Refine Search

New Search

Results in Journal Head and Neck Tumors (HNT): 272

(searched for: journal_id:(2755484))
Page of 6
Articles per Page
by
Show export options
  Select all
M. S. Kuznetsov, A. V. Voronov, V. V. Dvoryanchikov, , А. И. Никитина
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-2-57-63

Abstract:
Introduction. Juvenile nasopharyngeal angiofibroma is a rare, benign, well-vascularized tumor of the skull base characterized by destructive growth. The development of endoscopic techniques and experience of surgeons have enabled the removal of this tumor both at early stages and late stages (advanced disease). Patients may develop various complications in the intraoperative and postoperative periods, including massive bleeding, nasal liquorrhea, facial paresthesia, lacrimal hyposecretion, etc. Air penetration into the subcutaneous fat and mediastinum during endoscopic surgery on the paranasal sinuses is rare. Such complication as subcutaneous emphysema and pneumomediastinum after endoscopic endonasal removal of juvenile nasopharyngeal angiofibroma has not been reported in the literature. Case report. A 19-year-old male patient has undergone endoscopic endonasal removal of juvenile nasopharyngeal angiofibroma. The tamponade was removed within the first 24 h postoperatively. Ten hours after it, the patient developed subcutaneous emphysema and pneumomediastinum triggered by sneezing. The diagnosis was confirmed by computed tomography of the neck and chest. The patient was transferred to the intensive care unit and received conservative treatment (including infusion, antibacterial, and antiinflammatory therapy). The symptoms of subcutaneous emphysema and pneumomediastinum subsided in response to treatment. Follow-up examinations (computed tomography and magnetic resonance imaging) confirmed that the tumor had been completely removed. The patient was discharged in a satisfactory condition. Conclusion. Subcutaneous emphysema and pneumomediastinum are exceedingly rare complications of endoscopic endonasal removal of juvenile nasopharyngeal angiofibroma and are caused by anatomical connection between the parapharyngeal / retropharyngeal spaces and mediastinum. To prevent such complications, it is necessary to keep tampons in the nasal cavity for at least 2 days, as well as to instruct patients after surgery (avoid sneezing with their mouth closed, lifting weights, coughing, and vomiting). The nasoseptal flap used to repair the nasopharyngeal defect after tumor removal also ensures its sealing. Patients with complications should undergo computed tomography of the neck and chest (in case of emergency) and should be transferred to an intensive care unit. Conservative treatment (antibacterial and antiinflammatory therapy) will ensure good results in most patients.
, , D. E. Kulbakain, V. A. Aleekseev
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-2-41-49

Abstract:
The study objective – to evaluate the feasibility of correcting eating disorders in patients undergoing surgery for oral and oropharyngeal cancers using various reconstructive techniques to restore postoperative defects. Materials and methods. Between 2012 and 2019, a total of 56 patients with stage II–IV oral and oropharyngeal cancer underwent reconstructive surgery after either hemiglossectomy or glossectomy. The patients ranged in age from 26 to 70 years. The patients were divided into two groups. Group I consisted of 36 (64.3 %) patients who underwent tongue reconstruction using rotation flaps. For reconstruction of hemiglossectomy defects, a chin flap was used, and for reconstruction of glossectomy defects, a pectoral flap was used. Group II comprised 20 (35.7 %) patients who underwent tongue reconstruction using free revascularized flaps. For the tongue reconstruction after hemiglossectomy, the radial flap, medial sural perforator flap and fasciocutaneous anterolateral thigh flap were used. For the tongue reconstruction after glossectomy, the fasciocutaneous anterolateral thigh flap was used. The acts of chewing and swallowing were restored during speech rehabilitation due to the activation and coordination of the work of the muscles of the cheeks, lips, soft palate, pharynx, and the reconstructed tongue. Eating disorders were assessed by interviewing patients. A comparative analysis of eating disorders included mobility and coordination of facial muscles and reconstructed tongue, increased sensitive in the oral cavity, the presence of aspiration and nasal regurgitation, and subjective difficulties of patients. The time before the start of rehabilitation and its duration were taken into account. Patients were interviewed before the start of the combined treatment, at the beginning and after the completion of rehabilitation. Results. After the completion of rehabilitation, all patients received food by the oral route. The best outcomes were achieved in group 2a patients, who underwent tongue reconstruction with free revascularized flaps. This group of patients had a lower percentage of the asymmetry of facial muscles and limited mobility of the tongue compared to other groups of patients. In the subgroups of patients undergoing glosssectomy, most of the studied parameters did not have statistically significant differences in values. However, it should be noted that in group 2b, the period from the date of surgical treatment to the beginning of rehabilitation was significantly longer than in group 1b. Conclusion. The use of the microvascular surgical techniques using various donor flaps creates the basis for a more complete functional recovery and expands the rehabilitation potential of patients after surgical treatment of oral and oropharyngeal cancer.
D. Sh. Polatova,
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2313-805x-2021-11-2-31-40

Abstract:
Currently, the role of human papillomavirus (HPV) in carcinogenesis is well known: more than 90 % of HPV-positive oropharyngeal squamous cell carcinomas are caused by HPV type 16 (HPV-16). HPV E6 and E7 oncoproteins play a significant role in the development of this tumor. The E6- mediated degradation of suppressor protein p53 results in G2/M-phase checkpoint dysregulation and inhibition of apoptosis. HPV oncoprotein E7 binds to pRb, promoting its degradation and the release of E2F transcription factor. Diagnostic assays for HPV detection include immunohistochemical staining for p16, polymerase chain reaction, in situ hybridization, and next-generation sequencing. Immunohistochemical examination (determination of p16 protein expression) is an economical and very specific way to detect a viral infection. Patients with HPV-positive oropharyngeal squamous cell carcinoma demonstrate significantly better response to treatment and overall survival rates than those with HPV-negative oropharyngeal squamous cell carcinoma. Despite the fact that five-year overall survival rate in patients with HPV-positive oropharyngeal squamous cell carcinoma after treatment exceeds 80 %, some patients have poor survival. Unfortunately, currently available methods of risk stratification still do not endure their timely identification. Further research is needed to address these problems.
M. V. Bolotin, V. Yu. Sobolevskiy, A. A. Akhundov, И. М. Гельфанд, S. V. Sapromadze
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-2-18-24

Abstract:
Introduction. Partial maxillectomy involves resection of 1 or 2 walls of the upper jaw, usually medial and anterior ones. The main purposes of reconstruction include the formation of an adequate support for the eyeball; isolation of the orbit from the nasal cavity, nasopharynx, and anterior skull base; normal symmetry; good aesthetic result. Materials and methods. Between 2014 and 2020, we followed up 13 patients. Nine of them (69 %) had combined defects involving the inferior orbital, anterior, and medial walls of the maxilla (class V according to according to the Brown–Shaw classification, 2010), as well as skin on the buccal and zygomatic areas; 1 patient also had lower eyelid affected. Four individuals (31 %) had isolated defects involving the inferior orbital, anterior, and medial walls of the maxilla (class V according to according to the Brown–Shaw classification, 2010). Twelve patients have undergone preoperative 3D-computer simulation. We divided patients into 2 groups according to the size of their defects and resection areas in the anterior wall of the maxillary sinus. Group 1 included 5 patients with partial maxillary defects (involving 25–40 % of the total area), whereas Group 2 comprised 7 patients with limited maxillary defects (involving 25–40 % of the total area). Five patients have undergone reconstructive surgeries with fasciocutaneous flaps, including anterolateral thigh flaps used in 4 individuals (31 %) and thoracodorsal flap used in 1 individual (8 %). Eight patients had their defects repaired using radial fasciocutaneous flaps. The inferior orbital wall was reconstructed using an individual titanium mesh implant. Results. All patients from Group 1 after defect repair with anterolateral thigh flaps and thoracodorsal flaps (4 individuals) had satisfactory aesthetic result. One patient had an unsatisfactory aesthetic result after reconstruction with a radial fasciocutaneous flap due to mesh implant protrusion and formation of an opening in the nasal cavity. The assessment of the eyeball position demonstrated that symmetry was achieved in 4 patients (80 %) after reconstruction using anterolateral thigh flaps (3 patients) and thoracodorsal flap (1 patient). Five patients from Group 2 (72 %) had excellent results, while 2 patients (28 %) had satisfactory results. The assessment of the eyeball position demonstrated that symmetry was achieved in 5 patients (70 %); two participants (28 %) had lower eyelid ectropion. Conclusion. Patients with large maxillary defects (involving 41–60 % of the total area of the anterior wall of the maxillary sinus and the alveolar process of the maxilla) should undergo reconstructive surgeries with fasciocutaneous anterolateral thigh flaps. In case of relatively small defects (involving 25–40 % of the total area of the anterior wall of the maxillary sinus and the alveolar process of the maxilla) the best option is defect repair with radial fasciocutaneous flaps. Such strategy ensures excellent aesthetic and functional results in 75 % of patients.
E. G. Khazarova, E. L. Dronova
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-2-10-17

Abstract:
Introduction. Сomputed tomography (СТ) and magnetic resonance imaging (MRI) are the main methods of radiological diagnostics, which makes it possible to objectively assess the local advancement of malignant tumors of the hearing organ and decide on the possibility of surgical intervention. The objective of this scientific research – to determine the main indications for surgical intervention, taking into account the radiological criteria for the lesion of the temporal bone (CT, MRI) in locally advanced outer ear skin cancer. Materials and methods. This research work based on a retrospective and prospective analysis case history for patients with locally advanced external ear skin cancer. These are 45 patients, who received treatment in surgical department of head and neck tumors in N. N. Blokhin National Medical Research Center of Oncology between 1994 and 2020. Patient observation time averaged 30.0 ± 32.3 months (from 0.7 to 117.4 months, median – 12.0 months). Results. The prevalence of the tumor process in cancer of the skin of the external auditory canal in accordance with the staging system for lesions of the temporal bone structures (University of Pittsburgh, 1990), which takes into account CT and MRI signs of damage to the temporal bone and adjacent anatomical structures, is a factor that significantly affects the long-term results of treatment (for disease-free survival: hazard ratio (HR) 4.76, 95 % confidence interval (CI) 1.93–11.73, р = 0.00069; for tumor-specific survival: HR 4.25, 95 % CI 1.74–10.39, р = 0.0015; for overall survival: HR 1.96, 95 % CI 1.07–3.58, р = 0.029). Conclusion. CT and MRI are mandatory methods of radiological diagnosis of patients with skin cancer of the external auditory canal.
A. P. Polyakov, I. V. Rebrikova,
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-2-50-56

