Pub Date : 2021-04-24DOI: 10.17650/2222-1468-2021-11-1-51-72
A. Polyakov, A. Gevorkov, A. Stepanova
Squamous cell carcinoma (SCC) is the second most common skin cancer after basal cell carcinoma. Usually, antitumor treatment is sufficiently effective: recovery rate is about 90 %. Primary SCC is characterized by variable growth rate, as well as by involvement of regional lymph nodes (from 1 % for well differentiated tumors to 10 % for poorly differentiated tumors, size >3 cm and /or invasion depth >4 mm). In case of SCC development near post-burn scar, the rate of regional metastasis is 10-30 %. A relatively small possibility of distant metastasis also exists, with overall mortality of 2-3 %. In SCC of the head and neck, both hematogenic and perineural advancement into the CNS are possible. Total rate of local recurrences is 25 %. The main factors of local and regional recurrences are location (head and neck), size (tumor diameter >2 cm), invasion depth (>4 mm), tumor differentiation, perineural involvement, patient's immune status and previous treatment. Tumors in areas that weren»t subjected to solar radiation and tumors in the areas of pervious irradiation, thermal damage, scarring or chronic ulcers are more prone to recurrences and metastasis. Poorly differentiated and anaplastic SCC is more likely to metastasize compared to well differentiated tumors. Medially located SCC is the area of the face mask and lip is more prone to neural invasion. Multidisciplinary approach with involvement of all specialists in antitumor treatment is necessary for development of treatment tactics.
{"title":"Current strategy of squamous cell carcinoma diagnosis and treatment","authors":"A. Polyakov, A. Gevorkov, A. Stepanova","doi":"10.17650/2222-1468-2021-11-1-51-72","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-1-51-72","url":null,"abstract":"Squamous cell carcinoma (SCC) is the second most common skin cancer after basal cell carcinoma. Usually, antitumor treatment is sufficiently effective: recovery rate is about 90 %. Primary SCC is characterized by variable growth rate, as well as by involvement of regional lymph nodes (from 1 % for well differentiated tumors to 10 % for poorly differentiated tumors, size >3 cm and /or invasion depth >4 mm). In case of SCC development near post-burn scar, the rate of regional metastasis is 10-30 %. A relatively small possibility of distant metastasis also exists, with overall mortality of 2-3 %. In SCC of the head and neck, both hematogenic and perineural advancement into the CNS are possible. Total rate of local recurrences is 25 %. The main factors of local and regional recurrences are location (head and neck), size (tumor diameter >2 cm), invasion depth (>4 mm), tumor differentiation, perineural involvement, patient's immune status and previous treatment. Tumors in areas that weren»t subjected to solar radiation and tumors in the areas of pervious irradiation, thermal damage, scarring or chronic ulcers are more prone to recurrences and metastasis. Poorly differentiated and anaplastic SCC is more likely to metastasize compared to well differentiated tumors. Medially located SCC is the area of the face mask and lip is more prone to neural invasion. Multidisciplinary approach with involvement of all specialists in antitumor treatment is necessary for development of treatment tactics.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"11 1","pages":"51-72"},"PeriodicalIF":0.0,"publicationDate":"2021-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67785421","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 : 2021-04-24DOI: 10.17650/2222-1468-2021-11-1-78-85
I. Plaksa, M. R. Savchuk, N. Shved, N. Savelov, D. Khmelkova, А. A. Isaev, R. Deev
The study objective is to analyze the mutation profile of the tall cell variant (TCV) of papillary thyroid carcinoma (PTC).Materials and methods. The main inclusion criteria according to the WHO classification (2017) was PTC composed of at least 30 % of tall cells. Genetic examination was conducted using the FoundationOne CDx assay (USA) with median depth of coverage of >500x. This study included 5 patients (1 man and 4 women) with a mean age of 52.6 years (range: 48-56 years). The tumor size varied between 0.4 x 0.5 cm and 11.0 x 9.0 cm. All patients have undergone surgical treatment: hemithyroidectomy for patient No. 1 with a small tumor (pT1b); thyroidectomy for patient No. 2 (pT3b); extensive thyroidectomy with the removal of paratracheal tissue for patients No. 3, 4, and 5 (No. 3 - pT3bN0; No. 4 - pT3bN1b; No. 5 - pT3bN1b). Three out of the five patients also had adenomatous goiter. The mean follow-up time was 3.4 to 5.2 years.Results. Tumors in all patients were characterized by low mutational load (0 to 4 mutations per 1 million nucleotides (megabase)) and no microsatellite instability. All study participants were found to have p.V600E mutation in the BRAF gene; two patients had c.