Comparative analysis of the efficacy of definitive chemoradiation therapy and surgery followed by adjuvant radiation therapy in advanced-stage oral tongue cancer.

The aim of the study was to compare the efficacy of definitive chemoradiation therapy (CRT) and primary surgery followed by adjuvant radiotherapy (RT) or CRT in the management of patients with stage III-IVA-B resectable oral tongue squamous cell carcinoma (OTSCC). MATERIALS AND METHODS: It is a retrospective analysis of the treatment outcomes of 211 patients with stage III-IVA-B resectable OTSCC. The patients were divided into two groups depending on the treatment modality: 114 patients received surgery followed by adjuvant RT or CRT (S-RT/CRT) group; the definitive CRT group consisted of 97 patients. RESULTS: The five-year overall survival (OS) was 57.0% in S-RT/CRT group vs 20.4% in CRT group; the five-year disease-free survival (DFS) in S-RT/CRT group was 56.5% vs 15.5%, in the CRT group. Comparison of survival curves revealed statistically significant higher OS and DFS rates in patients of S-RT/CRT group as compared with those in CRT patients (hazard ratio = 0.33 (95% confidence interval 0.23-0.47), p < 0.001 vs hazard ratio = 0.25 (95% confidence interval 0.17-0.37), p < 0.001). A multivariate analysis showed a statistically significant prognostic effect of the primary tumor extension cT4 (p = 0.004), cervical lymph node involvement cN2 (p < 0.001), cN3 (p = 0.04) and treatment modality (p < 0.001) on OS. There was also found a statistically significant prognostic effect of the primary tumor extension cT4 (p = 0.02), cervical lymph node involvement cN2 (p < 0.001) and treatment modality (p < 0.001) on DFS. 18 (15.8%) patients of S-RT/CRT group and 13 (13.4%) patients (p = 0.77) of CRT group developed mandibular osteoradionecrosis. CONCLUSION: Primary surgery with adjuvant RT or CRT in advanced-stage resectable OTSCC significantly increases five-year OS and DFS rates as compared to those after definitive CRT.

Clinical and pathological prognostic factors in patients with stage III-IVA-B oral squamous cell carcinoma.

The aim of the work was to study clinical and pathological factors affecting the prognosis of the disease in patients with stage III-IVA-B oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: A retrospective review of medical records of 234 patients with stage III-IVA-B OSCC was performed in order to study the impact of clinical and pathological factors on disease-free survival (DFS) and overall survival (OS). RESULTS: Multivariable analysis of clinical factors revealed a statistically significant effect of stage IVA-B and the presence of surgical complications on DFS (hazard ratio (HR) = 4.9 (95% confidence interval (CI) 2.9-8.3), p < 0.001; HR = 1.6 (95% CI 1.0-2.6), p = 0.047), respectively. Stage IVA-B, the presence of surgical complications and the retromolar trigone subsite were found to have a statistically significant impact on OS (HR = 4.0 (95% CI 2.5-6.5), p < 0.001; HR = 1.8 (95% CI 1.1-2.8), p = 0.01; HR = 1.9 (95% CI 1.1-3.2), p = 0.02), respectively. Multivariable analysis of pathological factors showed a statistically significant effect of positive resection margins, the multiple lymph node involvement and high-grade tumor on DFS (HR = 3.7 (95% CI 2.0-6.6), p < 0.001; HR = 4.3 (95% CI 2.8-6.7), p < 0.001; HR = 1.6 (95% CI 1.1-2.2), p = 0.01), respectively. Besides, positive resection margins and multiple lymph node involvement were found to cause a statistically significant impact on the OS (HR = 3.6 (95% CI 2.0-6.5), p < 0.001; HR = 3.7 (95% CI 2 5-5.6), p < 0.001), respectively. A tumor grade tended to worsen OS (HR = 1.4 (95% CI 1.0-1.9), p = 0.053). CONCLUSION: Stage IVA, B, the presence of surgical complications, the retromolar trigone subsite, positive resection margins, multiple lymph node involvements and high-grade tumor were found to be significant clinical and pathological prognostic factors in patients with stage III-IVA-B OSCC.

