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DIAGNOSIS AND TREATMENT OF HEAD AND NECK TUMORS
Background. The worldwide increasing incidence of thyroid cancer (TC) is mainly due to a rise in its major form of differentiated TC (DTC): papillary. Most patients with DTC have a good prognosis; 10-year survival overall rates are as high as 85 %, but not greater than 40 % in a group of patients with distant metastases. At the same time, the lung is the most frequent target for distant metastases, accounting for 70 % of all sites.
Objective: to estimate and compare the capabilities of different diagnostic techniques to detect lung metastases of DTC. Materials and methods. The results of diagnosing lung metastases were retrospectively analyzed in 36 patients (33 women and 3 men; mean age 53 years) with DTC (29 patients with papillary TC and 7 with follicular TC) treated at the department of radiotherapy with systemic therapy, Chelyabinsk Regional Clinical Oncology Center from 2011 to 2014.
Results. Chest X-ray could reveal pulmonary metastases in 13 (36 %) patients; lung pathology foci were absent in 23 (64 %) patients. 131I whole-body scintigraphy (WBS) proved to be of informative value in 24 (66.7 %) patients, it displayed no increased accumulation of the radiopharmaceutical in the lung of 12 (33.3 %) cases. Multislice spiral computed tomography (MSCT) of the chest was carried out in 22 (61 %) patients; out of them 21 (95.5 %) were found to have 1.4-to-20-mm lung cancer foci. 18Fluorodeoxyglucose (18FDG) positron emission tomography / computed tomography (PET / CT) was performed in 18 (50 %) patients, which showed 3–26-mm lung pathology foci in all the patents; out of them 16 (88.9 %) were detected to have metastases owing to the CT component of this method. Thus, the highest sensitivity was exhibited by MSCT (95.5 %), 18FDG PET / CT (100 % due to its CT component), and 131I WBS (66.7 %).
Conclusion. When lung metastases of DTC are suspected, 1) chest X-ray should be used as a screening test; 2) 131I WBS should be performed in all patients; 3) MSCT of the chest is the gold standard for diagnosis; 4) 18FDG PET / CT should not be employed in routine practice.
Objective: to investigate the efficiency of radiotherapy for malignant salivary gland tumors and to reveal prognostic factors influencing overall and relapse-free survival rates in this patient group.
Materials and methods. The retrospective and prospective data of 111 patients with malignant salivary gland tumors were analyzed. All the examinees received preoperative radiotherapy to the primary focus and, if need be, regional metastatic areas; the cumulative focal dose was 40–65 (56.0 ± 8.9) Gy. In the following step, the patients were surgically treated. They were divided into 2 groups according to the degree of therapeutic pathomorphism: 1) Degree 0–III (91.9 %) and 2) Degree IV (8.1 %).
Results. Five- and ten-year overall survival rates were 60.1 ± 5.1 and 50.4 ± 5.7 % and 7.5 ± 11,69 and 87.5 ± 11.69 % (unachieved median) in Groups 1 and 2, respectively (p = 0.04); relapse-free survival rates were 53.6 ± 5.1 and 41.33 ± 5.5 % in Group 1 and 88.8 ± 10.4 and 88.8 ± 10.4 % in Group 2 (unachieved median) (р = 0.015). Cox multivariate regression analysis showed that the significant independent signs for overall survival were the pathomorphological characteristics of a tumor (risk ratio (RR) = 1.933; p = 0.010), process location (RR = 0.705; р = 0.010), and tumor grade (RR = 1.825; р = 0.010); those for relapse-free survival were the pathomorphological characteristics of a tumor (RR = 2.177; р = 0.001), regional lymph node metastases (RR = 1.543; р = 0.013), tumor localization (RR = 0.700; р = 0.014), effect of radiotherapy (RR = 1.767; р = 0.042), and tumor grade (RR = 1.754; р = 0.005).
ORIGINAL REPORT
LITERATURE REVIEW
Background. One of the methods of radiotherapy of malignant tumors of oral cavity and oropharyngeal region today is interstitial radiation therapy – brachytherapy, allowing you to create the optimum dose of irradiation to the tumor, necessary for its destruction, without severe radiation reactions in the surrounding tissues unchanged. Brachytherapy has the following advantages: high precision – the ability of the local summarization of high single doses in a limited volume of tissue; good tolerability; a short time of treatment. At this time, brachytherapy is the method of choice used as palliative therapy and as a component of radical treatment.
Objective: The purpose of this article is a literature review about the latest achievements of interstitial brachytherapy in malignant tumors of the oral cavity and oropharynx.
CASE REPORT
OBITUARY
ISSN 2411-4634 (Online)