification."]=>
string(150) "Условие для "{attribute}" должно быть или значением или верной спецификацией оператора."
["Operator "{operator}" must be used with a search attribute."]=>
string(111) "Оператор "{operator}" должен использоваться через атрибут поиска."
["Operator "{operator}" requires multiple operands."]=>
string(83) "Оператор "{operator}" требует несколько операндов."
["The format of {filter} is invalid."]=>
string(53) "Формат фильтра {filter} не верен."
["Unknown filter attribute "{attribute}""]=>
string(66) "Неизвестный атрибут фильтра "{attribute}""
[" and "]=>
string(4) " и "
["(not set)"]=>
string(19) "(не задано)"
["An internal server error occurred."]=>
string(66) "Возникла внутренняя ошибка сервера."
["Are you sure you want to delete this item?"]=>
string(80) "Вы уверены, что хотите удалить этот элемент?"
["Delete"]=>
string(14) "Удалить"
["Error"]=>
string(12) "Ошибка"
["File upload failed."]=>
string(48) "Загрузка файла не удалась."
["Home"]=>
string(14) "Главная"
["Invalid data received for parameter "{param}"."]=>
string(71) "Неправильное значение параметра "{param}"."
["Login Required"]=>
string(28) "Требуется вход."
["Missing required arguments: {params}"]=>
string(76) "Отсутствуют обязательные аргументы: {params}"
["Missing required parameters: {params}"]=>
string(76) "Отсутствуют обязательные параметры: {params}"
["No"]=>
string(6) "Нет"
["No results found."]=>
string(33) "Ничего не найдено."
["Only files with these MIME types are allowed: {mimeTypes}."]=>
string(119) "Разрешена загрузка файлов только со следующими MIME-типами: {mimeTypes}."
["Only files with these extensions are allowed: {extensions}."]=>
string(127) "Разрешена загрузка файлов только со следующими расширениями: {extensions}."
["Page not found."]=>
string(37) "Страница не найдена."
["Please fix the following errors:"]=>
string(51) "Исправьте следующие ошибки:"
["Please upload a file."]=>
string(28) "Загрузите файл."
["Powered by {yii}"]=>
string(27) "Работает на {yii}"
["Showing {begin, number}-{end, number} of {totalCount, number} {totalCount, plural, one{item} other{items}}."]=>
string(100) "Показаны записи {begin, number}-{end, number} из {totalCount, number} ."
["The combination {values} of {attributes} has already been taken."]=>
string(92) "Комбинация {values} параметров {attributes} уже существует."
["The file "{file}" is not an image."]=>
string(67) "Файл «{file}» не является изображением."
["The file "{file}" is too big. Its size cannot exceed {formattedLimit}."]=>
string(118) "Файл «{file}» слишком большой. Размер не должен превышать {formattedLimit}."
["The file "{file}" is too small. Its size cannot be smaller than {formattedLimit}."]=>
string(118) "Файл «{file}» слишком маленький. Размер должен быть более {formattedLimit}."
["The format of {attribute} is invalid."]=>
string(63) "Неверный формат значения «{attribute}»."
["The image "{file}" is too large. The height cannot be larger than {limit, number} {limit, plural, one{pixel} other{pixels}}."]=>
string(219) "Файл «{file}» слишком большой. Высота не должна превышать {limit, number} {limit, plural, one{пиксель} few{пикселя} many{пикселей} other{пикселя}}."
["The image "{file}" is too large. The width cannot be larger than {limit, number} {limit, plural, one{pixel} other{pixels}}."]=>
string(219) "Файл «{file}» слишком большой. Ширина не должна превышать {limit, number} {limit, plural, one{пиксель} few{пикселя} many{пикселей} other{пикселя}}."
["The image "{file}" is too small. The height cannot be smaller than {limit, number} {limit, plural, one{pixel} other{pixels}}."]=>
string(219) "Файл «{file}» слишком маленький. Высота должна быть более {limit, number} {limit, plural, one{пиксель} few{пикселя} many{пикселей} other{пикселя}}."
