Comparison of titanium mesh implants with PLA-hydroxyapatite coatings for maxillofacial cancer reconstruction

Since 2013 physics of TPU and oncologists from the TCRI with participation of the “ConMet” company (Moscow) and the “Sintel” company (Tomsk Special Economic Zone resident) have been working on the theme entitled “Development of the composite implants for reconstructive surgery of a craniofacial areas of the traumatological and oncological patients” supported with the Federal Program ”R&D, part 1.3”. The goal was to develop the maxillo-facial implants on the basis of the transformable titanium mesh with PLA & hydroxyapatite coating. According to the Contract No. 14.578.21.0031, the team of developers had to start supplying these advanced implants to the industrial partners up to 2017. This research was supported with the preliminary market researches by the ISPMS SB RAS and the TP “MF”. The stages of preliminary market researches were: 1) research of the Worldwide CMF market; 2) forecasting the BRIC CMF market up to 2020; 3) the total Russian market (epidemiology) estimation as a sum of official calculations and statistics; 4) looking for the best foreign analogue prices, comparing their and our implant properties; 5) search for the best Russian analogues; 6) the investigation of the world patent databaseEspacenet for the last years, and finding the owners and applicants of patents of CMF osteosynthesis plates on the basis of titanium coated with PLA & hydroxyapatite; 7) comparison of the domestic implants, and making conclusions. Several variants of the meshes have got the equal quality with the best foreign and Russian implants. The closest analogues were titanium, polyethylene, PEEK composite meshes suited to the patient shape by the Synthes company in 2014, and the only hybrid titanium "Grey" implant with layers of gelatin, dextran, collagen, HAP & BMP-2 was found. This implant was produced by Russian institution, and it was mentioned in the report on clinical trials by L.A. Pavlova et al., 2014 [1]. There are no manufacturers of the coated implants in Russia. The average price of the similar foreign implants varies from 12 up to 4

Reconstructive surgery for oral cavity cancer

Treatment of patients with advanced oral cavity cancer remains challenging

БОРИС НИКОЛАЕВИЧ ЗЫРЯНОВ (1940–2002) – ВИДНЫЙ РОССИЙСКИЙ ОНКОЛОГ

The article presents a biographical sketch of B.N. Zyryanov, a prominent Russian oncologist, Director of Tomsk Cancer Research Institute in the period from 1987 to 2002, Academician of the Russian Academy of Medical Sciences, Professor.Представлен биографический очерк, посвященный видному российскому онкологу, директору Томского НИИ онкологии в период с 1987 по 2002 г., академику РАМН, профессору Б.Н. Зырянову

Concurrent thermochemoradiotherapy for brain high-grade glioma

Despite the achievements in the current strategies for treatment, the prognosis in malignant glioma patients remains unsatisfactory. Hyperthermia is currently considered to be the most effective and universal modifier of radiotherapy and chemotherapy. Preliminary treatment outcomes for 28 patients with newly diagnosed (23) and recurrent (5) high-grade gliomas were presented. All the patients received multimodality treatment including surgery, thermoche-moradiotherapy followed by 4 cycles of adjuvant chemotherapy. All the patients endured thermochemoradiotherapy well. A complication, limited skin burn (II stage), was diagnosed in two cases and treated conservatively without treatment interruption. A month after thermochemoradiotherapy the results were as follows: complete regression was achieved in 4 cases, partial regression in 4 cases, stable disease in 14 cases and disease progression in 6 cases (one of them is pseudo-progression). After completing the adjuvant chemotherapy 2 more patients demonstrated complete response and 1 patient had disease progression. Introduction of local hyperthermia in multimodal therapy of malignant glioma does not impair the combined modality treatment tolerability of patients with malignant gliomas. A small number of studied patients and short follow-up time do not allow making reliable conclusions about the impact of local hyperthermia on the treatment outcomes; however, there is a tendency towards the increase in disease-free survival in the patients with newly diagnosed malignant gliomas

Calcium phosphate coatings produced by radiofrequency magnetron sputtering method

Calcium phosphate coatings on titanium implants surface, produced by radio frequency (RF) magnetron sputtering method with hydroxyapatite solid target were investigated. It was found that produced coatings are calcium deficient compared to stoichiometric hydroxyapatite. The surface of the coatings is highly rough at the nanoscale and highly elastic. In vivo experiments on rats revealed that titanium implants with the calcium phosphate coatings do not cause negative tissue reaction after 6 months incubation period

