Skin Cancer Therapy Research Articles

A New Approach for a Safe and Reproducible Seeds Positioning for Diffusing Alpha-Emitters Radiation Therapy of Squamous Cell Skin Cancer: A Feasibility Study.

The purpose of this study is to discuss how to use an external radio-opaque template in the Diffusing Alpha-emitters Radiation Therapy (DaRT) technique's pre-planning and treatment stages. This device would help to determine the proper number of sources for tumour coverage, accounting for subcutaneous invasion and augmenting DaRT safety. The procedure will be carried out in a first phase on a phantom and then applied to a clinical case. A typical DaRT procedure workflow comprises steps like tumour measurements and delineation, source number assessment, and therapy administration. As a first step, an adhesive fiberglass mesh (spaced by 2 mm) tape was applied on the skin of the patient and employed as frame of reference. A physician contoured the lesion and marked the entrance points for the needles with a radio opaque ink marker. According to the radio opaque marks and metabolic uptake the clinical target volume was defined, and with a commercial brachytherapy treatment planning system (TPS) it was possible to simulate and adjust the spatial seeds distribution. After the implant procedure a CT was again performed to check the agreement between simulations and seeds positions. With the procedure described above it was possible to simulate a DaRT procedure on a phantom in order to train physicians and subsequently apply the novel approach on patients, outlining the major issues involved in the technique. The present work innovates and supports DaRT technique for the treatment of cutaneous cancers, improving its efficacy and safety.

Development, Characterization, and Evaluation of α-Mangostin-Loaded Polymeric Nanoparticle Gel for Topical Therapy in Skin Cancer.

The aim of this study was to prepare and evaluate α-mangostin-loaded polymeric nanoparticle gel (α-MNG-PLGA) formulation to enhance α-mangostin delivery in an epidermal carcinoma. The poly (D, L-lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) were developed using the emulsion–diffusion–evaporation technique with a 3-level 3-factor Box–Behnken design. The NPs were characterized and evaluated for particle size distribution, zeta potential (mV), drug release, and skin permeation. The formulated PLGA NPs were converted into a preformed carbopol gel base and were further evaluated for texture analysis, the cytotoxic effect of PLGA NPs against B16-F10 melanoma cells, and in vitro radical scavenging activity. The nanoscale particles were spherical, consistent, and average in size (168.06 ± 17.02 nm), with an entrapment efficiency (EE) of 84.26 ± 8.23% and a zeta potential of −25.3 ± 7.1 mV. Their drug release percentages in phosphate-buffered solution (PBS) at pH 7.4 and pH 6.5 were 87.07 ± 6.95% and 89.50 ± 9.50%, respectively. The release of α-MNG from NPs in vitro demonstrated that the biphasic release system, namely, immediate release in the initial phase, was accompanied by sustained drug release. The texture study of the developed α-MNG-PLGA NPs gel revealed its characteristics, including viscosity, hardness, consistency, and cohesiveness. The drug flux from α-MNG-PLGA NPs gel and α-MNG gel was 79.32 ± 7.91 and 16.88 ± 7.18 µg/cm2/h in 24 h, respectively. The confocal study showed that α-MNG-PLGA NPs penetrated up to 230.02 µm deep into the skin layer compared to 15.21 µm by dye solution. MTT assay and radical scavenging potential indicated that α-MNG-PLGA NPs gel had a significant cytotoxic effect and antioxidant effect compared to α-MNG gel (p < 0.05). Thus, using the developed α-MNG-PLGA in treating skin cancer could be a promising approach.

Treatment of Skin Cancer by Topical Drug Delivery of Nanoparticles: A Review

Nanoparticles offer novel openings for the management of dermal diseases. The skin being a largest organ of the body poses a barrier to all the delivery system including nanoparticles to permeate deep in to the cells or tissues. This barrier was ruptured in case of skin trauma or injury and also in the case of skin cancer. This conditions of the skin allowed the nanoparticles to permeate through the skin for the treatment of cancer. Worldwide research is going in to the formulation and development of the Nano carrier for the dermal delivery through the skin. But the little or negligible technology transfer occur from the R&amp;D to Industry for the treatment of skin cancer using nanoparticles. The main aim of review is to discuss about the basic fundamentals of cancer with relate to dermal delivery of drug through Nanoparticles. The nanotechnologies for dermal delivery of drugs were explained for their effective tool for skin cancer. In this review types of skin cancer with various nanotechnologies were discussed along with pathology of disease and various therapies used. Further we had discussed challenges in developing the nanoparticles for the treatment in the skin cancer therapy. Finally various therapies like Chemotherapies, Immunotherapy, Gene therapy, Nano carriers combined with physical methods and Laser irradiation therapies were summarized.

