Possibilities of chemoradiation treatment primary locally advanced head and neck tumors

Introduction. Laryngopharyngeal cancer accounts for about half of the total number of malignant neoplasms of ENT organs. Despite the availability of examination, in most patients tumors of this localization are detected at late stages, and the long-term results of treatment of locally advanced cancer of the larynx remain unsatisfactory.Clinical case. This article presents two clinical cases of combined organ-preserving treatment of laryngopharyngeal cancer with spread to the cervical esophagus. At the first stage, patients underwent organ-preserving surgical treatment with a reconstructive plastic component according to the methodology developed at the A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Center of Radiology. Then a postoperative course of chemoradiotherapy was carried out.Conclusion. The use of combined organ-preserving techniques using displaced skin-muscle flaps in the treatment of locally advanced laryngopharyngeal cancer involving the cervical esophagus allows in some cases to avoid crippling surgery, preserve the larynx and achieve satisfactory functional results, which significantly improves the quality of life of patients.

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Diagnosis of sentinel lymph nodes in patients with cancer of the larynx and laryngopharynx using a new radiopharmaceutical based on technetium-99m-labeled gamma aluminum oxide

Medvedeva

Chernov

Bragina

et al. 2023

Bûll. sib. med.

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Аim. To study the possibility of using a radiopharmaceutical based on aluminum oxide labeled with 99mТс ([99mТс]-Al2O3) for the diagnosis of sentinel lymph nodes (SLN) in tumors of the larynx and laryngopharynx in comparison with a phytate colloid ([99mTc]-phytate colloid).Materials and methods. The study included patients with cancer of the larynx and laryngopharynx (T2–4N0M0) (n = 54). In the prospective group (n = 30), [99mТс]-Al2O3 was used as a radiopharmaceutical, in the retrospective group (n = 24), [99mТс]-phytate colloid was used. All radiopharmaceuticals were introduced endoscopically into the submucosal space along the periphery of the tumor. After 18 hours, single-photon emission computed tomography (SPECT) and intraoperative SLN detection were performed.Results. In the retrospective group, SLNs were detected in 20 out of 24 patients. A total of 32 lymph nodes were identified in the retrospective group. The median number of detected lymph nodes in one patient was 1.3 [0–3], the intensity of the radiopharmaceutical uptake on scintigrams was 2.2 [0.7–8.1], intraoperatively – 4 [1.6–9.0]. In the prospective group, [99mTc]-Al2O3 uptake in the lymph nodes of the neck was determined in 27 patients (90%); in3 patients, SLNs were not visualized. A total of 57 lymph nodes were identified (in 27 patients). The median number of visualized SLNs was 1.5 [0–5], the intensity of [99mТс]-Al2O3 uptake according to SPECT and intraoperative detection was 4.8 [0.7–19.4] and 6 [1.1–22.0], respectively.Conclusion. The most significant advantage of using [99mТс]-Al2O3 as a radiopharmaceutical is its high uptake in SLNs, which leads to an increase in the sensitivity of the method as a whole up to 90 versus 83% when using [99mTc]-phytate colloid.

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Possibilities of chemoradiation treatment primary locally advanced head and neck tumors

Cited by 4 publications

References 41 publications

Prospects of accelerated fractionation chemoradiotherapy for locally advanced oropharyngeal cancer during the COVID-19 pandemic

Prospects of accelerated fractionation chemoradiotherapy for locally advanced oropharyngeal cancer during the COVID-19 pandemic

Clinical experience of combined organ-preserving treatment of laryngopharyngeal cancer with spread to the cervical esophagus

Diagnosis of sentinel lymph nodes in patients with cancer of the larynx and laryngopharynx using a new radiopharmaceutical based on technetium-99m-labeled gamma aluminum oxide

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