Pub Date : 2021-09-08DOI: 10.37748/10.37748/2686-9039-2021-2-3-6
N. Guskova, L. Vladimirova, Elena A. Sycheva, A. A. Morozova, D. A. Rosenko, A. Donskaya, O. Selyutina, A. M. Skopintsev, N. Golomeeva
Cancer is one of the leading causes of death and disability worldwide. Timely diagnosis and the introduction of new effective treatments, including intensive radiation and chemotherapy regimens, have significantly improved survival forecasts in recent years. At the same time, the use of these types of treatment increases the risk of complications, one of which includes chemotoxic cardiopathies. In this regard, timely detection and treatment of complications from the cardiovascular system in patients receiving chemotherapy courses in combination with surgical methods of treatment is important. This paper presents an assessment of the significance of the use of cardiomarkers in the early diagnosis of acute myocardial infarction that developed during chemotherapy in a patient with tongue cancer with a complicated cardiac history. Patient M., 45 years old, was admitted for surgical treatment for cancer of the tongue St. IVA, T4aN1M0, cl. gr. 2. Planned laboratory and instrumental studies were performed. Contraindications for surgical treatment were not identified. A preoperative course of chemotherapy was performed, against the background of which the patient's condition worsened with symptoms of acute cardiopathy. A second ECG was urgently performed, as a result of which an increase in the ST segment in III, aVF was established, as well as a study of the concentration of cardiomarkers: highly sensitive troponin I, N-terminal propeptide of natriuretic hormone, creatine phosphokinase MB, myoglobin, the dynamics of changes in the level of which indicated the development of acute coronary syndrome. The complex application of diagnostic procedures, including the determination of the level of cardiomarkers, made it possible to timely diagnose the development of acute type 1 myocardial infarction in a patient with tongue cancer on the background of chemotherapy. When analyzing the entire array of clinical and laboratory data, the leading initiating factor that played a decisive role in the development of myocardial infarction in this case was, in our opinion, a preoperative course of polychemotherapy with paclitaxel and carboplatin, which have cardiotoxicity. Thus, the category of patients with an initial unfavorable background, due to a common malignant process and the presence of a history of cardiodisfunction, requires more careful preparation for preoperative courses of polychemotherapy, including cardiotropic therapy with mandatory monitoring of the level of the main cardiomarkers. The most significant changes were in the levels of creatine phosphokinase MB, troponin I, and myoglobin, which were recorded in the first hours of myocardial infarction. An association was found between an increase in troponin I concentration and an increase in the ST segment of the electrocardiogram.
{"title":"Changes in the level of cardiomarkers in the development of acute myocardial infarction on the background of chemotherapy of a patient with tongue cancer","authors":"N. Guskova, L. Vladimirova, Elena A. Sycheva, A. A. Morozova, D. A. Rosenko, A. Donskaya, O. Selyutina, A. M. Skopintsev, N. Golomeeva","doi":"10.37748/10.37748/2686-9039-2021-2-3-6","DOIUrl":"https://doi.org/10.37748/10.37748/2686-9039-2021-2-3-6","url":null,"abstract":"Cancer is one of the leading causes of death and disability worldwide. Timely diagnosis and the introduction of new effective treatments, including intensive radiation and chemotherapy regimens, have significantly improved survival forecasts in recent years. At the same time, the use of these types of treatment increases the risk of complications, one of which includes chemotoxic cardiopathies. In this regard, timely detection and treatment of complications from the cardiovascular system in patients receiving chemotherapy courses in combination with surgical methods of treatment is important. This paper presents an assessment of the significance of the use of cardiomarkers in the early diagnosis of acute myocardial infarction that developed during chemotherapy in a patient with tongue cancer with a complicated cardiac history. Patient M., 45 years old, was admitted for surgical treatment for cancer of the tongue St. IVA, T4aN1M0, cl. gr. 2. Planned laboratory and instrumental studies were performed. Contraindications for surgical treatment were not identified. A preoperative course of chemotherapy was performed, against the background of which the patient's condition worsened with symptoms of acute cardiopathy. A second ECG was urgently performed, as a result of which an increase in the ST segment in III, aVF was established, as well as a study of the concentration of cardiomarkers: highly sensitive troponin I, N-terminal propeptide of natriuretic hormone, creatine phosphokinase MB, myoglobin, the dynamics of changes in the level of which indicated the development of acute coronary syndrome. The complex application of diagnostic procedures, including the determination of the level of cardiomarkers, made it possible to timely diagnose the development of acute type 1 myocardial infarction in a patient with tongue cancer on the background of chemotherapy. When analyzing the entire array of clinical and laboratory data, the leading initiating factor that played a decisive role in the development of myocardial infarction in this case was, in our opinion, a preoperative course of polychemotherapy with paclitaxel and carboplatin, which have cardiotoxicity. Thus, the category of patients with an initial unfavorable background, due to a common malignant process and the presence of a history of cardiodisfunction, requires more careful preparation for preoperative courses of polychemotherapy, including cardiotropic therapy with mandatory monitoring of the level of the main cardiomarkers. The most significant changes were in the levels of creatine phosphokinase MB, troponin I, and myoglobin, which were recorded in the first hours of myocardial infarction. An association was found between an increase in troponin I concentration and an increase in the ST segment of the electrocardiogram.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83081901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-20DOI: 10.37748/2686-9039-2021-2-2-6
O. Kit, E. Dzhenkova, E. Mirzoyan, Y. Gevorkyan, A. Sagakyants, N. N. Timoshkina, O. Y. Kaymakchi, D. Kaymakchi, R. E. Tolmakh, A. Dashkov, V. E. Kolesnikov, A. Milakin, S. I. Poluektov
Today, colorectal cancer (CRC) is the third most common cancer and therefore an urgent problem of oncology. Despite all modern diagnostic capabilities, the rates of advanced cases are growing steadily. CRC was proven to be a result of a phased dysplastic change in the colon mucosa, molecular genetic changes that determine the molecular biology of the tumor, its properties, morphology, disease prognosis and response to therapy. The following mechanisms of CRC tumor progression are distinguished: chromosomal instability, microsatellite instability, "methylator" phenotype, and serrated pathway of adenocarcinoma development. Application of molecular and diagnostic methods has become a promising direction in recent years. This led to the development of a molecular genetic classifi cation with 4 CRC subtypes differing not only in their molecular genetic characteristics, but also in clinical course and response to therapy.