Ageing research: rethinking primary prevention of skin cancer.

Ageing research: rethinking primary prevention of skin cancer.

In vivo optical coherence tomography-guided photodynamic therapy for skin pre-cancer and cancer

BackgroundThe primary aim of this prospective study is to demonstrate the technical feasibility of OCT to map real tumor margins and to monitor skin changes that occurred post- PDT. Moreover, to optimize PDT efficacy based on the relationship between measured OCT features and treatment outcome. Material and MethodsA series of 12 patients with overall 18 facial skin lesions were investigated by OCT before surface illumination by PDT to determine tumor free margins. Monitoring of the healing process was undertaken at 3, 6 and 12 months post-PDT. Parameters measured by the in vivo OCT during healing phase were the organization of skin layer and the degree skin fibroses for the active center and peripheral transit zone of the treated lesion. Clinical and aesthetics assessment was carried out at 12-month post-PDT. ResultsDistinct microstructural differences between normal skin, pre-cancer, cancer, and the transition zone between the two tissues were observed on OCT images. In the subsequent healing phase, OCT demonstrate marked delineation and organization of skin layer at late stage of healing. Early features showing bizarre non-homogenous disorganized layering (scab) but afterwards, OCT was able to differentiate between different histological layers. One lesion demonstrated clinical healing by fibrosis (scar) without sign of recurrence. Another lesion demonstrated skin erythema. Only one lesion did not response to treatment despite margins clearance. The CR rate was 95% at the end of the study. The cosmetic effect was "excellent" in 89% of the patients. ConclusionsThis feasibility study lays the groundwork for using OCT as a real-time, noninvasive monitoring device for PDT in patients with skin cancer.

Photodynamic therapy for facial skin cancer developed in the zone of previous radiotherapy (clinical case)

The results of a 13-year clinical observation of a patient after treatment for basal cell carcinoma of the skin of the right cheek Ist cT1N0M0 are presented. The history of the course of the disease is associated with the fact that the patient underwent radiation therapy in early childhood for hemangioma of the lower eyelid of the right eye and right cheek. In 2008, against the background of post-radiation changes in the area of the right cheek, basal cell carcinoma was diagnosed at the Moscow Oncological Research Institute. P.A. Herzen. At the Center for Laser and Photodynamic Diagnostics and Tumor Therapy, the patient underwent organ-preserving PDT treatment. A course of photodynamic therapy (PDT) with 5-aminolevulic acid was carried out. Subsequently, the patient was followed up until 2021 without relapse in the PDT area. In 2016, the patient was diagnosed with a relapse of the disease in the form of a new focus of basal cell carcinoma of the upper eyelid skin on the right Iast cT1N0M0. The patient underwent a course of PDT with a chlorin e6-based photosensitizer. Complete regression of the tumor was achieved, the period of relapse-free follow-up was 5 years.

In vitro Antiproliferative Effects of Cotinus coggygria Scop. on human non-melanoma and melanoma skin cancer cells

Skin cancer is one of the most frequently diagnosed malignancies worldwide and its incidence constantly increases. The disease divides in two major subtypes: non-melanoma and melanoma skin cancer. The main drawbacks of the traditional skin cancer therapy are primary and acquired drug resistance and serious side effects due to the nonspecific treatments targeting. Despite advances in therapy strategies there is a need of new affordable natural anti-skin cancer agents, which to possess higher efficiency without causing detrimental side effects. Medicinal plants provide great possibility for the discovery of new anticancer therapeutics with preventive and treatment potential. Cotinus coggygria Scop. is a plant species widely applied in phytotherapy predominantly against disorders of the skin and mucosal tissues. The herb has a large range of valuable biological activities but its anticancer properties have not been thoroughly studied. The aim of the present research was to assess the antiproliferative properties of the crude leaf aqueous ethanolic extract from Bulgarian herb C. coggygria and its chloroformic and aqueous fractions on a panel of human skin cancer cell lines: basal cell carcinoma (TE 354.T), squamous cell carcinoma (A431) and malignant melanoma (A375) and to compare them to the cell growth inhibitory potential on normal dermal cell line (BJ). The antiproliferative capacity of the plant substances was investigated using MTT assay and microscopy cell morphology observation after 72 h cell treatment in a wide scale of concentrations. The obtained results showed that the crude extract and both fractions inhibit significant proliferation of A431 squamous cell carcinoma and A375 melanoma cells with the highest cytostatic effect registered for the aqueous fraction on A375 cells with a half maximal inhibitory concentration value of 44.33 ?g/ml. C. coggygria exhibited no cytostatic activity towards TE 354.T basal cell carcinoma cells. The established marked slight