Abstract:
Melanoma is a malignant skin tumor associated with a poor clinical prognosis. The incidence of melanoma is constantly rising. Several studies demonstrated that overall and relapse-free survival rates in patients with head and neck melanoma were lower than those in patients with skin melanoma of other locations. Some authors showed that patients with scalp melanoma had the worst prognosis. Surgery is currently the main treatment option for resectable skin melanoma. It has a number of specific characteristics, such as the need for a smaller resection margin at primary tumor removal in some cases, lower accuracy of sentinel lymph node identification due to the complexity of lymph flow from the scalp and neck, and changes in the standard volumes of lymphadenectomy considering lymph flow from the scalp and neck. Oncologists should have reconstructive surgery skills, because their aim is not only to ensure complete tumor excision, but also to achieve a satisfactory appearance of the patient, especially if the tumor is located in the face, open areas of the head and neck and ears, since this is of functional and aesthetic importance. The administration of adjuvant therapy still causes some controversy in cases where both radiation therapy and pharmacotherapy are indicated. In this article, we describe the main characteristics of the current treatment strategy for resectable scalp and neck melanoma and cover the main problems in this area that have not been addressed so far.
S. B. Alieva, I. A. Zaderenko, T. N. Borisova, R. R. Kaledin, A. O. Sekretnaya, A. V. Khromushina
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-2-25-30

Abstract:
During 1996–2015 years, 53 patients with stage locally-advanced squamous cell carcinoma of the pharynx with stage N3 were treated in N. N. Blokhin National Research Center of Oncology. Depending on the treatment method, patients were divided into 2 groups: concurrent (n = 26) and induction (n = 27) chemoradiotherapy. Concurrent chemoradiotherapy (option 1) was given using: cisplatin 100 mg/m2 – every 3 weeks, or carboplatin 1.5 AUC weekly, or cisplatin 100 mg/m2 with 5-fluorouracil 1000 mg/m2 every 24 hours, in continuous infusion for 96 hours (PF). Induction chemotherapy (option 2) was performed in 2 modes: TPF (docetaxel, cisplatin, 5-fluorouracil) or PF (cisplatin, 5-fluorouracil). Radiation therapy was performed on a linear accelerator for 2 Gy daily up to SD 68–70 Gy for the primary tumor and 66 Gy for the affected lymph nodes. According to the results of our retrospective study, the 3 year overall and relapse-free survival rate depending on the chemoradiotherapy option was 37 and 32 % (option 1), 62 and 56 % (option 2). A promising option for chemoradiotherapy of locally advanced squamous cell carcinoma of the pharynx is induction chemoradiotherapy.
, В. В. Полькин, , F. E. Sevrukov, N. Yu. Dvinskych, M. I. Ryzhenkova, , A. D. Kaprin
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-2-64-71

Abstract:
Thyroid carcinoma with thymus-like differentiation (Carcinoma Showing Thymus-Like Differentiation, CASTLE) is an extremely rare disease. It arises from the thymus tissue ectopic into the tissue of the thyroid gland, usually in patients 40–50 years old. In this work, we present an observation of the development of CASTLE in a patient at a young age. A 21-year-old woman was admitted to our clinic with a volumetric education in the projection of the left lobe of the thyroid gland. Ultrasound revealed a 5-centimeter thyroid tumor. Surgery was performed in the scope of thyroidectomy, selective cervical dissection (level VI). Morphological and immunohistochemical studies showed that cancer has a thymus-like differentiation (CASTLE). After 32 months, she recurred to the lymph nodes of the neck (level IV on the left). She underwent repeated surgery, after which she was observed without signs of relapse for 120 months. The rarity of the pathology leads to difficulties in establishing a diagnosis at the preoperative stage and in choosing the optimal treatment tactics during treatment and further follow-up.
A. A. Mitrofanov, , V. A. Aleshin, D. M. Belov, A. Kh. Bekyashev, V. B. Karakhan, N. V. Sevyan, E. V. Prozorenko, K. E. Roshchina
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-101-108

Abstract:
Glioblastoma multiform^ is one of the most aggressive malignancies, wich standard of treatment not changed over the past decade, and the average life expectancy from diagnosis to death does not exceed two years in the most optimistic trials. The review examines the features of the glioblastoma microenvironment, its genetic heterogeneity, the development of recurrent glioblastoma, the formation of drug resistance, the influence of the blood-brain barrier and the brain lymphatic system on the development of immunotherapy and targeted therapy. Molecular subgroups of glioblastomas with an assumed prognostic value were analyzed. It was determined that numerous relationships between glioblastoma cells and the microenvironment are aimed at ensuring tumor progression, and also cause a state of reduced effector function of T cells. Data on the development of future molecular-targeted therapies for four types of cancer cells based on their different properties and response to therapy are summarized: primary GSC, RISC cells, and proliferating and postmitotic non-GSC fractions. The penetration of blood-brain barrier with chemotherapeutic drugs and antibodies currently remains the main limitation in the treatment of glioblastoma. The resulting analysis of the causes is reduced to the following conclusions. A detailed understanding of the evolutionary dynamics of tumor progression can provide insight into the related molecular and genetic mechanisms underlying glioblastoma recurrence. The most promising methods of treatment for glioblastoma are combined therapy using immune checkpoint inhibitors in combination with new treatment methods -vaccine therapy, CAR-T-cell therapy and viral therapy. A deeper study of the mechanisms of drug resistance and acquisition resistance, biology and subcloning clonal populations of glioblastoma and its microenvironment, with active consideration of combined trips to the treatment will increase the survival rate of patients, and may lead to stable remission of the disease.
D. A. Safarov, , B. I. Dolgushin, A. A. Akhundov, I. A. Zaderenko, D. A. Peshko
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-41-50

Abstract:
The study objective is to evaluate the results of organ-preserving treatment of locally advanced larynx squamous cell carcinoma. Materials and methods. Analysis of 28 patients with locally advanced larynx squamous cell carcinoma (stages III-IV) who underwent treatment at the N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russia between 2017 and 2020 was performed. At the first stage, 2-3 courses of combined inductive polychemotherapy per the DCF scheme with 21-day interval were performed (docetaxel 60 mg/m2, cisplatin 60 mg/m2 intraarterially bolus with detoxication with sodium thiosulfate, 5-fluorouracil 1000 mg/m2/day as 96-hour infusion). The second stage included external beam radiotherapy (60-70 Gy, 2 Gy per day 5 days a week) as monotreatment if complete clinical response after chemotherapy was achieved or with regional administration of cisplatin (60 mg/m2 once per 3 weeks) if after inductive stage full clinical response wasn»t observed. Results. In 20 (71.5 %) patients, complete clinical response was observed after inductive treatment; in 7 (25 %) patients, partial response was observed. Tumor stabilization was detected in 1 (3.5 %) patient. Two-year overall survival was 95.8 ± 4.1 %, progression-free survival was 90.1 ± 6.8 %. Conclusion. The proposed strategy of organ-preserving treatment of stage III-IV larynx cancer with substitution of systemic chemotherapy with regional intraarterial chemotherapy prior to radiotherapy is highly effective from the point of view of direct anti-tumor effect and recurrence-free and overall survival.
S. B. Alieva, R. I. Azizyan, , I. A. Zaderenko, N. A. Daykhes, V. Z. Dobrokhotova, E. N. Novozhilova, S. S. Reshulskiy, T. N. Borisova, V. V. Vinogradov
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-24-33

Abstract:
Radiation therapy as one of the main specific method of treatment is widely used to treat patients with laryngeal cancer. Currently, the main radiotherapy technique for the treatment of patients with head and neck cancer is linear electron accelerators that can provide individual, complex configurations of radiation volumes. The article presents new modern technologies of radiation therapy in the early and locally-advanced stages of the disease, principles of organ-preservation treatment in laryngeal tumors, indications for pre-and postoperative radiation, methods of prevention of post-therapeutic complications.
, E. G. Khazarova, M. V. Bolotin
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-12-23

