ФОТОДИНАМИЧЕСКАЯ ТЕРАПИЯ ОСТАТОЧНОЙ ОПУХОЛИ ГОРТАНИ ПОСЛЕ ДЛТ (КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ)

A case of successful photodynamic therapy of residual laryngeal tumor after external beam radiotherapy (EBRT) is reported. The female patient with diagnosis of laryngeal cancer T1N0M0 underwent a course of EBRT on larynx, fraction dose = 2 Gy, 5 fractions per week, total radiation dose = 60 Gy. One month after EBRT the continued growth of residual tumor in the left vocal fold was diagnosed. The patient had 4 courses of photodynamic therapy with photosensitizer fotoditazin at a dose of 100 mg combined with electroresection of residual laryngeal tumor. The control video-assisted laryngoscopy 1 month after the 4th course of photodynamic therapy showed that larynx was flexible, vocal function was fully restored, tumor of the left vocal fold wasn’t detected. Non-recurrence follow-up period is 10 month. The patient is under follow-up.Приведено клиническое наблюдение успешной фотодинамической терапии остаточной опухоли гортани после ДЛТ. Пациентке с диагнозом рак гортани, T1N0M0, было проведен курс ДЛТ на область гортани, РОД = 2 Гр, 5 фракций в неделю, СОД = 60 Гр. Через 1 мес после завершения курса ДЛТ диагностирован продолженный рост остаточной опухоли левой голосовой складки. Пациентке проведено 4 курса фотодинамической терапии с фотосенсибилизатором фотодитазин в дозе 100 мг в сочетании с электрорезекцией остаточной опухоли гортани. При контрольной видеоларингоскопии через 1 мес после 4-го курса фотодинамической терапии гортань подвижна, голосовая функция полностью восстановлена, опухоль левой голосовой складки не определяется. Безрецидивный период наблюдения составляет 10 мес. Пациентка находится под динамическим наблюдением

Комбинированное эндоскопическое лечение больного раком гортаноглотки с распространением на верхнюю треть пищевода

We present a clinical case with a complete endoscopic and clinical effect after endoscopic treatment of a patient with laryngeal cancer involving the upper third of the esophagus. The patient was treated as follows: conformal radiation therapy TFD = 40 gr, targeted chemotherapy using Cetuximab (total dose of 1800 mg). 1.5 months after the end of the treatment, a residual laryngopharyngeal tumor with a spread into the upper third of the esophagus was found during videolaryngoscopy examination. The result of the following histological examination was G2 squamous cell carcinoma. From August 2015 to February 2017, the patient underwent 8 photodynamic therapy sessions in combination with argon plasma coagulation. A control videolaryngoscopy, carried out 1 month after the fnal session, showed complete tumor regression without cicatricial deformity and narrowing of the esophageal lumen.Авторы описывают клиническое наблюдение с полным клиническим эффектом после эндоскопического лечения больного раком гортаноглотки, вовлекающим верхнюю треть пищевода. Пациент получал лечение в объеме: конформная лучевая терапия СОД = 40 Гр, таргетная химиотерапия препаратом цетуксимаб, суммарной дозой 1800 мг. Через 1,5 мес после окончания лечения на видео‑ларингоскопии была выявлена остаточная опухоль гортаноглотки с распространением на верхнюю треть пищевода. Результат гистологического исследования – плоскоклеточный рак, G2. С августа 2015 по февраль 2017 г. пациенту было проведено 8 курсов фотодинамической терапии в сочетании с аргоноплазменной коагуляцией. На контрольной видеоларингоскопии, выполненной через 1 мес после последнего курса, зарегистрирована полная регрессия опухоли без рубцовой деформации или сужения просвета пищевода

ЭНДОСКОПИЧЕСКАЯ ФОТОДИНАМИЧЕСКАЯ ТЕРАПИЯ БОЛЬНОГО С МЕТАСТАЗАМИ РАКА ЛЕГКОГО В БИФУРКАЦИОННЫЕ ЛИМФАТИЧЕСКИЕ УЗЛЫ (КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ)

AbstractThis clinical case demonstrates the feasibility of photodynamic therapy (PDT) as a method of choosing the treatment of recurrent lung cancer in inoperable patients with ineffective chemoradiotherapy. An operation was performed on the patient with a diagnosis of pT4N0M0 central cancer of the lower lobe of the right lung after 2 courses of neoadjuvant chemotherapy in October 2015: an expanded combined lower bilobectomy of the right lung, with resection of the pericardium and left atrium. Then 4 courses of adjuvant chemotherapy (cisplatin + vinorelbine) and a course of radiotherapy on the mediastinum area up to a total dose of 45 Gy were carried out. After 2 months, a metastatic lesion of bifurcation lymph nodes with invasion of the mucosa of the tracheal bifurcation, involving the distal trachea, proximal right and left main bronchi was detected. The result of histological analysis: G2 squamous cell carcinoma without keratinization. From Dec 2016 to Jun 2017, the patient underwent 5 courses of PDT, as a result of which a significant cytoreductive effect and stabilization of the process were achieved. The continuation of the PDT treatment is planned.Описанный авторами клинический пример демонстрирует целесообразность применения фотодинамической терапии (ФДТ) как метода выбора лечения рецидивов заболевания у неоперабельных пациентов раком легкого с неэффективным химиолучевым лечением. Пациенту с диагнозом центральный рак нижней доли правого легкого pT4N0M0 после 2 курсов неоадъювантной химиотерапии в октябре 2015 г. была выполнена операция: расширенная комбинированная нижняя билобэктомия легкого справа, с резекцией перикарда и левого предсердия. Затем было проведено 4 курса адъювантной химиотерапии (цисплатин+винорельбин) и курс лучевой терапии на область средостения до СОД 45 Гр. Через 2 мес выявлено метастатическое поражение бифуркационных лимфоузлов с прорастанием слизистой оболочки бифуркации трахеи, вовлечением дистального отдела трахеи, проксимальных отделов правого и левого главных бронхов. Результат гистологического исследования биоптата: плоскоклеточный рак без ороговения, G2. С декабря 2016 по июнь 2017 гг. пациенту проведено 5 курсов ФДТ, в результате которых удалось добиться значительного циторедуктивного эффекта и стабилизации опухолевого процесса. Планируется продолжение лечения методом ФДТ