{"title":"Molecular genetic classification of colorectal cancer subtypes: current state of the problem","authors":"O. Kit, E. Dzhenkova, E. Mirzoyan, Y. Gevorkyan, A. Sagakyants, N. N. Timoshkina, O. Y. Kaymakchi, D. Kaymakchi, R. E. Tolmakh, A. Dashkov, V. E. Kolesnikov, A. Milakin, S. I. Poluektov","doi":"10.37748/2686-9039-2021-2-2-6","DOIUrl":"https://doi.org/10.37748/2686-9039-2021-2-2-6","url":null,"abstract":"Today, colorectal cancer (CRC) is the third most common cancer and therefore an urgent problem of oncology. Despite all modern diagnostic capabilities, the rates of advanced cases are growing steadily. CRC was proven to be a result of a phased dysplastic change in the colon mucosa, molecular genetic changes that determine the molecular biology of the tumor, its properties, morphology, disease prognosis and response to therapy. The following mechanisms of CRC tumor progression are distinguished: chromosomal instability, microsatellite instability, \"methylator\" phenotype, and serrated pathway of adenocarcinoma development. Application of molecular and diagnostic methods has become a promising direction in recent years. This led to the development of a molecular genetic classifi cation with 4 CRC subtypes differing not only in their molecular genetic characteristics, but also in clinical course and response to therapy.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90431300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-20DOI: 10.37748/2686-9039-2021-2-2-2
P. Svetitskiy
Surgery for advanced cancer of the oral cavity and oropharynx are among the most difficult. This is due to the topographical and anatomical features that limit the operating field and the proximity of the internal carotid artery, which penetrates into the skull without branches. Her injury and bandaging are fraught with lethality. In the postoperative period, due to a violation of the function of swallowing, there is a stagnation of oral fluid in the oral cavity, which pro[1]motes healing by secondary tension. The functions of the oropharynx are impaired: swallowing, chewing, breathing and speech.Purpose of the study. To develop an operation in patients with advanced cancer of the oral cavity and oropharynx, allowing to visualize the area of the tumor with it’s radical removal and postoperative healing without suppuration.Patients and methods. We’ve operated a patient with advanced cancer of the oral cavity and oropharynx with me[1]tastases to the cervical lymph nodes (T4 N1 M0 – IV st.). Cervical lymphodessection and removal of the tumor from the oral cavity and oropharynx was performed according to the method developed at the National Medical Research Centre for Oncology of the Ministry of Health of Russia: the tumor was removed after a preliminary modified mandib-ulotomy. Good visualization allowed for a radical operation, after which a urostoma was formed, which promotes the free flow of oral fluid from the oral cavity, without its stagnation and without suppuration of the tissues. The jaw was restored with two titanium mini-plates.Results. The healing was carried out by primary tension. On the 7th day after the operation, breathing was restored[1]decanulated. On day 20, epithelialization of the wound surface of the oral cavity and oropharynx occurred. The nasoesophageal probe was removed. Plastic orostoma was produced. By this time, the functions of the oropharyngeal region were partially restored: chewing, swallowing, and speech. Discharged home. Remission for more than 2 years.Conclusions. Previously performed modifi ed mandibulotomy in patients with advanced cancer of the oral cavity and oropharynx, allows you to expand the view of the operating field and provide a radical operation. The formed orostoma, preventing suppuration in the oral cavity, accelerates healing with the restoration of functions: chewing, swallowing, breathing and speech.
