scholarly journals Modern combined treatment of multiple cerebral and visceral metastases of skin melanoma on the example of clinical observation

2021 ◽  
Vol 67 (6) ◽  
pp. 837-845
Author(s):  
Mikhail Kurzhupov ◽  
Konstatntin Titov ◽  
Dmitriy Grekov
Keyword(s):  
Clinical Case ◽  
Combined Treatment ◽  
Anticancer Therapy ◽  
Driver Mutations ◽  
Left Adrenal Gland ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Modern Methods ◽  
Visceral Metastases ◽  
The Brain

Introduction. The article discusses modern methods of combined treatment of patients with cerebral and visceral metastases of melanoma, including drug therapy and radiation therapy, the place of neurosurgery, and also discusses a clinical case of long-term relapse-free survival after effective treatment of multiple intracerebral and extracranial metastases of non-pigmented melanoma without a driver mutations. Purpose. Analysis of the results of the application of modern methods of antitumor treatment of melanoma with metastases to the brain and their effect on survival on the example of a clinical case of a patient with metastatic non-pigmented melanoma without an identified primary focus without driver mutations with multiple metastases to the brain, single metastases to the cervical lymph node and left adrenal gland. Materials and methods. Using a clinical example, a possible sequence of an individual approach to the treatment of a patient with multiple intracerebral metastases of non-pigmented melanoma without a primary identified focus without driver mutations and metastasis to the left adrenal gland is considered, the place of modern methods of treatment and examination. Results. The use of a combination of modern methods of anticancer therapy, including immunotherapy, stereotactic radiosurgery and radiation therapy, has increased the overall and relapse-free survival of patients with metastases of melanoma to the brain and visceral organs, and, moreover, reduces the need in neurosurgical interventions. As confirmation of this, the patient is alive for more than 25 months from the moment of progression with a life expectancy of 3-6 months. Conclusions. Modern methods of anticancer therapy can significantly increase the survival rate of patients with metastases of melanoma to the brain and visceral organs, and the accumulation of clinical experience will contribute to the optimization of approaches in the combined and sequential treatment of metastatic melanoma.

scholarly journals MODERN EFFECTIVE TREATMENT OF BRAIN METASTASES OF SKIN MELANOMA. THE EXAMPLE OF CLINICAL OBSERVATION

2021 ◽  
Vol 20 (2) ◽  
pp. 53-60
Author(s):  
M. I. Kurzhupov ◽  
A. V. Shabunin ◽  
K. S. Titov ◽  
E. L. Slobina ◽  
D. N. Grekov
Keyword(s):  
Radiation Therapy ◽  
Targeted Therapy ◽  
Brain Metastases ◽  
Anticancer Therapy ◽  
Skin Melanoma ◽  
Term Survival ◽  
Modern Methods ◽  
Neurosurgical Treatment ◽  
The Brain ◽  
Methods Of Treatment

Introduction. Melanoma of the skin has the highest potential for metastasis to the brain, ranking 15th in the frequency of occurrence among all malignant tumors – it is in third place in the incidence of intracerebral metastases. Modern methods of treatment of metastases of skin melanoma to the brain include neurosurgical treatment, radiation therapy and radiosurgery, antitumor drug therapy, including targeted therapy, immunotherapy and chemotherapy. The article discusses the indications for different methods of treatment, provides data on patient survival when using these methods of treatment alone or in combination. Additionally, a clinical case of long-term survival of a patient with skin melanoma with progression in the form of extra- and intracranial metastasis is discussed.Purpose. Evaluation of the result of using modern methods of antitumor treatment in real clinical practice in a patient with skin melanoma metastases in the brain. Materials and methods. On a clinical example, a possible sequence of an individual approach to the treatment of a patient with extracranial and intracerebral metastases of skin melanoma based on modern methods of treatment and examination is considered.Results. The use of modern methods of anticancer therapy has increased the overall survival and disease-free survival of patients with metastases of skin melanoma to the brain and reduces the need for neurosurgical interventions. As a confirmation of this, the life expectancy of the patient after the progression of skin melanoma in the form of metastases to the brain against the background of all the antitumor treatment carried out to date was 5.5 years, while neurosurgical treatment was not carried out at the request of the patient, although it was shown, but were used the possibilities of modern anticancer therapy, including sequential radiation therapy, targeted therapy and immunotherapy.Conclusion. Modern methods of anticancer therapy can significantly increase the survival rate of patients with melanoma brain metastases and individualize the treatment plan.

Combined radiotherapy and chemotherapy with bleomycin and methotrexate for advanced inoperable head and neck cancer: update of a Northern California Oncology Group randomized trial.