["The image "{file}" is too small. The width cannot be smaller than {limit, number} {limit, plural, one{pixel} other{pixels}}."]=>
string(219) "Файл «{file}» слишком маленький. Ширина должна быть более {limit, number} {limit, plural, one{пиксель} few{пикселя} many{пикселей} other{пикселя}}."
["The requested view "{name}" was not found."]=>
string(90) "Запрашиваемый файл представления "{name}" не найден."
["The verification code is incorrect."]=>
string(55) "Неправильный проверочный код."
["Total {count, number} {count, plural, one{item} other{items}}."]=>
string(128) "Всего {count, number} {count, plural, one{запись} few{записи} many{записей} other{записи}}."
["Unable to verify your data submission."]=>
string(73) "Не удалось проверить переданные данные."
["Unknown alias: -{name}"]=>
string(50) "Неизвестный псевдоним: -{name}"
["Unknown option: --{name}"]=>
string(43) "Неизвестная опция: --{name}"
["Update"]=>
string(26) "Редактировать"
["View"]=>
string(16) "Просмотр"
["Yes"]=>
string(4) "Да"
["Yii Framework"]=>
string(13) "Yii Framework"
["You are not allowed to perform this action."]=>
string(84) "Вам не разрешено производить данное действие."
["You can upload at most {limit, number} {limit, plural, one{file} other{files}}."]=>
string(157) "Вы не можете загружать более {limit, number} {limit, plural, one{файла} few{файлов} many{файлов} other{файла}}."
["in {delta, plural, =1{a day} other{# days}}"]=>
string(103) "через {delta, plural, =1{день} one{# день} few{# дня} many{# дней} other{# дня}}"
["in {delta, plural, =1{a minute} other{# minutes}}"]=>
string(125) "через {delta, plural, =1{минуту} one{# минуту} few{# минуты} many{# минут} other{# минуты}}"
["in {delta, plural, =1{a month} other{# months}}"]=>
string(125) "через {delta, plural, =1{месяц} one{# месяц} few{# месяца} many{# месяцев} other{# месяца}}"
["in {delta, plural, =1{a second} other{# seconds}}"]=>
string(135) "через {delta, plural, =1{секунду} one{# секунду} few{# секунды} many{# секунд} other{# секунды}}"
["in {delta, plural, =1{a year} other{# years}}"]=>
string(101) "через {delta, plural, =1{год} one{# год} few{# года} many{# лет} other{# года}}"
["in {delta, plural, =1{an hour} other{# hours}}"]=>
string(105) "через {delta, plural, =1{час} one{# час} few{# часа} many{# часов} other{# часа}}"
["just now"]=>
string(23) "прямо сейчас"
["the input value"]=>
string(35) "введённое значение"
["{attribute} "{value}" has already been taken."]=>
string(72) "Значение «{value}» для «{attribute}» уже занято."
["{attribute} cannot be blank."]=>
string(56) "Необходимо заполнить «{attribute}»."
["{attribute} contains wrong subnet mask."]=>
string(93) "Значение «{attribute}» содержит неверную маску подсети."
["{attribute} is invalid."]=>
string(48) "Значение «{attribute}» неверно."
["{attribute} is not a valid URL."]=>
string(80) "Значение «{attribute}» не является правильным URL."
["{attribute} is not a valid email address."]=>
string(97) "Значение «{attribute}» не является правильным email адресом."
["{attribute} is not in the allowed range."]=>
string(126) "Значение «{attribute}» не входит в список разрешенных диапазонов адресов."
["{attribute} must be "{requiredValue}"."]=>
string(86) "Значение «{attribute}» должно быть равно «{requiredValue}»."
["{attribute} must be a number."]=>
string(68) "Значение «{attribute}» должно быть числом."
["{attribute} must be a string."]=>
string(70) "Значение «{attribute}» должно быть строкой."
["{attribute} must be a valid IP address."]=>
string(94) "Значение «{attribute}» должно быть правильным IP адресом."
["{attribute} must be an IP address with specified subnet."]=>
string(93) "Значение «{attribute}» должно быть IP адресом с подсетью."
["{attribute} must be an integer."]=>
string(79) "Значение «{attribute}» должно быть целым числом."