Passively Scattered Proton Therapy for Nonmelanoma Skin Cancer with Clinical Perineural Invasion

PurposeTo report our experience with the delivery of passively scattered proton therapy in the management of nonmelanoma skin cancers with clinical perineural invasion.Materials and MethodsWe reviewed the medical records of patients who received definitive or postoperative proton therapy for nonmelanoma skin cancer with clinical perineural invasion at our institution and updated patient follow-up when possible. All patients were treated with curative intent with or without the delivery of concurrent systemic therapy. We report disease control rates and the rates of late toxicity among this cohort.ResultsTwenty-six patients treated between 2008 and 2017 were included in the analysis. Following proton therapy, the 3-year overall, cause-specific, and disease-free survival rates were 59%, 73%, and 60%, respectively. The 3-year local control, local regional control, and distant metastasis-free survival rates were 80%, 65%, and 96%, respectively. On univariate analysis, surgical resection before radiation therapy significantly improved local regional control rates at 3 years (55% versus 86%; P = .04). Grade 3+ late toxicities occurred in 13 patients (50%) and the most common toxicities included grade 3+ keratitis of the ipsilateral eye, which occurred in 4 patients (15%) and grade 3+ brain necrosis in 4 patients (15%).ConclusionProton therapy is effective in the management of nonmelanoma skin cancer with clinical perineural invasion. Although disease control and complication rates compare favorably to those previously published for photon-based radiation therapy, the risk for late toxicity is significant and patients should be appropriately counseled.

Near-infrared light-controllable MXene hydrogel for tunable on-demand release of therapeutic proteins

Precise delivery of therapeutic protein drugs that specifically modulate desired cellular responses is critical in clinical practice. However, the spatiotemporal regulation of protein drugs release to manipulate the target cell population in vivo remains a huge challenge. Herein, we have rationally developed an injectable and Near-infrared (NIR) light-responsive MXene-hydrogel composed of Ti3C2, agarose, and protein that enables flexibly and precisely control the release profile of protein drugs to modulate cellular behaviors with high spatiotemporal precision remotely. As a proof-of-concept study, we preloaded hepatic growth factor (HGF) into the MXene@hydrogel (MXene@agarose/HGF) to activate the c-Met-mediated signaling by NIR light. We demonstrated NIR light-instructed cell diffusion, migration, and proliferation at the user-defined localization, further promoting angiogenesis and wound healing in vivo. Our approach's versatility was validated by preloading tumor necrotic factor-α (TNF-α) into the composite hydrogel (MXene@agarose/TNF-α) to promote the pro-apoptotic signaling pathway, achieving the NIR light-induced programmed cell deaths (PCD) of tumor spheroids. Taking advantage of the deep-tissue penetrative NIR light, we could eradicate the deep-seated tumors in a xenograft model exogenously. Therefore, the proposed MXene-hydrogel provides the impetus for developing therapeutic synthetic materials for light-controlled drug release under thick tissue, which will find promising applications in regenerative medicine and tumor therapy. Statement of significanceCurrent stimuli-responsive hydrogels for therapeutic proteins delivery mainly depend on self-degradation, passive diffusion, or the responsiveness to cues relevant to diseases. However, it remains challenging to spatiotemporally deliver protein-based drugs to manipulate the target cell population in vivo in an “on-demand” manner. Therefore, we have rationally constructed an injectable and Near-infrared (NIR) light-responsive composite hydrogel by embedding Ti3C2 MXene and protein drugs within an agarose hydrogel to enable the remote control of protein drugs delivery with high spatiotemporal precision. The NIR light-controlled release of the growth factor or cytokine has been carried out to regulate receptor-mediated cellular behaviors under deep tissue for skin wound healing or cancer therapy. This system will provide the potential for precision medicine through the development of intelligent drug delivery systems.

