Photodynamic therapy is an effective method for treating superficial forms of malignant neoplasms, characterized by a minimal risk of damage to normal tissues. In this study, we presented our experience of treating cancer of the oral mucosa using photodynamic therapy, and analyzed the immediate and long-term results of treatment. 38 patients with squamous cell carcinoma of oral cavity mucosa, with a depth of invasion no more than 7 mm, were included in the study. All patients underwent photodynamic therapy with chlorine e6 based photosensitizer. Photosensitizers were administered intravenously 3 hours before irradiation, at a dosage of 1 mg/kg of the patient’s weight. Photodynamic therapy was performed with the following parameters: P – 1.0 W, Ps – 0.31 W/cm2, E – 300 J/cm2. The area of one irradiation field ranged 1.0-2.0 cm2. Treatment effect was evaluated by RECIST 1.1. Overall survival, cancer-specific survival, and disease-free survival were calculated using Kaplan-Meier curves. Evaluation of adverse events was made by .TCAE 5.0 criteria. At 35 (92.1%) out of 38 cases, complete regression was observed after photodynamic therapy. Among them in 3 out of 35 patients relapse was diagnosed in 11.5 to 43.2 months. The total number of patients who didn’t respond to treatment was 6 (15.8%). Follow-up period was 4.2-87.3 months. (mean 42.9). 34 (89.5%) out of 38 patients are alive, 1 (2.6%) died from progression, and three died from other causes. The 5-year overall survival rate was 82.1%, cancer-specific survival rate was 97.0%, and disease-free survival rate was 81.1%. Among the factors significantly (p < 0.05) influencing relapse-free survival: depth of invasion < 5 mm (p – 0.013) and the presence of leukoplakia (p – 0.007). When assessing cancer-specific survival, factors worsening the prognosis were: age >70 years (p – 0.034) and the presence of leukoplakia (p – 0.007). Photodynamic therapy is an alternative treatment method of oral cancer superficial lesions, in case of proper assessment of primary lesion and in case of possibility of full irradiation of the tumor. Moreover, after using photodynamic therapy, the underlying connective-muscular structures are preserved, which promotes rapid healing with minimal scarring, the functions of the affected organ remain intact, and cosmetic defects do not form.

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.

Introduction. Squamous cell carcinoma of the tongue is the most common oral cancer. The tumor microenvironment has a significant impact on tumor progression; therefore, better understanding of its characteristics is crucial for the treatment strategy, since in some cases it modifies the tumor microenvironment resulting in tumor resistance to therapy.Study objective – to compare the number of CD8+Т-lymphocytes, CD57+NK-cells, and CD20+B-lymphocytes in the microenvironment of tongue squamous cell carcinoma in patients receiving and not receiving neoadjuvant chemoradiotherapy.Materials and methods. We performed immunohistochemical examination of specimens from 67 patients with tongue squamous cell carcinoma who did not receive neoadjuvant chemoradiotherapy. Eleven patients were diagnosed with well differentiated tumors (G1); 21 patients had moderately differentiated tumors (G2); and 35 patients had poorly differentiated tumors (G3). T1 tumors were observed in 11 individuals, T2 tumors – in 26 individuals, T3 tumors – in 26 individuals, and T4 tumors – in 4 individuals. We also examined 30 patients who had undergone neoadjuvant chemoradiotherapy, including external beam radiotherapy (total dose of 60 Gy) and a cycle of polychemotherapy (cisplatin and 5‑fluorouracil). Of them, 6 patients had T1 tumors, 17 patients – T2 tumors, 5 patients – T3 tumors, and 2 patients – T4 tumors. We measured the areas occupied by CD8+T-lymphocytes, CD20+B-lymphocytes, and CD57+NK-cells in the hot spots in the tumor microenvironment.Results. The number of CD8+T-lymphocytes in the tumor microenvironment was higher in patients after neoadjuvant chemoradiotherapy than in those who did not receive it (р = 0.000), whereas the number of CD20+B-lymphocytes was lower after neoadjuvant chemoradiotherapy. The area occupied by CD57+NK-cells in the hot spots of the tumor microenvironment did not differ significantly before and after therapy (p >0.05).Conclusion. Thus, neoadjuvant chemoradiotherapy in patients with tongue squamous cell carcinoma caused an increase in the number of CD8+T-lymphocytes, a decrease in the number of CD20+B-lymphocytes in the tumor microenvironment, and had no effect on the population of CD57+NK-cells.

Purpose: To study the dynamics of frequency of tumor cells with polysomy 7 and 11 chromosomes in patients with oral cancer during fractionated gamma-radiotherapy. Material and methods: The study was carried out using fluorescence in situ hybridization (FISH) on smears of 19 patients with oral cancer before treatment, after first total focal dose of gamma-radiotherapy (up to 18 Gy) and after second total focal dose (up to 32 Gy). As for control oral smears of 12 healthy donors were taken. Molecular cytogenetic abnormalities were examined in taken samples. Results: The average group frequency of cell with polysomy 7 and 11 chromosomes in controls was 0.7 ± 0.2 % and 0.3 ± 0.1 % respectively. The average frequency of cells with chromosome 7 polysomy in group oral cancer patients before treatment was 32.3 ± 4.5 %, after first focal dose was 15.7 ± 2.9 % and after second focal dose was 8.0 ± 2.3 %. Dynamics analysis of these values revealed the significant decreasing (р < 0.05) in cells with chromosome 7 polysomy during radiotherapy. The average group frequency of cells with polysomy 11 in cancer patients before treatment was 25.8 ± 5.6 %, 12.2 ± 2.4 % and 5.4 ± 0.9 % after first and second focal dose respectively. These values was significantly (р < 0.01) higher compare with the one in the control group. After radiotherapy the 16 (84 %) patients with polysomy chromosomes 7 and/or 11 had significant decreasing (р < 0.05) in aberrant levels. Some of them (6 persons – 32 %) had decreasing frequency up to the control levels. 4 persons (21 %) observed firstly the increasing of cells with polysomy but after there was the reduction. 5 patients (26 %) over full course of gamma-radiotherapy demonstrated the gain in frequency of cells with polysomy or the same value as it was before treatment. Conclusion: Thus, the study of molecular cytogenetic abnormalities in cells of oral cancer patients before and after radiotherapy was shown the polysomy of chromosomes being the marker of genome instability could indicate the tumor response ongoing therapy.