晚期口腔癌和口咽癌的手术是最困难的。这是由于地形和解剖特征限制了手术范围和颈内动脉的接近性，颈内动脉穿透颅骨而没有分支。她的伤势和包扎都有致命的危险。术后，由于吞咽功能的破坏，口腔内出现口液淤滞，通过二次张力促进口腔愈合。口咽部的功能受损:吞咽、咀嚼、呼吸和说话。研究目的:为晚期口腔和口咽癌患者开发一种手术，使肿瘤区域的根治和术后愈合无化脓可视化。患者和方法。我们为一位患有晚期口腔癌和口咽癌的患者做了手术，他的颈部淋巴结(T4 N1 M0 - IV st.)有5个[1]肿块。根据俄罗斯卫生部国家肿瘤医学研究中心制定的方法进行宫颈淋巴清扫和从口腔和口咽部切除肿瘤:在初步改良的下颌-尿道切开术后切除肿瘤。良好的视觉效果允许进行根治性手术，手术后形成尿口，这促进了口腔液体的自由流动，没有口腔停滞，也没有组织化脓。下颌用两个微型钛板修复。愈合是通过初级张力进行的。术后第7天，呼吸恢复正常。第20天，口腔和口咽创面出现上皮化。取出鼻食管探头。形成塑料口造口。此时，口咽区的功能部分恢复:咀嚼、吞咽和说话。出院回家。缓解超过2年。先前在口腔和口咽部晚期癌症患者中进行的改良下颌切开术，可以扩大手术视野并提供根治性手术。形成的口瘘，防止口腔化脓，加速愈合，恢复功能:咀嚼，吞咽，呼吸和语言。
{"title":"Radical removal of advanced cancer of the oral cavity and oropharynx","authors":"P. Svetitskiy","doi":"10.37748/2686-9039-2021-2-2-2","DOIUrl":"https://doi.org/10.37748/2686-9039-2021-2-2-2","url":null,"abstract":"Surgery for advanced cancer of the oral cavity and oropharynx are among the most difficult. This is due to the topographical and anatomical features that limit the operating field and the proximity of the internal carotid artery, which penetrates into the skull without branches. Her injury and bandaging are fraught with lethality. In the postoperative period, due to a violation of the function of swallowing, there is a stagnation of oral fluid in the oral cavity, which pro[1]motes healing by secondary tension. The functions of the oropharynx are impaired: swallowing, chewing, breathing and speech.Purpose of the study. To develop an operation in patients with advanced cancer of the oral cavity and oropharynx, allowing to visualize the area of the tumor with it’s radical removal and postoperative healing without suppuration.Patients and methods. We’ve operated a patient with advanced cancer of the oral cavity and oropharynx with me[1]tastases to the cervical lymph nodes (T4 N1 M0 – IV st.). Cervical lymphodessection and removal of the tumor from the oral cavity and oropharynx was performed according to the method developed at the National Medical Research Centre for Oncology of the Ministry of Health of Russia: the tumor was removed after a preliminary modified mandib-ulotomy. Good visualization allowed for a radical operation, after which a urostoma was formed, which promotes the free flow of oral fluid from the oral cavity, without its stagnation and without suppuration of the tissues. The jaw was restored with two titanium mini-plates.Results. The healing was carried out by primary tension. On the 7th day after the operation, breathing was restored[1]decanulated. On day 20, epithelialization of the wound surface of the oral cavity and oropharynx occurred. The nasoesophageal probe was removed. Plastic orostoma was produced. By this time, the functions of the oropharyngeal region were partially restored: chewing, swallowing, and speech. Discharged home. Remission for more than 2 years.Conclusions. Previously performed modifi ed mandibulotomy in patients with advanced cancer of the oral cavity and oropharynx, allows you to expand the view of the operating field and provide a radical operation. The formed orostoma, preventing suppuration in the oral cavity, accelerates healing with the restoration of functions: chewing, swallowing, breathing and speech.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"196 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73120771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-20DOI: 10.37748/2686-9039-2021-2-2-5
S. N. Tikhonova, D. A. Rozenko, N. D. Ushakova, N. Popova, A. M. Skopintsev, A. Shulga, I. A. Ten
The article describes a clinical case of surgical treatment of a patient with multiple primary malignant lesions of the lungs (cancer of the left lung, central peribronchial nodular tumor with involvement of the upper lobe and distal parts of the main bronchus; cancer of the right lung, central tumor with involvement of the upper lobar bronchus). Radical treatment became possible due to using the potential of artifi cial gas exchange of both lungs with two devices with fundamentally different ventilation mechanics. The choice of an optimal tactics for the functional correction of the supposed hypoxemia by volumetric and high-frequency pulmonary ventilation allowed avoiding an imbalance in the ventilation/perfusion ratio and preventing the development of life-threatening complications, as well as ensured an adequate gas exchange for the patient during surgical treatment.