Systemic Therapy for Head and Neck Skin Cancers

The mainstay of curative therapy for head and neck skin cancers relies upon surgery and/or radiation therapy. However, for some aggressive, non-resectable or recurrent tumors, systemic therapy is necessary. Recent emerging classes of drugs have shown to improve survival for high-risk, recurrent, and unresectable variants of these tumors. The goal of this paper is to review options for systemic therapies for head and neck skin cancers including melanoma, non-melanoma skin cancers and other rare and non-malignant tumors.

Development of a high payload, cancer-targeting liposomes of methyl aminolevulinate for intraoperative photodynamic diagnosis/therapy of peritoneal carcinomatosis

Methyl aminolevulinate (MAL) is a photosensitizer topically used for photodynamic diagnosis (PDD) and photodynamic therapy (PDT) of skin pre-cancers and cancers. In this study, our goal is to expand the application of MAL to dual intraoperative PDD and PDT of peritoneal carcinomatosis. A new liposomal MAL formulation (lipMAL) designed for systemic or intraperitoneal administration was developed. LipMALs prepared by ammonium sulfate gradient technique achieved MAL payload up to 18% (w/w) with drug encapsulation efficiency in the range of 15.1–31.5%. All lipMALs demonstrated controlled MAL release behavior, and achieved strong fluorescence in cancer cells (SKOV3) but minimal fluorescence in non-cancer peritoneal cells (B14FAF28-G3). LipMALs led to significantly higher fluorescence levels than free MAL groups (P < 0.05), up to 6.8-fold of the free MAL fluorescence levels in SKOV3 cells. The PDD performance of lipMALs was also compared with free MAL in SKOV3/ B14FAF28-G3 co-cultures simulating ovarian cancer micrometastases on peritoneal surface. The lipMAL-treated cancer colonies glew more brightly than the free MAL treated colonies and were clearly distinguishable from the dim peritoneum background with unaided eyes. LipMAL also achieved significantly stronger anticancer PDT effects than free MAL both in terms of cell viability and colony-formation (P < 0.05) while demonstrating minimal dark toxicity. To conclude, a new promising aid for the surgeons to achieve more complete resection of tumors and PC micrometastases and clean up any residual cancer cells undetected was developed.

BSA-Silver Nanoparticles: A Potential Multimodal Therapeutics for Conventional and Photothermal Treatment of Skin Cancer.

Silver nanoparticles (NPs) have attracted a considerable interest in the field of cancer research due to their potential utility in cancer therapy. In the present study, we developed bovine serum albumin (BSA)-coated silver NPs (BSA-Silver NPs) and characterized in vitro multimodal therapeutic activities of NPs for the treatment of skin cancer. BSA-Silver NPs were synthesized by a single-step reduction process, and the successful preparation was verified through a list of physical characterizations, including transmission electron microscopy (TEM), ultraviolet-visible (UV–VIS) light spectroscopy, dynamic light scattering (DLS), and Fourier transform infrared (FT-IR) spectroscopy. The synthesized BSA-Silver NPs showed marked cytocidal effects on B16F10 melanoma cells, which was likely caused by oxidative stress. BSA-Silver NPs also elicited significant anti-angiogenic effects on HUVEC (human umbilical vein endothelial cell) by inhibiting their proliferation, migration, and tube formation. Moreover, BSA-Silver NPs showed a considerable light-to-heat conversion ability, suggesting their utility as photothermal agents. Overall, our findings suggest that BSA-Silver NPs may be promising candidates for the multimodal therapy of skin cancer.

Radiation therapy of non-melanoma skin cancer of the pinna: an Italian 35-year experience.

Radiation therapy (RT) is a well-known alternative to surgery for the treatment of non-melanoma skin cancer (NMSC), especially in elderly people or in patients who cannot undergo or refuse surgical procedure. It has also a pivotal role in those areas, as pinna, where both function and cosmesis must be preserved. We report our experience in treating cutaneous carcinoma of the auricle with radiation therapy. We conducted a retrospective monocentric study on 363 NMSC of the auricle treated by conventional energy radiation therapy as a primary treatment or with adjuvant and salvage purpose. Tumors involving the external canal of the ear or regional lymph node at diagnosis were excluded. A complete response has been obtained in 95.5% with a 2- and 5-year cure rate respectively of 84% and 76%. Fifty-two tumors developed a central or marginal relapse. Aesthetic result was good or acceptable in the majority of the cases. No cartilage necrosis has been registered. Our experience confirms safety and effectiveness of RT on selected auricle carcinoma, affording good cosmetic and functional results.

