The purpose of the study was to evaluate the effectiveness of treatment of patients with recurrent nasal cavity and paranasal sinus cancer using photodynamic diagnosis (PDD) and photodynamic therapy (FDT).Material and Methods. The study included 40 patients with locally advanced nasal cavity and paranasal sinus cancer, who were admitted to the clinics of the Cancer Research Institute of Tomsk National Research Medical Center with disease progression or recurrence. All patients were divided into the study group (n=20) and the control group (n=20). Patients in both groups received chemotherapy combined with radiotherapy, chemotherapy combined with surgery or a combination of chemotherapy, radiotherapy and surgery. Treatment of patients included intraoperative assessment of resection margin using a laser electron spectral analyzer LESA-01 BIOSPEC. The bed of the removed tumor was examined to detect residual tumor tissues. Photodynamic therapy of the bed of the removed tumor was then performed using Photoditazine at a dose of 1 mg/kg body weight. Radiotherapy at a dose of 300–350 J per feld was given using a Latus–T apparatus, the feld diameter ranged from 1 to 2 cm. The power density varied from 0.4 W/cm2 to 0.5 W/cm2.Results. Nonparametric tests revealed a statistically signifcant difference in disease-free survival: 3.10, p=0.001 by Gehan-Wilcoxon test and 3.03, p=0,002 by Log-Rank test. When assessing overall survival, there were 10 (50.0 %) completed cases in the control group, 4 (20.0 %) in the study group, and 10 (50.0 %) and 16 (80.0 %) censored cases, respectively. Gehan-Wilcoxon test – -2.02 p=0.04. Log-Rank test –2.10 p=0.04. The results of the study showed that according to any of the criteria, there were statistically signifcant differences in survival between the control and study groups.Conclusion. Inclusion of intraoperative PDD and PDT in the treatment algorithm for nasal cavity and paranasal sinus recurrent carcinomas signifcantly increases the disease-free and overall survival of patients.
The analysis of the effect of various physical therapy methods on tumor growth in the historical aspect and comparison with our own scientific results were carried out. The role of physical therapy methods such as galvanization (electrophoresis), light therapy (ultraviolet irradiation, lasers of different light wave spectra), alternating currents (UHF, microwave, inductothermia), mechanical vibrations (ultrasound, vibration), magnetic field, pulse currents (DDT, SMT), high voltage currents (darsonvalization), and thermal factors (mud and heat treatment) in stimulation of tumor growth was studied. The results of our own studies confirm the statement that the physiotherapeutic factors used do not stimulate tumor growth, and can have a beneficial influence on the improvement of the quality of life of cancer patients. Thus, there is a growing evidence that physiotherapy is a safe and effective adjunct to cancer treatment.
Background. Colorectal cancer is the third most common cancer worldwide. The tendency towards increased incidence of colorectal cancer in Tomsk region correlates with World and Russian tendencies. The purpose of the study was to analyze the incidence rate of colorectal cancer in Tomsk region. Material and methods. The study was based on cancer register data collected at the Cancer Research Institute and Regional Cancer Center (Tomsk) and covered the period 2005 по 2015. Demographic data were obtained from local authorities and government statistics. Results. In Tomsk region, colorectal cancer is the second most common cancer. During the study period (2005–15), the incidence rate of colorectal cancer increased by 39.9 %. The highest incidence rates were observed in patients aged 55 years and older. The median age of patients diagnosed with colorectal cancer in 2015 was 56.3 years. The female and male median age showed a decreasing tendency. In 2015, the colorectal cancer incidence rate in both females and males was the highest among the territories included into the Siberian Federal Region, being 30.9 per 100,000. The rate then stabilized in females, but tended to increase in males. The cumulative risk of developing cancer among the population of Tomsk region had increased, being 7.9 in 2015 compared to 6.5 % in 2005. The cumulative risk of developing cancer was higher in males than in females (10.1 % versus 6.9 %). A specialized care to patients with colorectal cancer over a 10-year period has improved, however one-year mortality rate remains high. The study has shown that screening programs based on the detection of occult blood in the stool are not specific enough. Colonoscopy using high-resolution endoscopy and narrow beam imaging (NBI) are recommended to use as a screening method for the detection of precancerous diseases of the colon.
