The basic principle for the diagnosis of melanoma metastases in the brain should be the management of multidisciplinary teams including at least a neurosurgeon, radiotherapist and clinical oncologist experienced in the treatment of melanoma and melanoma metastases in the CNS. Detection of brain lesions is associated with poor prognosis; metastases in the brain are the cause of death in 20-50% patients, and symptomatic tumours are a direct cause of death in about 90% patients. Treatment of melanoma with CNS metastases may include local management and/or systemic and symptomatic treatment. In the last 5 years, 10 new advanced melanoma drugs have been registered in Europe. Two-drug therapy anti-PD-1 and anti-CTLA-4 (nivolumab with ipilimumab) is the treatment of choice for asymptomatic melanoma metastases in the brain, while in the presence of BRAF mutations and asymptomatic metastases systemic treatment with BRAFi and MEKi may be the first-choice treatment.
Incidence of skin cancers is constantly increasing, what constitutes a significant epidemiologic problem of modern medicine. Basal cell carcinoma is the most common neoplasm affecting Caucasians. Histopathological examination is a gold standard that allows for diagnosing skin cancers. The presented recommendations discuss clinical and pathomorphological sub-types of basal cell carcinoma, their dermoscopic features, stage assessment, and methods for treatment as well as prevention of recurrence of this cancer. Surgical excision of the lesion is a basic and preferred therapeutic option. Other non-surgical options show lower treatment efficacy, and thus, should be considered in cases of cancers with low risk of recurrence, when a surgery is contraindicated or impossible.
Aim of the studyOral mucositis is a common side effect of the oral mucosa due to anticancer therapy, especially for head and neck cancer. Caphosol is indicated for dryness of the mouth and oropharynx and treatment of mucositis due to irradiation or high-dose chemotherapy. The aim of the study was to evaluate the efficacy of Caphosol in preventing and alleviating mucositis due to radiotherapy in the head and neck region.Material and methodsCaphosol was used from the beginning of the irradiation and for two weeks more after the treatment was completed. Mucositis, xerostomia, and dysphagia were scored by radiotherapists. Subjective evaluation was made by patients. Caphosol was assessed in a non-blinded, matched clinical study. Each treatment arm consisted of 50 patients. The groups were similar. The only difference in the management protocol between the treatment arms was the use of Caphosol in the experimental arm.ResultsA statistically significant difference in mean severity of early irradiation-induced side effects between the studied groups was observed with respect to: mucositis in the clinical target volume (CTV) area, mucositis in the increased dose (boost) area, dysphagia and xerostomia (p < 0.001 for all reactions). In the group of patients who used Caphosol, the mucositis was less intense, both in the CTV and in the boost area.ConclusionsThe use of Caphosol reduces the severity of acute mucositis, dysphagia and xerostomia, exerting a positive effect on comfort in the oral cavity in patients irradiated for head and neck tumors.
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