Invagination of the Adductor Loop of the Small Intestine into the Lumen of the Gastric Stump after Pancreatoduodenal Resection

Aim. To present a rare clinical observation of invagination of the adductor loop of the small intestine into the lumen of the gastric stump after pancreatoduodenal resection. Results. A 69-year-old patient complained of paroxysmal abdominal pain, nausea, vomiting without relief. The patient also reported an episode of black stools 7 years after pancreatoduodenal resection for pancreatic head cancer and 3 years after reconstructive surgery by performing choledochoenteroanastomosis. The invagination of the adductor loop of the small intestine into the lumen of the gastric stump was identified. The mobilization and resection of a fragment of the jejunum with an invagination zone was performed followed by suturing of the distal end of the intestine. Conclusions. Small bowel invagination after abdominal surgery occurs in 1–5% of cases. This case of invagination of the blind end of the adductor loop into the gastric stump through gastroenteroanastomosis caused an acute adductor loop syndrome in the patient. No similar cases have been reported in Russian and foreign publications

Invagination of the Adductor Loop of the Small Intestine into the Lumen of the Gastric Stump after Pancreatoduodenal Resection

Aim. To present a rare clinical observation of invagination of the adductor loop of the small intestine into the lumen of the gastric stump after pancreatoduodenal resection. Results. A 69-year-old patient complained of paroxysmal abdominal pain, nausea, vomiting without relief. The patient also reported an episode of black stools 7 years after pancreatoduodenal resection for pancreatic head cancer and 3 years after reconstructive surgery by performing choledochoenteroanastomosis. The invagination of the adductor loop of the small intestine into the lumen of the gastric stump was identified. The mobilization and resection of a fragment of the jejunum with an invagination zone was performed followed by suturing of the distal end of the intestine. Conclusions. Small bowel invagination after abdominal surgery occurs in 1–5% of cases. This case of invagination of the blind end of the adductor loop into the gastric stump through gastroenteroanastomosis caused an acute adductor loop syndrome in the patient. No similar cases have been reported in Russian and foreign publications

ENDOSCOPIC PHOTODYNAMIC THERAPY OF A PATIENT WITH LUNG CANCER METASTASIS IN BIFURCATION LYMPH NODES (CLINICAL OBSERVATION)

AbstractThis clinical case demonstrates the feasibility of photodynamic therapy (PDT) as a method of choosing the treatment of recurrent lung cancer in inoperable patients with ineffective chemoradiotherapy. An operation was performed on the patient with a diagnosis of pT4N0M0 central cancer of the lower lobe of the right lung after 2 courses of neoadjuvant chemotherapy in October 2015: an expanded combined lower bilobectomy of the right lung, with resection of the pericardium and left atrium. Then 4 courses of adjuvant chemotherapy (cisplatin + vinorelbine) and a course of radiotherapy on the mediastinum area up to a total dose of 45 Gy were carried out. After 2 months, a metastatic lesion of bifurcation lymph nodes with invasion of the mucosa of the tracheal bifurcation, involving the distal trachea, proximal right and left main bronchi was detected. The result of histological analysis: G2 squamous cell carcinoma without keratinization. From Dec 2016 to Jun 2017, the patient underwent 5 courses of PDT, as a result of which a significant cytoreductive effect and stabilization of the process were achieved. The continuation of the PDT treatment is planned

Combined endoscopic treatment of a patient with cancer of the hypopharynx to the upper third of the esophagus with complete clinical and endoscopic effect

We present a clinical case with a complete endoscopic and clinical effect after endoscopic treatment of a patient with laryngeal cancer involving the upper third of the esophagus. The patient was treated as follows: conformal radiation therapy TFD = 40 gr, targeted chemotherapy using Cetuximab (total dose of 1800 mg). 1.5 months after the end of the treatment, a residual laryngopharyngeal tumor with a spread into the upper third of the esophagus was found during videolaryngoscopy examination. The result of the following histological examination was G2 squamous cell carcinoma. From August 2015 to February 2017, the patient underwent 8 photodynamic therapy sessions in combination with argon plasma coagulation. A control videolaryngoscopy, carried out 1 month after the fnal session, showed complete tumor regression without cicatricial deformity and narrowing of the esophageal lumen

PHOTODYNAMIC THERAPY OF RESIDUAL LARYNGEAL TUMOR AFTER EBRT (CASE REPORT)

A case of successful photodynamic therapy of residual laryngeal tumor after external beam radiotherapy (EBRT) is reported. The female patient with diagnosis of laryngeal cancer T1N0M0 underwent a course of EBRT on larynx, fraction dose = 2 Gy, 5 fractions per week, total radiation dose = 60 Gy. One month after EBRT the continued growth of residual tumor in the left vocal fold was diagnosed. The patient had 4 courses of photodynamic therapy with photosensitizer fotoditazin at a dose of 100 mg combined with electroresection of residual laryngeal tumor. The control video-assisted laryngoscopy 1 month after the 4th course of photodynamic therapy showed that larynx was flexible, vocal function was fully restored, tumor of the left vocal fold wasn’t detected. Non-recurrence follow-up period is 10 month. The patient is under follow-up