Superficial radiotherapy and volumetric modulated Arc therapy for skin cancers within hamartomatous skin in patient with PTEN mutation: A case report

Phosphatase and tensin homolog (PTEN) gene acts as a tumour suppressor gene. Mutations of this gene are a step in the development of many cancers. Sufferers can have large fields of symptomatic hamartomatous skin change especially in sun exposed areas. RT has been reported to cause increased acute toxicity in this cohort. A 78-year-old fit male had a confirmed PTEN variant LRG_311t1 Exon 5, c353A&gt;C. Symptomatic skin lesions of left frontal scalp and left nasal ala were confirmed on punch biopsy to be basal cell carcinoma (BCC) and he was referred for definitive radiotherapy (RT). He was treated with lesion based superficial radiotherapy to the left nasal ala to a total dose of 50 Gy in 25 fractions given at 5 fractions per week using a Xstrahl 300 machine via a 3cm circle applicator at 30cm source surface distance with a generating energy of 100 kV. The left frontal scalp was treated with a field-based volumetric modulated arc therapy technique to a planning target volume (PTV) of 74.8cm3 to 45 Gy with a simultaneous integrated boost PTV to 55 Gy of 4.1 cm3 to the BCC, all in 25 fractions. He developed the expected desquamation, erythema and mucositis within the nasal field and desquamation and erythema in the left temple. The PTEN mutation had no visible increase on the acute side effect profile compared with those without the mutation. After more than 6 months, the areas treated with RT remained clear of symptomatic hamartomatous skin change with no late toxicities. To our knowledge this is the longest benefit received of any treatment for fields of symptomatic hamartomatous skin change associated with PTEN mutation. It is also a report of not observing increased acute toxicity of RT in the definitive treatment of skin cancer in those with proven PTEN mutation. This one case adds evidence that definitive RT to skin may be delivered safely in this cohort. More studies with multiple patients with longer follow up are needed to confirm that those suffering with PTEN mutation can be safely and successfully treated with definitive RT for skin cancer and fields of symptomatic hamartomatous skin change with no increase in late effects.

3-Deoxysappanchalcone Inhibits Skin Cancer Proliferation by Regulating T-Lymphokine-Activated Killer Cell-Originated Protein Kinase in vitro and in vivo.

BackgroundSkin cancer is one of the most commonly diagnosed cancers worldwide. The 5-year survival rate of the most aggressive late-stage skin cancer ranges between 20 and 30%. Thus, the discovery and investigation of novel target therapeutic agents that can effectively treat skin cancer is of the utmost importance. The T-lymphokine-activated killer cell-originated protein kinase (TOPK), which belongs to the serine-threonine kinase class of the mitogen-activated protein kinase kinase (MAPKK) family, is highly expressed and activated in skin cancer. The present study investigates the role of 3-deoxysappanchalcone (3-DSC), a plant-derived functional TOPK inhibitor, in suppressing skin cancer cell growth.PurposeIn the context of skin cancer prevention and therapy, we clarify the effect and mechanism of 3-DSC on different types of skin cancer and solar-simulated light (SSL)-induced skin hyperplasia.MethodsIn an in vitro study, western blotting and in vitro kinase assays were utilized to determine the protein expression of TOPK and its activity, respectively. Pull-down assay with 3-DSC and TOPK (wild-type and T42A/N172 mutation) was performed to confirm the direct interaction between T42A/N172 amino acid sites of TOPK and 3-DSC. Cell proliferation and anchorage-independent cell growth assays were utilized to determine the effect of 3-DSC on cell growth. In an in vivo study, the thickness of skin and tumor size were measured in the acute SSL-induced inflammation mouse model or SK-MEL-2 cell-derived xenografts mouse model treated with 3-DSC. Immunohistochemistry analysis of tumors isolated from SK-MEL-2 cell-derived xenografts was performed to determine whether cell-based results observed upon 3-DSC treatment could be recapitulated in vivo.Results3-DSC is able to inhibit cell proliferation in skin cancer cells in an anchorage-dependent and anchorage-independent manner by regulation of TOPK and its related signaling pathway in vitro. We also found that application of 3-DSC reduced acute SSL-induced murine skin hyperplasia. Additionally, we observed that 3-DSC decreased SK-MEL-2 cell-derived xenograft tumor growth through attenuating phosphorylation of TOPK and its downstream effectors including ERK, RSK, and c-Jun.ConclusionsOur results suggest that 3-DSC may function in a chemopreventive and chemotherapeutic capacity by protecting against UV-induced skin hyperplasia and inhibiting tumor cell growth by attenuating TOPK signaling, respectively.