["{attribute} must be either "{true}" or "{false}"."]=>
string(96) "Значение «{attribute}» должно быть равно «{true}» или «{false}»."
["{attribute} must be equal to "{compareValueOrAttribute}"."]=>
string(96) "Значение «{attribute}» должно быть равно «{compareValueOrAttribute}»."
["{attribute} must be greater than "{compareValueOrAttribute}"."]=>
string(115) "Значение «{attribute}» должно быть больше значения «{compareValueOrAttribute}»."
["{attribute} must be greater than or equal to "{compareValueOrAttribute}"."]=>
string(133) "Значение «{attribute}» должно быть больше или равно значения «{compareValueOrAttribute}»."
["{attribute} must be less than "{compareValueOrAttribute}"."]=>
string(115) "Значение «{attribute}» должно быть меньше значения «{compareValueOrAttribute}»."
["{attribute} must be less than or equal to "{compareValueOrAttribute}"."]=>
string(133) "Значение «{attribute}» должно быть меньше или равно значения «{compareValueOrAttribute}»."
["{attribute} must be no greater than {max}."]=>
string(76) "Значение «{attribute}» не должно превышать {max}."
["{attribute} must be no less than {min}."]=>
string(79) "Значение «{attribute}» должно быть не меньше {min}."
["{attribute} must not be a subnet."]=>
string(77) "Значение «{attribute}» не должно быть подсетью."
["{attribute} must not be an IPv4 address."]=>
string(80) "Значение «{attribute}» не должно быть IPv4 адресом."
["{attribute} must not be an IPv6 address."]=>
string(80) "Значение «{attribute}» не должно быть IPv6 адресом."
["{attribute} must not be equal to "{compareValueOrAttribute}"."]=>
string(101) "Значение «{attribute}» не должно быть равно «{compareValueOrAttribute}»."
["{attribute} should contain at least {min, number} {min, plural, one{character} other{characters}}."]=>
string(192) "Значение «{attribute}» должно содержать минимум {min, number} {min, plural, one{символ} few{символа} many{символов} other{символа}}."
["{attribute} should contain at most {max, number} {max, plural, one{character} other{characters}}."]=>
string(194) "Значение «{attribute}» должно содержать максимум {max, number} {max, plural, one{символ} few{символа} many{символов} other{символа}}."
["{attribute} should contain {length, number} {length, plural, one{character} other{characters}}."]=>
string(183) "Значение «{attribute}» должно содержать {length, number} {length, plural, one{символ} few{символа} many{символов} other{символа}}."
["{delta, plural, =1{1 day} other{# days}}"]=>
string(79) "{delta, plural, one{# день} few{# дня} many{# дней} other{# дня}}"
["{delta, plural, =1{1 hour} other{# hours}}"]=>
string(83) "{delta, plural, one{# час} few{# часа} many{# часов} other{# часа}}"
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string(1323) "Преимущества радиолечения за границей
Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
Высокий профессионализм. Врачи-радиологи за границей – это профессионалы высокого уровня. Пациент может узнать сведения об опыте и квалификации медика на сайте клиники, в которой он работает.
Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
"
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string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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Использование аппаратуры последнего поколения. Лечение становится более эффективным и безопасным.
Инновационные методики. Врач подбирает тот способ проведения терапии, который даст лучший эффект.
Высокий профессионализм. Врачи-радиологи за границей – это профессионалы высокого уровня. Пациент может узнать сведения об опыте и квалификации медика на сайте клиники, в которой он работает.
Стоимость лучевой терапии за рубежом Цена лучевой терапии за границей зависит от выбранного метода лечения и объема необходимых процедур. Цена лечения в радиологических клиниках за рубежом полностью соответствует его высокой эффективности.