{"title":"Optimization of anesthetic tactics in the surgical treatment of multiple primary non-small cell lung cancer","authors":"S. N. Tikhonova, D. A. Rozenko, N. D. Ushakova, N. Popova, A. M. Skopintsev, A. Shulga, I. A. Ten","doi":"10.37748/2686-9039-2021-2-2-5","DOIUrl":"https://doi.org/10.37748/2686-9039-2021-2-2-5","url":null,"abstract":"The article describes a clinical case of surgical treatment of a patient with multiple primary malignant lesions of the lungs (cancer of the left lung, central peribronchial nodular tumor with involvement of the upper lobe and distal parts of the main bronchus; cancer of the right lung, central tumor with involvement of the upper lobar bronchus). Radical treatment became possible due to using the potential of artifi cial gas exchange of both lungs with two devices with fundamentally different ventilation mechanics. The choice of an optimal tactics for the functional correction of the supposed hypoxemia by volumetric and high-frequency pulmonary ventilation allowed avoiding an imbalance in the ventilation/perfusion ratio and preventing the development of life-threatening complications, as well as ensured an adequate gas exchange for the patient during surgical treatment.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80300442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-20DOI: 10.37748/2686-9039-2021-2-2-1
S. Dimitriadi, N. D. Ushakova, A. Velichko, E. Frantsiyants
Purpose of the study. To assess the state of renal function in the application of therapeutic plasmapheresis in order to correct the disorders accompanying the development of preclinical stage of AKI in patients after partial nephrectomy under conditions of warm ischemia.Patients and methods. We examined 119 patients (average aged 57.6±7.8 years) from 2018 to 2019, who underwent open or laparoscopic kidney resection for cancer according to elective indications and with the usage of standard WIT technique within 15-21 minutes. Patients with a high risk of developing a clinical stage of AKI (n=21) were divided into 2 groups: in group I (n=10), patients continued to receive standard nephroprotective therapy, in group II (n=11), 24 hours after surgery, therapeutic plasmapheresis was performed according to the TPE (Therapeutic plasma exchange) protocol. During 7 days after the surgery patients in both groups were monitored daily for the rate of hourly diuresis, serum creatinine, and creatinine GFR. The presence of significant differences in the groups was evaluated using the STATISTICA 12.6 software package and the differences between the samples were considered significant at p<0.05.Results. The development of the clinical stage of AKI in group I was detected in 80.0 % of cases, in group II in 9.0 % of patients (p=0.0019). The rate of diuresis in group II was significantly higher: by more than 2 times by day 3, by 90.0 % on day 4, by 81.4 % on day 5, by 36.8 % on day 6, and by 25.4 % on day 7 (p<0.05). The average increase in creatinine in group I was significantly higher: more than 5 times on day 5 and more than 4 times on day 6 and 7 of the study (p<0.05). GFR in group II was significantly higher on day 3 (65.3 %), day 5 (54 %), day 6 (39.2 %) and day 7 (50 %) (p<0.05).Conclusion. Therapeutic plasmapheresis is highly effective in the correction of renal function disorders after kidney resection under WIT conditions and demonstrates an advantage in reducing the risk of developing a clinical stage of AKI in comparison with preventive measures that include standard nephroprotective infusion therapy.
{"title":"Evaluation of the corrective effect of therapeutic plasmapheresis on the state of renal function in patients after surgical treatment of localized kidney cancer","authors":"S. Dimitriadi, N. D. Ushakova, A. Velichko, E. Frantsiyants","doi":"10.37748/2686-9039-2021-2-2-1","DOIUrl":"https://doi.org/10.37748/2686-9039-2021-2-2-1","url":null,"abstract":"Purpose of the study. To assess the state of renal function in the application of therapeutic plasmapheresis in order to correct the disorders accompanying the development of preclinical stage of AKI in patients after partial nephrectomy under conditions of warm ischemia.Patients and methods. We examined 119 patients (average aged 57.6±7.8 years) from 2018 to 2019, who underwent open or laparoscopic kidney resection for cancer according to elective indications and with the usage of standard WIT technique within 15-21 minutes. Patients with a high risk of developing a clinical stage of AKI (n=21) were divided into 2 groups: in group I (n=10), patients continued to receive standard nephroprotective therapy, in group II (n=11), 24 hours after surgery, therapeutic plasmapheresis was performed according to the TPE (Therapeutic plasma exchange) protocol. During 7 days after the surgery patients in both groups were monitored daily for the rate of hourly diuresis, serum creatinine, and creatinine GFR. The presence of significant differences in the groups was evaluated using the STATISTICA 12.6 software package and the differences between the samples were considered significant at p<0.05.Results. The development of the clinical stage of AKI in group I was detected in 80.0 % of cases, in group II in 9.0 % of patients (p=0.0019). The rate of diuresis in group II was significantly higher: by more than 2 times by day 3, by 90.0 % on day 4, by 81.4 % on day 5, by 36.8 % on day 6, and by 25.4 % on day 7 (p<0.05). The average increase in creatinine in group I was significantly higher: more than 5 times on day 5 and more than 4 times on day 6 and 7 of the study (p<0.05). GFR in group II was significantly higher on day 3 (65.3 %), day 5 (54 %), day 6 (39.2 %) and day 7 (50 %) (p<0.05).Conclusion. Therapeutic plasmapheresis is highly effective in the correction of renal function disorders after kidney resection under WIT conditions and demonstrates an advantage in reducing the risk of developing a clinical stage of AKI in comparison with preventive measures that include standard nephroprotective infusion therapy.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83467627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.37748/2686-9039-2021-2-2-3
I. V. Pustovaya, M. Engibaryan, P. Svetitskiy, I. V. Aedinova, V. L. Volkova, N. A. Chertova, Yulia Ulianova, M. V. Bauzhadze
Relevance. Staged orthopedic treatment was used to improve the quality of life of patients who underwent radical maxillofacial surgeries for cancer.Patients and methods. 197 patients receiving treatment for maxillofacial cancer were observed at the Department of head and neck tumors, National Medical Research Centre for Oncology of the Ministry of Health of Russia, in 1998- 2018. All patients underwent radical surgical treatment resulting in postoperative defects of the upper jaw, soft tissues of the zygomatic- buccal-orbital region, nose, or auricle.Results. Removable obturator prostheses with various supporting and retaining elements were made for 159 (80.7 %) patients. Individual facial prostheses were made for 38 (19.3 %) patients: 17 (44.7 %) – external orbital prostheses, 14 (36.8 %) – external nasal prostheses, 6 (15.8 %) – external zygomatic- buccal-orbital prostheses, 1 (2.7 %) – external auricle prosthesis. Combined prostheses were made for 4 patients– removable upper jaw obturator and nose prosthe[1]sis; removable upper jaw obturator and eye prosthesis. Combined prostheses were fixed to each other using magnets. The results of maxillofacial prosthetics were evaluated according to the aesthetic requirements of the patients and their quality of life. Maxillofacial prostheses allowed a complete restoration of chewing, swallowing, and speaking, restored facial deformation, and improved the appearance of patients.Conclusions. Timely and comprehensive orthopedic treatment of patients with postoperative maxillofacial defects after radical surgeries for malignant tumors takes the main place in the complex of rehabilitation measures. Early elimination of extensive defects is aimed at maximum restoration of oral dysfunctions and appearance preservation. The apparent advantages of maxillofacial prostheses involve improvement of social adaptation and the quality of life of patients, which promotes complete rehabilitation and a return to socially useful activities.
