[Cryoradiation therapy of the patients presenting with locally advanced auricular skin cancer].

The objective of the present work was to improve the efficacy of treatment of locally advanced auricular skin cancer with the use of the newly proposed combined method including cryogenic and radiotherapy. The choice of the optimal temporal and thermal parameters of combined cryoradiotherapy was based on the results of previous experimental and theoretical investigations. Each radiation treatment session was immediately preceded by local cooling of the tumour down to 0°C - minus 5°C with a nitrogen vapour. Radiotherapy was performed with the use of either photon or electron radiation at a single local dose of 2 Gy-2.25 Gy (the total cumulative dose 64 Gy-68 Gy). As many as 14 patients presenting with locally advanced auricular skin cancer received combined cryogenic and radiotherapy; 10 of them had basal cell carcinoma and 4 squamous cell carcinoma. In all these cases, the treatment resulted in the complete regression of the tumours. Further observation during a follow-up period from 2 to 14 years in duration demonstrated that only two patients developed tumour relapses. These secondary neoplasms were successfully treated by cryodestruction (n=1) and surgical ablation (n=1). The proposed cryoradiotherapy made it possible to preserve the anatomical relief of the auricle and the auditory passage with good aesthetic and functional outcomes.

[Current state of the treatment of thyroid cancer]. / Sovremennoe sostoianie problemy lecheniia raka shchitovidnoi zhelezy.

Individually-tailored approach is recommended in designing the mode of treatment and extent of surgery for thyroid tumors. In cases of papillary and follicular tumors, the main therapy should be surgery to make sure that pre- and paratracheal fat is removed. Radical surgery on the neck is not indicated unless there are metastases. Combined treatment may be used in cases of medulla and poorly-differentiated cell cancer. Application of 131I may be recommended in cases of apparent metastasis or when there is no convincing evidence that surgery was radical enough since the 10-year data on treatment of differentiated cell cancer make up 90%.

[Autofluorescence diagnosis of malignant tumors of the head and neck]. / Autofliuorestsentnaia diagnostika zlokachestvennykh opukholei golovy i shei.

A new method for diagnosing human malignant tumors is dealt with, which is based on fluorescence of malignant neoplasms and their adjacent normal tissue. To measure the fluorescence spectra, a fiber optic system and a multi-channel optic spectral analyser have been designed. While analysing the resultant spectra, a greater fluorescence excess was observed in the red wave band in the tumors than in normal tissue. Further investigations are required in order to use the method in question in clinical diagnosis.

[Combined treatment of stage III laryngeal cancer with different schedules of radiotherapy and surgery. Evaluation of preventive methods of the treatment of regional areas (cooperative randomized study)]. / Kombinirovannoe lechenie raka gortani III stadii s razlichnoi posledovatel'nost'iu oblucheniia i operatsii. Otsenka preventivnykh metodov vozdeistviia na regionarnye zony (po materialam kooperirovannogo randimizirovannogo issledovaniia).

In 1980-1987, a cooperative randomized study of 363 patients with stage III laryngeal cancer (T1-3N0-1M0) was carried out. In 249 patients tumor was located in the vestibular space and in 114 in the vocal cord area; 78.5% of the patients had no regional metastases (N0) and 21.5% had metastases (N1). Combined therapy was applied to 251 patients, 135 of which were first exposed to radiotherapy and then to surgery and 116 were first exposed to surgery and then radiotherapy. In 71 patients, regional zones underwent preventive treatment (in 24 patients elective radiotherapy and in 47 preventive removal of the cervical fat were used). In 112 patients, the therapeutic protocol was modified due to different reasons (69 patients underwent only surgery and 43 radical radiotherapy). The therapeutic results were assessed in terms of three parameters: incidence of relapses and regional metastases, relapse-free time, and survival. This approach revealed no significant differences in the efficacy of the different protocols of the combined treatment. The 5-year survival rate of the patients with vestibular and cord space tumor was 77.9% and 80.7% respectively, when treated according to the radiotherapy + surgery protocol, and 82.8% and 89.2%, respectively, when treated according to the surgery + radiotherapy protocol. Comparison of preventive approaches showed that the 5-year survival rate increased by 92% as a result of removal of the subcutaneous fat from the neck area.