Abstract:
The study objective is to assess long-term results of treatment for patients with locally advanced external ear skin cancer. Materials and methods. This research work based on a retrospective and prospective analysis case history for patients with locally advanced external ear skin cancer. These are 45 patients, who received treatment in surgical department of head and neck tumors in Blokhin National Medical Research Center of Oncology between 1994 and 2020. Patient observation time averaged 30.0 ± 32.3 months (from 0.7 to 117.4 months, median 12.0 months). We divided patients into 3 groups depending on treatment methods. Group 1 consisted of patients who received combined or complex treatment (33.3 %, n = 15). Treatment for first group patients involved subtotal, lateral temporal bone resection or incomplete lateral resection and postoperative radiation therapy on the area of primary tumor and regional metastasis zone (total focal dose from 60 Gy). In the case of complex treatment, radiation therapy had carried out against background cisplatin introduction. The second group consisted of patients who received only surgical treatment (40.0 %, n = 18). Temporal bone resections were not performed for patients of the third group (26.7 %, n = 12). Treatment for patients of the third group involved one of the treatment methods: cryodestruction, laser destruction, photodynamic therapy, radiotherapy or chemoradiation treatment. Results. Five-year survival without signs of progression in a group of patients with locally advanced of the ear skin cancer, who received combined or complex treatment was 73.8 ± 13.1. Median progression-free survival not achieved. In the surgical treatment group 5 year progression-free survival was 40.4 ± 13.0, median was 34.1 months. In a group of patients who did not undergo temporal bone resection (3rd group) median progression-free survival was 4.5 months. Group differences are statistically significant (p <0.05). The most significant adverse prognosis factors that reduce overall survival for patients with locally advanced external ear skin cancer are positive histological margin (p = 0.0001, hazard ratio (HR) = 10.611, 95 % confidence interval (CI) 3.058-36.820), signs of destruction branch of the lower jaw/ zygomatic bone (p = 0.027, HR = 4.65, 95 % CI 1.193-18.116). Facial paralysis is the most unfavorable prognosis factor, reducing tumor-specific survival in patients with locally advanced outer ear skin cancer (p = 0.0001, HR = 19.146, 95 % CI 4.056-90.388). Conclusion. Combined/complex treatment of patients with locally advanced ear skin cancer (surgery with postoperative radiotherapy/chemoradiotherapy) provides better long-term results compared to other treatment options.
S. A. Lukyanov, S. V. Sergiyko, , , , V. Z. Dobrokhotova, , S. L. Vorobyov, A. V. Vazhenin, , et al.
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-34-40

Abstract:
Background. Anaplastic thyroid cancer (ATC) is one of the most aggressive human tumors. Since median survival of ATC patients is only 4 months, its early diagnosis is very important. Although ATC has specific clinical manifestations, the analysis of expression of different microRNAs can facilitate preoperative diagnostics and help to detect its potential precursors among differentiated cancers and other thyroid malignancies. The study objective is to identify microRNAs specific for ATC that are different from microRNAs in other thyroid cancers. Materials and methods. We analyzed the expression of 14 microRNAs in histological specimens of 67 patients with ATC. The control groups included 25 patients with benign nodules, 36 patients with follicular adenomas, 32 patients with follicular cancer, and 152 patients with papillary thyroid cancer. For 7 out of 67 ATC patients, we compared mi-croRNA levels in histological and cytological specimens. Results. Patients with ATC demonstrated a statistically significant decrease in the expression of miR-145, miR-125b and increase in the expression of miR-155 and miR-21 compared to all control groups. We found two reliable diagnostic markers of ATC: relative miR-21 expression (at a cutoff of 14.9, sensitivity was 0.955 and specificity was 0.837) and the miR-21/miR-145 ratio (at a cutoff of 122, sensitivity was 0.955 and specificity was 0.955). The level of miR-21 expression and miR-21/miR-145 ratio in cytological specimens were accurate in all 7 cases (100 %). Conclusion. the level of expression of specific microRNAs can be used as a reliable biomarker for ATC. The consistency between the results obtained in cytological and histological specimens enables the use of stained cytological samples for this analysis.
, N. А. Sharafutdinova, A. V. Sultanbaev, S. V. Osokin, B. A. Ibragimov, ,
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-109-114

Abstract:
Background. In the structure of malignant neoplasms, basal cell skin cancer (BCC) occupies a leading position. In the initial stages of a malignant neoplasm, the main treatments are local treatment methods, both surgical and radiation. However, in about 1.3 % of cases, BCC can become locally or metastatic in which local treatment methods are limited. With the development of targeted drugs, such as the Hedgehog pathway inhibitor, the possibilities for effective and safe treatment of this category of patients have appeared. The objective is to present the clinical case of treating a patient with BCC who is receiving systemic therapy with a Hedgehog signaling pathway inhibitor. Case report. According to the patient, a tumor in the lower eyelid of the left eye appeared in 2000, did not seek medical help. In 2011, he applied to the clinic and was diagnosed with skin cancer of the lower eyelid of the left eye T2bN0M0. The patient refused the proposed treatment. Reapplied only in June 2017 already with a locally distributed process. The case is recognized as unresectable. From June 30, 2017 to September 4, 2017, he underwent a course of a radical program of radiotherapy, with a positive effect. 07/01/2019, he relapsed with a relapse of an orbital tumor on the left. From July 16, 2019, the patient began taking the drug wismodegib 150 mg once a day. Against the background of the treatment, control CT studies on 11/24/2019 and 11/03/2020 compared with CT data from 07/09/2019 reduced the volume of the tumor by 78 and 82 %. The patient currently continues to take wismodegib. Conclusion. The clinical case demonstrates successful treatment of locally advanced basal cell skin cancer with a Hedgehog signaling pathway inhibitor.
A. P. Polyakov, , A. A. Stepanova
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-51-72

Abstract:
Squamous cell carcinoma (SCC) is the second most common skin cancer after basal cell carcinoma. Usually, antitumor treatment is sufficiently effective: recovery rate is about 90 %. Primary SCC is characterized by variable growth rate, as well as by involvement of regional lymph nodes (from 1 % for well differentiated tumors to 10 % for poorly differentiated tumors, size >3 cm and /or invasion depth >4 mm). In case of SCC development near post-burn scar, the rate of regional metastasis is 10-30 %. A relatively small possibility of distant metastasis also exists, with overall mortality of 2-3 %. In SCC of the head and neck, both hematogenic and perineural advancement into the CNS are possible. Total rate of local recurrences is 25 %. The main factors of local and regional recurrences are location (head and neck), size (tumor diameter >2 cm), invasion depth (>4 mm), tumor differentiation, perineural involvement, patient's immune status and previous treatment. Tumors in areas that weren»t subjected to solar radiation and tumors in the areas of pervious irradiation, thermal damage, scarring or chronic ulcers are more prone to recurrences and metastasis. Poorly differentiated and anaplastic SCC is more likely to metastasize compared to well differentiated tumors. Medially located SCC is the area of the face mask and lip is more prone to neural invasion. Multidisciplinary approach with involvement of all specialists in antitumor treatment is necessary for development of treatment tactics.
, S. O. Podvyaznikov, G. A. Tkachenko, , S. B. Shakhsuvaryan, Yu. V. Alymov, А. В. Игнатова
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-122-133

Abstract:
Four stages of medical rehabilitation of patients with differentiated thyroid cancer in Russia are described. Specific rehabilitation programs and methods are described for every stage. The pre-rehabilitation program includes psychological and nutritional support, exercise therapy, consultations by the surgeon and anesthesiologist, correction of concomitant disorders, prevention of thromboembolic complications and local hemodynamic abnormalities. At the rehabilitation stage in the ICU antibacterial therapy, patient positioning, percussion massage of the chest, passive mobilization, massage of the extremities are performed. The rehabilitation program at the specialized surgical department includes psychological rehabilitation, adequate pain management, exercise therapy, massage, nutritional support, prevention of thromboembolic complications, treatment of early postoperative complications. The in-hospital rehabilitation at medical facilities additionally includes treatment of delayed and late surgical complications, correction of radioiodine therapy consequences. The outpatient rehabilitation program also involves correction of hypothyroidism and minimization of adverse effects of suppressive hormone therapy, health resort treatment.
D. N. Reshetov
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-73-77

Abstract:
Introduction. Skin cancer is the most common type among the cancer statistics. It accounts up to 14.2 % of all types of cancer. Basal cell cancer (BCC) is the most common among the skin cancers. Despite the possibilities of using different types of treatment BCC the long-term results are infavorable-the relapse rates are still high and cosmetic results are unsufficient. Using the local chemotherapy is alternative method of head&neck BCC treatment. The study objective. Efficency analysis of using «Glycifon» as a local chemotherapy drug for head&neck BCC. Materials and methods. The study included 24 patients with head&neck BCC who underwent local chemotherapy with "Glycifon" drug. 18 (75 %) patients had primary tumors, 6 (25 %) - relapsed tumors. 7 (29.2 %) patients had multicentre BCC. All patients received local chemotherapy by "Glycifon" according to recommended instructions. Results. 79.2 % of patients had full regress of BCC after "Glycifon" local chemotherapy. Medium follow up time was 11.5 month. 2 patients (8.35) had to interrupt the treatment but for the intensive pain after the drug application. Other patients finished the therapy satisfactorily. No toxic reactions were observed. Inflammatory reactions in application zones were moderate and easily fixed. All patients who finished the therapy (100 %) we satisfied about the cosmetic results. Conclusion. Usage of "Glycifon" drug for local chemotherapy of head&neck DCC is effective, safe and cosmetic satisfied method. Possibility of using "Glycifon" in ambulatory treatment reduce the total medical & economic costs.
Е. Н. Менькова, Д. Е. Кульбакин, , M. R. Mukhamedov, V. A. Alekseev, V. I. Shtin
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-96-100

Abstract:
Currently accepted standard of surgical treatment of patients with locally advanced stage III and IV laryngeal and laryngopharyngeal cancer is laryngectomy which leads to loss of vocal function. Therefore, vocal rehabilitation is one of the most important tasks of the doctor. It allows to increase quality of life of patients after treatment. Currently used techniques of vocal rehabilitation have their advantages and disadvantages. The article considers various techniques of vocal rehabilitation, primarily, subtotal laryngectomy with laryngotracheal shunt as a promising method of surgical rehabilitation of patients with locally advanced caner of the larynx and laryngopharynx.
N. A. Daikhes, V. V. Vinogradov, I. A. Kim, С. С. Решульский, V. F. Prikuls, O. V. Karneeva, A. M. Khabazova,
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-86-95