The paper presents the analysis of the frequency of synchronous gastric and esophageal carcinomas in 176 patients with primary respiratory tract cancer, 122 (69.3%) of them with head and neck cancer and 54 (30.7%) with lung cancer. The endoscopic examination revealed synchronous gastric cancer (n=4) and synchronous esophageal cancer (n=1) in 5 (2.8 %) cases (3 with primary lung cancer and 2 with primary laryngeal cancer). These patients received anticancer treatment for synchronous polyneoplasias. Ninety-one (51.7 %) patients had gastric mucosal atrophy, which in 25.7 % of cases was characterized as premalignant lesions: grade I-II dysplasia (20.2%) and grade III dysplasia (5.5%). Considering the data obtained, patients with respiratory tract cancer have an increased risk for developing gastric and esophageal cancer. Endoscopic esophageal and gastric examination using advanced technologies should be included in the algorithm of management of these patients.
The paper presents the results of determining the concentration of specific antiviral immunoglobulins to viral antigens in blood serum of patients with gastric dysplasia (n=56) and gastric cancer (n=54), as well as the incidence of their titers depending on tumor location and histotype. In patients with precancerous gastric lesions, the increase in the IgG titer to Epstein Barr Virus (EBV) capsid antigen (VCA) and IgG to EBV early antigen (EA) in blood serum was found to be associated with enhancement of inflammatory activity. In patients with gastric cancer, high titers of IgG to VCA and IgG to EA were observed more frequently than in patients with gastric dysplasia, and the decrease in differentiation grade was followed by the increase in the concentration of IgG to EBV VCA. High titers (≥1:320) of IgG to VCA were found of patients with tumors located in the gastric body and cardia. High IgG titers to EBV VCA were shown to be associated with the presence of exophytic and ulcerated exophytic tumor growth.
Characteristics of inflammatory infiltrate in the gastric mucosa of patients with gastric dysplasia (n=56) and gastric cancer (n=50) with different levels of humoral immune response to Epstein-Barr virus (EBV) and EBV viral load were studied. In patients with dysplasia of the gastric mucosa, the increase in antibody titers to VCA IgG leaded to a significant decrease in the level of lymphocytes, neutrophils and macrophages and an increase in the number of eosinophils and plasma cells. When the levels of IgA to viral capsid antigen (VCA) and IgG to EBV early antigens (EA) were increased, the number of neutrophils in the composition of the cellular infiltrate was significantly decreased. In gastric cancer patients with different levels of humoral immune response to EBV, the number of plasma cells and eosinophils in the inflammatory infiltrate of the tumor was decreased when increasing the titers of IgG to VCA and IgA to VCA. When VCA/IgA titer was high, the number of neutrophils in a tumor was decreased and the proportion of macrophages was slightly increased. The data obtained can serve as additional criteria for indentifying markers for viral infection of the gastric mucosa.
The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.
The paper presents the analysis of the frequency of synchronous gastric and esophageal carcinomas in 176 patients with primary respiratory tract cancer, 122 (69.3%) of them with head and neck cancer and 54 (30.7%) with lung cancer. The endoscopic examination revealed synchronous gastric cancer (n=4) and synchronous esophageal cancer (n=1) in 5 (2.8 %) cases (3 with primary lung cancer and 2 with primary laryngeal cancer). These patients received anticancer treatment for synchronous polyneoplasias. Ninety-one (51.7 %) patients had gastric mucosal atrophy, which in 25.7 % of cases was characterized as premalignant lesions: grade I-II dysplasia (20.2%) and grade III dysplasia (5.5%). Considering the data obtained, patients with respiratory tract cancer have an increased risk for developing gastric and esophageal cancer. Endoscopic esophageal and gastric examination using advanced technologies should be included in the algorithm of management of these patients.
The new laser medical complex «LITT-FDT» for cancer treatment has been presented. The laser complex is based on the system of the dye laser with copper vapor laser pumping and is capable of smoothly reconstructing the wave length, allowing the use of any photosensitizer for photodynamic therapy. Results of clinical trial of the complex «LITT-FDT» for patients with basal-cell skin cancer have been presented.