{"title":"Orthopedic treatment in cancer patients with maxillofacial pathology","authors":"I. V. Pustovaya, M. Engibaryan, P. Svetitskiy, I. V. Aedinova, V. L. Volkova, N. A. Chertova, Yulia Ulianova, M. V. Bauzhadze","doi":"10.37748/2686-9039-2021-2-2-3","DOIUrl":"https://doi.org/10.37748/2686-9039-2021-2-2-3","url":null,"abstract":"Relevance. Staged orthopedic treatment was used to improve the quality of life of patients who underwent radical maxillofacial surgeries for cancer.Patients and methods. 197 patients receiving treatment for maxillofacial cancer were observed at the Department of head and neck tumors, National Medical Research Centre for Oncology of the Ministry of Health of Russia, in 1998- 2018. All patients underwent radical surgical treatment resulting in postoperative defects of the upper jaw, soft tissues of the zygomatic- buccal-orbital region, nose, or auricle.Results. Removable obturator prostheses with various supporting and retaining elements were made for 159 (80.7 %) patients. Individual facial prostheses were made for 38 (19.3 %) patients: 17 (44.7 %) – external orbital prostheses, 14 (36.8 %) – external nasal prostheses, 6 (15.8 %) – external zygomatic- buccal-orbital prostheses, 1 (2.7 %) – external auricle prosthesis. Combined prostheses were made for 4 patients– removable upper jaw obturator and nose prosthe[1]sis; removable upper jaw obturator and eye prosthesis. Combined prostheses were fixed to each other using magnets. The results of maxillofacial prosthetics were evaluated according to the aesthetic requirements of the patients and their quality of life. Maxillofacial prostheses allowed a complete restoration of chewing, swallowing, and speaking, restored facial deformation, and improved the appearance of patients.Conclusions. Timely and comprehensive orthopedic treatment of patients with postoperative maxillofacial defects after radical surgeries for malignant tumors takes the main place in the complex of rehabilitation measures. Early elimination of extensive defects is aimed at maximum restoration of oral dysfunctions and appearance preservation. The apparent advantages of maxillofacial prostheses involve improvement of social adaptation and the quality of life of patients, which promotes complete rehabilitation and a return to socially useful activities.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"439 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84780938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.37748/2686-9039-2021-2-2-4
I. Kamaeva, I. Lysenko, Nadezhda V. Nikolaeva, Tatyana F. Pushkareva, E. Kapuza, Yakha S. Gaisultanova, Alexey V. Velichko
With a frequency of 2.2 cases per 100,000 population in Russia, Hodgkin's lymphoma (HL) is one of the most common malignant neoplasms in young people. In connection with the predominant spread of HL among young people, the issue of effective treatment of various forms of HL remains relevant. Currently, 70-90 % of patients with HL who have received standard chemotherapy or chemoradiotherapy have a long period of remission. However, 10 % of patients with progressive course, can`t achieve a response, and 30 % of patients subsequently recur. The standard approach of treating recurrent and/or refractory HL after initial treatment is “salvage therapy” followed by consolidation with high-dose chemotherapy and stem cell transplantation. Although there is a model for treating these patients, recent research has focused on improving the effectiveness and tolerability of rescue therapy. The use of anti- PD-1 drugs opens up new possibilities for the treatment of recurrent/refractory HL. The article describes the results of using checkpoint inhibitors for patients with a history of multi- course chemotherapy. Inhibitors of immune check points were supplemented in the 3rd and subsequent lines of ChT. A clinical case with immunotherapy supplementation in a patient with severe comorbidity is also presented.