-124C>T mutation in the promoter region of the TERT gene. All patients carried mutations with unknown clinical significance: p.V562I in the EPHB1 gene (in 2 patients); mutations in the genes AR, CREBBP, EP300, ERCC4, FLT1, IKBKE, JAK2, MAF, MLL2, MST1R, MYC, MYCL1, NTRK2, TSC2 (each mutation registered in one patient). One individual with the largest tumor and the most aggressive disease was found to have amplifications of the BTG2, MAP3K1, SMAD2, and TBX3 genes.Conclusion. In 5 patients analyzed in this study, the mutation profile of TCV PTC was characterized by low mutational load, no microsatellite instability, and presence of p.V600E mutation in the BRAF gene in all cases. Some patients also had c.-124C>T mutation in the TERT gene and p.V562I mutation in the EPHB1 gene.
{"title":"Mutation profile of the tall cell variant of papillary thyroid carcinoma: analysis of 5 cases using wide-panel next-generation sequencing","authors":"I. Plaksa, M. R. Savchuk, N. Shved, N. Savelov, D. Khmelkova, А. A. Isaev, R. Deev","doi":"10.17650/2222-1468-2021-11-1-78-85","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-1-78-85","url":null,"abstract":"The study objective is to analyze the mutation profile of the tall cell variant (TCV) of papillary thyroid carcinoma (PTC).Materials and methods. The main inclusion criteria according to the WHO classification (2017) was PTC composed of at least 30 % of tall cells. Genetic examination was conducted using the FoundationOne CDx assay (USA) with median depth of coverage of >500x. This study included 5 patients (1 man and 4 women) with a mean age of 52.6 years (range: 48-56 years). The tumor size varied between 0.4 x 0.5 cm and 11.0 x 9.0 cm. All patients have undergone surgical treatment: hemithyroidectomy for patient No. 1 with a small tumor (pT1b); thyroidectomy for patient No. 2 (pT3b); extensive thyroidectomy with the removal of paratracheal tissue for patients No. 3, 4, and 5 (No. 3 - pT3bN0; No. 4 - pT3bN1b; No. 5 - pT3bN1b). Three out of the five patients also had adenomatous goiter. The mean follow-up time was 3.4 to 5.2 years.Results. Tumors in all patients were characterized by low mutational load (0 to 4 mutations per 1 million nucleotides (megabase)) and no microsatellite instability. All study participants were found to have p.V600E mutation in the BRAF gene; two patients had c.-124C>T mutation in the promoter region of the TERT gene. All patients carried mutations with unknown clinical significance: p.V562I in the EPHB1 gene (in 2 patients); mutations in the genes AR, CREBBP, EP300, ERCC4, FLT1, IKBKE, JAK2, MAF, MLL2, MST1R, MYC, MYCL1, NTRK2, TSC2 (each mutation registered in one patient). One individual with the largest tumor and the most aggressive disease was found to have amplifications of the BTG2, MAP3K1, SMAD2, and TBX3 genes.Conclusion. In 5 patients analyzed in this study, the mutation profile of TCV PTC was characterized by low mutational load, no microsatellite instability, and presence of p.V600E mutation in the BRAF gene in all cases. Some patients also had c.-124C>T mutation in the TERT gene and p.V562I mutation in the EPHB1 gene.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"11 1","pages":"78-85"},"PeriodicalIF":0.0,"publicationDate":"2021-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67786331","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 : 2021-01-16DOI: 10.17650/2222-1468-2020-10-4-16-24
T. Geliashvili, A. Vazhenin, T. P. Berezovskaya, E. Vasilieva, N. Afanasieva, V. Krylov, P. I. Garbuzov
