Introduction: Portal vein embolization (PVE) provokes tumor progression. LC decreases FLR regeneration capacity doubling the risk for patient dropout. Our aim was to develop method of FLR augmentation that convert aggressive tumor into safe vaccine and prolonged waiting period for FLR regeneration into effective In situ immunization period. Methods: 3 initially unresectable patients due to small FLR with advanced hepatocellular carcinoma (HCC) and LC were treated. Selective transarterial chemoembolization with short term biodegradable starch microspheres (DSM-TACE), into tumor bearing liver to be resected, was followed by simultaneous PVE of latter. Upon completion of PVE selective intratumoral immunotherapy (HIT-IT) with antiPD-L1 (atezolizumab 1,200 mg) into restored after DSM-TACE tumor arterial feeders (for selective connection with PD-L1 ligands located on tumor cells but not on normal human tissues) was done. DSM-TACE and HIT-IT was repeated one more time in all patients after postzenith decrease of T-cytotoxic cells. Results: Predominantly T and NK cells response was observed. All patients had successfully underwent major liver resection upon sufficient FLR regeneration. In all 3 cases we had achieved effective local tumor control via total or subtotal HCC necrosis, even more, in 1 (33%) case planned amount of liver resection was decreased due to achieved tumor downsizing. There were no severe morbidity or Immune-related adverse events (irAEs). Conclusions: Herein we had proposed new aggressive but safe method of FLR augmentation for patients with HCC and LC that could potentially preclude drop out of patients during anticipated prolonged waiting period of FLR augmentation and possible improves long-term outcomes by means of tumor downsizing and HCC immunoscore conversion.
BACKGROUND: Psoriasis is a common disease, and many of its forms are resistant to treatment.
AIM: This study aimed to analyze the effects of complex treatment with Lake Saki sulfide peloids on the clinical and immunological parameters patients with psoriasis.
MATERIALS AND METHODS: The study included 90 patients with steady-state psoriasis of mild or moderate severity (51 men and 39 women) aged 2365 (mean age 37.3 12.7) years, who received treatment at the N.I. Pirogov Saki Military Clinical Health Resort of the Russian Ministry of Defense. The control group consisted of 30 apparently healthy volunteers.
RESULTS: Taking into account the clinical and immunological parameters of patients with mild and moderate psoriasis, we have developed a complex differentiated method of treatment using Lake Saki peloids and brine supplemented with an alpha-lipoic acid preparation.
CONCLUSION: The presented complex method of peloid balneotherapy in combination with alpha-lipoic acid preparation intensifies the 14-day course of sanatorium-resort treatment, increases the duration of remission, and enhances the quality of life of patients with mild-to-moderate psoriasis.
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