1987 ◽  
Vol 5 (9) ◽  
pp. 1410-1418 ◽  
Author(s):  
K K Fu ◽  
T L Phillips ◽  
I J Silverberg ◽  
C Jacobs ◽  
D R Goffinet ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Randomized Trial ◽  
Combined Treatment ◽  
Oncology Group ◽  
Survival Curves ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Regional Control ◽  
The Difference ◽  
Local Regional Control

Between 1978 and 1984, the Northern California Oncology Group (NCOG) conducted a randomized trial to study the efficacy of combined radiotherapy (RT) and chemotherapy (CT) for stage III or IV inoperable head and neck cancer. One hundred four patients were randomized to receive: (1) RT alone, or (2) RT plus CT. RT consisted of 7,000 cGy to the involved areas and 5,000 cGy to uninvolved neck at 180 cGy/fraction, five fractions/wk. CT consisted of bleomycin, 5 U intravenously (IV), twice weekly during RT, followed by bleomycin, 15 U IV, and methotrexate, 25 mg/m2 IV weekly for 16 weeks after completion of RT. Fifty-one patients in the RT alone group and 45 in the combined treatment group were evaluable. The local-regional complete response (CR) rate was 45% v 67% (P = .056); the 2-year local-regional control rate, including salvage surgery, was 26% v 64% (P = .001); and the incidence of distant metastasis was 24% v 38% (P greater than .25), for the RT alone and RT plus CT groups, respectively. The relapse-free survival curves were significantly different (P = .041), favoring the combined treatment. However, the survival curves were not significantly different (P = .16). Patient compliance to maintenance CT was poor. Bleomycin significantly increased the acute radiation mucositis, although the difference in late normal tissue toxicity was not statistically significant. Thus, bleomycin and concurrent RT produced a more favorable CR rate, local-regional control rate, and relapse-free survival, but the difference in survival was not statistically significant.

scholarly journals Long-term results of combined treatment of patients with locally advanced gastric cancer with the inclusion of neoadjuvant chemoradiotherapy.

2021 ◽  
Vol 67 (2) ◽  
pp. 254-259
Author(s):  
Дмитрий Кудрявцев ◽  
Vitaliy Skoropad ◽  
Sergey Gamayunov ◽  
Igor` Gulidov ◽  
Sergey Ivanov ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Combined Treatment ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Independent Effect ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Locally Advanced Gastric Cancer

ntroduction.  Gastric cancer remains one of the most common malignant neoplasms. In the world, including Russia, high incidence rates and low efficacy rates of long-term treatment outcomes remain. The use of neoadjuvant therapy is now increasingly seen as a standard therapy approach for locally advanced gastric cancer and cardioesophageal junction. Materials and methods. This work presents the results of treatment using a new method – combined treatment of locally advanced stomach cancer (neoadjuvant chemoradiotherapy in the regime of accelerated hyperfraction with daily dose splitting up to SOD 46 Gy against the background of modified polychemotherapy according to the Xelox scheme). The structure of the development of locoregional relapses and metastases, the indicators of overall and relapse-free survival, depending on various clinical and morphological factors, were described. In total, the results were analyzed in 43 patients diagnosed with gastric cancer. Results and discussion. At the time of this analysis, 22 patients died, 21 patients continued to be observed or were lost from the observation. Life expectancy ranged from 6.1 to 122 months. According to the multivariate analysis, two factors were identified that have a statistically significant independent effect on overall survival: the macroscopic type of growth according to Borrmann (P≤0.009) and the degree of therapeutic pathomorphism (P≤0.015). In 3 cases, a complete therapeutic tumor pathomorphism was registered. Patients continue observation for up to 6 years. Local recurrence was not detected in any case. Regional recurrence was detected and morphologically confirmed in one patient. Peritoneal metastases, the development of which more often occurred in the case of low-grade forms of gastric cancer, were observed in 12 cases. Conclusion. All in all, the annual survival rate was 80.5 ± 6.2%, three-year 55.5 ± 7.8%, and five-year 45.0 ± 7.9%. The results show that combined treatment of locally advanced gastric cancer, using a new technique of neoadjuvant chemoradiotherapy, contributes to an increase in overall and relapse-free survival.

5-Fluorouracil and 1-(2-Chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) Followed by Hydroxyurea, Misonidazole, and Irradiation for Brain Stem Gliomas: A Pilot Study of the Brain Tumor Research Center and the Childrens Cancer Group

Neurosurgery ◽  
1984 ◽  
Vol 14 (6) ◽  
pp. 679-681 ◽  
Author(s):  
Victor A. Levin ◽  
Michael S. Edwards ◽  
William M. Wara ◽  
Jeffrey Allen ◽  
Jorge Ortega ◽  
...  
Keyword(s):  
Brain Stem ◽  
Brain Stem Glioma ◽  
Older Children ◽  
Relapse Free Survival ◽  
Karnofsky Score ◽  
Free Survival ◽  
Cancer Group ◽  
Tumor Research ◽  
Brain Tumor Research ◽  
The Brain

Abstract Twenty-eight evaluable children with the diagnosis of brain stem glioma were treated with 5-fluorouracil and CCNU before posterior fossa irradiation (5500 rads); during irradiation, the children received hydroxyurea and misonidazole, The treatment was well tolerated, and minimal toxicity was produced. The median relapse-free survival was 32 weeks, and the median survival was 44 weeks. Analysis of covariates showed that, in patients between the ages of 2 and 19 years, survival was longest in the older children (P < 0.02). Tumor histology, sex, extent of operation (if any), Karnofsky score, and radiation dose did not correlate with survival.