Plumbagin-Loaded Glycerosome Gel as Topical Delivery System for Skin Cancer Therapy.

Plumbagin (PLM) is a phytochemical which has shown cytotoxicity against of cancer cells both in vitro and in vivo. However, the clinical application of PLM has been hindered due to poor aqueous solubility and low bioavailability. The aim of the present study was to develop, optimize and evaluate PLM-loaded glycerosome (GM) gel and compare with conventional liposome (CL) for therapeutic efficacy against skin cancer. The GM formulations were optimized by employing design expert software by 3-level 3-factor design. The prepared GMs were characterized in vitro for vesicle size, size distribution, zeta potential, vesicle deformability, drug release, skin permeation, retention, texture, antioxidant and cytotoxicity activities. The optimized formulation showed a vesicle size of 119.20 ± 15.67 nm with a polydispersity index (PDI) of 0.145 ± 0.02, the zeta potential of −27 ± 5.12 mV and entrapment efficiency of 76.42 ± 9.98%. The optimized PLM-loaded GM formulation was transformed into a pre-formed gel which was prepared using Carbopol 934 polymer. The drug diffusion fluxes of CL gel and GM-loaded gel were 23.31 ± 6.0 and 79.43 ± 12.43 µg/cm2/h, respectively. The result of texture analysis revealed the adequate hardness, cohesiveness, consistency, and viscosity of the developed GM-loaded gel compared to CL gel. The confocal images showed that glycerosomal gel has deeper skin layer penetration as compared to the control solution. GM-loaded gel treated rat skin showed significantly (p < 0.05) higher drug accumulation in the dermis, higher cytotoxicity and higher antioxidant activity as compared to CL gel and PLM suspension. Thus, findings revealed that novel GM-loaded gel could be potential carriers for therapeutic intervention in skin cancer.

Pathophysiological justification of the use of photodynamic therapy in the initial stage of squamous cell skin cancer

The work is based on an analysis of the course of the disease in 185 patients with squamous cell skin cancer. The study program included studies in three major groups. The first included 74 (40%) patients who underwent combined treatment: an operation involving widespread excision of a tumor under intravenous anesthesia + photodynamic therapy (group 1). The second group was 111 (60%) patients with squamous cell carcinoma of the skin who received only operative treatment. To control and compare the obtained laboratory indicators, a second group was created, which included patients without established pathology. This group included 17 people who voluntarily agreed to conduct the study. The study traced the dynamics of changes in hemostasis scores and metalloproteinases in the two groups being compared. In the group of patients with squamous cell skin cancer, there was a statistically significant decrease in the metalloproteinase-1 inhibitor index, which led to an increase in all metalloproteinase-2, -7 and -9 indicators. Performing surgical treatment did not lead to correction of these indicators, both in the near and distant periods after treatment. The mechanism of influence of photodynamic therapy in squamous cell skin cancer can be characterized as follows: there is a decrease in the inhibitor of metalloproteinase-1, which leads to an increase in matrix metalloproteinases-2, -7 and -9 in the blood, as a result of damage to the endothelium of the vascular wall, which is confirmed by an increase in endothelin, this, in turn, led to the development of vasoconstriction and increased procoagulant activity The use of photodynamic therapy restores the index of metalloproteinase-1 inhibitor, this leads to the restoration of matrix metalloproteinases-2, -7 and -9 in the blood and the prevention of damage to the vascular wall. Comprehensive treatment of patients with squamous cell skin cancer in the initial stage of the disease should include photodynamic therapy with simultaneous intravenous blood irradiation, laser tumor training, and then surgical treatment, consisting in excision of the tumor with observance of oncological principles.