The study included 85 inpatients and outpatients in whom composition of inflammatory infiltrate from gastric mucosa (GM) was determined at the Oncological Research Institute, Tomsk Research Centre of the Siberian Division, Russian Academy of Medical Sciences. The patients were allocated to 4 groups depending on nosological form of the disease. Group 1 comprised 21 patients with grade II-III GM epithelial dysplasia, group 2 - 24 patients having stomach cancer (histologically confirmed adenocarcinoma), group 3 - 19 patients with stage II-III mucinous gastric carcinoma, group 4 - 20 allegedly healthy subjects without signs of gastrointestinal pathology. It was shown that dysplastic processes in GM are associated with an increase of neutrophil, eosinophil, macrophage, and mast cell count along with a drop in the number of lymphocytes and plasmocytes. Stroma of invasive stomach cancer underwent intense inflammatory infiltration accompanied by a rise in the number of lymphocytes, plasmocytes, and neutrophils. Mucinous gastric carcinoma was characterized by an increase of the number of neutrophils and macrophages. Patients having adenocarcinoma of the stomach showed enhanced plasmocytic infiltration by plasmocytes with a low number of eosinophils and mast cells. It is concluded that characteristics of inflammatory GM infiltrate may be useful for the objective assessment of stomach cancer risk in patients with GM dysplasia, formation of a high oncological risk group, adequate dynamic monitoring and treatment of these patients.
Experimental results of initial testing dye-laser "LITT-PDT" pumped by a copper vapor laser are presented. "LITT PDT" is a modern laser medical complex on CVL-pumped dye laser, generating radiation in a red spectrum area with a tuning wavelength of 630 - 700 nm and preserving high intensity of radiation on each wavelength, necessary for treatment by a photodynamic therapeutic method (PDM). Radiation in a red spectrum area (630 - 700 nm) enables treatment for oncological diseases by PDM using any photosensitizer. The given laser medical complex, generating radiation simultaneously on yellow and green discrete spectrum lines, makes methods of low intensive laser therapy for treatment of precancer and dermatological diseases possible.
Potential use of endoscopic laser technologies in cancer diagnosis and treatment has been shown. Problems dealing with the use of photodynamic therapy, laser technologies and low-intensity laser irradiation in clinical oncology have been described.
The study included 78 patients who underwent subtotal distal resections for gastric cancer. Forty-four patients received postoperative endoscopic lasertherapy and 34 patients were treated with drug therapy. Endoscopic examination and morphologic analysis of biopsy specimens from gastrointestinal anastomosis area and mucosa of stomach stump were performed. The analysis of data obtained showed that drug therapy resulted in elimination of inflammation of gastric mucosa and anastomosis area for a short period of time but failed to prevent from the development and progression of atrophic processes in the resected stomach. As concerns the endoscopic lasertherapy, it not only stabilized epithelial integument and considerably reduced inflammatory processes in stroma but also slowed down the processes in mucosa reorganization that was shown in the absence of atrophic processes within one year.
The aim of investigation was to study structural functional state of parietal mucous layer and cavity secretion of the remaining part of the stomach in 64 patients after subtotal distal resection for cancer in early postoperative period and the effect of endoscopic laser therapy (44 patients) and local anti-inflammatory therapy (20 patients) on the correction of damages. A significant change in composition of both structural and extra-structural glycoproteins and partial composition of separate monosacchars was found in both groups. It was concluded that laser therapy had greater effect on biosynthesis of polymerized glycoproteins as compared with drug therapy.
: The study included 52 patients after gastrectomy for carcinoma of the proximal part of the stomach. Endoscopic laser therapy was made in 32 patients to reduce inflammation in the anastomosis zone 2-3 weeks after surgery. Drug therapy was made in 20 patients within the same time period. Histochemical study of the biopsy material of esophageal and intestinal part of the anastomosis was carried out. It is revealed that application of copper vapor laser early after surgery reduces edema and inflammation in the anastomosis zone for 2 weeks as well as accelerates the growth of granulation tissue forming a delicate scar thus preventing formation of scar stenosis.