[Prognostic value of hemoglobin concentration in the course of chemoradiotherapy of patients with oropharyngeal squamous cell carcinoma].

There was performed a comparative analysis of the indicators of immediate and long-term results of chemoradiotherapy in 342 patients with squamous cell oropharyngeal carcinoma depending on hemoglobin level before and after treatment. In patients with normal level of hemoglobin a rate of response to treatment was almost two times higher than that of patients with anemia (75,3% vs. 23,5%) and complete regression of tumors was detected by more than three times often (65,4% vs. 17,6%). The overall five-year survival of patients with anemia was significantly worse than that of patients who had normal hemoglobin level (50,7% vs. 67,7%). Patients who had normal hemoglobin level at the time of discharge demonstrated a five-year overall survival of 75,7%, while those with a hemoglobin level below normal, but more than 80 g/l,--only 57,8%. Hemoglobin concentration was a significant prognostic factor for survival of patients with squamous cell carcinoma of the oral cavity and oropharynx. Low baseline of hemoglobin was also a negative prognostic factor for tumor response to treatment, especially to chemotherapy.

[Immediate and long-term results of simultaneous chemoradiotherapy in non-traditional modes of fractionation in the treatment of patients with oropharyngeal squamous cell carcinoma].

The analysis of the effectiveness of treatment was carried out in 257 patients with squamous cell carcinoma of the mucous membranes of the oral cavity and oropharynx. Two methods of irradiation were used in combination with concurrent polychemotherapy: standard radiotherapy (2 Gy 5 times a week) and radiotherapy in non-traditional modes of fractionation with uneven breaking of the daily dose into two fractions (1 Gy + 1.5 Gy or 1 Gy + 2 Gy with 4-hour intervals) to a focal dose of 60 Gy. Chemoradiotherapy with fractionated dose was more effective than standard chemoradiotherapy in frequency of objective tumor responses and regional metastases in the absence of increasing the number of early radiation reactions and late radiation damages. External beam radiotherapy in non-traditional modes of fractionation with simultaneous polychemotherapy exposure can significantly improve the results of the overall five-year survival compared with conventional fractionation technique--60.4 +/- 4.5%, 63.3 +/- 8.2% vs 27.6 +/- 10.2%, respectively.

[Radiation therapy for medullary thyroid carcinoma].

The paper analyzes the effectiveness of external beam radiation therapy of medullary thyroid cancer in 38 patients. The radiation therapy of the first phase combined therapy was performed in 9 (24 %) patients: after treatment, 5 patients had a partial response, 4--stabilization. The radiation therapy of the second phase combined therapy was performed in 27 (71%) patients: after treatment, 2 patients had a complete response (booster method), 5--partial response, 4--stabilization. External beam therapy has been performed in 2 (5 %) patients with palliative and symptomatic goals. Additionally has been estimated level of calcitonin in patients after combined treatment. The calcitonin level becomes normal without radiation therapy. Therefore, exposure for medullary thyroid carcinoma is questionable (exception for cases gain exposure to the rest of the tumor).

[Concurrent radiochemotherapy in the treatment of squamous cell oral and oropharyngeal cancer].

The aim of this study was to evaluate the end results of the radiochemotherapy of 237 patients with squamous cell carcinoma of oral mucosa (locally advanced, stage III-IV, - 134; 56.4%, and metastases to regional lymph nodes of the neck - 91; 38.4%) carried out at the Center's Clinic. Interstitial neutron (252 californium) plus polychemotherapy was given to 26 (11%) (group 1); neutron + distant radio + polychemotherapy - 34 (14 %) (group 2); distant fractionated radiotherapy + polychemotherapy - 177 (75%) (group 3). Complete response was reported in 190 (80.2%); partial - 44 (18.6%) and stabilization - 3 (1.3%). Overall response was 98.8%; 5-year survival - 64.5 +/- 3.3%, irrespective of tumor site, grade and method of treatment. Concomitant modality proved highly effective, free from toxic and functional or cosmetic harm.

[Early-onset radiation complications and tissue damage in the treatment of head and neck tumors].

The report discusses the results of an evaluation of the effectiveness of combined radiotherapy in 1,192 cases of head and neck tumors divided into 4 groups: distant radiotherapy in standard fractions of 1.8-2.3 Gy, 5 times a week, TTD of 60 Gy (group 1 - 486 40.8%); radiotherapy + local UHF hyperthermia + regional intraarterial chemotherapy + hyper glycemia + administrations of regional intraarterial chemotherapy + hyperglycemia + local UHF hyperthermia (group 2 - 244 20.5%); accelerated superfractition radiotherapy with variable STD of 1 and 1.5/2 Gy, TTD of 60 Gy, plus neoadjuvant polychemotherapy with cisplatin 100 mg/lm2 + 5-fluorouracil, continuous intravenous infusion of 3,000 mg for 72 h (group 3 - 204 17%1); combined photon-neutron therapy (group 4 - 258 21.6%): neutron beam therapy - 36 (3%); interstitial neutron brachytherapy with 252 Cf sources in combination with external beam gamma-therapy and chemotherapy. Overall radiation injury incidence was 1,087 (91.2%); oral mucositis grade I (WHO) - 110 (9.2%), grade II - 166(13.9%), grade III - 811 (68%), radiation dermatitis - 279 (23.4%), grade I/II - 196 (16.4%), grade III/IV - 83 (7%). Grade III/IV side effects developed in 26.7% after gamma therapy and in 72.2% - in the photon-neutron group (p < or = 0.0001). Skin damage was rare, as expected, in the photon-brachytherapy group (1.8%) (p < or = 0.0001). Hence, Cf252 neutron brachytherapy and radiotherapy with concomitant chemotherapy appeared to produce the most sparing effects.

[Neck skin-muscular flap use in cases of expanded operations on the occasion of malignant neoplasms of maxillo-facial region].

Comparative analysis of the results of different flaps, cut out on side surface of the neck for plastic cover of extensive defects of maxillo-facial region (MFR) formed after malignant tumors ablation, use was carried out. Reconstructive plastic operations were performed in 84 patients: displacement of neck skin-facial flap on the stem in 54 (64.1%) patients, use of neck skin-muscle flap (SMF) in 20 (23.8%) patients, use of improved method of skin-muscle transplant forming from only medial part of nodding muscle in 10 (12.1%) patients. Good cosmetic and functional results were received in 62 (73.8%) observations. Use of complex SMF after surgical interventions in cases of malignant tumors in MFR let reduce the number of postoperative complications and provide earlier rehabilitation of this heavy group of patients.

[Immediate and long-term results of plastic reconstruction of soft tissues of the head and neck in areas previously treated with surgery for tumor and radiation injury].

The efficiency was studied of vascularized tissue complexes in 346 cancer patients with extensive facial injuries to the head and neck who had undergone combined treatment. Free microsurgical autotransplantation was carried out in 7 (2%) patients, deltapectoral graft--151 (44%), sternocleidomastoid myocutaneous flap--39 (11%), pectoralis major flap--10 (3%), bi- and tri-lobed flap--55 (16%), temporal musculoperiosteal flap--25 (7%), cheek flap--24 (6.9%), thoraco-dorsal axillary flap--24 (6.9%), frontal flap--6 (1.7%), free-flap transfer--5 (1.5%). Although most vascularized tissue complexes were placed in previously irradiated areas, primary engraftment was reported in 249 (72%) patients, while peripheral or partial necrosis in distal part of flap- in 97 (28%). Good cosmetic and functional results were obtained in 298 (86%) patients who considered themselves cured.