scholarly journals Prospects of Chemotherapy for Gastrointestential Stromal Colon Tumours

2020 ◽  
Vol 10 (3) ◽  
pp. 249-253
Author(s):  
A. R. Mukhamediyarov ◽  
L. I. Bashirova ◽  
A. I. Maksyutova ◽  
A. T. Gattarova
Keyword(s):  
Surgical Treatment ◽  
Kinase Inhibitors ◽  
Combined Treatment ◽  
Objective Response ◽  
Symptomatic Treatment ◽  
Objective Evaluation ◽  
The United States ◽  
Surgical Removal ◽  
Gastrointestinal Stromal Tumours ◽  
Initial Stage

Gastrointetinal stromal tumours are the most common primary mesenchymal tumours of the gastrointestinal tract. According to statistical data, the annual incidence of this pathology in Russia comprises 13 patients per 1 million inhabitants, i.e. about 2,000 patients per year on average. In the United States, 3,000–4,000 cases are registered every year. This article discusses general and specific issues associated with morbidity and mortality from gastrointestinal stromal tumours, as well as reasons for the low efficacy of surgical and targeted therapies. Methods for combined treatment of patients with gastrointestinal stromal tumours are proposed. The treatment of such pathologies has evolved with the development of immunohystochemical analytical procedures and therapies against KIT/PDGFRA-specific protooncogenes, as well as the emergence of low-molecular kinase inhibitors. However, the probability of non-recurrence survival can only be increased by complete surgical removal of gastrointestinal stromal colon tumours. In the surgical treatment, three main approaches are defined: the initial stage of treatment, provided that the tumour is resectable and has a small size; surgical treatment after neoadjuvant therapy; symptomatic treatment, so-called ‘debulking surgery’. Adjuvant targeted therapy with Imatinib provides for a high objective response. The use of Imatinib chemotherapy determines the efficacy and radicality of surgical treatment in most cases. In general, the question of treating gastrointestinal stromal colon tumours is still relevant, requiring further research and objective evaluation of all technical and tactical approaches in the context of distant results.

scholarly journals Pathophysiological justification of the use of photodynamic therapy in the initial stage of squamous cell skin cancer

2021 ◽  
Vol 67 (1) ◽  
pp. 77-84
Author(s):  
Vladimir Masljakov ◽  
Dmitry Grebnev ◽  
Larisa Kim
Keyword(s):  
Photodynamic Therapy ◽  
Surgical Treatment ◽  
Skin Cancer ◽  
Matrix Metalloproteinases ◽  
Squamous Cell ◽  
Therapy Group ◽  
Combined Treatment ◽  
Vascular Wall ◽  
Comprehensive Treatment ◽  
Initial Stage

The work is based on an analysis of the course of the disease in 185 patients with squamous cell skin cancer. The study program included studies in three major groups. The first included 74 (40%) patients who underwent combined treatment: an operation involving widespread excision of a tumor under intravenous anesthesia + photodynamic therapy (group 1). The second group was 111 (60%) patients with squamous cell carcinoma of the skin who received only operative treatment. To control and compare the obtained laboratory indicators, a second group was created, which included patients without established pathology. This group included 17 people who voluntarily agreed to conduct the study. The study traced the dynamics of changes in hemostasis scores and metalloproteinases in the two groups being compared. In the group of patients with squamous cell skin cancer, there was a statistically significant decrease in the metalloproteinase-1 inhibitor index, which led to an increase in all metalloproteinase-2, -7 and -9 indicators. Performing surgical treatment did not lead to correction of these indicators, both in the near and distant periods after treatment. The mechanism of influence of photodynamic therapy in squamous cell skin cancer can be characterized as follows: there is a decrease in the inhibitor of metalloproteinase-1, which leads to an increase in matrix metalloproteinases-2, -7 and -9 in the blood, as a result of damage to the endothelium of the vascular wall, which is confirmed by an increase in endothelin, this, in turn, led to the development of vasoconstriction and increased procoagulant activity The use of photodynamic therapy restores the index of metalloproteinase-1 inhibitor, this leads to the restoration of matrix metalloproteinases-2, -7 and -9 in the blood and the prevention of damage to the vascular wall. Comprehensive treatment of patients with squamous cell skin cancer in the initial stage of the disease should include photodynamic therapy with simultaneous intravenous blood irradiation, laser tumor training, and then surgical treatment, consisting in excision of the tumor with observance of oncological principles.