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string(13210) "Более половины случаев заболеваний раком требуют лечения при помощи радиационного облучения. Этот метод используется достаточно давно, его эффективность доказана. Но проблема в том, что радиотерапия, которая была распространена еще десять-пятнадцать лет назад, имеет массу побочных эффектов и порой осложнения после лечения достаточно серьезны. Современная радиотерапия за границей построена на использовании последних инноваций, которые призваны минимизировать вред радиационного излучения для здоровых органов и систем человека. Радиологические клиники за границей оснащены инновационным оборудованием, оно постоянно заменяется более прогрессивным, что способствует более эффективному и щадящему подходу к лечению. Большое внимание уделяется подготовке специалистов: зарубежные радиологи проходят многоступенчатое обучение, перед тем как начать использовать новый вид радиотерапии, врачи стажируются в лучших мировых центрах радиологии. Наиболее продвинутые методики лучевой терапии используются в клиниках США, Израиля, Германии, Австрии, Франции.
Подготовка к радиолечению Прежде чем будет применена лучевая терапия, за границей проводят тщательную подготовку к ней. Выясняется, нет ли противопоказаний к проведению лучевой терапии (крайняя истощенность организма, анемия, острая фаза заболеваний, инфаркт миокарда, туберкулез и так далее). Если гистологический анализ показал, что неоплазия относится к числу тех видов новообразований, которые нечувствительны к излучению, радиотерапию не назначают. Также крайне опасно такое лечение в период беременности: облучение может нанести вред плоду и вызвать серьезные аномалии его развития.
Пациенту проводят диагностические исследования:
Анализы крови
МРТ, КТ
ПЭТ-КТ
Обязательным является компьютерное планирование полей облучения – определение точных границ неоплазии и дозы радиации, которая будет оптимальной для достижения поставленного результата. Для этого используют компьютерное моделирование. Врачи создают 3-D модель неоплазии и программируют направление лучей таким образом, чтобы они нанесли максимальный ущерб раковым клеткам и минимально задели здоровые. Для того, чтобы проверить правильность рассчитанных параметров, радиологи проводят симуляцию облучения. Только после такой серьезной подготовки можно приступать к сеансам радиотерапии.
Современные методы радиотерапии В зарубежных клиниках применяют различные виды радиотерапии:
Предоперационную – с целью уменьшения опухолевой массы и облегчения хирургического удаления новообразования.
Послеоперационную – для ликвидации остаточных раковых клеток, которые не были удалены хирургически.
Лечебную – для полного удаления небольших по размеру новообразований.
Паллиативную – с целью остановки или замедления ракового процесса и облегчения тяжелой симптоматики.
В данный момент в зарубежных клиниках используют такие методы радиотерапии:
Наружная (дистанционная) радиотерапия. Это самый часто применяемый метод, при котором патологические ткани облучаются дистанционно. В настоящее время в зарубежных клиниках для лучевой терапии используют исключительно аппараты нового поколения – линейные ускорители (TrueBeam, Novalis). От предшественников их отличает точность фокусировки лучей (до 0,5 мм), что повышает эффективность процедуры и снижает лучевую нагрузку на здоровые ткани. Поскольку радиация минимально задевает окружающие опухоль ткани, у врачей есть возможность использовать более мощную дозу. Сеанс на новых линейных ускорителях длится порядка 10-15 минут (на старых – от получаса до часа). Порой опухоль имеет сложные границы, ранее было трудно запрограммировать направление лучей так, чтобы они покрыли всю ее поверхность. Сейчас вопрос решен: компьютерная программа в состоянии точно подстроить пучки излучения под индивидуальные очертания неоплазии. Не всякий больной может выдержать сеанс, лежа совершенно неподвижно, ведь даже покашливание или чихание немного изменяет положение тела и может сместить цель облучения. Чтобы не повредить радиацией здоровые ткани, линейный ускоритель снабжен контроллером, который, при малейших микродвижениях, корректирует направление лучей.
Стереотаксическая радиохирургия. Инновационный метод, который применяется тогда, когда нет возможности хирургически удалить опухоль, например, при онкопатологиях головного мозга. Метод позволяет за один-два сеанса уничтожить раковое новообразование мощным зарядом радиации. Процедуру проводят на установке CyberKnife (Кибер нож). Она генерирует до 300 облучающих лучей, которые входят в тело человека под разными углами. Каждый луч имеет невысокую мощность, поэтому, когда он проходит через здоровые органы, лучевая нагрузка на них минимальна. Доза суммируется только там, где все лучи скрещиваются – в области неоплазии. Сочетания высокой эффективности и бережного отношения к здоровым тканям, безболезненность и бескровность позволяют этому методу быть достойной альтернативой хирургическому вмешательству. По данным исследований компании Accuray, эффективность стереотаксической радиохирургии составляет 93%.
