Soft tissue sarcomas of the head and neck region: clinical and histopathological study of 39 patients.

<b>Introduction:</b> Soft tissue sarcomas (STS) constitute about 1-2% of all malignant tumors, with approximately 10% of them located in the head and neck region.<b>Aim:</b> The aim of this study was the assessment of treatment efficiency in head and neck STS of adult patients of the ENT Department of Medical University of Silesia, treated surgically in the period 1980-2023.<b>Materials and methods:</b> Retrospective analysis of 39 patients with the diagnosis of head and neck STS.<b>Results:</b> Histopathological examination showed 21 different types of STS located most commonly in: paranasal sinuses (13 cases), orbital cavity (6 cases), nasal cavity (3 cases), and larynx (3 cases). Other locations: parapharyngeal space, parotid gland, nasal septum, bridge of the nose, soft and hard palate, mandibular mucosa, tongue, auricle, palatine tonsil, and cheek. All those patients underwent chemoradiation as postoperative treatment. Radical surgical procedure was achieved in 32 patients (82%). However, in 11 patients (28%), microscopic examination did not confirm radical resection (R1 - PSM - positive surgical margin). In 7 patients (18%), the surgical procedure turned out to be not radical on macroscopic examination (R2). Dissemination of neoplasms (distant metastases) was found in 7 patients (18%). Five-year survival time without local recurrence was achieved in 25 patients (64%). The most frequent reason for unsuccessful interventions was local recurrence noted in 18 patients (46%), while distant metastases occurred in 9 patients (23%).<b>Conclusions:</b> The basic procedure in the treatment of STS is radical surgery combined with preoperative or postoperative radiotherapy and/or chemotherapy and, in case of a metastasis, surgical removal thereof. Despite the fact that sarcomas are rare tumors, they remain a challenge for head and neck surgery. Recurrence rates and mortality remain high due to the high degree of malignancy.

Assessment of connective tissue metabolism in patients with head and neck malignancies treated with radiotherapy.

<br><b>Introduction:</b> Despite the use of highly specialized irradiation techniques in the treatment of head and neck tumors, it is still impossible to selectively destroy cancer cells without damaging normal structures, including connective tissue cells.</br> <br><b>Aim:</b> The aim of the study was to analyze the concentration of degradation markers such as collagen type I (carboxyterminal telopeptide of type I collagen; ICTP) and elastin (elastin-derived peptides; EDPs) as well as selected metalloproteinases (MMP-1, MMP-2, MMP-9) in patients with head and neck malignancies undergoing radiotherapy.</br> <br><b>Material and methods:</b> The test group consisted of 56 men, who underwent radical or palliative radiotherapy. The concentrations of ICTP, EDPs, MMP-1, MMP-2, MMP-9 were determined in three blood samples collected from patients prior to radiotherapy, immediately after its completion and 3 months after the therapy.</br> <br><b>Results</b>: Both radical and palliative radiotherapy contribute to a significant increase in the concentration of EDPs. At the time of healing of post-irradiation lesions, the level of EDPs was reduced in both groups. The ICTP concentration was not affected by radiotherapy. No significant differences were observed in the concentration of MMP-1 and MMP-2 before and after radiotherapy. Radical radiotherapy caused a statistically significant late reduction in the concentration of MMP-9. The lowest concentrations of MMP-1, MMP-2, MMP-9 in the serum of patients qualified for palliative radiotherapy were recorded in a samples collected three months post-irradiation.</br> <br><b>Conclusions:</b> The degradation markers of key extracellular matrix structural proteins may be helpful tools in the objective assessment of radiation-induced injuries to the connective tissue.</br>.

Collagen Type III Metabolism Evaluation in Patients with Malignant Head and Neck Cancer Treated with Radiotherapy.

Ionizing radiation affects the metabolism of key proteins of extracellular matrix including type III collagen, an important component of human skin. The aim of the work is an analysis of the impact of radical and palliative radiotherapy on collagen type III synthesis in patients with head and neck cancer. The test group consisted of 56 males with histopathologically confirmed head and neck cancer, for whom radiotherapy was applied as a form of radical or palliative treatment. The level of procollagen III aminoterminal propeptide (PIIINP), which is a marker of collagen type III synthesis, was determined in blood serum before radiotherapy, immediately following radiotherapy, and 3 months after it was finished. As a result of radical radiotherapy a statistically significant decrease of PIIINP levels in serum (p < 0.0001) was observed, both immediately after the radiotherapy and 3 months after the end of the treatment. Also the palliative radiotherapy caused a significant decrease of PIIINP right after the treatment (p = 0.0052), as well as during the examination performed 3 months later (p = 0.0004). The achieved results suggest that PIIINP can be used as a marker helpful in assessing radiation damage to connective tissue.

Comparison of efficacy of products containing azelaic acid in melasma treatment.

BACKGROUND: Melasma is one of the most frequently diagnosed hyperpigmentation changes on the skin of women's faces. Nearly 30% of women using oral estrogen therapy struggle with this problem. A common way of reducing melasma is the application of azelaic acid products. AIM: Comparison of efficacy of three dermocosmetic products, containing azelaic acid, in the reduction in melasma for women aged 35-55. MATERIAL AND METHODS: A group of 60 women diagnosed with melasma were divided into three even, twenty-person subgroups. Each subgroup was assigned one dermocosmetic product containing azelaic acid. For 24 weeks, the patients applied the assigned product twice a day. The level of the colorant within the hyperpigmentation was marked before the treatment, after 1 month, after 3 months, and after 6 months of therapy. The pigmentation was measured using Mexameter(®) (Courage + Khazaka electronic, Germany). In addition, during each inspection, the patients' level of hydration, elasticity, and intensity of erythema was checked using Corneometer(®) , Reviscometer(®) . RESULTS: All dermocosmetics containing azelaic acid that were applied significantly contributed to the reduction in pigment in the pigmentary lesion. The largest decrease in the amount of pigment was observed in the first 3 months of use of the products. A combination containing 20% azelaic acid and mandelic acid, phytic acid, 4N-butyl resorcinol, and ferulic acid proved to be the most effective dermocosmetic III (Sesderma, Valencia, Spain). CONCLUSIONS: Dermocosmetics containing azelaic acid significantly contribute to the clearing of melasma. The effect depends on the treatment time, the acid concentration, and addition of other components.