{"title":"The use of immunotherapy for the treatment of refractory forms of Hodgkin lymphoma in real clinical practice.","authors":"I. Kamaeva, I. Lysenko, Nadezhda V. Nikolaeva, Tatyana F. Pushkareva, E. Kapuza, Yakha S. Gaisultanova, Alexey V. Velichko","doi":"10.37748/2686-9039-2021-2-2-4","DOIUrl":"https://doi.org/10.37748/2686-9039-2021-2-2-4","url":null,"abstract":"With a frequency of 2.2 cases per 100,000 population in Russia, Hodgkin's lymphoma (HL) is one of the most common malignant neoplasms in young people. In connection with the predominant spread of HL among young people, the issue of effective treatment of various forms of HL remains relevant. Currently, 70-90 % of patients with HL who have received standard chemotherapy or chemoradiotherapy have a long period of remission. However, 10 % of patients with progressive course, can`t achieve a response, and 30 % of patients subsequently recur. The standard approach of treating recurrent and/or refractory HL after initial treatment is “salvage therapy” followed by consolidation with high-dose chemotherapy and stem cell transplantation. Although there is a model for treating these patients, recent research has focused on improving the effectiveness and tolerability of rescue therapy. The use of anti- PD-1 drugs opens up new possibilities for the treatment of recurrent/refractory HL. The article describes the results of using checkpoint inhibitors for patients with a history of multi- course chemotherapy. Inhibitors of immune check points were supplemented in the 3rd and subsequent lines of ChT. A clinical case with immunotherapy supplementation in a patient with severe comorbidity is also presented.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76114594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-29DOI: 10.37748/2686-9039-2021-2-1-3
O. Kit, Yulia Fomenko, N. Karnaukhov, T. Lapteva, M. Voloshin, G. Y. Vakulenko, S. Z. Bosenko, I. A. Suhar, K. S. Eremin, G. V. Kaminskij, M. Kuznecova
Purpose of the study. Demonstrate the possibilities of statistical analysis of the digital archive at pathological department (PD). To conduct internal quality control of the coding of malignant tumors according to the ICD-O-3 system of pathology reports using the example of gastric cancer (GC).Materials and methods. We retrospectively analyzed the digital archive of 368,157 pathology reports of the National Medical Research Centre for Oncology of the Ministry of Health of Russia from 2000 to 2019. For the study, 4,857 pathology reports of patients operated for gastric malignancies (ICD-X codes: C16.0 – C16.9) were selected for the period from 2000 to 2019.Results. The analysis of 368,157 protocols of the digital archive of PD revealed 4,614 malignant epithelial tumors of the stomach: tubular adenocarcinoma – 2,958, signet ring cell carcinoma – 791, undifferentiated cancer – 565, mucinous adenocarcinoma – 210, neuroendocrine neoplasia – 90. A significant increase in the ICD-O codes for "adenocarcinoma NOS" was found in 2018 and 2019. The pathology reports for these 2 years were reviewed by an independent pathologist and changes were made to the ICD-O codes according to the WHO classification digestive system tumors 2019. The adenocarcinoma NOS (8140/3) was replaced by the codes: tubular adenocarcinoma (ICD-O: 8211/3) – 41%, papillary adenocarcinoma (8260/3) – 9% and adenocarcinoma with mixed subtypes (8255/3) – 29%.Conclusion. The study, based on analysis of coding ICD-O stomach MN demonstrated the importance of digital archive at the PD, as a tool for rapid static analysis pathology reports and quality control of coding. The coding system can be the basis for large multicenter studies in oncology. Therefore, it is important to control the quality of coding of the pathology reports and to timely update the codes when new pathological classifications are released.
{"title":"Using the digital archive of pathological reports of stomach cancer as internal quality control of coding according to the ICD-O system","authors":"O. Kit, Yulia Fomenko, N. Karnaukhov, T. Lapteva, M. Voloshin, G. Y. Vakulenko, S. Z. Bosenko, I. A. Suhar, K. S. Eremin, G. V. Kaminskij, M. Kuznecova","doi":"10.37748/2686-9039-2021-2-1-3","DOIUrl":"https://doi.org/10.37748/2686-9039-2021-2-1-3","url":null,"abstract":"Purpose of the study. Demonstrate the possibilities of statistical analysis of the digital archive at pathological department (PD). To conduct internal quality control of the coding of malignant tumors according to the ICD-O-3 system of pathology reports using the example of gastric cancer (GC).Materials and methods. We retrospectively analyzed the digital archive of 368,157 pathology reports of the National Medical Research Centre for Oncology of the Ministry of Health of Russia from 2000 to 2019. For the study, 4,857 pathology reports of patients operated for gastric malignancies (ICD-X codes: C16.0 – C16.9) were selected for the period from 2000 to 2019.Results. The analysis of 368,157 protocols of the digital archive of PD revealed 4,614 malignant epithelial tumors of the stomach: tubular adenocarcinoma – 2,958, signet ring cell carcinoma – 791, undifferentiated cancer – 565, mucinous adenocarcinoma – 210, neuroendocrine neoplasia – 90. A significant increase in the ICD-O codes for \"adenocarcinoma NOS\" was found in 2018 and 2019. The pathology reports for these 2 years were reviewed by an independent pathologist and changes were made to the ICD-O codes according to the WHO classification digestive system tumors 2019. The adenocarcinoma NOS (8140/3) was replaced by the codes: tubular adenocarcinoma (ICD-O: 8211/3) – 41%, papillary adenocarcinoma (8260/3) – 9% and adenocarcinoma with mixed subtypes (8255/3) – 29%.Conclusion. The study, based on analysis of coding ICD-O stomach MN demonstrated the importance of digital archive at the PD, as a tool for rapid static analysis pathology reports and quality control of coding. The coding system can be the basis for large multicenter studies in oncology. Therefore, it is important to control the quality of coding of the pathology reports and to timely update the codes when new pathological classifications are released.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"105 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83635886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-29DOI: 10.37748/2686-9039-2021-2-1-5