Oral mucosa cancer is a common disease with relatively low survival rates. The standard for the treatment of malignant neoplasms (MNO) of the oral mucosa is the surgical method, chemotherapy and / or radiation therapy. With the introduction of modern protocols and the improvement of current treatment methods, the increase in survival is insignificant due to the development of local and distant relapses, the appearance of simultaneous tumors of the oral cavity. Cosmetic and functional results in patients who have undergone complex treatment for oral cancer are often unsatisfactory. There is an obvious need to develop new approaches to treating patients with cancer of the oral mucosa. Photodynamic therapy (PDT) has similar properties. With the development of endoscopic and fiber-optic equipment, the fields of PDT application have significantly expanded. Foci in the oral cavity and oropharynx became available for PDT. The early stages of oral mucosal cancer are optimal for PDT because large surface defects can be treated with minimal complications. Preservation of subepithelial and collagen structures, which is typical for PDT, promotes healing without the formation of scar processes, thereby achieving an ideal cosmetic and functional effect. The use of PDT in the treatment of oral cavity cancer is not limited only to the initial stages in an independent version. It is possible to use PDT in combination with surgical and radiation treatment. In case of massive tumor processes, PDT is used for palliative purposes. The influence of the adaptive immune response under the influence of PDT is being studied.

Radiotherapy is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in radiotherapy planning and delivery, a significant number of pa-tients will experience radiation-associated toxicities. Many effective management options are available for acute radiotherapy-associated toxicities, but treatment options are much more lim-ited and of variable benefit among patients who develop late sequelae after radiotherapy. The present work is based on observations of 586 patients with oral and oropharynx cancer, for which interstitial neutron therapy was carried out in an independent version or in combination with re-mote radiation therapy. Radiation injuries occurred in 130 (22.2%) patients, in 92 (15.7%) they appeared in the form of radiation ulcers and in 38 (6.4%) – osteoradionecrosis of the lower jaw. The clinical picture and the course of radiation injuries after interstitial neutron therapy with sources of 252Cf did not differ significantly from radiation complications after photon irradiation.

Thyroid carcinoma with thymus-like differentiation (Carcinoma Showing Thymus-Like Differentiation, CASTLE) is an extremely rare disease. It arises from the thymus tissue ectopic into the tissue of the thyroid gland, usually in patients 40–50 years old. In this work, we present an observation of the development of CASTLE in a patient at a young age. A 21-year-old woman was admitted to our clinic with a volumetric education in the projection of the left lobe of the thyroid gland. Ultrasound revealed a 5-centimeter thyroid tumor. Surgery was performed in the scope of thyroidectomy, selective cervical dissection (level VI). Morphological and immunohistochemical studies showed that cancer has a thymus-like differentiation (CASTLE). After 32 months, she recurred to the lymph nodes of the neck (level IV on the left). She underwent repeated surgery, after which she was observed without signs of relapse for 120 months. The rarity of the pathology leads to difficulties in establishing a diagnosis at the preoperative stage and in choosing the optimal treatment tactics during treatment and further follow-up.

A clinical case of successful treatment of isolated tongue neurofibroma presented patient K., 64 years old, referred to the clinic complaining of a feeling of «discomfort» on swallowing. With a comprehensive examination, a diagnosis of an isolated tongue neurofibroma was established. Surgical treatment was performed. The diagnosis was confirmed morphologically. The presented clinical case of isolated tongue neurofibroma in an elderly patient is casuistic in nature, of scientific and practical interest due to the rarity and unusualness of the disease.

Clinical case of solitary metastasis of the clear cell variant of renal cell carcinoma into the thyroid gland was analyzed. The thyroid mass was initially considered to be benign. The diagnostic showed signs similar to thyroid follicular neoplasia. The patient was operated on. The thyroid tumor was finally diagnosed as metastasis from clear cell variant of renal cell carcinoma.

Ранние результаты лучевой терапии местнораспространённого рака органов головы и шеи в режиме ускоренного фракционированияГордон К.Б., Гулидов И.А., Семёнов А.В., Раджапова М.У

In the article a case of non-resectable differentiated thyroid cancer (DTC) is described. A recurrent thyroid tumor deforms the oropharyngeal lumen and laryngeal vestibule and bears down on the left esophageal wall and trachea. The authors present literature data on Nexavar target therapy and focus on the fact that no cases of combination treatment with target therapy and surgery of non-resectable progressive DTC were described until now. In view of this, this clinical report is unique and dictates a need to determine new Nexavar (Sorafenib) indications for use in a neoadjuvant regimen.