A clinical case of combined treatment of a patient with breast cancer and metastases to the brain and meninges

2016 ◽  
Vol 80 (1) ◽  
pp. 83 ◽  
Author(s):  
E. A. Moskvina ◽  
D. R. Naskhletashvili ◽  
A. Kh. Bekyashev ◽  
S. V. Medvedev ◽  
D. M. Belov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Case ◽  
Combined Treatment ◽  
The Brain

Hybrid treatment of multilevel revascularization in patients with peripheral arterial disease – a multi-centre study in Korea

VASA ◽  
2018 ◽  
Vol 47 (3) ◽  
pp. 235-241 ◽  
Author(s):  
Soon Cheon Lee ◽  
Jin Hyun Joh ◽  
Jeong-Hwan Chang ◽  
Hyung-Kee Kim ◽  
Jang Yong Kim ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Combined Treatment ◽  
Ankle Brachial Index ◽  
Primary Patency ◽  
Limb Ischaemia ◽  
University Hospitals ◽  
Multi Centre Study ◽  
Free Survival ◽  
Technical Success Rate ◽  
Hybrid Treatment

Abstract. Background: Endovascular treatment is an alternative first-line management for peripheral artery disease (PAD). Hybrid treatment (HT) is defined as a combined treatment for patients with PAD using endovascular and open surgery, simultaneously performed in an operating room. The results of HT are reportedly good for multilevel revascularization (MR) in patients with chronic limb ischaemia, and even in older high-risk patients. The goal of this study was to examine the clinical and haemodynamic outcomes of HT in patients who need MR. Patients and methods: Nine university hospitals in Korea participated in this multicentre study. A total of 134 patients with multilevel PAD underwent HT and MR. Patients were enrolled from July 2014 to June 2015 and were followed for 18 months. Results: The mean age of the patients was 68.8 ± 9.93 years and 88.1 % were men. Patients with Rutherford category 2 to 3 and 4 to 6 comprised 59.0 % and 42.0 % of the group, respectively. The technical success rate was 100 %. The primary patency rates at 12 and 18 months were 77.6 % and 63.9 %, respectively. The primary-assisted patency rates at 12 and 18 months were both 90.0 %. The pre-operative mean ankle brachial index (0.43 ± 0.23) increased to 0.87 ± 0.23 at six months post-operatively (t-test, p < 0.05). The amputation free survival rate was 97.1 %. Conclusions: Although outcomes of multilevel PAD are reportedly poor when endovascular treatment alone is used, we have shown that HT is a feasible alternative modality for patients with multilevel PAD, with satisfactory amputation-free survival and freedom from re-intervention rates.

Surgery and metastases of stomach cancer in liver

2020 ◽  
pp. 21-24
Author(s):  
F. M. Dzhuraev ◽  
S. L. Gutorov ◽  
E. I. Borisova ◽  
G. G. Khakimova
Keyword(s):  
Gastric Cancer ◽  
Liver Metastases ◽  
Lymphovascular Invasion ◽  
Peritoneal Dissemination ◽  
Surgical Removal ◽  
Relapse Free Survival ◽  
Cancer Markers ◽  
Free Survival ◽  
The Poor ◽  
Isolated Liver

Liver metastases of gastric cancer determine the poor prognosis. Until now The expediency of their surgical removal has been controversial. However, according to a number of studies, the removal of potentially operable isolated liver metastases allows a significant increase of overall and relapse-free survival in some cases. The review is dedicated to the analysis of prognostic factors that allow selecting patients for surgical removal of liver metastases of gastric cancer. The main criteria are: effective perioperative chemotherapy; stage under T4, N0, absence of lymphovascular invasion, absence of peritoneal dissemination, number less than 3, size up to 4 cm, localization of metastases in one lobe, low level of cancer markers CA 19-9 and CEA.

Új lehetőségek a refrakter és relabált Hodgkin-lymphomás betegek kezelésében

2015 ◽  
Vol 156 (45) ◽  
pp. 1824-1833 ◽  
Author(s):  
Árpád Illés ◽  
Ádám Jóna ◽  
Zsófia Simon ◽  
Miklós Udvardy ◽  
Zsófia Miltényi
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Novel Treatment ◽  
Refractory Hodgkin Lymphoma

Introduction: Hodgkin lymphoma is a curable lymphoma with an 80–90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. Aim: The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Method: Retrospective analysis of data was performed. Results: A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. Conclusions: During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure. Orv. Hetil., 2015, 156(45), 1824–1833.

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