The study objective is to evaluate value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (PET-CT) and whole-body scintigraphy (131I-WBS) performed during the first course of radioiodine therapy for its ability to detect persistence metastatic foci and for its role in the management of differentiated thyroid cancer patients.Materials and methods. Forty patients with DTC underwent both post-therapeutic 131I-WBS and PET-CT. PET-CT performed on a positron emission tomograph combined with a 16-slice computer tomograph. Post-therapeutic 131I-WBS performed during radioiodine therapy on the single-detector gamma camera.Results. Sensitivity in detecting of the tumor persistence for PET-CT was 84 %, for post-therapeutic 131I-WBS 66 % (р >0.05). In 17 (42.5 %) patients additional PET-CT foci were found that negative on 131I-WBS, including 11 (27.5 %) cases of distant metastases. Fifteen percent of patients had metastatic foci visualized only on 131I-WBS, including 4 (10 %) cases of distant metastases. In 17 (44 %) patients tumor foci were identified by both methods. A high pre-ablative level of stimulated thyroglobulin was the only independent predictor of the presence of PET-CTpositive metastatic foci (p = 0.001).Conclusion. 18F-fluorodeoxyglucose PET-CT can be recommended during the first radioiodine therapy in differentiated thyroid cancer patients with a high risk progression group, as well as with suspected the tumor persistence in case of a high pre-ablation thyroglobulin level, to complete staging, improve the quality of management and ongoing risk stratification.
{"title":"Value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in staging of patients with differentiated thyroid cancer after thyroidectomy during the first course of radioiodine therapy","authors":"T. Geliashvili, A. Vazhenin, T. P. Berezovskaya, E. Vasilieva, N. Afanasieva, V. Krylov, P. I. Garbuzov","doi":"10.17650/2222-1468-2020-10-4-16-24","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-4-16-24","url":null,"abstract":"The study objective is to evaluate value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (PET-CT) and whole-body scintigraphy (131I-WBS) performed during the first course of radioiodine therapy for its ability to detect persistence metastatic foci and for its role in the management of differentiated thyroid cancer patients.Materials and methods. Forty patients with DTC underwent both post-therapeutic 131I-WBS and PET-CT. PET-CT performed on a positron emission tomograph combined with a 16-slice computer tomograph. Post-therapeutic 131I-WBS performed during radioiodine therapy on the single-detector gamma camera.Results. Sensitivity in detecting of the tumor persistence for PET-CT was 84 %, for post-therapeutic 131I-WBS 66 % (р >0.05). In 17 (42.5 %) patients additional PET-CT foci were found that negative on 131I-WBS, including 11 (27.5 %) cases of distant metastases. Fifteen percent of patients had metastatic foci visualized only on 131I-WBS, including 4 (10 %) cases of distant metastases. In 17 (44 %) patients tumor foci were identified by both methods. A high pre-ablative level of stimulated thyroglobulin was the only independent predictor of the presence of PET-CTpositive metastatic foci (p = 0.001).Conclusion. 18F-fluorodeoxyglucose PET-CT can be recommended during the first radioiodine therapy in differentiated thyroid cancer patients with a high risk progression group, as well as with suspected the tumor persistence in case of a high pre-ablation thyroglobulin level, to complete staging, improve the quality of management and ongoing risk stratification.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67785245","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 : 2021-01-16DOI: 10.17650/2222-1468-2020-10-4-91-97
R. V. Lutovinin, V. Oshchepkov, Yu. A. Shubina, V. Kokareva
Introduction. Surgery is frequently preferable to therapy as it yields longer overall and recurrence-free survival. But surgery of locally advanced tumors of the oral cavity can not always guarantee preservation of oral functions. In the EORTC 24971 and RTOG 90-03 trials, effectiveness of conventional radiotherapy was demonstrated. Addition of brachytherapy allowed to double recurrence-free and overall survival. Implementation of proton therapy increased treatment safety. However, high cost of modern technology for radiotherapy limits its accessibility. Intra-arterial chemotherapy is characterized by lower toxicity. Additionally, it allows to create a pool for the 1st cycle of systemic circulation directly in the tumor and neighboring tissues, and a significant portion of the drug enters the draining lymph node replicating lymphogenic metastasis.The objective was to present a clinical case of successful treatment of inoperable squamous-cell carcinoma of the oropharynx using intra-arterial chemoradiotherapy.Clinical case. A patient sought medical help at the multidisciplinary clinical medical center “Medical