Abstract:
Introduction. Diagnosis verification in patients with malignant tumors developed in the context of chronic inflammation is technically complex with a high percentage of false negative results of histological examination. None of the methods provides sufficiently accurate results necessary for ruling out or confirming a diagnosis. The study objective is to test a new patented method of pre- and intraoperative differential diagnosis of oncological pathology of the ent-organs using the "InSpektr-M" hardware and software system. Materials and methods. The study included 30 patients with suspected malignant tumors of the larynx. The study excluded patients with previously verified diagnosis of malignant tumor of the larynx. A diagnostic probe emitting laser light with wavelength 350 nm and radiation power density 25 mW/cm2 was introduced through an additional channel of a fiberscope for a period of time sufficient for excitation of intrinsic tissue fluorescence (from 10-6 to 10-9 ms). Fluorescence intensity in the range of wavelengths between 600 and 650 nm was measured. This intensity was conditionally labelled "epithelial proliferative activity index". Spectrometric analysis of the intact points allowed to evaluate normal values for an individual patient; in the areas with the maximal increase in the index, targeted biopsy was performed. Results. Values obtained during examination of various types of tumors (epithelial and non-epithelial) are different while tumor location has a negligible effect. In patients with malignant tumors containing non-squamous epithelium, increased protoporphyrin IX and decreased FAD fluorescence were observed in the direction from intact tissues to the center of the suspected tumor; in patients with malignant tumors containing squamous epithelium: increased protoporphyrin IX fluorescence with maximum at 635 nm and dynamic increase in FAD fluorescence in the direction from intact tissues to the tumor center. Conclusion. Fluorescent spectroscopy can be used for pre- and intraoperative differential diagnosis of squamous and non-squamous cancers of the ENT-organs. Further studies for establishment of reference values of fluorescence intensity in intact and affected tissues are necessary.
, M. R. Savchuk, N. V. Shved, N. A. Savelov, D. N. Khmelkova, , R. V. Deev
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-78-85

Abstract:
The study objective is to analyze the mutation profile of the tall cell variant (TCV) of papillary thyroid carcinoma (PTC). Materials and methods. The main inclusion criteria according to the WHO classification (2017) was PTC composed of at least 30 % of tall cells. Genetic examination was conducted using the FoundationOne CDx assay (USA) with median depth of coverage of >500x. This study included 5 patients (1 man and 4 women) with a mean age of 52.6 years (range: 48-56 years). The tumor size varied between 0.4 x 0.5 cm and 11.0 x 9.0 cm. All patients have undergone surgical treatment: hemithyroidectomy for patient No. 1 with a small tumor (pT1b); thyroidectomy for patient No. 2 (pT3b); extensive thyroidectomy with the removal of paratracheal tissue for patients No. 3, 4, and 5 (No. 3 - pT3bN0; No. 4 - pT3bN1b; No. 5 - pT3bN1b). Three out of the five patients also had adenomatous goiter. The mean follow-up time was 3.4 to 5.2 years. Results. Tumors in all patients were characterized by low mutational load (0 to 4 mutations per 1 million nucleotides (megabase)) and no microsatellite instability. All study participants were found to have p.V600E mutation in the BRAF gene; two patients had c.-124C>T mutation in the promoter region of the TERT gene. All patients carried mutations with unknown clinical significance: p.V562I in the EPHB1 gene (in 2 patients); mutations in the genes AR, CREBBP, EP300, ERCC4, FLT1, IKBKE, JAK2, MAF, MLL2, MST1R, MYC, MYCL1, NTRK2, TSC2 (each mutation registered in one patient). One individual with the largest tumor and the most aggressive disease was found to have amplifications of the BTG2, MAP3K1, SMAD2, and TBX3 genes. Conclusion. In 5 patients analyzed in this study, the mutation profile of TCV PTC was characterized by low mutational load, no microsatellite instability, and presence of p.V600E mutation in the BRAF gene in all cases. Some patients also had c.-124C>T mutation in the TERT gene and p.V562I mutation in the EPHB1 gene.
, T. S. Antipova
Head and Neck Tumors (HNT), Volume 11; https://doi.org/10.17650/2222-1468-2021-11-1-115-121

Abstract:
Introduction. Papillary thyroid cancer (PTC) usually metastasizes into the central and lateral lymph nodes (LNs) of the neck. Metastases into the retropharyngeal and parapharyngeal LNs are rare. Their presence attests to aggressive PTC. The study objective is to describe a rare case of metastases of papillary radioiodine-refractory PTC into the parapharyngeal LN. Clinical case. In 2015, female patient K., 40 years old, underwent thyroidectomy due to PTC. Histological examination verified papillary PTC with growth through the capsule and ingrowth into the surrounding tissues and muscles. In a separately admitted LN, metastases of the same cancer were observed. One year later, regional metastases in the lateral neck LNs were detected. Radioiodine therapy (activity 131I 4.5 GBq) was performed followed by fascial circular section of the neck tissues on the right per thyroid type. Morphological examination verified presence of papillary PTC metastases in 4 LNs. In January of 2018, positron emission tomography showed metastases in the paratracheal LNs. Central neck lymph node dissection was performed. Per histological conclusion, fat tissue and LN contained multiple metastases of papillary PTC. In October of the same year, repeat radioiodine therapy (activity 131I 3.0 GBq) was performed. Thyroglobulin levels increased. In June of 2020, repeat positron emission tomography showed a single metastasis in the parapharyngeal LN. Due to small size of the metastasis and absence of signs of progression, dynamic follow-up and hormone therapy were suggested to the patient. Conclusion. Metastatic involvement of parapharyngeal LNs is rare, especially in radioiodine-refractory PTC. They can be detected both during primary diagnosis and after the treatment during dynamic follow-up, as well as a single manifestation of PTC, which should be taken into account during differential diagnosis.
M. A. Krylovetskaya, I. G. Komarov, A. Yu. Kontsevaya,
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-10-15

Abstract:
Background. The detection of primary tumor in patients with cervical lymph node metastases without the primary tumor found is very important, because its location often determines the treatment strategy. The study objective is to analyze the capabilities of upper respiratory tract fibroscopy for the detection of primary tumor in patients with cervical lymph node metastases from squamous-cell carcinoma without the primary tumor found.Materials in methods. A total of 70 patients with cervical lymph node metastases without the primary tumor found, in whom cytological examination of biopsy specimens collected from cervical lymph nodes revealed squamous-cell carcinoma, underwent upper respiratory tract fibroscopy in N.N. Blokhin National Medical Research Center of Oncology between January 2017 and May 2020.Results. In 24 out of 70 patients, fibroscopy helped to identify the primary tumor and collect biomaterial for morphological examination. Twelve patients were found to have oropharyngeal cancer; ten patients were diagnosed with nasopharyngeal cancer; and 2 patients had laryngopharyngeal cancer. Fifteen out of 24 patients had tumors less than 1.2 cm.Conclusion. Upper respiratory tract fibroscopy is a highly effective method for detecting small asymptomatic tumors. It can be recommended for the examination of patients with metastases from squamous-cell carcinoma without the primary tumor found, if the primary tumor is believed to be located in the upper respiratory tract
S. E. Titov, G. A Katanyan, T. L. Poloz, L. G. Izmaylova, О. А. Zentsova, L. G. Dryaeva, V. V. Anishchenko
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-50-59

Abstract:
Introduction. The main method of preoperative diagnosis of thyroid tumors and the identification of possible metastasis is a cytological examination of smears obtained by fine-needle aspiration biopsy. However, the cytological material of the lymph nodes may not be adequate, and the detection of metastases faces a number of difficulties. In our recent study, we described a variant of the molecular classifier that allows the detection and typing of malignant thyroid tumors by analyzing several molecular markers in cytological preparations.The study objective was to assess the applicability of the developed method for the preoperative detection of metastases of papillary and medullary thyroid cancer in the lymph nodes of the neck lateral cellular tissue.Materials and methods. A total of 86 cytological samples were used, obtained from individual lymph nodes of 62 patients who had a diagnosis – thyroid cancer. Samples were analyzed by real-time polymerase chain reaction regarding the preselected set of molecular markers: the BRAF V600E mutation, the normalized concentration of HMGA2, FN1 and SERPINA1 mRNA, 5 miRNAs and the mitochondrial/nuclear DNA ratio. The decision tree-based classifier was used to discriminate between benign and malignant samples.Results. The previously described classifier, based on the analysis of the BRAF V600E mutation, the content of HMGA2 mRNA, 3 miRNAs and the mitochondrial/nuclear DNA ratio, revealed metastases of thyroid cancer with good specificity (98 %) but less sensitivity (83 %). Therefore, a new classifier was built, including three markers – HMGA2 and FN1 mRNA, and miRNA-375, which, with regard to the detection of metastases, showed good sensitivity – 93 % with a slight decrease in specificity (up to 96 %).Conclusion. Thus, we demonstrated the possibility of preoperative detection of thyroid cancer metastases in the lymph nodes of the neck lateral cellular tissue by analyzing several molecular markers in cytological material.
М. V. Bolotin, A. M. Mudunov, V. Yu. Sobolevsky, А. А. Akhundov, И. М. Гельфанд, S. V. Sapromadze
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-25-31

