ABSTRACT
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.
Subject(s)
Carcinoma, Basal Cell , Cryosurgery/methods , Ear Neoplasms , Radiotherapy/methods , Skin Neoplasms , Aged, 80 and over , Carcinoma, Basal Cell/pathology , Carcinoma, Basal Cell/surgery , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Combined Modality Therapy , Dermatologic Surgical Procedures , Ear Neoplasms/pathology , Ear Neoplasms/surgery , Ear, External/surgery , Female , Humans , Male , Middle Aged , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Treatment OutcomeABSTRACT
An original method of cryotherapy is presented. After each exposure during standard fractionation regimen tumor was cooled to 0-5 deg C in 20 patients with locoregional skin cancer of the face. Complete remission was registered in 18 cases of good cosmetic effect. Recurrence was reported in 2 cases during 9 month--10 year follow-up.
Subject(s)
Carcinoma, Squamous Cell/therapy , Cryotherapy , Face , Lip Neoplasms/therapy , Skin Neoplasms/therapy , Aged , Carcinoma, Squamous Cell/radiotherapy , Humans , Lip Neoplasms/radiotherapy , Male , Radiotherapy/methods , Skin Neoplasms/radiotherapy , Treatment OutcomeABSTRACT
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%.