Yuriy A. Gevorkyan, N. Soldatkina, V. E. Kolesnikov, D. Kharagezov, A. Dashkov, S. I. Poluektov, N. Samoylenko
Benign and malignant tumors are the most common diseases of the rectum and tend to grow. Various techniques have been developed for the treatment of rectal tumors: endoscopic electroexcision through a colonoscope, transanal removal of tumors, and transabdominal removal. The use of all these methods made it possible to determine their advantages and indications, as well as limitations and disadvantages. Technical advances in modern oncology resulted in developing a method for transanal tumor removal with a number of advantages: radical surgery, adequacy, and functionality. This technique can be used in benign and malignant rectal tumors. One of its main advantages involves a small number of postoperative complications, while intra- operative complications such as penetration into the free abdominal cavity during transanal endoscopic resection of the rectum are quite rare. It is also important that the method of transanal endoscopic resection of the rectum also has good oncological and functional results (according to various studies). We present a clinical case of penetration into the free abdominal cavity during transanal endoscopic rectal resection for adenoma. This case is also interesting in that the patient also had another complication – postoperative bleeding from the rectum, which required surgical intervention, also with the use of a minimally invasive approach.This clinical observation demonstrates successful suturing of penetrating openings into the abdominal cavity arising during transanal endoscopic removal of rectal tumors with the upper pole located above the pelvic peritoneum and effective minimally invasive tactics in the development of postoperative bleeding.
{"title":"Penetration into free abdominal cavity during transanal endoscopic rectal resection for adenoma","authors":"Yuriy A. Gevorkyan, N. Soldatkina, V. E. Kolesnikov, D. Kharagezov, A. Dashkov, S. I. Poluektov, N. Samoylenko","doi":"10.37748/2686-9039-2021-2-1-5","DOIUrl":"https://doi.org/10.37748/2686-9039-2021-2-1-5","url":null,"abstract":"Benign and malignant tumors are the most common diseases of the rectum and tend to grow. Various techniques have been developed for the treatment of rectal tumors: endoscopic electroexcision through a colonoscope, transanal removal of tumors, and transabdominal removal. The use of all these methods made it possible to determine their advantages and indications, as well as limitations and disadvantages. Technical advances in modern oncology resulted in developing a method for transanal tumor removal with a number of advantages: radical surgery, adequacy, and functionality. This technique can be used in benign and malignant rectal tumors. One of its main advantages involves a small number of postoperative complications, while intra- operative complications such as penetration into the free abdominal cavity during transanal endoscopic resection of the rectum are quite rare. It is also important that the method of transanal endoscopic resection of the rectum also has good oncological and functional results (according to various studies). We present a clinical case of penetration into the free abdominal cavity during transanal endoscopic rectal resection for adenoma. This case is also interesting in that the patient also had another complication – postoperative bleeding from the rectum, which required surgical intervention, also with the use of a minimally invasive approach.This clinical observation demonstrates successful suturing of penetrating openings into the abdominal cavity arising during transanal endoscopic removal of rectal tumors with the upper pole located above the pelvic peritoneum and effective minimally invasive tactics in the development of postoperative bleeding.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80629192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.37748/2686-9039-2021-2-1-4
L. Vladimirova, A. E. Storozhakova, E. A. Kalabanova, P. N. Meshcheryakov, S. Oskin, S. N. Kabanov, N. Samaneva, Y. V. Svetitskaya, A. V. Tishina
Lung cancer is among the most common malignant diseases in Russia. In 80–90%, its morphological type is nonsmall cell lung cancer. Stage IV primary advanced lung cancer is diagnosed in 41% of patients. Median overall survival in stage IV patients receiving chemotherapy is 7–12 months. Treatment for stage IV lung adenocarcinoma is based on predictive and prognostic factors. Chemotherapy, chemoimmunotherapy or immunotherapy is recommended in the absence of driver mutations in the EGFR (exons 19 and 21) and BRAF genes, ALK and ROS1 translocations.Platinum- based regimens are preferred as the fi rst-line chemotherapy. Stabilization, partial or complete response after 4–6 chemotherapy cycles allow for maintenance therapy with pemetrexed to increase progression-free survival and overall survival.Purpose of the study. Using a real clinical case, to confirm the efficacy of pemetrexed in the treatment for stage IV lung adenocarcinoma in the second-line therapy in combination with platinum- based agents and in a maintenance therapy.A clinical case of a patient with central cancer of the lower lobe of the right lung St IV (cT3N2M1) is presented; the first treatment stage involved 3 cycles of the fi rst-line polychemotherapy (paclitaxel 175 mg/m² intravenously on day 1, carboplatin AUC 5 intravenously on day 1, every 3 weeks), and 6 cycles of the second-line polychemotherapy (pemetrexed 500 mg/m2 intravenously on day 1, cisplatin 75 mg/m² intravenously on day 1 of the 21-day cycle). Stabilization of the disease was achieves, and 20 cycles of maintenance therapy with pemetrexed followed; the achieved effect persisted and was confirmed by spiral X-ray computed tomography every 3 months. The objective effect of anticancer therapy was assessed according to the RECIST 1.1 criteria. It took 20 months from the beginning of the second-line anticancer medical therapy to progression, and 16 months from the start of maintenance pemetrexed to progression. The safety profile was satisfactory, and the ECOG performance status 0 maintained. Only one adverse effect, degree I general weakness, was noted, which did not have a negative impact on the patient's quality of life.