Abstract:
Background. The main aims of hard palate reconstruction include separation of the nasal and oral cavities, restoration of chewing, swallowing, speech, ensuring good aesthetic results, and preparation for dental rehabilitation. The choice of reconstruction method is determined by such factors as the nature and location of the defect, surgeon’s experience in certain reconstruction methods, cancer prognosis, and patient’s preference. The study objective is to analyze the results of microsurgical reconstruction of hard palate defects using different types of flaps. Materials and methods. Forty-one (41) patients underwent microsurgical reconstruction of defects of the hard palate, soft palate, and alveolar process between 2014 and 2020. Defects of the anterior portion of the hard palate (grade I, IIc, IId according to the classification of J.S. Brown; grade IB, II, III according to the classification of D.J. Okay) were formed in 13 cases; all of them involved the alveolar margin of the maxilla to some extent. To repair these defects, we used flaps containing revascularized bone (n = 10; scapular tip flaps in 8 patients and fibular flaps in 2 patients) and fasciocutaneous or musculocutaneous flaps (n = 3; radial fasciocutaneous flaps in 2 patients and musculocutaneous flap from the anterior surface of the thigh in 1 patient). Defects of the posterior portion of the hard palate (grade Ib according to the classification of J.S. Brown; grade Ib according to the classification of D.J. Okay) were formed in 18 patients. To repair these defects, we used radial fasciocutaneous flaps (n = 17) and fibular autologous graft containing skin, muscles, and bone (n = 1). Soft palate resection was performed in 10 patients; all surgeries were combination, since the lateral oropharyngeal wall was included in the block of removed tissues. None of the patients had the opposite side affected. These defects were repaired using radial fasciocutaneous flaps.Results. Six patients (15 %) developed total flap necrosis due to venous thrombosis on days 2, 3, and 6 postoperatively; two patients developed flap necrosis due to arterial thrombosis 2 days postoperatively. Good speech quality was achieved in 33 patients (80 %), while 6 patients (15 %) had satisfactory speech; rhinolalia was observed in 2 patients (5 %). All patients with defects of the posterior hard palate and of the soft palate had excellent aesthetic results. Among participants with defects of the anterior hard palate and alveolar process, 10 patients had excellent aesthetic results, while 5 individuals had good results. Three patients had unsatisfactory results due to scarring in the middle portion of the face.Conclusion. Patients with subtotal defects of the hard palate and defects of its anterior portion (grade I, IIb, IIc according to the classification of J.S. Brown; grade II, III according to the classification of D.J. Okay) require repair of the alveolar margin of the maxilla; flaps containing revascularized bone are preferable in this case. The method of choice is defect repair using musculoskeletal scapular tip flap. In patients with short defects, defects located posteriorly, minimal or no defect of the alveolar margin of the maxilla (grade Ia, IB according to the classification of J.S. Brown; grade Ia, Ib according to the classification of D.J. Okay; grade V according to the classification of M.A. Aramany), soft palate defects, radial fasciocutaneous flaps should be used.
A. R. Gevorkov, A. V. Boyko, L. V. Bolotina, S. V. Shashkov, G. R. Abuzarova, R. R. Sarmanaeva
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-60-73

Abstract:
The study objective is to improve quality of life in patients with oropharyngeal squamous-cell carcinoma during chemo/bioradiation therapy and at early stages after its completion which allows to perform the full extent of radiation within optimal treatment period.Materials and methods. A retrospective analysis of data on 196 patients who underwent chemoradiation therapy between 2005 and 2016 was performed. The results were used to develop and implement a program of support for chemo/bioradiotherapy. The program was characterized by: 1. use of Russian hydrogel materials for local delivery of antibiotics and wound-healing, anesthetizing, anti-inflammatory medications; 2. new regimens of pain relief with differentiated pathogenetic approach and use of modern transdermal long-acting forms; 3. nutritional support at every treatment stage; 4. assurance of compliancy. To evaluate the program, prospective randomized controlled study was performed between January of 2017 and March of 2019 including 60 patients.Results. Mucositis and dermatitis severity and changes in physical state associated with them, progression and duration of radiation did not significantly differ in the two groups. Use of the support program allowed to control adverse effects and to perform chemoradiotherapy to the full extent, at optimal time and with satisfactory quality of life.Conclusion. The program of support of chemo/bioradiotherapy in combination with psychological support is effective both form the point of view of optimization of treatment and rehabilitation times and from the point of view of maintenance of high quality of life in patients.
F. S. Sevryukov, E. V. Borodavina, Р. А. Isaev, В. В. Полькин, , С. В. Васильков, Yu. А. Panaseykin, D. N. Derbugov, , S. О. Podvyaznikov, et al.
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-44-49

Abstract:
Dermal toxicity of anti-cancer drugs apparent in patients with thyroid cancer. This side effect appears, in particular, in relation to increased administration of targeted anti-cancer treatment, especially tyrosinkinase inhibitors, towards various receptors of growth factors which are applied in the ethiopathogenesis of a tumor cell. Our article focuses on the dermatotoxity, designated also as skin reaction, which most frequently occurs in patients treated by tyrosinkinase inhibitors – sorafenib, vandetonib, cabozantinib and lenvantinib. High prevalence of dermatotoxity, reported by patients, treated with these drugs underscores the need for greater understanding of the pathogenesis and management of this syndrome.
A. E. Kazimov, A. M. Mudunov, Z. V. Grigorievskaya, I. A. Zaderenko, S. B. Alieva, N. S. Bagirova, I. N. Petukhova, I. V. Tereshchenko, M. B. Pak
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-74-85

Abstract:
The study objective is to evaluate the effect of periodontal microorganisms on development of squamous-cell carcinoma of the oral mucosa and the risk of its recurrence.Materials and methods. Microbiological study of biomaterials from 150 patients was performed. The study group included 100 patients with T3–T4 squamous-cell carcinoma of the oral mucosa and was subdivided into two subgroups with 50 patients in each. The control group included 50 patients.Results. Analysis of the results obtained in the subgroup of primary patients showed the following trends: in 2 (50 %) of 4 patients with Fusobacterium spp., recurrence of the main disease was observed as well as a case of distant metastasis into the bones. Among 35 patients with Prevotella spp. in the biomaterials, in 16 (45.7 %) recurrence of the tumor was observed. Among 10 patients with Veillonella spp., recurrence was observed in 20 %. The most common aerobic microorganism was Streptococcus spр. Among patients who underwent treatment at the N.N. Blokhin National Medical Research Center of Oncology, recurrence was diagnosed in 28.5 %, distant metastases in 4.7 %. In the subgroup of repeat patients, the following trends were observed: among 27 patients with Fusobacterium spp., recurrence of the main disease was observed in 63 %. Among 26 patients with Prevotella spp. in the biomaterial, in 11 (42.3 %) local recurrence was observed. Among 24 patients with Veillonella spp., recurrence developed in 33.3 %. The most common aerobic microorganism was Streptococcus spр., recurrences developed in 21 % of cases.
R. V. Lutovinin, V. N. Oshchepkov, Yu. A. Shubina, V. V. Kokareva
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-91-97

Abstract:
Introduction. Surgery is frequently preferable to therapy as it yields longer overall and recurrence-free survival. But surgery of locally advanced tumors of the oral cavity can not always guarantee preservation of oral functions. In the EORTC 24971 and RTOG 90-03 trials, effectiveness of conventional radiotherapy was demonstrated. Addition of brachytherapy allowed to double recurrence-free and overall survival. Implementation of proton therapy increased treatment safety. However, high cost of modern technology for radiotherapy limits its accessibility. Intra-arterial chemotherapy is characterized by lower toxicity. Additionally, it allows to create a pool for the 1st cycle of systemic circulation directly in the tumor and neighboring tissues, and a significant portion of the drug enters the draining lymph node replicating lymphogenic metastasis.The objective was to present a clinical case of successful treatment of inoperable squamous-cell carcinoma of the oropharynx using intra-arterial chemoradiotherapy.Clinical case. A patient sought medical help at the multidisciplinary clinical medical center “Medical City” where combination treatment was chosen: a course of chemoradiation therapy using an original approach combining external beam 3D-conformal radiotherapy and intraarterial chemotherapy. According to control computed tomography data, dynamics was described as partial response: 30 % reduction in marker lesions. The patient did not have any complaints and evaluated their quality of life as high which corresponded to the testing results.Conclusion. We have demonstrated benefits of intra-arterial chemoradiation therapy: low toxicity allows patients to receive a full course of radiotherapy without breaks and achieve high functional results. Considering palliative status of the patient, we did not aim to increase recurrence-free period but the objective of ensuring satisfactory quality of life was achieved. New, more physiological regimens of intra-arterial infusion will improve pharmacokinetic profile of chemotherapeutic drugs and will allow to achieve positive results.
A. M. Mudunov, E. G. Khazarova, Yu. V. Alymov
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-86-90

Abstract:
Skin cancer of external ear is a very aggressive type of cancer with spread to the parotid gland, bone structures of the lateral skull base, meninges and brain tissue. At the same time, malignant tumors of the external ear are very rare disease, accounting for 0.2 % of all malignant head and neck tumors. This fact explains the small amount of investigation in this scientific field. Now, does not exist unanimous opinion about the treatment tactics for patient with locally advanced ear cancer. Surgical tactics for volumes of block resections of the temporal bone are different. Controversial issues relate to the appropriateness of surgical treatment in general in the case of advanced tumor process. In this article we performed publication analysis devoted to selection of optimal treatment tactics for patient with locally advanced ear cancer.
T. M. Geliashvili, A. V. Vazhenin, T. P. Berezovskaya, E. B. Vasilieva, N. G. Afanasieva, V. V. Krylov, P. I. Garbuzov
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-16-24

Abstract:
The study objective is to evaluate value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (PET-CT) and whole-body scintigraphy (131I-WBS) performed during the first course of radioiodine therapy for its ability to detect persistence metastatic foci and for its role in the management of differentiated thyroid cancer patients.Materials and methods. Forty patients with DTC underwent both post-therapeutic 131I-WBS and PET-CT. PET-CT performed on a positron emission tomograph combined with a 16-slice computer tomograph. Post-therapeutic 131I-WBS performed during radioiodine therapy on the single-detector gamma camera.Results. Sensitivity in detecting of the tumor persistence for PET-CT was 84 %, for post-therapeutic 131I-WBS 66 % (р >0.05). In 17 (42.5 %) patients additional PET-CT foci were found that negative on 131I-WBS, including 11 (27.5 %) cases of distant metastases. Fifteen percent of patients had metastatic foci visualized only on 131I-WBS, including 4 (10 %) cases of distant metastases. In 17 (44 %) patients tumor foci were identified by both methods. A high pre-ablative level of stimulated thyroglobulin was the only independent predictor of the presence of PET-CTpositive metastatic foci (p = 0.001).Conclusion. 18F-fluorodeoxyglucose PET-CT can be recommended during the first radioiodine therapy in differentiated thyroid cancer patients with a high risk progression group, as well as with suspected the tumor persistence in case of a high pre-ablation thyroglobulin level, to complete staging, improve the quality of management and ongoing risk stratification.
A. V. Karpenko, R. R. Sibgatullin, А. А. Boyko, М. G. Kostova
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-4-32-43

