Purpose: To evaluate the efficacy of neoadjuvant chemotherapy in combination with regional inductive moderate hyperthermia for patients with locally advanced breast cancer. Patients and Methods: 200 patients with stage IIB-IIIA breast cancer received neoadjuvant chemotherapy (control group, n = 97) or chemotherapy combined with hyperthermia (experimental group, n = 103). Inductive hyperthermia was set at 27.12 ± 0.16 MHz and the 50 W output power. Results: Thermal and color Doppler ultrasound imaging demonstrated that hyperthermia increased the surface temperature on the breasts to < 4°С while the mean values for systolic blood flow were 3.5 times as high as those prior to treatment. Assessment of tumor size and response found a (31.24 ± 3.85)% reduction in the size of the primary tumor in patients receiving chemotherapy + hyperthermia, while chemotherapy alone showed a (22.95 ± 3.61)% decrease on average (p = 0.034). The rate of objective response increased by 15.9% in the experimental group (р = 0.034) compared with the control group. The patients in the experimental group also had axillary lymph node regression of 14.17% greater than in the control group (p = 0.011). Moreover, the combination treatment allowed to increase the proportion of women eligible for breast-conserving and reconstructive surgery by 13.63% in the experimental group. The viable tumor volume was lower in patients receiving neoadjuvant chemotherapy + hyperthermia (24.4 ± 0.2)% compared with those given chemotherapy alone (30.4 ± 0.25)%. The 10-year overall survival rates were higher (log-rank: p = 0.009) in breast cancer patients who underwent chemotherapy combined with hyperthermia than in patients receiving chemotherapy only. Conclusion: The combination neoadjuvant chemotherapy and the technology of regional inductive moderate hyperthermia improved the efficacy of treatment for patients with locally advanced breast cancer staged IIB-IIIA.
Radical surgery of the breast cancer (ВС) with the radical mastectomy often lead to a dysfunction of the upper lymb on the operation side. The symptom complex of disorders is manifested by swelling, numbness, paresthesias, pain syndrome of varying severity, heaviness, convulsions, spasms, and limited mobility. It is called postmastectomy syndrome (PMS). According to literature sources, the incidence of PMS is 60–80 % of all patients undergoing mastectomy. The severity of postmasectomy syndrome in patients with an inflammatory breast cancer (IBC) and locally advanced (non inflammatory) breast cancer (LABC) was compared. It turned out , that majority of patients with IBC had postmastectomy syndrome of the III degree according to Beltran while the patients with LABC (non inflammatory) – II. The limitation of mobility of the upper limb was also more pronounced in the IBC group, while the severity of pain syndrome was the same in both groups.
Both in Russia and worldwide, morbidity and mortality from acute coronary syndrome (ACS) remain high. The emergence of a new coronavirus infection, the active participation of medical workers in its elimination, determined a new phenotype of patients, which determines the relevance of the problem and of a more detailed assessment of this cohort of patients. Aim of the study was to identify and determine the clinical and functional features, phenotype and endotype of the course of ACS in medical workers who have had a new coronavirus infection. Material and methods. An open cohort comparative study was conducted. It included 60 healthcare workers with ACS and a previous novel coronavirus infection, who were selected based on the identification of SARS-CoV-2 and/or its antibodies (positive PCR test) in anamnesis. All patients were admitted to the regional vascular center № 7 of the City Clinical Hospital № 2, Novosibirsk. The comparison group consisted of 60 healthcare workers with ACS without positive PCR test in anamnesis. General clinical and instrumental, coronary angiography with possible stenting. Results. Of the 60 medical workers with ACS after a new coronavirus infection, myocardial infarction with ST segment elevation was detected in 21 people, myocardial infarction without ST segment elevation – in 31, unstable angina pectoris – in 8 people. Within 6 months of undergoing COVID-19, they developed complex rhythm disorders, such as paroxysm of fibrillation or atrial flutter, more frequently than in the comparison group, as well as a full AV-blockade (n = 25, 41.6 %, p = 0.020), bradyarrhythmias and conductivity disturbances (n = 8, 13.3 %, p = 0.045), revealed a more than 2-fold increase in the pro-brain natriuretic peptide (proBNP) (n = 21, 35 %, p = 0.033), observed myocardial dysfunction (ejection fraction less than 50 %) (n = 6, 10 %, p = 041). Conclusions. The data obtained indicate the formation of a new ACS phenotype in medical workers who have undergone a new coronavirus infection.
Inductive hyperthermia treatment plans were built using Comsol Multiphysics software for patients with breast cancer metastasis to lymph nodes. To assess the influence of electromagnetic irradiation on temperature increase in metastatic lymph nodes, treatment plans were based on moderate hyperthermia parameters (< 42 °C). The proposed technology can be used to provide a more personalized approach to treatment planning for patients with locally advanced breast cancer receiving combination therapy which involves neoadjuvant chemotherapy and expand eligibility for organ-preserving surgery.
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