City” where combination treatment was chosen: a course of chemoradiation therapy using an original approach combining external beam 3D-conformal radiotherapy and intraarterial chemotherapy. According to control computed tomography data, dynamics was described as partial response: 30 % reduction in marker lesions. The patient did not have any complaints and evaluated their quality of life as high which corresponded to the testing results.Conclusion. We have demonstrated benefits of intra-arterial chemoradiation therapy: low toxicity allows patients to receive a full course of radiotherapy without breaks and achieve high functional results. Considering palliative status of the patient, we did not aim to increase recurrence-free period but the objective of ensuring satisfactory quality of life was achieved. New, more physiological regimens of intra-arterial infusion will improve pharmacokinetic profile of chemotherapeutic drugs and will allow to achieve positive results.
{"title":"Palliative intraarterial chemoradiotherapy as a method of choice in the treatment of unresectable oropharyngeal tumors: a clinical case","authors":"R. V. Lutovinin, V. Oshchepkov, Yu. A. Shubina, V. Kokareva","doi":"10.17650/2222-1468-2020-10-4-91-97","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-4-91-97","url":null,"abstract":"Introduction. Surgery is frequently preferable to therapy as it yields longer overall and recurrence-free survival. But surgery of locally advanced tumors of the oral cavity can not always guarantee preservation of oral functions. In the EORTC 24971 and RTOG 90-03 trials, effectiveness of conventional radiotherapy was demonstrated. Addition of brachytherapy allowed to double recurrence-free and overall survival. Implementation of proton therapy increased treatment safety. However, high cost of modern technology for radiotherapy limits its accessibility. Intra-arterial chemotherapy is characterized by lower toxicity. Additionally, it allows to create a pool for the 1st cycle of systemic circulation directly in the tumor and neighboring tissues, and a significant portion of the drug enters the draining lymph node replicating lymphogenic metastasis.The objective was to present a clinical case of successful treatment of inoperable squamous-cell carcinoma of the oropharynx using intra-arterial chemoradiotherapy.Clinical case. A patient sought medical help at the multidisciplinary clinical medical center “Medical City” where combination treatment was chosen: a course of chemoradiation therapy using an original approach combining external beam 3D-conformal radiotherapy and intraarterial chemotherapy. According to control computed tomography data, dynamics was described as partial response: 30 % reduction in marker lesions. The patient did not have any complaints and evaluated their quality of life as high which corresponded to the testing results.Conclusion. We have demonstrated benefits of intra-arterial chemoradiation therapy: low toxicity allows patients to receive a full course of radiotherapy without breaks and achieve high functional results. Considering palliative status of the patient, we did not aim to increase recurrence-free period but the objective of ensuring satisfactory quality of life was achieved. New, more physiological regimens of intra-arterial infusion will improve pharmacokinetic profile of chemotherapeutic drugs and will allow to achieve positive results.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67785312","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 : 2021-01-16DOI: 10.17650/2222-1468-2020-10-4-44-49
F. S. Sevryukov, E. Borodavina, Р. А. Isaev, V. Polkin, А. А. Ilyin, S. Vasilkov, Yury Panaseykin, D. N. Derbugov, S. A. Ivanov, S. Podvyaznikov, А. Kaprin
Dermal toxicity of anti-cancer drugs apparent in patients with thyroid cancer. This side effect appears, in particular, in relation to increased administration of targeted anti-cancer treatment, especially tyrosinkinase inhibitors, towards various receptors of growth factors which are applied in the ethiopathogenesis of a tumor cell. Our article focuses on the dermatotoxity, designated also as skin reaction, which most frequently occurs in patients treated by tyrosinkinase inhibitors – sorafenib, vandetonib, cabozantinib and lenvantinib. High prevalence of dermatotoxity, reported by patients, treated with these drugs underscores the need for greater understanding of the pathogenesis and management of this syndrome.