Abstract:
The study objective is to assess functional and oncologic results of transhyoid approach used for surgical treatment of oropharyngeal carcinoma.Materials and methods. Operative records, hospital charts and data from out-patient department of 55 patients (T1 – 6, T2 – 16, T3 – 19, T4 – 14) with oropharyngeal carcinoma operated via a transhyoid approach were reviewed. Postoperative period was reviewed for complications. All oncologic adverse events were registered with special emphasis on the rate of local recurrence. A univariate analysis with chisquare and Fisher’s exact test was used to check the correlation between tumor factors and surgical variables (complications, mode of reconstruction). The influence of tumor- and treatment-related variables (T stage, differentiation, perineural invasion, p16 status, depth of invasion, extension to the oral cavity, adjuvant treatment) on the rate of local recurrence was studied in the same way. The log-rank test was used to assess differences in survival curves. The data was compared with other series of patients treated with the same technique.Results. Seventeen (30,9 %) patients developed 29 complications. There was 1 postoperative death. Five (9,1 %) patients required repeated operation. The mode of reconstruction (primary closure vs flaps) was a major factor influencing the rate of complications. Fifty (92,6 %) patients were able to resume oral diet with a duration of nasogastric tube feeding of 7–35 days. Three-year overall/disease-specific survival for the whole cohort were 47 and 51,1 %, for p16-positive (22 %) cohort – 65,6 and 87,5 %, for p16-negative (78 %) cohort – 40,6 and 46,8 %. Thirteen (24 %) patients developed a local recurrence. The rate of local recurrence was negatively affected by p16 negativity (p = 0,048), depth of invasion >10 mm (p = 0,044) and depth of invasion >15 mm (p = 0,003).Conclusion. Transhyoid approach may be considered as a surgical option for treatment of oropharyngeal carcinoma with acceptable rate of complications.
C. R. Rahimov, A. A. Ahundov, G. I. Hajiyeva, R. Ch. Rahimli, D. A. Safarov, I. M. Farzaliyev
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-97-110

Abstract:
Background. Reconstruction of subtotal and total defects of maxillofacial region after ablative tumor surgery is a challenging task of reconstructive surgery. The “golden rule” is maintaining of radicalism of ablative surgery as well as appropriate surgical reconstruction and prosthodontic rehabilitation, that allows patient return to normal life. Wherein reconstructive procedure is focusing on restoring of mandibular continuity by the means of different flaps and grafts, while prosthodontic rehabilitation is performing after some period of time (usually around year) by the means of removable and non-removable prosthodontic devices. Non-removable device requiring dental implants insertion into grafted material followed by period of osteointegration, that is requiring some time as well. However, within this period of time one could observe significant soft tissue deformity.The objective is to improve the outcomes of surgical reconstruction of extensive defects of the mandible and to carry out rapid prosthodontic rehabilitation supported by dental implants by application of 3D preoperative planning and navigation devices.Clinical case. Forty-nine years-old female patient with recurrent ameloblastoma, that affects vertical and horizontal ramus of the mandible. Within virtual preoperative planning one performed: resection of the mandible associated with exarticulation of condylar head, virtual plate bending according to contours of the mandible (that were determined by application of “mirror” function of virtual planning software), arthroplasty of temporomandibular joint, determination of donor site on fibula bone, osteotomy of fibula free flap, positioning of dental implants, transferring of composite flap and it’s fixation by reconstructive plate. According to acquiring data one performed fabrication of patient specific navigation guides for both fibula flap segmentation and dental implants positioning. Surgical procedure included single-step tumor ablation and exarticulation of condylar head, reconstruction of defect by the means of osseo-myo-cutaneous fibula free flap, that was pre-implanted by dental implants, total joint reconstruction by titanium condylar head and polypropylene fossa, fixation of the flap and condylar head in recipient site by the means of prebended reconstructive plate, as well as insertion of non-removable bridge prosthodontic device. Postoperative result was asses clinically and radiologically. No significant postoperative complications occurred. Restoration of facial contours, mouth opening, I class occlusion, as well as adequate meal and speech were detected. Postoperative radiological investigation revealed adequate positioning of dental implants within neo-mandible, as well as positioning of artificial joint.Conclusion. In cases of extensive tumors of the jaws single-step ablative surgical procedure, reconstruction of missing anatomical structures of the jaws and simultaneous prosthodontic rehabilitation allows to prevent possible deformities of the soft tissues and due to rapid restoration of vital functions has great impact to quality of patient’s life. Adequacy of performing procedures could be reached by implementation of virtual preoperative planning and fabrication of patient-specific surgical guides.
E. R. Oganyan, , S. B. Alieva, N. A. Pirogova, A. A. Markovich, L. A. Kurbanova
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-27-40

Abstract:
The study objective is to summarize clinical experience in the treatment of esthesioneuroblastoma (ENB) accumulated by specials at N.N. Blokhin National Medical Research Center of Oncology.Materials and methods. We analyzed the data of 115 ENB patients who had undergone treatment between 1965 and 2019.Results. The 15-year overall survival rate was 1.2–1.7 times higher in patients receiving comprehensive treatment (47.7 ± 11.3 %) than in those receiving other types of therapy. In addition to that, comprehensive treatment ensured the highest rates of 3-year, 5-year, and 10-year relapse-free survival (49.3 ± 11.8 %), as well as the longest median survival (7.2 years). Chemoradiotherapy was effective in 34.8 % of patients with locally advanced ENB, while in 9 out of 45 patients (20.0 %), it resulted in partial response, which suggest that such treatment can control aggressive disease course and increase survival. Surgical treatment (alone or in combination with chemotherapy and radiotherapy) was indicated for 64 patients. However, only in 43 of them (67.1 %), it was performed as originally planned. Five patients (7.8 %) had partially radical surgeries and sixteen patients (25.1 %) had non-radical surgeries.Conclusion. The most effective treatment strategy for locally advanced ENB is a combination of surgery, chemotherapy, and radiotherapy. Chemoradiotherapy at the first stage followed by surgery was found to be an optimal treatment scheme. Tumor sensitivity to chemo- and radiotherapy affects both short-term and long-term treatment outcomes. Partially radical surgeries for locally advanced ENB are acceptable if conservative treatment is planned after operation. Treatment strategy should depend on the tumor spread (stage), grade, and proliferative activity, as well as patient’s age, somatic status, and comorbidities. Multivariate analysis has demonstrated that none of treatment methods decrease survival. The most significant factors negatively affecting the prognosis were as follows: T3–4 tumor, involvement of regional lymph nodes before treatment initiation, distant metastasis, grade IV tumor, and Ki-67 index >21 %.
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-90-96

Abstract:
Background. Currently, the proportion of pregnancies obtained by assisted reproductive technologies (ARTs) reaches 1.7–4.0 %. Short-term and long-term results of ART implementation require public and, most importantly, legal assessment. Some publications suggest higher risks of congenital deformities and head and neck cancers in children conceived by ART.Objective: to review publications analyzing the problem of head and neck cancers in children conceived by ART and legal protection of the embryo.Materials and methods. We performed retrospective analysis of 42 articles published in 1995–2019, including 33 foreign and 9 Russian articles.Results. Earlier studies have demonstrated that children conceived by ART have an increased risk of cancers, including head and neck cancers, such as central nervous system tumors and retinoblastoma. Recent publications have shown no significant differences in the prevalence of malignant tumors between children born after ART and children conceived naturally. Nevertheless, the risk of developing head and neck tumors is higher in children after ART. The analysis of Russian and international legislation has demonstrated that the legal status of an embryo differs depending on whether it develops in vivo or in vitro.Conclusion. Children conceived by ART are at higher risk of malignant head and neck tumors, primarily central nervous system tumors and retinoblastoma. The legal status of an embryo depends on whether it develops in vivo or in vitro.
Yu. V. Kostalanova, K. A. Ganina, A. A. Makhonin, A. G. Gabrielyan
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-41-47

Abstract:
The immune system plays a key role in the development and progression of head and neck squamous cell carcinoma. Understanding the dysregulation and blockage of the immune system of malignant tumors in this location can improve treatment outcomes. A special group is made up of patients who have a widespread process and relapse after chemotherapy with platinum drugs, because they have a very poor prognosis and limitations in the possibilities of further treatment. To date, the most important data relate to drugs acting on the PD-1 (programmed cell death protein 1)/PD-L1 (programmed death ligand 1) immune checkpoints, which are used by the tumor to block the immune system, which have allowed to increase the effectiveness of treatment. The article presents a clinical case demonstrating the effectiveness of the use of checkpoint inhibitors after the use of platinum preparations.
S. I. Kutukova, , G. A. Raskin, Yu. V. Ivaskova, N. P. Belyak, , , P. M. Baykalova
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-65-71

Abstract:
Introduction. Standard methods of drug or radiation therapy administration for salivary gland cancer is the least successful for now. Therefore, the identification of new markers with morphological features is extremely necessary to improve the effectiveness of treatment and increase the survival rates of patients with this pathology.The study objective is to assess the prevalence of expression of HER2/neu, PD-L1, and RET mRNA in salivary gland malignancies and assess their impact on overall and disease-free survival.Materials and methods. Fifty-nine patients with a confirmed diagnosis of salivary gland cancer (stages II–IVA) were examined in the period from 2012 to 2014 at Saint Petersburg City Clinical Oncology Dispensary. All materials were subjected to immunohistochemical research to determine the expression of HER2, PD-L1 in tumor and immune cells, the CPS index was calculated, and the frequency of the mRNA gene RET expression using a real-time polymerase chain reaction was detected.Results. The overall survival of patients with mild and high HER2 expression was 41 months (95 % confidence interval (CI) 4.50–72.00), which is more than 4 time less than in patients with low or no expression (p = 0.00715). Significant differences were also received in the progression-free survival in the group of patients with negative or insignificant expression of HER2 receptors. The overall survival of patients with CPS >1 was 72 months (95 % CI 19.5–72.00) and significantly differed from the group of patients with CPS Conclusion. When analyzing the obtained data, it was proved that knowledge of the salivary glands malignant tumors receptor status become one of the factors in determining the prognosis of the disease, as well as a predictive factor of targeted drugs effectiveness (after сonducting prospective randomized studies).
, A. V. Ignatova, A. S. Morozova, S. O. Podvyaznikov, Yu. V. Alymov
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-111-117