肺癌是俄罗斯最常见的恶性疾病之一。80-90%为非小细胞肺癌。41%的患者被诊断为IV期原发性晚期肺癌。接受化疗的IV期患者的中位总生存期为7-12个月。IV期肺腺癌的治疗是基于预测和预后因素。在EGFR(外显子19和21)和BRAF基因、ALK和ROS1易位没有驱动突变的情况下，推荐化疗、化学免疫治疗或免疫治疗。以铂为基础的方案是首选的一线化疗方案。4-6个化疗周期后的稳定、部分或完全缓解允许培美曲塞维持治疗以增加无进展生存期和总生存期。研究目的:通过一个真实的临床病例，证实培美曲塞在与铂类药物联合二线治疗和维持治疗中治疗IV期肺腺癌的疗效。临床病例1例患者与右肺下叶中心癌St IV (cT3N2M1)提出;第一个治疗阶段包括3个周期的一线多化疗(第1天紫杉醇175 mg/m²静脉注射，第1天卡铂AUC 5静脉注射，每3周一次)和6个周期的二线多化疗(第1天培美曲塞500 mg/m²静脉注射，顺铂75 mg/m²静脉注射，21天周期的第1天)。病情得到稳定，随后用培美曲塞进行20个周期的维持治疗;所取得的效果持续存在，并每3个月通过螺旋x线计算机断层扫描证实。根据RECIST 1.1标准评价抗癌治疗的客观效果。从开始接受二线抗癌药物治疗到进展用时20个月，从开始使用培美曲塞维持治疗到进展用时16个月。安全概况令人满意，ECOG性能状态保持0。只有一个不良反应，I度全身无力，被注意到，这没有对患者的生活质量产生负面影响。
{"title":"Experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinoma","authors":"L. Vladimirova, A. E. Storozhakova, E. A. Kalabanova, P. N. Meshcheryakov, S. Oskin, S. N. Kabanov, N. Samaneva, Y. V. Svetitskaya, A. V. Tishina","doi":"10.37748/2686-9039-2021-2-1-4","DOIUrl":"https://doi.org/10.37748/2686-9039-2021-2-1-4","url":null,"abstract":"Lung cancer is among the most common malignant diseases in Russia. In 80–90%, its morphological type is nonsmall cell lung cancer. Stage IV primary advanced lung cancer is diagnosed in 41% of patients. Median overall survival in stage IV patients receiving chemotherapy is 7–12 months. Treatment for stage IV lung adenocarcinoma is based on predictive and prognostic factors. Chemotherapy, chemoimmunotherapy or immunotherapy is recommended in the absence of driver mutations in the EGFR (exons 19 and 21) and BRAF genes, ALK and ROS1 translocations.Platinum- based regimens are preferred as the fi rst-line chemotherapy. Stabilization, partial or complete response after 4–6 chemotherapy cycles allow for maintenance therapy with pemetrexed to increase progression-free survival and overall survival.Purpose of the study. Using a real clinical case, to confirm the efficacy of pemetrexed in the treatment for stage IV lung adenocarcinoma in the second-line therapy in combination with platinum- based agents and in a maintenance therapy.A clinical case of a patient with central cancer of the lower lobe of the right lung St IV (cT3N2M1) is presented; the first treatment stage involved 3 cycles of the fi rst-line polychemotherapy (paclitaxel 175 mg/m² intravenously on day 1, carboplatin AUC 5 intravenously on day 1, every 3 weeks), and 6 cycles of the second-line polychemotherapy (pemetrexed 500 mg/m2 intravenously on day 1, cisplatin 75 mg/m² intravenously on day 1 of the 21-day cycle). Stabilization of the disease was achieves, and 20 cycles of maintenance therapy with pemetrexed followed; the achieved effect persisted and was confirmed by spiral X-ray computed tomography every 3 months. The objective effect of anticancer therapy was assessed according to the RECIST 1.1 criteria. It took 20 months from the beginning of the second-line anticancer medical therapy to progression, and 16 months from the start of maintenance pemetrexed to progression. The safety profile was satisfactory, and the ECOG performance status 0 maintained. Only one adverse effect, degree I general weakness, was noted, which did not have a negative impact on the patient's quality of life.","PeriodicalId":22147,"journal":{"name":"South Russian Journal of Cancer","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84484745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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