[The importance of radionuclide tests in postop monitoring of patients with differentiated thyroid cancer]. / Znachenie radionuklidnogo issledovaniia v posleoperatsionnom monitoringe bol'nykh s differentsirovannym rakom shchitovidnoi zhelezy.

The results of postoperative dynamic examination of 270 patients with differentiated cancer (DC) of thyroid gland (TG) using radionuclide method were analysed. In 74.7% of patients the residual TG tissue was revealed, in 21.8%--the cancer metastases in cervical and mediastinal lymph nodes, in 2.6%--the distant metastases. Inradicalicity of the 1st operation in 14.1% of patients had caused the necessity of the reoperation performance in 43.1% of them. The radioiodine therapy performance after the operation was indicated in 65.5% of patients with DCTG, the distance radiation therapy--in 1.1%. The necessity of performance of postoperative radionuclide monitoring in patients with DCTG was established.

[Immediate and remote results of cryosurgical treatment of oral cavity cancer]. / Blizhaishie i otdalennye rezul'taty kriokhirurgicheskogo lecheniia raka organov polosti rta.

The results of treatment using cryodestruction, combined and complex therapy of the malignant tumor of the oral cavity mucosa in 116 patients was summarised.

[Importance of scintigraphy in the evaluation of surgical treatment outcome in differentiated cancer of the thyroid gland]. / Znachenie stsintigrafii v otsenke iskhoda khirurgicheskogo lecheniia differentsirovannogo raka shchitovidnoi zhelezy.

Experience of radionuclide investigation in 493 patients with differentiated cancer of thyroid gland is summarized. The consequences due to incorrect conducting of patients with cancer after the operation were adduced on distinct examples. The program for conducting and observation of patients with thyroid gland cancer after the operation conduction was proposed directed on the early diagnosis of recurrencies and metastases, determination of indications for radioiodine therapy.

[Thymus endocrine function and the immune system indices of cancer patients after neutron and gamma therapy]. / Endokrinnaia funktsiia timusa i nekotorye pokazateli sostoiannia immunnoi systemy onkologicheskikh bol'nykh posle neitronnoi i gamma-terapii.

Patients with head and neck and locomotor system tumors received neutron therapy in the total doses of 4-8 and 12-14 Gy which was followed by a pronounced dose-dependent decrease in the serum thymus factor and total blood-lymphocyte levels. The latter changes were predominantly due to a decrease in the non-T-non-B cell concentration. Following the treatment, a rise in the level of circulating immune complexes and those of IgA and IgG was observed. Changes in the immune system proved less apparent in patients with locomotor system cancer who had been given 20 Gy of gamma-ray radiation.

[Effects of recombinant interleukin-2 on several characteristics of functional activity of lymphocytes from the lymph nodes regional to tumor and mononuclear cells of peripheral blood in cancer patients]. / Vliianie rekombinantnogo interleikina-2 na nekotorye osobennosti funktsional'noi aktivnosti limfotsitov regionarnykh k opukholi limfaticheskikh uzlov i mononuklearnykh kletok perifericheskoi krovi onkologicheskikh bol'nykh.

The level of endogenous production of IL-2 by lymphocytes of lymph nodes regional to tumour and by mononuclear cells of peripheral blood, proliferative response of these cell to recombinant IL-2, as well as a modifying influence of autologous serum and actively proliferating bioptats of autologous tumours on enumerated parameters have been studied in cancer patients (tumours of the head and neck and locomotor system). Regional IL-2-dependent immunotherapy of malignant tumors with obligatory preliminary testing for individual sensitivity of the tumor bioptat to the influence of the RIL-2 and RIL-2 activated lymphocytes is shown to be promising.