Abstract:
Head and neck squamous cell carcinoma (HNSCC) is the most common cancer among head and neck malignancies and causes of cancer death. More than 50 % of patiens have relapses within first 3 years after treatment, with median survival less than 6 months. Cetuximab is the first targeted agent for HNSCC, is considered as alternative regiment in case of intolerance to platinum-based chemotherapy, and also can activate an antigenspecific T-cell immunity in head and neck cancer patients. Nivolumab is a check-point inhibitor, that improves overall survival of patients with advanced recurrent/metastatic HNSCC, due to the CheckMate-141 study results. The results of phase II study сoncurrent cetuximab and nivolumab in patients with recurrent and/or metastatic HNSCC showed a benefit for patients without prior check-point inhibitor exposure and overall well tolerated. Thus, we have 6 cases of HNSCC, treated with combination of nivolumab and cetuximab, resulted in durable (12 months) partial response or stabilization without severe adverse events. In our study, all 6 patients had prior check-point inhibitor exposure with nivolumab. Cetuximab was added to a treatment protocol after evidence-based progression during check-point inhibitor therapy. We demonstrate a case report of recurrent locally advanced HNSCC, treated with combination of nivolumab and cetuximab and resulted in stabilization. Only 1 patient had a progression after concurrent targeted and immune-therapy with nivolumab and cetuximab. New combination was well tolerated without severe adverse events. To our opinion, first results are challenging and we believe in great perspectives of comprehensive molecular profiling and combination of targeted and immune-therapy for better results.
A. O. Eremina, I. A. Zaderenko, , S. B. Alieva, A. B. Dymnikov, A. V. Khromushina, B. C. Pkheshkhova
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-72-80

Abstract:
Oral mucositis is one of the most common effects of chemoradiotherapy in patients with oropharyngeal cancer. The development of oral mucositis is the main cause of interruption of antitumor therapy, which significantly affects the results of treatment of the main disease. Despite the fact that the disease is well studied in the literature, today there is no universal treatment and prevention protocol. The aim of this review is to analyze scientific publications devoted to the problems of etiology, pathogenesis, clinic, diagnosis, treatment and prevention of oral mucositis.
D. A. Miroshnichenko, A. P. Polyakov,
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-81-89

Abstract:
One of the main problems of nasopharyngeal carcinoma treatment is the high incidence regional and distant failures. The method of choice in the first line therapy for the primarily diagnosed nasopharyngeal carcinoma is chemoradiotherapy with poor success rate. The main etiological factor in the occurrence of nasopharyngeal carcinoma is the Epstein–Barr virus, which DNA’s copies could be detected in blood samples in patients with nasopharyngeal carcinoma, which may indicate tumor activity. The indicators of these titers reach different values depending on the stage of the tumor process, the presence of distant metastases, individual patient parameters, and the tumor response to the therapy. Given the high specificity of this biological marker, it is necessary to consider the possibility of its use as a prognostic indicator for assessing the success of the selected method of conservative treatment, as well as assessing the prognosis.
, , I. V. Chebotareva, N. V. Zhelonkina, V. V. Polkin, , D. N. Derbugov, S. O. Podvyaznikov
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-19-26

Abstract:
Background. Parathyroid cancer (PC) is extremely rare, usually diagnosed after surgery, there are no clinical recommendations for the treatment of metastatic PC.The study objective is to present the results of a clinical examination and treatment of patients with PC.Materials and methods. Retrospective analysis of 15 PC patients treated from 2001 to 2019. The results of laboratory tests, the surgical approach, the results of treatment, the rate of metastasis and relapse within 19 months (3 months – 11.6 years) after surgery are presented.Results. Tumor size is 35 mm (20–45 mm). Lymph node metastases – 1 (6.7 %), distant metastases – 2 (13 %). The median initial parathyroid hormone (PTH) is 735 pg/mL, calcium 3.22 mmol/L. Severe hyperparathyroidism with osteitis fibrosa cystica – in 6 (40 %). The surgical approach was parathyroidectomy in 10 (67 %), en bloc resection in 5 (33 %). Normalization of PTH and calcium after surgery – 13 (87 %). In two patients with distant metastases, the PTH and calcium remained high. A patient with Th6 vertebral metastasis was successfully operated on, with normalization of PTH and calcium, and 1.5 years was without relapse. A patient with lung and liver metastases received sorafenib after surgery, with decrease in calcium level. She died of progression 12 months after operation. Among patients with normalization of postoperative PTH, one had local relapse after 4 years. The patient was re-operated and 1 year after the second operation without relapse. The remaining patients are without relapse/progression.Conclusion. At the time of diagnosis, lymph node metastases are in 6.7 %, distant metastases – 13 %. Normalization of PTH and calcium after surgery suggests a good prognosis, but does not exclude the recurrence in the future, which requires long-term follow-up. Repeated surgery for local recurrence or solitary distant metastases can provide stable remission. Sorafenib in metastatic PC has managed to control hypercalcemia in the short term, however, antitumor efficacy requires further study.
, M. B. Pak, L. V. Demidov, K. A. Baryshnikov
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-55-64

Abstract:
Introduction. The term “local recurrence” is usually understood as regrowth of a tumor after surgical treatment. The regrowth appears within 3–5 cm from postoperative cicatrix. The causes for such prolonged tumor growth or recurrence of patients with cutaneous melanoma are nonradical surgical treatment as well as satellite or transit metastases that were not removed in-block with primary tumor. A great number of clinical researches, aimed at examination of melanoma, its patterns, anatomical criteria and features of clinical course, gave an opportunity to separate satellite or transit metastases into an independent group. Such metastases are realized inside or subdermally, up to 2 cm or more than 2 cm from the primary tumor, yet, not reaching the location of the first regional barrier.The aim of the study is to define influence of the main prognostic factors such as tumor thickness according to Breslow, the level of invasion according to Clark and the presence of ulceration on the frequency of local recurrence with cutaneous melanoma of head and neck.Materials and methods. The research involved 174 patients with cutaneous melanoma of head and neck (1995–2014). According to our index of contraction of a skin flap (median 30 %) the true borders of resection were clearly defined within all the patients. Thereby, 3 groups were identified with the following resection margin: 1.0 cm, where followed-up treatment results were analyzed.Results. Progression-free survival didn’t correlate with the size of surgical resection margins. The survival rates were the best with the lowest resection margin under 0.5 cm (77.3 %) and the worst with the highest resection margin more then 1.0 cm (38.7 %). That means that the treatment results don’t depend on the width increase of tumor resection margin.Conclusions. We consider that clear surgical margins for any thickness of cutaneous melanoma of head and neck should be as follows: 4 mm – 0.72 mm (p = 0.016). In our work, the influence of the main prognostic factors, such as tumor thickness according to Breslow, level of invasion according to Clark and ulceration on the frequency of head and neck cutaneous melanoma local recurrences had no impact.
E. V. Borodavina, P. A. Isaev, F. S. Sevrukov, A. V. Sidorin, V. V. Polkin, A. A. Ilyin, , T. A. Agababyan, ,
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-48-54

Abstract:
The tall-cell variant of papillary thyroid carcinoma is a rare malignancy characterized by an aggressive course, low relapse-free survival, early metastasis, and frequent development of radioiodine refractoriness. We report two cases of tall-cell papillary thyroid carcinoma in patients who had disease progression after combination treatment and started to receive lenvatinib. We observed partial and complete regression of metastases in response to lenvatinib. Our findings are consistent with the results of other studies assessing treatment efficacy for disseminated tall-cell papillary thyroid carcinoma.
A. P. Polyakov, , , , E. A. Chistyakova
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-3-12-18

Abstract:
Background. Approximately 10 % of patients with well-differentiated thyroid cancer (WDTC) develop distant metastases. Of them, only 23 % have bone metastases. Complications associated with metastatic lesion in the skeleton significantly affect overall condition of patients and their quality of life. Surgery and pharmacotherapy are highly traumatic and toxic. Bisphosphonates are stable structural analogues of pyrophosphate that inhibit osteoclast activity, thereby reducing bone resorption, which increases the time to development of bone complications, improves patient’s quality of life, and reduces pain.The study objective is to assess performance status and pain severity in WDTC patients with distant bone metastases after bisphosphonate therapy.Materials and methods. We analyzed clinical experience in using bisphosphonates in WDTC patients treated in P.A. Herzen Moscow Oncology Research Institute between 2016 and 2020. This study included 41 patients with WDTC and bone metastases of various locations. Pain severity was evaluated using a 5-point verbal scale; performance status was evaluated using the Eastern Cooperative Oncology Group scale.Results. We observed an improvement in patients’ performance status (from score 2 to 0 according to the Eastern Cooperative Oncology Group scale) in response to therapy. We also found a decrease in pain intensity (from score 4 to 1.5).Conclusion. The inclusion of bisphosphonates into the treatment scheme for WDTC patients with bone metastases can reduce pain intensity and improve performance status.
N. V. Sevian, A. Kh. Bekyashev, E. V. Prozorenko, N. A. Kozlov, , V. B. Karakhan, T. G. Gasparyan, D. E. Avtomonov, E. A. Bogush, V. Yu. Kirsanov, et al.
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-2-97-100