[Comparative evaluation of the effectiveness of radiotherapy, surgery and combined treatment of stage I-II laryngeal cancer (T1-2NoMo) based on the data of a cooperative randomized study]. / Sravnitel'naia otsenka éffektivnosti luchevogo, khirurgicheskogo i kompleksnogo lecheniia raka gortani I-II stadii (T1-2NoMo) po materialam kooperirovannogo randomizirovannogo issledovaniia.

During 1979-1987 269 patients with laryngeal cancer stage I-II were included into a cooperative randomized study: 111 patients had T1 and 158 patients, T2 tumor; 13% of patients showed cancer of the vestibular cord and 87% of them of the true vocal cord. 76 patients underwent surgery, 129 patients--radiotherapy, and 64 patients received combined treatment, i.e. radio- and chemotherapy (prospidine). The rate of relapses and regional metastases was 11.8 +/- 3.7% and 2.6 +/- 1.8% after surgery, 21.4 +/- 3.8% and 1.6 +/- 1.1% after radiotherapy, and 23.4 +/- 5.3% and 6.3 +/- 3.0% after combined treatment. In terms of the recurrence-free time surgical intervention showed the highest efficacy. With respect to the 5-year survival, measured in the above patients plus 42 patients operated on because of relapses and regional metastases, surgery of vocal cord cancer was effective in 100% in case of stage I, 97.4% in case of stage II; radiotherapy was effective in 91.7% in case of stage I, 88.8% in case of stage II, and combined treatment was effective in 100% in case of stage I and 70.3% in case of stage II; surgery of vestibular cord cancer stage II was effective in 100%, combined treatment in 88.9%, and radiotherapy in 68.6%. When vocal cord cancer involves the anterior commissure, ventricle, and space, preference should be given to surgery because relapses after radiotherapy were seen in 38-42%. Combined radio- and chemotherapy did not reduce the recurrence rate and therefore cannot be recommended for practical purposes.

[Long-term results of complex and combined treatment of locally advanced cancer of the oral mucosa]. / Otdalennye rezul'taty kompleksnogo i kombinirovannogo lecheniia mestno-rasprostranennogo raka slizistoi obolochki polosti rta.

The analysis of data on 93 cases of stage III-IV cancer of the oral mucosa showed the superiority of combined treatment over complex in terms of five-year survival: 47 and 20%, respectively (p less than 0.01). However, no significant difference in respect to that parameter was established between the combined treatment group and patients rendered disease-free with complex therapy: 47 and 40%, respectively (p greater than 0.05). In the whole group studied, five-year survival rate was 32 +/- 5%; it was 37 +/- 6 and 25 +/- 7% in patients without and with regional lymph node metastases, respectively.

[Ultrasonic tomography in the diagnosis of diseases of the thyroid gland]. / Ul'trazvukovaia tomografiia v diagnostike zabolevanii shchitovidnoi zhelezy.

The paper deals with the characteristics of application of microwave computed tomography in diagnosis of most frequent tumors of the thyroid gland in 146 surgical cases. The role and scope of microwave studies carried out in dynamic monitoring thyroid cancer patients to assure early detection of metastasis and recurrence are discussed.

[Medullary cancer of the thyroid]. / Medulliarnyi rak shchitovidnoi zhelezy.

The paper deals with a study of 42 cases of medullary carcinoma which accounts for 12.6% of all forms of thyroid cancer. The female-to-male ratio was 1.3:1, mean age - 45 years. Medullary carcinoma occurs sporadically in cases of familial endocrine syndrome. A case of Sipple's syndrome is reported. Medullar carcinoma is a hormonally-active tumor which produces calcitonin, the latter serving as a tumor marker for this carcinoma. Medullary carcinoma is characterized by bilateral involvement of the thyroid, which is more frequent in cases of familial disease, and a high rate of incidence of regional metastases (82.5%). Apart from clinical diagnostic means, the disease is chiefly identified cytologically and by calcitonin assays in blood plasma. It is mainly treated by surgery; 5- and 10-year survival rates are 87.2 and 80%, respectively.