Method Of Local Therapy Research Articles

Surgical treatment of recurrent intrahepatic cholangiocarcinoma (systematic review)

Background: Liver resection for intrahepatic cholangiocarcinoma is accompanied by a high recurrence rate (up to 70 %) in the first 2 years after surgery. The results of treatment of recurrent intrahepatic cholangiocarcinoma are evaluated inconsistently.Aim: The results of repeated liver resections and methods of locoregional therapy for reccurent intrahepatic cholangiocarcinoma were analysed based on literature data.Materials and methods: Two publication databases have been used for search: PubMed and Google Scholar. Finally, 35 papers published from 2010 to 2022 were included in review.Results: Repeated liver resections followed by chemotherapy provide better long-term results compared to other methods of local therapy and systemic drug treatment. The rate of perioperative morbidity does not differ from resections for primary tumors. Repeat liver resection is possible in a limited number of patients (8–10 %). Thorough selection of patients is necessary in terms of prognosis and biological behavior of the tumor.Conclusion: Evidence for the benefit of resections in the treatment of recurrent intrahepatic cholangiocarcinoma is based on a scarse number of studies analyzing relatively small and heterogeneous patient cohorts. Patient selection is needed, the criteria for which are still being discussed.

Salvage Treatment for Progressive Brain Metastases in Breast Cancer.

Simple SummaryThirty percent of patients with human epidermal growth factor receptor 2-positive breast cancer and triple-negative breast cancer, and 15% of patients with the remaining subtypes of breast cancer will develop brain metastases. Available treatment methods include surgery and radiotherapy. However, some individuals will experience intracranial progression despite prior local treatment. This situation remains a challenge. In the case of progressing lesions amenable to local therapy, the choice of a treatment method must consider performance status, cancer burden, possible toxicity, and previously applied therapy. Stereotactic radiosurgery or fractionated radiotherapy rather than whole-brain radiotherapy should be used only if feasible. If local therapy is unfeasible, selected patients, especially those with human epidermal growth factor receptor 2-positive breast cancer, may benefit from systemic therapy.Survival of patients with breast cancer has increased in recent years due to the improvement of systemic treatment options. Nevertheless, the occurrence of brain metastases is associated with a poor prognosis. Moreover, most drugs do not penetrate the central nervous system because of the blood–brain barrier. Thus, confirmed intracranial progression after local therapy is especially challenging. The available methods of salvage treatment include surgery, stereotactic radiosurgery (SRS), fractionated stereotactic radiotherapy (FSRT), whole-brain radiotherapy, and systemic therapies. This narrative review discusses possible strategies of salvage treatment for progressive brain metastases in breast cancer. It covers possibilities of repeated local treatment using the same method as applied previously, other methods of local therapy, and options of salvage systemic treatment. Repeated local therapy may provide a significant benefit in intracranial progression-free survival and overall survival. However, it could lead to significant toxicity. Thus, the choice of optimal methods should be carefully discussed within the multidisciplinary tumor board.

PHOTODYNAMIC THERAPY IN PATIENTS WITH HILAR CHOLANGIOCARCINOMA

Extrahepatic bile duct cancer is one of those pathologies in which about 70% of patients due to the prevalence of the tumor process can not receive radical treatment, which determines the need for active implementation of methods that allow, while maintaining a satisfactory quality of life of patients, to increase survival rates. Due to the peculiarities of localization and development of malignant tumors of the extrahepatic bile ducts, as well as the nature of the disease, special importance in the treatment of these patients is given to various methods of external or internal bile removal and on the second stage of treatment can be considered local or systemic methods of exposure. Currently, as a method of local therapy in patients with unresectable extrahepatic bile duct cancer, various options of radiation therapy, radiofrequency and microwave ablation, photodynamic therapy are used. This article presents a literature review covering the feasibility, safety and efficacy of photodynamic therapy in patients with Klatskin tumor.