Abstract:
Esophageal cancer spreads locally via the circulatory and lymphatic systems and can, extremely rarely, form brain metastases. The development of intracranial metastases is a long-term adverse event indicating poor prognosis. In this paper, we present a case of esophageal cancer with a brain metastasis in a patient who received combination therapy and demonstrated long-term progression-free survival.
, S. B. Potkin, , , A. S. Polonskaya
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-2-30-37

Abstract:
Background. Multikinase inhibitors of angiogenesis are currently the most effective group of drugs in target therapy for cancer. They are associated with a high prevalence of a specific cutaneous adverse reaction, which manifests as a hand-foot skin reaction (HFSR). This side effect is quite prominent in the majority of patients, usually graded as II–III degree, which leads to the dose reduction and even discontinuation of the drug. The study objective is to evaluate clinical, histological and ultrasound characteristics of a HFSR associated with MKI treatment, and to assess the influence of a HFSR on patient’s quality of life. Materials and methods. The study included 46 patients with HFSR, who were previously treated with sorafenib or lenvatinib. Clinical characteristics of HFSR, including severity grading, were evaluated. We also performed ultrasound and histological examinations and assess the Dermatology Life Quality Index. Results. Grade III HFSR was in 5 (10.86 %) patients, grade II – in 25 (54.35 %), and grade I – in 16 (34.79 %). Dermatology Life Quality Index depended on the HFSR severity, with the mean value 24.5 ± 2.4. Pathomorphological examination revealed irregular epidermal proliferation with hypertrophic psoriasiform acanthosis, minimal keratinocyte vacuolization, few apoptotic figures, dyskeratosis, hyperkeratosis and microvessel dilation in the papillary dermis. Ultrasound examination showed increased vascularization in papillary and reticular dermis in affected skin areas, which was more prominent in patients with severe degrees of HFSR. The pronounced enhancement of vascularization was detected in fragmented hypoechogenic sites along the border of papillary and reticular dermis and in similar sites along the border of dermis and hypodermis. Conclusion. The use of multikinase inhibitors leads to pronounced changes not only in the surface layers of the skin, but also in the dermis and subcutaneous fat, which significantly worsens the quality of life of patients. This indicates the need to search for pathogenetically based methods of treatment of HFSR and create practical guidelines for supportive treatment of patients with HFSR taking multikinase inhibitors.
А. О. Гузь, D. M. Fatkullin, A. V. Garev, A. S. Zakharov, M. I. Sokolova, A. P. Alekseeva
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-2-54-60

Abstract:
This review analyzes the research data concerning the problem of antibiotic prophylaxis (ABP) of wound infections after various surgeries for head and neck tumors. In patients with clean wounds, ABP should be used in exceptional cases only (for example, if the patient has any risk factors), otherwise it should be avoided. A short ABP course is recommended for patients with clean-contaminated wounds; however highrisk patients may require a prolonged course. There is some evidence of ABP efficacy in patients with non-contaminated wounds after cervical lymphadenectomy. When choosing a drug for ABP, a doctor should consider the site of surgery and the risk of wound contamination. The optimal drugs after head and neck surgeries include first- and second-generation cephalosporins, ampicillin in combination with sulbactam, metronidazole, and clindamycin. First- and second-generation cephalosporins in combination with metronidazole are preferable, but if the wound is infected with gram-positive bacteria, it is necessary to use clindamycin monotherapy. Reconstructive surgeries with a free flap require a short course of ABP with one of the following combinations: cefazolin + metronidazole, cefuroxime + metronidazole, or ampicillin + sulbactam; if the patient is allergic to beta-lactams, clindamycin can be used. Despite the availability of standard ABP regimens, a surgeon must apply a tailored approach when choosing an ABP regimen for each patient, taking into account risk factors and the volume of surgery.
, T. I. Deshkina, , S. A. Kravtsov, T. V. Ustinova, A. A. Paychadze, , А. А. Fedenko
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-2-10-21

Abstract:
The results of the clinical studies have a direct impact on clinical practice. The main criteria for the effectiveness of treatment method are increasing the overall life expectancy and improving its quality. In the treatment of common forms of squamous cell carcinoma of the head and neck, induction chemotherapy can be used, including platinum drugs, preferably in combination with cetuximab. Next immuno-oncological drugs should be prescribed. In the future, in the 1st line of therapy, it is possible to replace cetuximab with pembrolizumab or monotherapy with pembrolizumab, which allows to increase the effectiveness of treatment and reduce its toxicity. The article presents 3 clinical observations that demonstrate the possibility of integration the results of clinical research in practice.
A. S. Sharapo, V. Yu. Ivashkov, , M. V. Bolotin, M. Bektemirov, A. E. Raportinova
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-2-22-29

Abstract:
The study objectiveis to analyze the results of the use of free osteomyofascial flaps in the reconstruction of combined post-resection facial defects with an intraoral component.Materials and methods.Fifty-three patients were operated by the proposed method. The muscle portions which were used with free flaps were: m. flexor hallucis longus with the free fibula flap (n = 27), m. vastus lateralis with anterolateral thigh flap (n = 11), m. subscapularis with the scapula free flap (n = 15). An analysis of postoperative complications was performed, as well as an analysis of the timing of dental implantation.Results.The average hospital stay was 15 days. The main complications from the recipient area were: local inflammation in the reconstruction area – 2 (3.8 %) cases, hematoma on the neck – 2 (3.8 %), fistula formation – 1 (1.9 %), full flap necrosis was noted in 1 (3.7 %) case, hypertrophic growths of granulation tissue on the muscle portions of the flaps in 3 (5.7 %). The main complications from the donor zone: hematomas – 0 cases. In 2 (13.3 %) patients after using a chimeric scapular flap, lymphorrea up to 50–70 ml was noted. Dental implantation was performed in 4 (9.5 %) cases. There were no complications or difficulties in performing dental implantation. The average time taken to form the soft tissue contour in the area of implants after installing the gingiva formers in our study was 2.5 weeks, which is 2 weeks faster than using flaps that include a skin paddle.Conclusion.This reconstruction method could be used as a main for the plastic elimination of combined facial defects with an intraoral component.
D. V. Sashin, , E. A. Kobyakova, A. Kh. Bekyashev, A. S. Subbotin, E. A. Nechipay, , N. A. Kozlov
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-2-38-45

Abstract:
The study objectiveis to assess the possibilities of magnetic resonance imaging (MRI) in SWI (susceptibility weighted imaging) in the differential diagnosis of glial brain tumors and primary brain lymphomas.Materials and methods.Fifty-four patients with brain tumors were studied (men – 27 (50 %), women – 27 (50 %)). Average age 57.9 years. Histological examination of the surgical material revealed the glial nature of tumors in 41 patients (26 of them with glioblastoma, anaplastic astrocytomas – 15), primary brain lymphomas – in 13 patients. Brain MRI was performed using tomographs with a magnetic field of 3 and 1.5 T. A semi-quantitative assessment of the data obtained in the SWI mode based on the classification of ITSS (intratumoral susceptibility signals), reflecting the severity of interstitial vascular architectonics and microbleeding.Results.The degree of ITSS was 3 in glioblastomas (G4 ) in 26 (100 %) cases, in the structure of gliomas (G3 ) the ITSS values were 3 in 3 (20 %) cases, in the remaining 12 (80 %) cases – ITSS 2. In the group of primary brain lymphomas, the ITSS 1 was in 4 (30.7 %) cases, ITSS 0 was in 9 (69.3 %) cases.Conclusion.MRI in SWI mode is a promising technique that allows one to quantify the degree of pathological changes in tumor vascular architectonics and intratumoral hemorrhages and has shown high specificity in the differential diagnosis of malignant gliomas and lymphomas of the brain, accompanied by active accumulation of contrast medium.
E. O. Kudasova, , , P. A. Demenchuk, A. V. Zotov, T. M. Vasilyeva
Head and Neck Tumors (HNT), Volume 10; https://doi.org/10.17650/2222-1468-2020-10-2-90-96

Abstract:
Introduction. Timely maxillofacial orthopedic care is aimed at leveling the message of the oral cavity with the nasal cavity and its paranasal sinuses, orbit, helps to improve swallowing, speech, breathing and salivation. The objective of this work is to demonstrate the possibility of application of a polymethyl methacrylate prosthesis with a superhydrophobic modified surface directly on the operating table, as well as to demonstrate the possibility of using in the shortest postoperative period. Materials and methods. Patient Z., 28 years old, clinical diagnosis: chondrosarcoma of the upper jaw on the right, Т2N0M0, stage 2. A resection of the upper jaw was proposed with simultaneous reconstructive treatment and the application of a dental resection forming denture of the upper jaw. To form a hydrophobic surface, the prosthesis was modified with a high-frequency plasma of sulfur hexafluorides. The study of the quantitative and qualitative composition of microflora on the surface of the resection forming prosthesis was carried out after transportation of the prosthesis from the dental laboratory, after processing of high-frequency plasma of sulfur hexafluoride and before applying the resection forming prosthesis, 3, 7 days after the prosthesis was applied. Results. After modification of sulfur hexafluoride in the medium, the contact angle of contact with distilled water increased, the critical surface tension decreased compared to the initial one, and the hydrophobic properties were increased. Conditionally pathogenic microflora in a diagnostically significant amount was cultivated from the surface of the resection forming prosthesis obtained from the dental laboratory. Bacterial seeding after modification in the plasma of sulfur hexafluoride showed the absence of microflora strains; a slight increase in opportunistic microflora was obtained on days 3 and 7 after application of the prosthesis. In the immediate postoperative period (3 days), the patient complained of pain and discomfort associated with the surgical stage. Conclusions. The presented clinical case indicate that the superhydrophobic surface modified by sulfur hexafluoride contributes to a more stable healing of the postoperative defect.
Page of 6
Articles per Page
by
Show export options
  Select all
Back to Top Top