{"title":"Side skin reactions of multikinase inhibitors in treatment of thyroid cancer","authors":"F. S. Sevryukov, E. Borodavina, Р. А. Isaev, V. Polkin, А. А. Ilyin, S. Vasilkov, Yury Panaseykin, D. N. Derbugov, S. A. Ivanov, S. Podvyaznikov, А. Kaprin","doi":"10.17650/2222-1468-2020-10-4-44-49","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-4-44-49","url":null,"abstract":"Dermal toxicity of anti-cancer drugs apparent in patients with thyroid cancer. This side effect appears, in particular, in relation to increased administration of targeted anti-cancer treatment, especially tyrosinkinase inhibitors, towards various receptors of growth factors which are applied in the ethiopathogenesis of a tumor cell. Our article focuses on the dermatotoxity, designated also as skin reaction, which most frequently occurs in patients treated by tyrosinkinase inhibitors – sorafenib, vandetonib, cabozantinib and lenvantinib. High prevalence of dermatotoxity, reported by patients, treated with these drugs underscores the need for greater understanding of the pathogenesis and management of this syndrome.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67785322","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 : 2021-01-16DOI: 10.17650/2222-1468-2020-10-4-60-73
A. Gevorkov, A. Boyko, L. Bolotina, S. Shashkov, G. Abuzarova, R. R. Sarmanaeva
The study objective is to improve quality of life in patients with oropharyngeal squamous-cell carcinoma during chemo/bioradiation therapy and at early stages after its completion which allows to perform the full extent of radiation within optimal treatment period.Materials and methods. A retrospective analysis of data on 196 patients who underwent chemoradiation therapy between 2005 and 2016 was performed. The results were used to develop and implement a program of support for chemo/bioradiotherapy. The program was characterized by: 1. use of Russian hydrogel materials for local delivery of antibiotics and wound-healing, anesthetizing, anti-inflammatory medications; 2. new regimens of pain relief with differentiated pathogenetic approach and use of modern transdermal long-acting forms; 3. nutritional support at every treatment stage; 4. assurance of compliancy. To evaluate the program, prospective randomized controlled study was performed between January of 2017 and March of 2019 including 60 patients.Results. Mucositis and dermatitis severity and changes in physical state associated with them, progression and duration of radiation did not significantly differ in the two groups. Use of the support program allowed to control adverse effects and to perform chemoradiotherapy to the full extent, at optimal time and with satisfactory quality of life.Conclusion. The program of support of chemo/bioradiotherapy in combination with psychological support is effective both form the point of view of optimization of treatment and rehabilitation times and from the point of view of maintenance of high quality of life in patients.