NEW POSSIBILITIES FOR LOCAL THERAPY OF BACK PAIN SYNDROME

Purpose of study – to examine effectiveness and tolerability of therapy рatch NANOPLAST forte in comparison with “placebo” patch in patients with back pain syndrome in conditions of prospective comparative randomized study, approved by the local ethics committee. Materials and methods. The study included 60 patients with acute/ recrudescence of chronic primary back pain syndrome, there were 30 patients in each group, which were comparable in main clinical parameters. A primary effectiveness criterion was reduction of back pain syndrome intensity at rest and during movements by no less than 50% from initial level according to visual analogue scale (mm). Overall effectiveness of NANOPLAST forte patch was evaluated separately by doctor and patient on the 10th day according to the following grading: significant improvement; improvement; absence of effect. A need for administration of non-steroidal anti-inflammatory drugs (NSAID) was assessed during the study. A patch was applied once a day for 12 h (from 9 to 21 h). Tolerability of NANOPLAST forte patch and “Placebo” patch was evaluated according to frequency and severity of local and/or systemic adverse events, and to tolerability grading: very good effect, good effect, satisfactory effect, absence of effect. Frequency of achievement of not less than 50% of back pain reduction at rest was significantly higher in NANOPLAST forte group than in “placebo” group (96,6% versus 23.3% respectively; р=0.001, Pearson’s chi-squared test), as well as during movements (93,3% versus 40% respectively; р=0.001, Pearson’s chi-squared test). Evaluation of treatment effectiveness was higher in NANOPLAST forte group in comparison with “Placebo” group in the opinion of both patient and doctor. Pain intensity during walking and at rest statistically significantly decreased according to visual analogue scale (p<0.05, Wilcoxon test) by the 10th day in NANOPLAST forte group. A need for additional administration of non-steroidal anti-inflammatory drugs was statistically significantly lower in NANOPLAST forte group in comparison with “Placebo” group (р<0.05, Pearson’s chi-squared test). All patients completed the study. Adverse events related to use of NANOPLAST forte patch were not detected. Conclusion. NANOPLAST forte can be recommended as an effective and safe method of local therapy in case of back pains.

AB0981 Comparison of the efficacy of autologous conditioned serum and hyaluronic acid treatment in hip osteoarthritis

BackgroundIn the synovial fluid of joints affected by osteoarthritis (OA),the concentration and molecular weight of hyaluronic acid (HA) is reduced,which negatively affects its viscoelastic properties and lubricity.In this regard,the possibility...

Die kutane Leishmaniose der Ohrmuschel

Cutaneous leishmaniasis is a parasitic infection which is especially endemic in the southern parts of Europe, in several regions of Africa, and in South and Central America. Whether treatment is necessary or not depends on the virulence of the germ, the infection's localization, and the host's immunological reaction. Because of the high rate of recidivation and the large number of undesirable side-effects of systemic chemotherapy of localized cutaneous leishmaniasis, several methods of local therapy have been tested. This case report demonstrates one of several approaches to the local treatment of this disease. Despite progress in this field, cutaneous leishmaniasis will continue to be a considerable medical and sociopolitical problem, because successful treatments in under-developed countries must be highly efficient, cost little, be easy to administer, and have a low rate of undesirable side-effects.

Pathogenesis and treatment of human genital papillomavirus infections: A review

HPV infection of the genital tract is common and anogenital warts or condyloma acuminatum is increasing rapidly in incidence. In addition, certain HPV types are closely associated with genital tract malignancies. Although recent advances in molecular biology have led to an increased understanding of the organization and functions of the papillomavirus genome, the pathogenesis of HPV infections and host responses to these diseases remain poorly understood. Treatment of anogenital warts is difficult and no completely satisfactory treatment modality is currently available. Comparatively few therapeutic modalities have been thoroughly evaluated, although recent studies of intralesionally and parenterally administered interferons have demonstrated beneficial effects of interferon compared to placebo. Additional studies of treatment for condyloma acuminatum are needed and should include the use of biologic response modifiers such as interferons, as well as antiviral drugs, with or without conventional methods of local therapy.

THE LOCAL INJECTION OF PENICILLIN IN ACUTE CIRCUMSCRIBED INFECTIONS

SUMMARY (1) The technic and the results of the local injection of penicillin in acute circumscribed areas of infection in over three hundred ambulatory patients are presented. (2) Experience with this method of local therapy with penicillin has demonstrated that it is safe, effective and economical. There were no complications. (3) Because of the impermeable inflammatory barrier surrounding an acute localized infection, penicillin, when given parenterally, may not reach a sufficient concentration in the affected area for therapeutic effectiveness. (4) By local injection it is possible to reach a concentration in the infected area far in excess of the highest levels obtained by intramuscular administration. (5) Following injection directly into the affected tissue, there is almost immediate improvement and recovery is established in a few days. (6) Extremely gratifying, in addition to the rapid healing time, is the cosmetic result obtained. There is practically no loss of skin and no deforming scars are seen as usually found following surgical intervention. (7) This procedure is not recommended for the treatment of the cellulitides, for infections in the dangerous areas of the face, or for bone felons. (8) Surgical judgment must be exercised in each individual case.