[Vertical resections for larynx cancer with preservation of the thyroid cartridge plates]. / Vertikal'nye rezektsii pri rake gortani s sokhraneniem plastin shchitovidnogo khryashcha.

This article presents a method of organ-preserving surgical treatment of laryngeal cancer, which has been developed and used since 1991 at the Tsyba Medical Radiological Research Center, Branch of the National Medical Research Center of Radiology of the Ministry of Health of Russia. The indications for this method are tumors affecting the middle part of the larynx, limiting its mobility, extending to the anterior commissure, laryngeal ventricle, vestibular fold, lower larynx and one arytenoid cartilage, but retaining mobility in the scooper-cricoid articulation. OBJECTIVE: To increase the functional safety of the larynx and improve the quality of life of patients with laryngeal cancer by using the developed method of organ-preserving surgical intervention in combined treatment. MATERIAL AND METHODS: The study included 197 patients who were operated on by the same method for a primary tumor or in connection with a relapse of the disease. At the first stage, all primary patients underwent a course of radiation or chemoradiation therapy 40-50 Gy. In 78 patients with recurrent laryngeal cancer who underwent resection of the larynx, the previous treatment was carried out in the form of a full course of radiation or chemoradiation therapy with a above 60 Gy. RESULTS: Wound healing by primary intention in patients with preoperative irradiation was observed in 92.4% of cases. With resections for a primary tumor, restoration of functions was observed in 115 (96.6%) patients, and with resections of recurrent tumors - in 71 (91%) patients. Three-year disease-free survival in these patients was 74.4%. CONCLUSION: The presented data showed the high efficiency of the method. This is evidenced by the course of the postoperative period, functional and oncological results are comparable, and in some cases exceed those of other researchers.

[Results of combined therapy for malignant tumors of the nasal cavity and accessory nasal sinus depending on the fractionation of preoperative radiotherapy].

Data on the treatment of 215 patients with locally advanced malignancies of the nasal cavity and accessory nasal sinus are presented. All patients received preoperative radiotherapy using different fractionation schemes under a total target dose (TTD) of 32-40 Gy. Surgery was carried out two weeks later. Whenever radicality of surgery was in doubt, postoperative gamma therapy included exposure to 2 Gy 5 times a week (TTD--30-40 Gy) (n=121). Group I (n-57) received radiation at standard fractionated dosage. In group II (n=66), fractionation, tentatively considered "dynamic" was used while, in group III, fractionation was dynamic in actual fact. In group IV (n=10), superfractionation (1+1 Gy) was employed in group V (n=6),--gamma-neutron therapy. Patients in group VI (n=51) were operated on as scheduled and received 5 Gy, twice a week (TTD--20 Gy). According to 5-year follow-up, the best results were obtained with the use of larger doses of preoperative radiation (groups II, III, VI). Postoperative radiotherapy proved ineffective and it would be useless unless ablative procedures were definitely faulty during surgery.