{"title":"Results of implementation of a program of individual support of chemoradiation therapy in patients with head and neck tumors","authors":"A. Gevorkov, A. Boyko, L. Bolotina, S. Shashkov, G. Abuzarova, R. R. Sarmanaeva","doi":"10.17650/2222-1468-2020-10-4-60-73","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-4-60-73","url":null,"abstract":"The study objective is to improve quality of life in patients with oropharyngeal squamous-cell carcinoma during chemo/bioradiation therapy and at early stages after its completion which allows to perform the full extent of radiation within optimal treatment period.Materials and methods. A retrospective analysis of data on 196 patients who underwent chemoradiation therapy between 2005 and 2016 was performed. The results were used to develop and implement a program of support for chemo/bioradiotherapy. The program was characterized by: 1. use of Russian hydrogel materials for local delivery of antibiotics and wound-healing, anesthetizing, anti-inflammatory medications; 2. new regimens of pain relief with differentiated pathogenetic approach and use of modern transdermal long-acting forms; 3. nutritional support at every treatment stage; 4. assurance of compliancy. To evaluate the program, prospective randomized controlled study was performed between January of 2017 and March of 2019 including 60 patients.Results. Mucositis and dermatitis severity and changes in physical state associated with them, progression and duration of radiation did not significantly differ in the two groups. Use of the support program allowed to control adverse effects and to perform chemoradiotherapy to the full extent, at optimal time and with satisfactory quality of life.Conclusion. The program of support of chemo/bioradiotherapy in combination with psychological support is effective both form the point of view of optimization of treatment and rehabilitation times and from the point of view of maintenance of high quality of life in patients.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67785158","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 : 2021-01-16DOI: 10.17650/2222-1468-2020-10-4-86-90
A. Mudunov, E. G. Khazarova, Y. Alymov
Skin cancer of external ear is a very aggressive type of cancer with spread to the parotid gland, bone structures of the lateral skull base, meninges and brain tissue. At the same time, malignant tumors of the external ear are very rare disease, accounting for 0.2 % of all malignant head and neck tumors. This fact explains the small amount of investigation in this scientific field. Now, does not exist unanimous opinion about the treatment tactics for patient with locally advanced ear cancer. Surgical tactics for volumes of block resections of the temporal bone are different. Controversial issues relate to the appropriateness of surgical treatment in general in the case of advanced tumor process. In this article we performed publication analysis devoted to selection of optimal treatment tactics for patient with locally advanced ear cancer.
{"title":"Efficiecy of modern treatment methods for locally advanced cancer of the external ear: review","authors":"A. Mudunov, E. G. Khazarova, Y. Alymov","doi":"10.17650/2222-1468-2020-10-4-86-90","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-4-86-90","url":null,"abstract":"Skin cancer of external ear is a very aggressive type of cancer with spread to the parotid gland, bone structures of the lateral skull base, meninges and brain tissue. At the same time, malignant tumors of the external ear are very rare disease, accounting for 0.2 % of all malignant head and neck tumors. This fact explains the small amount of investigation in this scientific field. Now, does not exist unanimous opinion about the treatment tactics for patient with locally advanced ear cancer. Surgical tactics for volumes of block resections of the temporal bone are different. Controversial issues relate to the appropriateness of surgical treatment in general in the case of advanced tumor process. In this article we performed publication analysis devoted to selection of optimal treatment tactics for patient with locally advanced ear cancer.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67785295","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 : 2021-01-16DOI: 10.17650/2222-1468-2020-10-4-25-31
М. V. Bolotin, A. Mudunov, V. Y. Sobolevsky, А. А. Akhundov, I. Gelfand, S. V. Sapromadze
Background. The main aims of hard palate reconstruction include separation of the nasal and oral cavities, restoration of chewing, swallowing, speech, ensuring good aesthetic results, and preparation for dental rehabilitation. The choice of reconstruction method is determined by such factors as the nature and location of the defect, surgeon’s experience in certain reconstruction methods, cancer prognosis, and patient’s preference. The study objective is to analyze the results of microsurgical reconstruction of hard palate defects using different types of flaps. Materials and methods. Forty-one (41) patients underwent microsurgical reconstruction of defects of the hard palate, soft palate, and alveolar process between 2014 and 2020. Defects of the anterior portion of the hard palate (grade I, IIc, IId according to the classification of J.S. Brown; grade IB, II, III according to the classification of D.J. Okay) were formed in 13 cases; all of them involved the alveolar margin of the maxilla to some extent. To repair these defects, we used flaps containing revascularized bone (n = 10; scapular tip flaps in 8 patients and fibular flaps in 2 patients) and fasciocutaneous or musculocutaneous flaps (n = 3; radial fasciocutaneous flaps in 2 patients and musculocutaneous flap from the anterior surface of the thigh in 1 patient). Defects of the posterior portion of the hard palate (grade Ib according to the classification of J.S. Brown; grade Ib according to the classification of