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The study objective is to evaluate the quality of life as one of the main parameters that determines the effectiveness of treatment of patients with head and neck squamous cell carcinoma.Materials and methods. Thirty-three stage III—IV oral cancer patients aged between 39 and 70 years were asked to fill EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer quality of life questionnaire core 30-questions) and QLQ-H&N35 (head and neck cancer-specific module) before and 12—18 months after completion of the treatment that consisted of surgery followed by radiation with or without chemotherapy. Surgery included neck dissection with removal of the primary tumor via transoral (n = 5) or combined (n = 28) approach. Reconstruction was performed by primary closure (n = 5), with pedicled (n = 8) or free (n = 20) flaps.Results. According to EORTC QLQ-C30 questionnaire only positive shifts turned out to be statistically significant: general health, emotional function, pain, insomnia and diarrhea. Site-specific EORTC QLQ-H&N35 questionnaire revealed several positive (pain in the head and neck, feeling ill, use of painkillers and weight gain) and negative (public eating, problems with taste and smell, sticky saliva and dry mouth) changes. Applying algorithms for determining clinical significance changed the number and value of several scales and domains. Changes in general health, emotional function, pain, insomnia, pain in the head and neck, taste and smell disorders, mouth opening, sticky saliva, dry mouth, painkillers and weight gain were found to have some clinical relevance. Moreover, for one of them (mouth opening) statistical significance was not reached.Conclusions. Further research of clinical significance of changes and differences in scales and domains that determine and affect quality of life are needed. They will allow to understand more fully problems that every patient with oral cavity cancer tries to cope with.

Introduction. Surgery with adjuvant radiation is the standard for treatment of advanced oral and oropharyngeal cancer. with the absence of randomized trials the assessment of the role of postoperative radiotherapy is difficult. Such assessments are usually based on retrospective analyses, whereas patient and tumor status during the time period between the operation and planned start of radiotherapy is not addressed.The study objective is to assess the role of adjuvant radiotherapy in the treatment of stage III—IV oral and oropharyngeal cancer not associated with human papillomavirus with regard to rapid clinical disease progression after upfront surgical treatment.Materials and methods. The case histories and outpatient records of 260 patients with oral and oropharyngeal cancer of stage III—IV, not associated with human papillomavirus, from 30 to 82 years old (average age - 56.52 years), operated in 2009-2018, were analyzed. Two groups of patients were identified. group 1 included 152 patients (58 %) irradiated postoperatively and group 2 consisted of 108 patients (42 %) treated surgically only. 22 patients of group 2 experienced rapid clinical disease progression, were deemed unsuitable for adjuvant treatment and formed group 2a. Comparison of the Kaplan-Meier overall survival and locoregional control was made for group 1 and the entire group 2 (formal analysis) and after exclusion from the latter patients of group 2a, based on the hypothesis of inability of radiotherapy to improve oncologic results in patients with such an unfavorable disease course.Results. Mean follow up was 33.2 months (range 2-121 months). Locoregional control and 5 year overall survival were statistically higher in group 1: 70.4 % versus 45.4 % (р = 0.000) and 40.2 % versus 24.9 % (р = 0.000) that may imply a significant advantage of the combined over monomodal approach. After exclusion of group 2a patients from the analysis both differences considerably narrowed and were 70.4 % versus 55.8 % for locoregional control, 40.2 % versus 31.3 % for overall survival and became statistically insignificant (p = 0.067 and 0.111, respectively).Conclusion. Rapid clinical disease progression in the time frame between surgical treatment and adjuvant radiotherapy is not a rare phenomenon with a very poor prognosis. It can be one of the reasons for postoperative treatment refusal. formal retrospective analyses of the role of adjuvant treatment without considering causes for its refusal may lead to the overestimation of the combined approach effectiveness.

Objective. To estimate efficiency and safety of application of a preparation of Aldara (imiquimod, 5% external application cream) it is independent or in combination with cryotherapy in therapy of the basal cell carcinoma of the skin (BCC). Material and methods. Research included 78 patients (22 women and 56 men) with various forms of a basal cell carcinoma of the skin. All patients were divided into 3 groups: the main group (n = 30) the patients receiving therapy by Aldara (imiquimod, 5% external application cream) made, second (n = 21) - the patients receiving therapy by Aldara’s, and also 1 course of cryotherapy, and the group of comparison (n = 27) receiving therapy of placebo in the form of external application cream. Therapy was carried out 3 times a week, within 16 weeks. Research was conducted in some stages with histologic confirmation of the diagnosis, and also an assessment of efficiency of therapy and undesirable effects. Results. At 27 of 30 patients of the first group (90%) and at 21 of 21 patients of the second group (100%) receiving treatment by Aldara’s absolute clinical recovery is reached. In group of comparison of clinical recovery at all 27 patients it wasn’t observed. It is expedient to note that at all patients of the second group (100%) already to 75 ± to the 2nd day of therapy (the 4th visit) clinical recovery while at 27 of 30 patients of the first group (90%) the total disappearance (clinical recovery) came for 105 and more days (the 5th and 6th visits) was noted. Recurrence of a disease after the end of therapy it wasn’t observed. Conclusion. Aldara (imiquimod, 5% external application cream) possesses high efficiency at therapy of various forms and sizes of BCC. Undesirable effects of therapy are easily resolved at cancellation of a preparation and not observed at its renewal. Unlike other immunomodulatory preparations (corticosteroids, retinoid, cyclosporin) Aldar’s application doesn’t promote suppression of cellular immunity.