Evaluation of effectiveness of a new combined method of treatment of primary progressive pterygium

2021 ◽  
pp. 221-225
Author(s):  
A.N. Bochkareva ◽  
◽  
V.V. Egorov ◽  
O.V. Kolenko ◽  
G.P. Smoliakova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Ultraviolet Irradiation ◽  
Combined Treatment ◽  
Disease Recurrence ◽  
Surgical Removal ◽  
Initial Growth ◽  
Ophthalmological Examination ◽  
Combined Method ◽  
Primary Progressive

Purpose. Evaluation of the effectiveness of the combined method in the surgical treatment of pterygium. Material and methods. There were 30 patients (30 eyes) under observation for primary progressive pterygium. To assess the condition of the ocular surface and the functional effectiveness of the new combined method of treating pterygium, the patients were divided into two groups. The main group consisted of 15 patients (15 eyes) who underwent surgical treatment of the pterygium according to the developed method. The comparison group consisted of 15 patients (15 eyes), who underwent pterygium removal using standard technology. Standard ophthalmological examination included: visometry, autorefractokeratometry, biomicroscopy with fluorescence test. The criteria for evaluating the effectiveness of treatment were: maximally corrected visual acuity; the degree of corneal astigmatism; the presence and degree of turbidity in the operation area; the frequency of relapse. Results. The use of the proposed method of combined treatment of pterygium, including surgical removal with plasty of the amnion in the zone of initial growth in combination with ultraviolet irradiation of the de-epithelialized corneal bed in the postoperative period, leads to the restoration of transparency and the correct shape of the cornea, therefore, and minimization of induced astigmatism, which is accompanied by an increase in functional parameters eyes. Conclusion. The results obtained, the simplicity and availability of the method developed by us allow us to recommend it for wider use in the surgical treatment of pterygium in order to increase the functional, cosmetic effect, surgical rehabilitation and prevention of disease recurrence. Key words: pterygium, combined treatment, visual acuity, ultraviolet irradiation.

scholarly journals Temsirolimus: A Review of its Use in the Treatment of Advanced Renal Cell Carcinoma

2009 ◽  
Vol 1 ◽  
pp. CMT.S2349 ◽  
Author(s):  
Fanny Chan ◽  
Erika E. Samlowski ◽  
Wolfram E. Samlowski
Keyword(s):  
Renal Cancer ◽  
Kinase Inhibitors ◽  
Single Agent ◽  
Objective Response ◽  
Mammalian Target Of Rapamycin ◽  
The United States ◽  
Treated Group ◽  
Phase Iii ◽  
Clinical Activity ◽  
Metastatic Renal Cancer

The mTOR (mammalian target of rapamycin) signaling pathway was discovered during studies of the immunosuppressive agent rapamycin. This pathway regulates cell growth, protein synthesis and angiogenesis in response to environmental factors. The mTOR complex-1 inhibitor temsirolimus was derived from rapamycin to have less immunosuppressive and improved solubility characteristics. The safety, tolerability and efficacy of temsirolimus have been well established in clinical trials. Drug related toxicity included rash, mucositis, asthenia, nausea, hyperglycemia, hypophosphatemia, anemia, and hypertriglyceridemia. An active and well-tolerated single agent dose is 25 mg i.v. weekly. A large Phase III trial in poor-prognosis patients with metastatic renal cancer compared i.v weekly temsirolimus administration to subcutaneous interferon alpha (IFNα), or a combination of temsirolimus plus IFNα. This study established that median overall survival was improved to 10.9 months in the temsirolimus group compared to 7.3 months in IFNα-treated group (0.73 hazard ratio for death; 95% confidence interval [CI], 0.58 to 0.92; P = 0.008). A modest objective response rate of 8.6%, 4.8%, and 8.1%, respectively was observed in the three groups, associated with a median time to treatment failure of 3.8 months for temsirolimus alone, 1.9 months for IFNα, and 2.5 months for the combination. These results led to approval of temsirolimus for the treatment of renal cancer in the United States. Temsirolimus is clearly indicated for first-line therapy of Motzer “poor risk” renal cancer and aggressive non-clear cell renal cancer. Temsirolimus may be useful after failure of VEGF tyrosine kinase inhibitors. Clinical activity in other tumor types, such as endometrial cancer has been observed. Temsirolimus is therefore an important new agent for cancer treatment.