D.J. Okay) were formed in 18 patients. To repair these defects, we used radial fasciocutaneous flaps (n = 17) and fibular autologous graft containing skin, muscles, and bone (n = 1). Soft palate resection was performed in 10 patients; all surgeries were combination, since the lateral oropharyngeal wall was included in the block of removed tissues. None of the patients had the opposite side affected. These defects were repaired using radial fasciocutaneous flaps.Results. Six patients (15 %) developed total flap necrosis due to venous thrombosis on days 2, 3, and 6 postoperatively; two patients developed flap necrosis due to arterial thrombosis 2 days postoperatively. Good speech quality was achieved in 33 patients (80 %), while 6 patients (15 %) had satisfactory speech; rhinolalia was observed in 2 patients (5 %). All patients with defects of the posterior hard palate and of the soft palate had excellent aesthetic results. Among participants with defects of the anterior hard palate and alveolar process, 10 patients had excellent aesthetic results, while 5 individuals had good results. Three patients had unsatisfactory results due to scarring in the middle portion of the face.Conclusion. Patients with subtotal defects of the hard palate and defects of its anterior portion (grade I, IIb, IIc according to the classification of J.S. Brown; grade II, III according to the classification of D.J. Okay) require repair of the alveolar margin of the maxilla; flaps containing revascularized bo
{"title":"Microsurgical reconstruction of the hard palate after resections for malignant tumors","authors":"М. V. Bolotin, A. Mudunov, V. Y. Sobolevsky, А. А. Akhundov, I. Gelfand, S. V. Sapromadze","doi":"10.17650/2222-1468-2020-10-4-25-31","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-4-25-31","url":null,"abstract":"Background. The main aims of hard palate reconstruction include separation of the nasal and oral cavities, restoration of chewing, swallowing, speech, ensuring good aesthetic results, and preparation for dental rehabilitation. The choice of reconstruction method is determined by such factors as the nature and location of the defect, surgeon’s experience in certain reconstruction methods, cancer prognosis, and patient’s preference. The study objective is to analyze the results of microsurgical reconstruction of hard palate defects using different types of flaps. Materials and methods. Forty-one (41) patients underwent microsurgical reconstruction of defects of the hard palate, soft palate, and alveolar process between 2014 and 2020. Defects of the anterior portion of the hard palate (grade I, IIc, IId according to the classification of J.S. Brown; grade IB, II, III according to the classification of D.J. Okay) were formed in 13 cases; all of them involved the alveolar margin of the maxilla to some extent. To repair these defects, we used flaps containing revascularized bone (n = 10; scapular tip flaps in 8 patients and fibular flaps in 2 patients) and fasciocutaneous or musculocutaneous flaps (n = 3; radial fasciocutaneous flaps in 2 patients and musculocutaneous flap from the anterior surface of the thigh in 1 patient). Defects of the posterior portion of the hard palate (grade Ib according to the classification of J.S. Brown; grade Ib according to the classification of D.J. Okay) were formed in 18 patients. To repair these defects, we used radial fasciocutaneous flaps (n = 17) and fibular autologous graft containing skin, muscles, and bone (n = 1). Soft palate resection was performed in 10 patients; all surgeries were combination, since the lateral oropharyngeal wall was included in the block of removed tissues. None of the patients had the opposite side affected. These defects were repaired using radial fasciocutaneous flaps.Results. Six patients (15 %) developed total flap necrosis due to venous thrombosis on days 2, 3, and 6 postoperatively; two patients developed flap necrosis due to arterial thrombosis 2 days postoperatively. Good speech quality was achieved in 33 patients (80 %), while 6 patients (15 %) had satisfactory speech; rhinolalia was observed in 2 patients (5 %). All patients with defects of the posterior hard palate and of the soft palate had excellent aesthetic results. Among participants with defects of the anterior hard palate and alveolar process, 10 patients had excellent aesthetic results, while 5 individuals had good results. Three patients had unsatisfactory results due to scarring in the middle portion of the face.Conclusion. Patients with subtotal defects of the hard palate and defects of its anterior portion (grade I, IIb, IIc according to the classification of J.S. Brown; grade II, III according to the classification of D.J. Okay) require repair of the alveolar margin of the maxilla; flaps containing revascularized bo","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67785286","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 : 2020-11-16DOI: 10.17650/2222-1468-2020-10-3-41-47
Yu. V. Kostalanova, K. A. Ganina, A. Makhonin, A. Gabrielyan
The immune system plays a key role in the development and progression of head and neck squamous cell carcinoma. Understanding the dysregulation and blockage of the immune system of malignant tumors in this location can improve treatment outcomes. A special group is made up of patients who have a widespread process and relapse after chemotherapy with platinum drugs, because they have a very poor prognosis and limitations in the possibilities of further treatment. To date, the most important data relate to drugs acting on the PD-1 (programmed cell death protein 1)/PD-L1 (programmed death ligand 1) immune checkpoints, which are used by the tumor to block the immune system, which have allowed to increase the effectiveness of treatment. The article presents a clinical case demonstrating the effectiveness of the use of checkpoint inhibitors after the use of platinum preparations.
