Abstract

Background: advantages of endobiliary photodynamic therapy (PDT) described in the first part of review, namely: the safety of the intervention, the predictability and reproducibility of the effect, the absence of rough scarring of bile ducts, the possibility of repeating of procedures, affordability financially and economically - make this technology preferred among others locoregional effects in patients with hilus cholangiocarcinoma.

Aim: was to get a clinical specialist' view of endobiliary PDT as the perspective method: to describe dynamics of photosensitizer (PS) accumulation by tumor in vivo, to describe tools for delivering light into the lumen of bile ducts and intervention technique, to describe characteristics of light dosimetry, and to analyze immediate and long-term results of intra-duct photo exposure.

Material and methods: 66 domestic and foreign literary sources were analyzed.

Conclusion: endobiliary photodynamic therapy is a safe and effective method of locoregional treatment of patients with hilar cholangiocarcinoma, which significantly increases the duration and improves the quality of life of previously considered incurable patients.

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Abstract

Aim: was to identify possibilities of MRI with contrast enhancement in assessment of differentiation

grade of liver metastases of neuroendocrine tumors (NET).

Materials and methods: 103 patents with morphologically confirmed liver metastases of NET were enrolled in the study. All patients underwent abdominal contrast-enhanced MRI. A total of 241 lesions were assessed. In the region of interest, which corresponded to the rounded locus in solid port-contrast T1-weighted images. Obtained data were compared in groups of different grade of tumor tissues differentiation; the correlation of MRI parameters with Ki67 was also evaluated.

Results: study demonstrated that Grade (G) 1 of NET metastases are characterized by a more active accumulation of MR contrast agent (MRCA) and a higher SI in arterial (p=0,0002, p=0,0003, respectively) and venous (p=0,0003, p=0,0001, respectively) phases of contrast enhancement compared with G2 and G3. Also, well-differentiated NETs had higher SI in the delayed phase of contrast enhancement (p = 0,0038) and the more rapid wash-out of MRCA (p=0,0314). The Ki67 index inversely correlated with the degree of MRCA accumulation in arterial and venous phases of MRI with contrast enhancement. Revealed consistency may be useful for guided tissue sampling in biopsy and identification of the grade "migration" phenomenon, which will allow competently and timely choose/change treatment modality.

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Abstract

Background: hilar cholangiocarcinoma (Klatskin tumor) is a rare and severe hepatobiliary malignancy of proximal bile ducts with dismal prognosis, slow periductal growth, late metastatic spread and is mostly fatal due to local complications. Surgical resection is considered to be the only curative method to the date, but its results aren't satisfactory as the majority of patients (70-80%) aren't suitable surgical candidates due to a large tumor extent in local hilar area. Moreover, local recurrence rate reaches 80% over 7 years. Thus endobiliary loco-regional technologies have been proposed, one of which is a photodynamic therapy (PDT).

Aim: was to provide provide a preclinical rationale of PDT in Klatskin tumor patients: to describe principles and mechanisms of the method and summary experimental studies data; this can prepare the reader for the second part of the review, which is based on the analysis of clinical studies and can give practical orientation.

Material and methods: 63 domestic and foreign literature sources were analyzed.

Conclusion: endobiliary photodynamic therapy showed its safety and efficacy in many experimental studies and can successfully be applied in clinical practice. 

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Abstract:

Background: article describes methodology of a selective ophtalmic arterieal infusion (SOAI) ir organ-preserving treatment of children with an intraocular retinoblastoma and demonstrates various ways of delivery of chemotherapeutic agent to a tumor.

Aim: was to increase efficacy of SOAI in treatment of children with intraocular retinoblastoma Material and methods: 289 SOAI procedures to 127 children (143 eyes) have been performed from 2013 to 2017. 2 methods of a SOAI were applied: 1) the microcatheter technique (n=223) - superselective catheterization of an eye artery or collateral branches of an external carotid artery (ECA) at blood flow hemodynamic redistribution; 2) the microballoon technique - balloon-occluder on ipsilateral internal carotid artery (ICA) for prevention of chemoinfusion of brain arteries (n=58). Results: technical success was 96,5%(279 procedures). From 223 procedures with using of a microcatheter infusion was carried out in: a. ophthalmica - 156(70%), a.meningea media - 44 (20%), a.infraorbitalis - 20(11%), a. temp. superficialis - 2, a.facialis - 1. From 58 procedures with using of microballoon - 56 were successful. We didn't manage to put a balloon more distally than the place of an entry of an eye artery in 2 cases. Unsuccessful attempts - 10 cases: failure of catheterization of a femoral artery - in 2, a kinking of the ICA - in 2, a vascular collapse as a result of reaction to injection of contrast agent and/or mechanical impact on ICA - in 2, lack of contrasting of a retina - in 3, an occlusion of an ICA - in 1.

Conclusion: possession and use of various techniques for chemotherapeutic agent delivery to an eye tumor allows to achieve the maximum effect and doesn't depend on anatomy options and blood flow hemodynamic redistribution in main vessels of an eye.

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Abstract:

Our experience of percutaneous vertebroplasty - one of the most up-to-date methods of vertebral tumors treatment - is presented in the article.

The purpose of the work was to assess vertebroplasty as a method, improving quality of life. In the years 2001-2007 235 vertebroplasty procedures (168 patients) were done in Blokhin's Cancer Research Center. The most common diagnoses were metastases of renal carcinoma, breast carcinoma or multiple myeloma. The main indications for vertebroplasty procedure were chronic pain due to vertebral tumor progression and the loss of vertebral supporting function. Quality of life is shown to improve in the majority of the operated patients.

Relative simplicity of the percutaneous vertebroplasty and high effectiveness of the method allow us to recommend its widespread adoption in clinical practice. 

Reference

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2.     Wingo P.A., Ries L.A., Rosenberg H.M., Miller D.S., Edwards B.K. Cancer incidence and mortality, 1973-1995: a report card for the U.S. Cancer. 1998; 1197-1207.

3.     Coleman R., Bone Metastases From BreastCancer and Other Solid Tumors. ASCO 2001, San-Fransisco, May 12-15. Education Book.152-163.

4.     Deramond H., Depriester C., Galibert P. et al. Percutaneous vertebroplasty with polymethylmetacrylate. Technique, indications and results. Radiol. Clin. North. Am. 1998; 36 (3): 533-546.

5.     Anselmetti G.C., Corrao G., Patrizia D.M., Tartaglia V. et al. Pain Relief Following Percutaneous Vertebroplasty. Results of Series of 283 Consecutive Patients Treated in Single Institution. Card. Vasc. and Int. Radiol. 2007; 30 (3): 441-447.

6.     Weill A., Chiras J., Simon J.M. Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. Radiology. 1996; 199: 241-247.

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Abstract:

The article makes an attempt to summarise variants of the PTBD that allows to change perceptions of this procedure as it is not a simple method as it seems in routine usage. A meaningful and reasonable use of PTBD combined with all modern technical possibilities in interventional radiology and professional personnel potential can significantly expand the scope of application for this technology and allows by using «small means» to deal with complicated clinical cases, optimizing the conditions for effective hi-tech medical support. Reducing PTBD options to the «common denominator» can optimize it's planning and accounting, can improve the quality and efficiency and can facilitate the clinical and scientific analysis of the results.

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Regional intra-arterial chemotherapy and chemoembolization in the treatment of liver tumors