Основная цель исследования - анализ результатов лечения четырех пациентов с метастатическим поражением печени медуллярным раком щитовидной железы (МРЩЖ) и перенесших по этому поводу хирургическое вмешательство. В Российской Федерации ежегодная заболеваемость МРЩЖ составляет до 600 новых случаев (0,2 на 100 000 жителей). По данным литературы, у половины пациентов при пролонгированном наблюдении выявляются отдаленные метастазы, из них изолированное поражение печени встречается до 0,5 %. Резекция метастазов МРЩЖ выполняется только у небольшого числа пациентов. Таким образом, мало что известно об результатах лечения этой категории больных МРЩЖ.
We report the experience of radical treatment by photodynamic therapy of patients with squamous cell carcinoma of oral cavity with serious side diseases. Completed treatment of two patients with serious side diseases (HIV infection with associated pulmonary hypertension of high degree and cardiac pathology) suffered from cancer of oral cavity. Extensive surgical treatment and/or aggressive course of chemoradiation therapy were not indicated to them due to concomitant pathology. Both patients were diagnosed with squamous cell carcinoma of oral cavity, with appropriate stage Ist. сT1N0M0. Patients received treatment by photodynamic therapy with chorine photosensitizer in dose 1 mg/kg. Options of photodynamic were: output power – 1.5W, power density – 0.31 W/cm2, light dose – 300 J/cm2. After one time session of photodynamic therapy, in both cases full response was diagnosed (according to RECIST 1.1). In one case the second session of photodynamic therapy was performed due to concomitant disease of oral cavity – multiply lesions of leukoplakia and after was diagnosed full remission of all lesions. Major adverse event was pain during the first 5-7 days after treatment, curable by painkillers. Follow-up (IQR) was 12 and 18 month respectively with no evidence of progression. It is available to avoid extensive surgical treatment and aggressive course of chemoradiation therapy (as an alternative) with the use of photodynamic therapy. Photodynamic therapy is minimally invasive method of radical treatment of localized squamous cell carcinoma of oral cavity with minimal adverse events, and could be especially relevant in patients with serious concomitant diseases.
The study objectiveis to evaluate modern-era radiotherapy (external beam radiotherapy, EBRT) and target therapy (TT) outcomes for advanced medullary thyroid cancer (MTC).Materials and methods.Seventy eight consecutive patients with stage IV MTC were evaluated. All of them with relapsing locally advanced or metastatic MTC, 16 had clinically relevant mediastinal involvement, and 59 had distant metastasis; 26 patients received conformal EBRT or intensity-modulated radiotherapy in monomode, 16 patients – conformal EBRT with simultaneous TT with vandenanib, 36 patients – TT in monomode. Median EBRT dose was 60 Gy.Results.Kaplan–Meier estimates of the median overall survival rate was 14 months for radiotherapy in monomode, 48 months – for conformal EBRT + simultaneous TT with vandenanib, 50 months – for TT in monomode. EBRT and TT allows for significantly shorter periods (median 3.8 weeks), to relieve the symptoms of compression-mediated organs and structures of the neck and mediastinum than in the TT (median 10.2 weeks) (p <0.001).Conclusion.EBRT and TT provided durable locoregional disease control with limited morbidity.
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