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Abstract Objectives To evaluate the efficacy and tolerance after the electrochemotherapy treatment for local therapy of cutaneous and subcutaneous metastases of head-and-neck tumors and malignant melanoma refractory to standard therapies, mainly in neck metastasis of squamous cell carcinoma. And, to evaluate the relation of this response according to the skin reaction (healing with ulcer or dry crust). Methods prospective pase II, observational clinical study of 56 patients with metastases of head-and-neck squamous cell carcinoma (n = 13), papillary thyroid carcinoma (n = 4), adenoid cystic carcinoma of parotid gland (n = 1) or malignant melanoma (n = 37, 5 in head). Patients were treated by electrochemotherapy (application of electrical pulses into the tumor) after the administration of a single intravenous dose of bleomycin. Kaplan-Meier curves were performed. The statistical significance was evaluated using log-rank test; p-value of less than 0.05 was considered as significant. Results Overall clinical response was observed in 47 patients (84%). Local side effects were mild in all the patients. Ten patients (76.9%) with neck metastasis of squamous cell carcinoma had some degree of response, but only in one was complete. Patients even with only partial response had a higher overall survival than patients without response (p = 0.02). Most of the patients with squamous cell carcinoma had diminution of pain and anxiety. Response rate and overall survival was higher in MM patients (86.5%) than in squamous cell cancer patients (76.9%) (p = 0.043). The healing process (dry crust/ulcer) was not associated with the overall survival (p = 0.86). Conclusions Electrochemotherapy is associated a higher overall survival and diminution of pain and anxiety. Therefore, it is an option as palliative treatment for patients with neck metastasis of squamous cell carcinoma refractory to other therapies or even as a concomitant treatment with newer immunotherapies. The type of healing of the surgical wound could not be associated with a higher rate of response or survival. Level of evidence III.
ABSTRACT
PURPOSE: To evaluate the inflammatory response following the insertion of corneal epithelium into rabbit corneal stroma using confocal microscope. METHODS: Newzealand white rabbits were underwent corneal flap procedure using Microkeratome (Hansatome, Chiron, USA) and corneal epithelium was inserted. We divided the rabbits into three groups: Group A: flap only, Group B: flap with central epithelium insertion, Group C: flap with peripheral epithelium insertion. We examined the rabbit corneas at the time point of 4, 24, 72hours, 7days, and 1 month after surgery using confocal microscope and CD 11b immunohistochemical stain. RESULTS: At the early stage, the inflammatory cells were more frequently observed in the group C than in the group A and B, and at postoperative 72hours only in the group C. In stromal and total corneal thickness, there was a tendency of increase to the postoperative 24 hours and decrease in all groups, but the group C was more stronger tendency than other groups (P0.05). In immunohistochemical staining (CD11b), polynucleated cells and mast cells were more visible in group B and C than in group A. CONCLUSIONS: The postoperative inflammatory reaction of the LASIK flap may be related with corneal epithelial cells, and we think that more attention should be needed with the management of microkeratome.