Cryosurgical and cryoradiation treatments in patients with calvarial skin cancer

The authors developed a novel cryoradiation treatment in patients with locally advanced basal cell and squamous cell carcinoma of the head skin, which included a combination of tumor cryogenic and radiation exposures. of a tumor. Immediately before each radiotherapy session, local tumor cooling is carried out until the freezing temperature is achieved at the tumor-intact tissue border. Irradiation is performed in cycles: at a single daily focal dose of 2.0–2.5 Gy during 5 days at a 2-day interval until the cumulative focal dose of 60–70 Gy is achieved. The results of cryosurgical and cryoradiation treatments were investigated in 112 patients with basal cell (n = 101) and squamous cell (n = 11) carcinoma of the calvarial skin. Among the patients, there were 48 (42.9 %) men and 64 (57.1 %) women; their mean age was 67.1 (39–107) years. The skin tumor was located in the parietal region in 30 (26.8 %) patients, in the temporal region in 55 (49.1 %), in the frontal region in 26 (23.2 %), and in occipital region in 1. The size of the neoplasms in all the patients was more than 1 cm; the tumors belonged to a high recurrence risk group. The method of treatment was chosen according to indicators. The postoperative follow-ups of the patients were 2 to 14 years (median follow-up, 7 years). Recurrences of skin cancer were diagnosed in 5 (4.5 %) of the 18 patients: 1 (1 %) after treatment for its primary forms and 4 (22.2 %) after that of recurrences. Cryosurgical and cryoradiation treatments performed as clinically indicated could yield good functional, aesthetic, and long-term results and ensure effective rehabilitation in patients after the treatment conducted.

1. Пачес А. И. Опухоли головы и шеи. М.: Практическая медицина, 2013. [Paches А. I. Head and neck tumors. М.: Prakticheskaya Meditsina, 2013. (In Russ.)].

2. Злокачественные новообразования в России в 2013 году (заболеваемость и смертность). Под ред. А. Д. Каприна, В. В. Старинского, Г. В. Петровой. М., 2015. [Malignant neoplasms in Russia in 2013 (morbidity and mortality rate). By eds.: A. D. Kaprin, V. V. Starinskiy, G. V. Petrova. Moscow, 2015. (In Russ.)].

3. Статистика злокачественных новообразований в России и странах СНГ в 2012 году. Под ред. М. И. Давыдова, Е. М. Аксель. М., 2014. [Statistics of malignant abnormalities in Russia and CIS countries in 2012. By eds.: М. I. Davydova, Е. М. Аxel. Мoscow, 2014. (In Russ.)].

4. Lawson V. G. Management of advanced and recurrent facial carcinoma. Arch Otolaryngol 1979;105(8):471–4.

5. Wollina U., Bayyoud Y., Krönert C., Nowak A. Giant epithelial malignancies (basal cell carcinoma, squamous cell carcinoma): a series of 20 tumors from a single center. J Cutan Aesthet Surg 2012;5(1):12–9.

6. Клинические рекомендации по лечению опухолей головы и шеи Общенациональной онкологической сети (США). М.: АБВ-Пресс, 2011. [Clinical recommendations for the treatment of head and neck tumors from the National Oncologic Network (USА). Мoscow: АBV-Press, 2011. (In Russ.)].

7. Edgerton M. T. Hayes Martin lecture. Advanced basal cell cancer. prognosis and treatment philosophy. Am J Surg 1982;144(4):392–400.

8. Ouyang Y. H. Skin cancer of the head and neck. Semin Plast Surg 2010;24(2):117–26.

9. Samarasinghe V., Madan V. Nonmelanoma skin cancer. J Cutan Aesthet Surg 2012;5(1):3–10.

10. Clarke P. Nonmelanoma skin cancers – treatment options. Aust Fam Physician 2012;41(7):476–80.

11. Kuflik E. G. Cryosurgery for skin cancer: 30-year experience and cure rates. Dermatol Surg 2004;30(2 Pt 2):297–300.

12. Пачес А. И., Шенталь В. В., Птуха Т. П. и др. Криогенный метод лечения опухолей головы и шеи. М.: Медицина, 1978. [Paches А. I., Shental V. V., Ptukha Т. P. et al. Cryogenic method of the head and neck treatment. М.: Меditsina, 1978. (In Russ.)].

13. Чурилова Л. А., Игитов В. И., Ходоренко С. А. Криохирургическое лечение базальноклеточного рака кожи. Вестник хирургии им. И. И. Грекова 1989;142(3):95–7. [Churilova L. А., Igitov V. I., Hodorenko S. А. Cryosurgical treatment of the basal skin cell carcinoma. Vestnik Khirurgii im. I. I. Grekova = I. I. Grekov Surgery Herald 1989;142(3):95–7. (In Russ.)].

14. Buschmann W. N2 cryotherapy and excision. Indications and limits in eyelid basalioma. Ophthalmologe 1992;89(3): 237–42.

15. Гладько В. В., Шафранов В. В., Таганов А. В. Исследование качества жизни пациентов с базально-клеточным раком кожи до, во время и после аппаратной криодеструкции. Клиническая дерматология и венерология 2005;1:50–53. [Glad, ko V.V., Shafranov V. V., Taganov А. V. Research of the life quality of patients with basal skin cell carcinoma before, during and after the instrumental cryodestruction. Klinicheskaya dermatologiya i venerologiya = Clinical Dermatology and Venerology 2005;1:50–3. (In Russ.)].

16. Писклакова Т. П. Опыт лечения базалиом кожи методом криодеструкции. В сб.: Пролиферативные заболевания кожи. М., 1988. С. 39–42. [Pisklakova Т. P. Experience of treatment of skin basaliomas by cryodestruction method. In: Proliferative skin diseases. Мoscow, 1988. P. 39–42. (In Russ.)].

17. Lindemalm-Lundstam B., Dalenbäck J. Prospective follow-up after curettage-cryosurgery for scalp and face skin cancers. Br J Dermatol 2009;161(3):568–76.

18. Lindgren G., Larkö O. Cryosurgery of eyelid basal cell carcinomas including 781 cases treated over 30 years. Acta Ophthalmol 2014;92(8):787–92.