Surgical treatment of transmissible venereal tumor (sticker sarcoma)

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Bougherara Hithem ◽  
Boukhechem Saïd ◽  
Aguezlane Abdelaziz ◽  
Benelhadj Khouloud ◽  
Aissi Adel
Keyword(s):  
Surgical Treatment ◽  
Cancer Cells ◽  
Treatment Method ◽  
High Rate ◽  
Surgical Removal ◽  
Characteristic Appearance ◽  
Recurrent Tumors ◽  
External Genital Organs

Background: Sticker sarcoma, also called venereal sarcoma or venereal lymphosarcomatosis, is a tumor of the external genital organs in females and males. In male animals the penis and foreskin (prepuce) are affected, in the female, it happens in vagina (vagina) and labia (vulva). The diagnosis of sticker sarcoma is based on the chronic discharge, the typical locations and the characteristic appearance of the tumor. Methods: We have relied on the treatment method on the complete surgical removal of all cancer cells that we can access. Results: After surgery, we notice recurrent tumors about six months after surgical treatment, indicating the need for other treatments in addition to surgery. Conclusion: Although spontaneous regressions of sticker sarcoma are documented (with permanent immunity), chemotherapy is the treatment of choice today. Irradiation should also be effective. If the tumor is only removed surgically, there is a high rate of recurrence, and this is what happened with the case that we treated, as the tumor reappeared after less than six months.

Hemangiomatosis of the greater omentum – a case report

2019 ◽  
Vol 98 (4) ◽  
pp. 178-180
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Histological Examination ◽  
Case Reports ◽  
Greater Omentum ◽  
Surgical Removal ◽  
Consumption Coagulopathy ◽  
Cavernous Hemangiomas ◽  
Mesodermal Origin ◽  
Benign Tumours

Cavernous hemangiomas are benign tumours of mesodermal origin. Even though various localizations of hemangioma have been described in the literature, its occurrence in the greater omentum is very rare. Only symptomatic hemangiomas are indicated for surgical treatment. There are case reports presenting resection or surgical removal of the greater omentum with hemangioma because of mechanical syndrome, consumption coagulopathy, bleeding, infection or suspicion of a malignancy. This article presents a case report of a patient operated on for a suspicion of carcinomatosis of the greater omentum. Histological examination found hemangiomatosis in the resected greater omentum.

scholarly journals Management of local recurrence after radical nephrectomy: surgical removal with or without systemic treatment is still the gold standard. Results from a multicenter international cohort

2021 ◽  
Vol 53 (11) ◽  
pp. 2273-2280
Author(s):  
Michele Marchioni ◽  
Petros Sountoulides ◽  
Maria Furlan ◽  
Maria Carmen Mir ◽  
Lucia Aretano ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Local Recurrence ◽  
Systemic Therapy ◽  
Radical Nephrectomy ◽  
Systemic Treatment ◽  
Survival Rates ◽  
Surgical Removal ◽  
Cancer Specific Survival ◽  
Time To Recurrence ◽  
Kaplan Meier

Abstract Objective To evaluate the survival outcomes of patients with local recurrence after radical nephrectomy (RN) and to test the effect of surgery, as monotherapy or in combination with systemic treatment, on cancer-specific mortality (CSM). Methods Patients with local recurrence after RN were abstracted from an international dataset. The primary outcome was CSM. Cox’s proportional hazard models tested the main predictors of CSM. Kaplan–Meier method estimates the 3-year survival rates. Results Overall, 96 patients were included. Of these, 44 (45.8%) were metastatic at the time of recurrence. The median time to recurrence after RN was 14.5 months. The 3-year cancer-specific survival rates after local recurrence were 92.3% (± 7.4%) for those who were treated with surgery and systemic therapy, 63.2% (± 13.2%) for those who only underwent surgery, 22.7% (± 0.9%) for those who only received systemic therapy and 20.5% (± 10.4%) for those who received no treatment (p < 0.001). Receiving only medical treatment (HR: 5.40, 95% CI 2.06–14.15, p = 0.001) or no treatment (HR: 5.63, 95% CI 2.21–14.92, p = 0.001) were both independently associated with higher CSM rates, even after multivariable adjustment. Following surgical treatment of local recurrence 8 (16.0%) patients reported complications, and 2/8 were graded as Clavien–Dindo ≥ 3. Conclusions Surgical treatment of local recurrence after RN, when feasible, should be offered to patients. Moreover, its association with a systemic treatment seems to warrantee adjunctive advantages in terms of survival, even in the presence of metastases.