{"title":"Current trends in the immunotherapy of metastatic and recurrent squamous cell carcinoma of the head and neck","authors":"Yu. V. Kostalanova, K. A. Ganina, A. Makhonin, A. Gabrielyan","doi":"10.17650/2222-1468-2020-10-3-41-47","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-3-41-47","url":null,"abstract":"The immune system plays a key role in the development and progression of head and neck squamous cell carcinoma. Understanding the dysregulation and blockage of the immune system of malignant tumors in this location can improve treatment outcomes. A special group is made up of patients who have a widespread process and relapse after chemotherapy with platinum drugs, because they have a very poor prognosis and limitations in the possibilities of further treatment. To date, the most important data relate to drugs acting on the PD-1 (programmed cell death protein 1)/PD-L1 (programmed death ligand 1) immune checkpoints, which are used by the tumor to block the immune system, which have allowed to increase the effectiveness of treatment. The article presents a clinical case demonstrating the effectiveness of the use of checkpoint inhibitors after the use of platinum preparations.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"33 1","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67784378","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 : 2020-11-16DOI: 10.17650/2222-1468-2020-10-3-48-54
E. Borodavina, P. A. Isaev, F. S. Sevrukov, A. V. Sidorin, V. Polkin, A. A. Ilyin, N. V. Severskaya, T. A. Agababyan, S. A. Ivanov, A. Kaprin
The tall-cell variant of papillary thyroid carcinoma is a rare malignancy characterized by an aggressive course, low relapse-free survival, early metastasis, and frequent development of radioiodine refractoriness. We report two cases of tall-cell papillary thyroid carcinoma in patients who had disease progression after combination treatment and started to receive lenvatinib. We observed partial and complete regression of metastases in response to lenvatinib. Our findings are consistent with the results of other studies assessing treatment efficacy for disseminated tall-cell papillary thyroid carcinoma.
{"title":"Tall-cell variant of papillary thyroid carcinoma: literature review and case reports","authors":"E. Borodavina, P. A. Isaev, F. S. Sevrukov, A. V. Sidorin, V. Polkin, A. A. Ilyin, N. V. Severskaya, T. A. Agababyan, S. A. Ivanov, A. Kaprin","doi":"10.17650/2222-1468-2020-10-3-48-54","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-3-48-54","url":null,"abstract":"The tall-cell variant of papillary thyroid carcinoma is a rare malignancy characterized by an aggressive course, low relapse-free survival, early metastasis, and frequent development of radioiodine refractoriness. We report two cases of tall-cell papillary thyroid carcinoma in patients who had disease progression after combination treatment and started to receive lenvatinib. We observed partial and complete regression of metastases in response to lenvatinib. Our findings are consistent with the results of other studies assessing treatment efficacy for disseminated tall-cell papillary thyroid carcinoma.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"48-54"},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67784167","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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