Retinoblastoma Morphology after Local Chemotherapy

Purpose. Determine the nature of tumor regression and possible complications associated with the retinotoxic effect of melphalan and carboplatin with local chemotherapy.Methods. A histological analysis of 19 enucleated eyes from 19 patients with retinoblastoma was performed after combined organ-preserving treatment, including systemic chemotherapy and local chemotherapy in various doses. The enucleated eyes were fixed in 10 % formalin and processed routinely for histological examination.Results. Significant changes in the tumor tissue such as tumor regression associated with the destruction of the tumor tissue and its replacement with fibrous tissue, glia proliferation, and the formation of petrificates were revealed. Complete regression of the tumor was detected in 3 out of 19 eyes, partial in 13 eyes. There were no signs of regression in 3 eyes. Tumor invasion into the choroid was found in 5 cases, into the anterior sector — in 3 cases, into the optic nerve — in 3 cases. The retrobulbar tumor was presented in 1 case. Retinotoxic complications revealed. Hemorrhagic changes associated with focal necrosis of the central retinal vessels (n = 4), destructive changes in retinal pigment epithelium (RPE; n = 10) associated with the accumulation of melphalan in RPE leading to atrophic processes in the retina. Complications in the form of secondary glaucoma, severe fibrosis and retinal detachment, despite the complete resorption of the tumor, led not only to loss of vision, but also hindered visualization of the fundus and substantiated the need for enucleation in 3 cases. In other cases, enucleation was performed due to continued tumor growth (n = 16) or progression during treatment (n = 3).Conclusions. Retinoblastoma can be controlled with local chemotherapy. However, clinical and morphological examinations of enucleated eyes revealed and confirmed, along with tumor resorption, intraocular complications as a result of the toxic effect of the drugs and the presence of active tumor tissue to varying degrees of therapeutic pathomorphism, which can be explained by the resistance of RB to these drugs. Thus, a further search is needed for drugs that destroy the tumor and minimize the retinotoxic effect.

Local Chemotherapy as an Adjuvant Treatment in Unresectable Squamous Cell Carcinoma: What Do We Know So Far?

Background: Squamous cell carcinoma (SCC) is one of the most common cancers involving skin and oral mucosa. Although this condition’s gold-standard treatment is the surgical removal of the lesions, the physician must propose alternative treatments in some cases due to the patient’s ineligibility for surgery. Among the available alternative therapies, local chemotherapy may represent an initial treatment in combination with radiotherapy or systemic chemotherapy due to the low frequency of side-effects and the lack of necessity for expensive devices. Methods: In this paper, we review all available literature in various databases (PubMed, Scopus-Embase, Web of Science), proposing local chemotherapy as a treatment for cutaneous and oral SCC. Exclusion criteria included ocular lesions (where topical treatments are common), non-English language, and non-human studies. Results: We included 14 studies in this review. The majority were case reports and case series describing the treatment of non-resectable localized SCC with either imiquimod or 5-fluorouracil. We also analyzed small studies proposing combination treatments. Almost all studies reported an excellent clinical outcome, with a low risk of relapses in time. Conclusions: Resection of the lesion remains the gold-standard treatment for SCC. When this approach is not feasible, local chemotherapy may represent a treatment alternative, and it may also be associated with radiotherapy or systemic chemotherapy.

Comparative Efficacy of Traditional Conservative Treatment and Ct-guided Local Chemotherapy for Mild Spinal Tuberculosis

Background: There are considerable differences in the treatment strategy for spinal tuberculosis, inclouding conservative or surgical procedures. Conservative treatment is always suitable for most patients. This study aimed to compare the clinical efficacy of traditional conservative treatment with CT-guided local chemotherapy strategy of mild spinal tuberculosis.Methods: This research retrospectively analysed 120 patients with spinal tuberculosis between January 2005 and January 2016 according to the diagnostic criteria of mild spinal tuberculosis. In total, 89 patients underwent traditional conservative treatment, 31 underwent CT-guided local chemotherapy. Clinical outcome, laboratory indexes, and radiological results were analysed to provide a clinical basis for the choice of mild spinal tuberculosis treatment.Results: All cases achieved a clinical cure with 24 to 50 months followed up. Cobb angle of the two groups spinal tuberculosis segments was 6.25 ± 3.11°, 5.69 ± 2.58° before treatment and 12.36 ± 6.31°, 14.87 ± 7.26° after treatment, respectively. VAS scores were significantly decreased post-treatment. There was no obvious kyphosis, symptoms or neurological deficits at the final follow-up.Conclusions: For mild spinal tuberculosis, traditional conservative treatment can achieve satisfactory results. The strategy combined with CT-guided local chemotherapy treatment is minimally invasive, beneficial for the drainage of paravertebral abscesses and pain relief.

Own experience of "Glicifon" using as a local chemotherapy drug for the patients with basal-cell head&neck carcinoma

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.

Development of a method for serial intravesical administration of drugs in experiment

The technical difficulties of serial intravesical administration of drugs are a significant problem in preclinical studies of the effectiveness of local chemotherapy for superficial bladder cancer. The aim of the study was to develop and evaluate the effectiveness of the method of serial intravesical administration of drugs in the experiment. The study included 49 Wistar rats of both sexes. Five proposed methods of intravesical administration of drugs were investigated: retrograde catheterization of the urinary bladder under anesthesia, method of transcutaneous puncture of the urinary bladder in rats, intraoperative puncture of the bladder, method of subcutaneous fixation of the bladder for subsequent puncture in the experiment, method of serial intravesical administration of drugs in female rats using special catheter. The obtained data were processed using a package of statistical programs SPSS 20.0 for Windows. The disadvantage of the first technique is its trauma – each insertion of the catheter is accompanied by trauma of the urethral mucosa and associated pain. The manipulations were failed because of edema of the urethral mucosa. The manipulation should be performed under general anesthesia. The second technique also requires general anesthesia. The aggressive cytostatic action of Doxorubicin prevented the closure of the puncture hole and caused the development of complications. Sealing the bladder with a collagen plate when performing the third technique prevents the release of the drug into the abdominal cavity, however, the adhesion of the tissues of the surrounding organs to the plate promotes the formation of an adhesive conglomerate and makes further manipulations impossible. The withdrawal of the bladder from the abdominal cavity during the implementation of the fourth technique, theoretically, should have helped to avoid the complications observed during the third technique. However, insufficiently reliable fixation of the urinary and adhesions in the area of the implanted ring make this technique such that it does not correspond to the tasks set. The fifth method was the only one proposed that met all the assigned tasks. This technique made it possible to perform a series of 5 intravesical injections of Doxorubicin without general anesthesia and without the development of postoperative complications from the postoperative wound and abdominal cavity. The proposed method of serial intravesical administration of drugs in female rats using a special catheter makes it technically easy to perform serial intravesical administration of drugs without the use of general anesthesia and without the development of complications from the postoperative wound and abdominal cavity.