Neutrophil-lymphocyte radio (NLR) as a possible predictive factor in patients with advanced NSCLC WHO received immunotherapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21042-e21042
Author(s):  
Eduardo Richardet ◽  
Luciana Paola Acosta ◽  
Maria gimena Ferreira ◽  
Ignacio Magi ◽  
Rocio tello Alfonso ◽  
...  
Keyword(s):  
General Population ◽  
Predictive Factor ◽  
Statistical Power ◽  
Advanced Nsclc ◽  
Combined Treatment ◽  
Objective Response ◽  
Strong Relationship ◽  
Neutrophil Lymphocyte Ratio ◽  
Platinum Based Chemotherapy ◽  
Number Of Patients

e21042 Background: There exists a strong relationship between cancer and inflammation. For this reason, attempts have been made to identify different biomarkers of inflammation in recent years. The neutrophil - lymphocyte ratio (NLR) a marker of systemic inflammation, and the infiltranting lymphocytes of the tumor stroma (TILs) have been studied by our research team in different tumors, such as melanoma, breast cancer, colon cancer and NSCLC in patient who had recieved tratment with chemotherapy. We could observe that there was a significant relationship beteween DFS and a high NLR on the one hand, and DSF an intense TILs on the other. Our main objective is to evaluate the relationship between the objective response rate (ORR) and the pretreatment NLR in patients with advanced NSCLC who recieved immunotherapy. Our secondary objective is to analyzed the associated between PFS and RNL in patients with advanced NSCLC undergoing immunotherapy. Methods: Patients with diagnosis of advanced-stage NSCLC who recieved only immunotherapy, immunotherapy with another immunomodulator or in combination with platinum-based chemotherapy werw included. All patients had a follow-up of at least 6 months. The cutoff value > or < 3 for the NLR was use to reference. The laboratory control prior to the beginning of treatment was taken, and the ORR was determined using the Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Statistical analysis was performed using dispersion and position measurements, T-Test and Chi Square test. For PFS analysis Kaplan-Meyer was used. The level of significance for the variables was p < 0.05. Results: 41 patients with advanced NSCLC were analyzed. 43.9% (18 pts) recieved immunotherapy alone with nivolumab. 34.14% (14 pts) received a combined treatment (nivo / ipi) and 21.95% (9 pts.), immuno / QT combination (based on platinum). Regarding the histological presentation, 80.48% were adenocarcinoma. 54% (22 pts) had an NLR > 3 and 46% (19 pts) an NLR < 3. The ORR in the general population was 24%. in pts with an NLR < 3, the ORR that was observed was 42% vs. ORR of 9% in pts with NLR > 3 (p: 0.02). These differences were statistically significant. The median PFS was 11.27 months in the general population. As regards RNL, the median PFS were 20.74 vs 5.52 months in favor of pts with an NLR < 3 (p: 0.04). Conclusions: We could conclude that patients with NSCLC and pretreatment NLR < 3, who undergo immunotherapy, had better ORR compared to those with NLR > 3. These differences was statistically significant. Also, we could observe better PFS in patient with NLR < 3. These difference was estatically significant. We will keep working to obtain a greater number of patients. Then we could have a better analysis and statistical power. It is possible that NLR will be a highly useful and easy-to-acces predictive factor, and it could be used in patients with immunotherapy in our daily practice.

Combined Treatment of Severe Hyponatremia Due to Inappropriate Antidiuretic Hormone Secretion

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 610-612
Author(s):  
Zvi Weizman ◽  
Kalman Goitein ◽  
Yair Amit ◽  
Uri Wald ◽  
Heddy Landau
Keyword(s):  
Antidiuretic Hormone ◽  
Hypertonic Saline ◽  
Serum Sodium ◽  
Combined Treatment ◽  
Hormone Secretion ◽  
Urinary Sodium ◽  
Surgical Removal ◽  
Hypertonic Saline Solution ◽  
Deoxycorticosterone Acetate ◽  
Low Serum

A 6-year-old girl developed generalized seizures followed by coma, five days after surgical removal of a craniopharyngioma. Low serum sodium levels and low serum osmolality with inappropriately high urinary sodium output confirmed the diagnosis of inappropriate antidiuretic hormone (ADH) secretion. Treatment with 3% hypertonic saline solution and repeated doses of furosemide (1 mg/kg) improved her clinical condition; serum sodium levels, however, rose slowly and urinary excretion remained high. Deoxycorticosterone acetate (DOCA), 4 mg/sq m/day, was added to the above regimen. A striking clinical improvement was noted. Serum sodium levels returned to normal with a concomitant sharp decline in urinary sodium output. The clinical course of this patient demonstrates the efficacy of the addition of deoxycorticosterone acetate to hypertonic saline and furosemide in the treatment of severe, lifethreatening hyponatremia due to the syndrome of inappropriate antidiuretic hormone seretion.

Sign in / Sign up

Export Citation Format

Share Document