Benchmarking failure mode and effects analysis of electronic brachytherapy with data from incident learning systems

PurposeFailure modes and effects analysis (FMEA) is a prospective risk assessment tool for identifying failure modes in equipment or processes and informing the design of quality control systems. This work aims to benchmark the performance of FMEAs for electronic brachytherapy (eBT) of the skin and for breast by comparing predicted versus actual failure modes reported in multiple incident learning systems (ILS). Methods and MaterialsTwo public and our institution's internal ILS were queried for Xoft Axxent eBT-related events over 9 years. The failure modes and Risk Priority Numbers (RPNs) were taken from FMEAs previously performed for Xoft eBT of nonmelanoma skin cancer and breast intraoperative radiation therapy (IORT). For each event, the treatment site and primary failure mode was compared with the failure modes and RPNs from that site's FMEA. Results49 events involving Xoft eBT were identified. Thirty-one (63.3%) involved breast IORT, and 18 (36.7%) involved the skin. Three events could not be linked to an FMEA failure mode. In 87.7% of events, the primary failure mode ranked in the FMEA top 10 by RPNs. In 83.3% of skin events, the failure modes ranked in the top 10 by RPN or severity. In 90.3% of IORT events, the failure modes ranked within the top 10 by RPN or severity. ConclusionsEvaluating FMEA failure modes against ILS data demonstrates that FMEA is effective at predicting failure modes but can be dependent on user experience. ILS data can improve FMEA by identifying potential failure modes and suggesting realistic occurrence, detectability, and severity values.

Synthesis and characterization of a novel pH-responsive drug-releasing nanocomposite hydrogel for skin cancer therapy and wound healing.

Local skin cancer recurrence occurs in ∼12% of the patients post-surgery due to persistent growth of residual cancer cells. Wound infection is another significant complication following surgery. We report a novel in situ-forming nanocomposite hydrogel (NCH) containing PLGA-carboxymethyl chitosan nanoparticles (186 nm) for localized pH-responsive skin cancer therapy and wound healing. This injectable hydrogel, comprising of a citric acid-derived polymer backbone, gelled within 5 minutes, and demonstrated excellent swelling (283% of dry weight) and compressive strengths (∼5.34 MPa). Nanoparticle incorporation did not significantly affect hydrogel properties. The NCH effluents were cytocompatible with human dermal fibroblasts at 500 μg ml-1 concentration and demonstrated pH-dependent drug release and promising therapeutic efficacy against A431 and G361 skin cancer cells in vitro. Significant zones of inhibition were observed in S. aureus and E. coli cultures on NCH treatment, confirming its antibacterial properties. Our studies show that the pH-responsive NCH can be potentially used for adjuvant skin cancer treatment and wound healing.

Профилактика лучевых осложнений при проведении близкофокусной рентгенотерапии при раке кожи и губы

Aim: to determine the effectiveness of preventive measures used to reduce radiation damage during close-focus radiation therapy for basal cell skin cancer and squamous cell carcinoma of the lower lip in stages I and II. Methods. The study included patients in the amount of 2030 people with malignant neoplasms of the skin (basal cell carcinoma) and red border of the lip (cancer of the red border of the lips) stages I and II, who underwent a course of close-focus X-ray therapy. To prevent radiation reactions of the mucous membrane of the cheeks, gums, in basal cell carcinoma (n = 1942), during a session of radiation therapy, a gauze pad was used, placing it in the vestibule of the oral cavity, in the buccal-gingival space, in the post-radiation period, hydrogel napkins with dimexide and sodium alginate «Coletex-D» (gel). In cancer of the mucous membrane of the red border of the lips (n = 88) in the pre-radiation period, in order to prevent radiation damage to the mucous membranes of the lip and oral cavity, a thorough sanitation of the oral cavity and prevention of exacerbation of inflammatory processes of the mucous membrane were carried out. At the same time, dosimetric planning of the course of radiation therapy was carried out. Results. The use of hydrogel wipes with dimexide and sodium alginate «Coletex-D» (gel) significantly reduces the severity of radiation reactions in the post-radiation period. Epithelization in the field of irradiation, as a rule, ended within 3-4 weeks. Conclusion. Reducing the risk of radiation injury improves the long-term results of radiation treatment and the patient’s quality of life.