Интраоперационная радиотерапия. Врачи выбирают этот метод тогда, когда необходимо по максимуму уничтожить оставшиеся раковые клетки сразу после удаления патоочага. Облучение проходит прямо во время операции: после того, как хирург произвел резекцию опухоли, облучающий элемент может быть введен внутрь полости, в мягкие ткани, возможно применение дистанционной методики.
Брахитерапия. Контактный метод терапии, показавший высокую результативность в лечении рака различного вида. Его суть в том, что радиационные элементы воздействуют на опухоль, располагаясь непосредственно внутри нее или на очень близком расстоянии. Радиационные частички, заключенные в миниатюрные микросферы, помещают в неоплазию или рядом с ней, на постоянной основе или временно. Постепенно радиация высвобождается и воздействует на опухолевую ткань предельно точно, не повреждая здоровую.
SIRT-терапия (селективная внутренняя радиационная терапия) – еще один инновационный метод, показавший свою эффективность в лечении рака и метастазов печени. радиоактивные частицы вводят в кровеносные сосуды, которые снабжают опухоль в печени кровью. В бедренную артерию вводится катетер, он доставляет к печеночной артерии микросферы с радиоактивным веществом. Они блокируют печеночную артерию, перекрывая доступ к неоплазии крови. Радиация, попадая через сосуды в ткань опухоли, вызывает прекращение роста и деления раковых клеток. Максимально прицельное воздействие на опухоль позволяет использовать облучения в 40 раз более мощное, чем при сеансе дистанционной радиотерапии, с минимальный повреждением здоровых тканей.
Таргетная радиотерапия. Метод, который дает возможность избирательно воздействовать только на раковые клетки. В лабораторный условиях создается препарат на основе моноклональных антител и радиационных частиц. Попадая в организм, моноклональные антитела присоединяются только к аномальным клеткам, реагируя на белок на их поверхности. Таким образом, облучаются только раковые клетки, здоровым не наносится вреда."
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*RECURSION*
}
}
}
["country"]=>
NULL
["_events":"yii\base\Component":private]=>
array(0) {
}
["_eventWildcards":"yii\base\Component":private]=>
array(0) {
}
["_behaviors":"yii\base\Component":private]=>
NULL
}
}
["bindParams":protected]=>
array(1) {
["doctorCount"]=>
string(2) "22"
}
["_events":"yii\base\Component":private]=>
array(0) {
}
["_eventWildcards":"yii\base\Component":private]=>
array(0) {
}
["_behaviors":"yii\base\Component":private]=>
NULL
}
}
[1]=>
NULL
}
}
["endPage"]=>
array(1) {
[0]=>
array(2) {
[0]=>
object(Closure)#22 (2) {
["this"]=>
object(app\components\AssetsAutoCompress)#23 (12) {
["enabled"]=>
bool(true)
["jsCompress"]=>
bool(false)
["jsCompressFlaggedComments"]=>
bool(true)
["cssCompress"]=>
bool(true)
["cssFileCompile"]=>
bool(true)
["cssFileCompress"]=>
bool(false)
["cssFileBottom"]=>
bool(false)
["jsFileCompile"]=>
bool(false)
["jsFileCompress"]=>
bool(true)
["_events":"yii\base\Component":private]=>
array(0) {
}
["_eventWildcards":"yii\base\Component":private]=>
array(0) {
}
["_behaviors":"yii\base\Component":private]=>
NULL
}
["parameter"]=>
array(1) {
["$e"]=>
string(10) ""
}
}
[1]=>
NULL
}
}
}
["_eventWildcards":"yii\base\Component":private]=>
array(0) {
}
["_behaviors":"yii\base\Component":private]=>
array(0) {
}
}