Introduction. Age is considered as an important clinical and pathological factor in cancer patients. Malignant tumors are more likely to develop in older people, but the disease is less aggressive than in young patients. According to various authors, the influence of age on the development of tumors largely depends on the age-related features of the immune system.The aim of the present study was to determine the relationship of indicators of systemic antitumor immune response with the age of patients with primary operable breast cancer and cancer of the oral mucosa.Materials and methods. The study included patients with all subtypes of primary-operable breast cancer (n = 145) and patients with cancer of the oral mucosa (n = 29). Immunophenotyping of peripheral blood lymphocytes was performed using a wide panel of monoclonal antibodies to markers of adaptive and innate immunity cells.Results. In elder patients (40 years and older) with primary-operable breast cancer, the percentage of activated CD25+ lymphocytes and CD4+CD25+ and CD3+CD4+ T cells, NKT cells, activated HLA-DR+ lymphocytes, including activated CD3+HLA-DR+ T cells before treatment, was statistically significantly higher than in patients younger than 40 years. Patients of this group showed increase of CD8+CD - 11b+CD28– CTLs and a decrease in the number of naive lymphocytes (CD4 – CD62L+ and CD8+CD11b – CD28+) in comparison with control percentage, and the downward trend in CD4+CD25+CD127– Treg, with increased numbers of CD4+CD25+ T cells. In patients with cancer of the oral mucosa, an increase in the number of cells of some populations of the immune effector link and a decrease in the number of suppressor lymphocytes were revealed with age.Conclusion. The results suggest that age-related differences in the state of systemic antitumor immune response contribute to a more favorable course of breast cancer and some other malignancies in older persons. It is obvious that the features of age differences in the immune response to the tumor should be taken into account when prescribing systemic therapy, including immunotherapy.All patients gave written informed consent to participate in the study
Oral mucositis is one of the most common effects of chemoradiotherapy in patients with oropharyngeal cancer. The development of oral mucositis is the main cause of interruption of antitumor therapy, which significantly affects the results of treatment of the main disease. Despite the fact that the disease is well studied in the literature, today there is no universal treatment and prevention protocol. The aim of this review is to analyze scientific publications devoted to the problems of etiology, pathogenesis, clinic, diagnosis, treatment and prevention of oral mucositis.
The study objective is to evaluate the effect of periodontal microorganisms on development of squamous-cell carcinoma of the oral mucosa and the risk of its recurrence.Materials and methods. Microbiological study of biomaterials from 150 patients was performed. The study group included 100 patients with T3–T4 squamous-cell carcinoma of the oral mucosa and was subdivided into two subgroups with 50 patients in each. The control group included 50 patients.Results. Analysis of the results obtained in the subgroup of primary patients showed the following trends: in 2 (50 %) of 4 patients with Fusobacterium spp., recurrence of the main disease was observed as well as a case of distant metastasis into the bones. Among 35 patients with Prevotella spp. in the biomaterials, in 16 (45.7 %) recurrence of the tumor was observed. Among 10 patients with Veillonella spp., recurrence was observed in 20 %. The most common aerobic microorganism was Streptococcus spр. Among patients who underwent treatment at the N.N. Blokhin National Medical Research Center of Oncology, recurrence was diagnosed in 28.5 %, distant metastases in 4.7 %. In the subgroup of repeat patients, the following trends were observed: among 27 patients with Fusobacterium spp., recurrence of the main disease was observed in 63 %. Among 26 patients with Prevotella spp. in the biomaterial, in 11 (42.3 %) local recurrence was observed. Among 24 patients with Veillonella spp., recurrence developed in 33.3 %. The most common aerobic microorganism was Streptococcus spр., recurrences developed in 21 % of cases.
Хирургическое лечение выполнялось в виде удаления рецидивной опухоли, резекции органа и пластики дефекта местными тканями, расширенно-комбинированных операций или крио-и лазерной деструкции. Выводы. Методом выбора при лечении рецидивных опухолей рака орофарингеальной области является хирургический в виде расширенных комбинированных операций с вариантом замещения дефекта тканей кожно-мышечным лоскутом с включением большой грудной мышцы.
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