Physical therapy methods in the treatment and rehabilitation of cancer patients

The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients

Прогнозирование локализации отдаленных метастазов при раке молочной железы

Background. Distant organ tumor dissemination is a major cause of breast cancer-related deaths. Breast cancer can metastasize to several organs, and the most frequent metastatic sites include the bones, lungs and liver. There is a question what factors can influence the direction of spread of tumor cells to a particular organ.Material and Methods. We summarized the data available in the world literature on methods for prediction of the localization of distant metastases in breast cancer patients.Results. We divided the factors associated with the localization of distant metastases into two main groups: clinicopathological parameters of breast cancer patients and molecular features of tumor microenvironment and tumor cells (primary tumor and circulating tumor cells) or its derivates – exosomes. From our point of view, the most powerful clinicopathological factor predicting the distant metastasis site is a molecular subtype of primary tumor. We can conclude that luminal (HR+/HER2-) tumors are often characterized by single metastases and bones are the most common metastatic site, while TNBC and HER2-enriched tumors often metastasize to multiple sites, most commonly brain and liver. However, several authors did not reveal these associations in their studies. It likely indicates the existence of other factors that significantly affect the organotropism of metastasis. Numerous studies demonstrate the association of different molecules expressed on tumor cells with organotropic metastasis. However, these data are very fragmentary and rather contradictory.Conclusion. The found associations are common to all participants of metastatic cascade, but remains unclear which factors are essential and crucial in determining the direction of metastasis.Введение. Метастазирование опухоли в отдаленные органы является основной причиной смерти при раке молочной железы. Преимущественная локализация отдаленных метастазов при раке молочной железы – кости, легкие и печень. Возникает вопрос, какие факторы могут влиять на направление распространения опухолевых клеток в тот или иной орган.Материал и методы. Мы обобщили имеющиеся в мировой литературе данные о методах прогнозирования локализации отдаленных метастазов у больных раком молочной железы.Результаты. Факторы, связанные с локализацией отдаленных метастазов, мы разделили на две основные группы: клинико-патологические параметры больных раком молочной железы и молекулярные особенности микроокружения опухоли и опухолевых клеток (первичных опухолевых и циркулирующих опухолевых клеток) или их производных – экзосом. Представляется, что молекулярный подтип первичной опухоли является наиболее перспективным предиктором, предсказывающим место отдаленного метастазирования. Люминальные опухоли (HR+/ HER2-) чаще характеризуются единичными метастазами, с преимущественной локализацией в костях, в то время как трижды негативные и HER2-обогащенные опухоли чаще образуют множественные метастазы, которые чаще локализуются в головном мозге и печени. Однако некоторые авторы не обнаруживают в своих исследованиях таких закономерностей, что, вероятно, свидетельствует о наличии других факторов, существенно влияющих на органотропность метастазирования. Многочисленные исследования демонстрируют ассоциацию различных молекул, экспрессируемых на опухолевых клетках, с органотропным метастазированием. Однако эти данные весьма фрагментарны и иногда весьма противоречивы.Заключение. Обнаруженные ассоциации относятся ко всем участникам метастатического каскада, но остается неясным, какие факторы являются существенными и решающими в определении направления метастазирования

Deletions of multidrug resistance gene loci in breast cancer leads to the down-regulation of its expression and predict tumor response to neoadjuvant chemotherapy

Neoadjuvant chemotherapy (NAC) is intensively used for the treatment of primary breast cancer. In our previous studies, we reported that clinical tumor response to NAC is associated with the change of multidrug resistance (MDR) gene expression in tumors after chemotherapy. In this study we performed a combined analysis of MDR gene locus deletions in tumor DNA, MDR gene expression and clinical response to NAC in 73 BC patients. Copy number variations (CNVs) in biopsy specimens were tested using high-density microarray platform CytoScanTM HD Array (Affymetrix, USA). 75%-100% persons having deletions of MDR gene loci demonstrated the down-regulation of MDR gene expression. Expression of MDR genes was 2-8 times lower in patients with deletion than in patients having no deletion only in post-NAC tumors samples but not in tumor tissue before chemotherapy. All patients with deletions of ABCB1 ABCB 3 ABCC5 gene loci--7q21.1, 6p21.32, 3q27 correspondingly, and most patients having deletions in ABCC1 (16p13.1), ABCC2 (10q24), ABCG1 (21q22.3), ABCG2 (4q22.1), responded favorably to NAC. The analysis of all CNVs, including both amplification and deletion showed that the frequency of 13q14.2 deletion was 85% among patients bearing tumor with the deletion at least in one MDR gene locus versus 9% in patients with no deletions. Differences in the frequency of 13q14.2 deletions between the two groups were statistically significant (p = 2.03 × 10(-11), Fisher test, Bonferroni-adjusted p = 1.73 × 10(-8)). In conclusion, our study for the first time demonstrates that deletion MDR gene loci can be used as predictive marker for tumor response to NAC

Numerical Simulation of the Medical Linear Accelerator Electron Beams Absorption by ABS-Plastic doped with Metal

In this paper the numerical simulation results of the dose spatial distribution of the medical electron beams in ABS-plastic doped with different concentrations of lead and zinc are shown. The dependences of the test material density on the lead and zinc mass concentrations are illustrated. The depth dose distributions of the medical electron beams in the modified ABS-plastic for three energies 6 MeV, 12 MeV and 20 MeV are tested. The electron beam shapes in the transverse plane in ABS-plastic doped with different concentrations of lead and zinc are presented

КАЧЕСТВО ЖИЗНИ БОЛЬНЫХ РАКОМ ГОРТАНИ И ГОРТАНОГЛОТКИ НА ЭТАПАХ КОМБИНИРОВАННОГО ЛЕЧЕНИЯ И В ОТДАЛЁННЫЕ СРОКИ

The study included 96 patients with morphologically verified  squamous cell carcinoma of larynx and laryngopharynx T2–4N0–2M0 stage of the tumor process who were administered two courses of neoadjuvant chemotherapy at 3–4 weeks interval by the scheme paclitaxel 175 mg/m2, carboplatin AUC-6 plus radiotherapy in the regimen of multifractionated radiation dose of 1.3 Gy twice a day at 4 hours interval. In case of complete regression of the tumor (n=33) radiotherapy was performed to the accumulated radical dose of 65 isoGy. The next stage in partial regression and stabilization of the process (n=63) was radical surgical intervention. EORTC QLQ-30 and QLQ – H&N35 questionnaires were used to estimate quality of life of the patients. Quality of life as a criterion for the assessment of treatment efficacy was correlated with a significant increase in the 2-year overall and disease-free survival in patients who received chemoradiotherapy compared to those who underwent combined modality treatment including surgery. Changes in the values of EORTC QLQ-30 and QLQ – H & N35 modules clearly indicate the relationship between the quality of life measures and treatment methods