Фотодинамическая терапия в самостоятельном и комбинированном лечении местнораспространенного базальноклеточного рака кожи

Outcomes after photodynamic therapy (PDT) in 33 patients with basal cell skin cancer Т3-Т4N0M0 primary stage are represented in the article. The irradiation was performed distantly 3h after intravenous injection of photosensitizer photolon with dose 0.8-1.0 mg/kg; light dose accounted for 200-400 J/cm2. Distant PDT was applied as monotherapy or in combination with electrochemical lysis, radiotherapy or interstitial PDT. 84.6% of patients with Т3N0M0 stage basal cell skin carcinoma had complete regression, 15.4% of patients – partial regression. The treatment for Т4N0M0 stage basal cell skin carcinoma was palliative and in 100% of cases it allows to shrink the tumor (defined as partial tumor regression), retard the progression time, improve quality of life. Interstitial PDT and electrochemical lysis improved the efficacy of distant PDT (increased volume of tumor destruction) and, thus, allowed to decrease treatment period. Combination of PDT with radiotherapy allowed to decrease radiation dose for 20-30% and, thus, to decrease the risk of radiation-induced complications.В статье приведены результаты лечения 33 больных базальноклеточным раком кожи (БКРК) с распространенностью первичного процесса Т3-Т4N0M0 методом фотодинамической терапии (ФДТ). Облучение проводили дистанционно через 3 часа после внутривенного введения фотосенсибилизатора фотолон в дозе 0,8–1,0 мг/кг; доза света составила 200–400 Дж/см2. Дистанционную ФДТ проводили в режиме монотерапии, а также в сочетании с электрохимическим лизисом, лучевой терапией или внутритканевой ФДТ. В результате лечения у 84,6% пациентов с БКРК стадии Т3N0M0 получена полная регрессия опухоли, у 15,4% пациентов – частичная регрессия. Лечение больных БКРК стадии Т4N0M0 проводилось с паллиативной целью и в 100% случаев позволило уменьшить размеры опухоли (эффект оценен как частичная регрессия опухоли), замедлить сроки прогрессирования, улучшить качество жизни. Внутритканевая ФДТ и электрохимический лизис повысили эффективность дистанционной ФДТ (увеличен объем деструкции опухоли) и тем самым позволили сократить сроки лечения. Комбинация ФДТ с лучевой терапией дала возможность снизить на 20–30% дозу лучевой терапии и, следовательно, уменьшить риски развития лучевых осложнений

Фотодинамическая терапия: развитие метода и применение в клинической практике ФГБУ МРНЦ МЗ РФ

This article is dedicated to clinical experience of photodynamic therapy (PDT) in Medical Radiological Research Center. Authors represent the results of treatment in 156 patients with primary untreated tumors of different localizations as follows: basal cell skin cancer (BCSC) in 156 patients, squamous cell carcinoma of the skin (SCCS) in 24 patients, cancer of upper and lower lips in 30 patients. The other group of patients included recurrent and metastatic diseases: recurrent BCSC were in 127 patients, recurrent or continued growth of SCCS – in 27, recurrent or continued growth of lip cancer – in 13, intracutaneous metastases of skin melanoma (62 patients) and breast cancer (46) – in 108. PDT was performed with photosensitizers Photosense (2.0 mg/kg), Photolon (0.9–2.5 mg/kg), and Photoditazine (0.7–0.8 mg/kg). The light irradiation dose was 100–600 J/cm2. After PDT of previously untreated BCSC the complete regression (CR) of tumor lesions was in 96.8% of patients, partial regression (PR) – in 3.2% of patients; for PDT of recurrent BCSC in 76.4% and 23.6%, respectively. After PDT treatment in patients with previously untreated SCCS CR of tumor lesions was achieved in 91.7% of patients, PR – in 8.3% of patients. For treatment of relapses in SCCS CR was achieved in 59.3% of cases, PR – in 33.3%, absence of regression was reported in 7.4% of cases. PDT of intracutaneous metastases of skin melanoma and breast cancer provided positive treatment effect (CR + PR + stabilizing) in 95 and 98% of cases, respectively. CR in primary lip cancer after PDT was reported in 86.0% of patients, PR – in 14.0%. For PDT of recurrent lip cancer CR accounted for 69.2%, PR – 30.8%. Статья посвящена опыту клинического применения фотодинамической терапии (ФДТ) в ФГБУ МРНЦ МЗ РФ. Авторами приведены результаты лечения первичных, ранее не леченных злокачественных опухолей различной локализации: базальноклеточного рака кожи (БКРК) у 156 больных, плоскоклеточного рака кожи (ПКРК) – у 24, рака верхней и нижней губы – у 30. Другую группу соста- вили пациенты с рецидивными и метастатическими опухолями: рецидивы БКРК были у 127 больных, рецидивы или продолжен- ный рост ПКРК – у 27, рецидивы или продолженный рост рака губы – у 13, внутрикожные метастазы меланомы (62 больных) и рака молочной железы (46) – у 108. ФДТ проводили с применением фотосенсибилизаторов фотосенс (2,0 мг/кг), фотолон (0,9-2,5 мг/кг), и фотодитазин (0,7–0,8 мг/кг). Доза лазерного облучения составила 100–600 Дж/см2. После ФДТ ранее не леченного БКРК полная регрессия (ПР) опухолевых очагов была зарегистрирована у 96,8% пациентов, частичная регрессия (ЧР) – у 3,2%; после ФДТ рецидивного БКРК – у 76,4% и 23,6% соответственно. После ФДТ больных с ранее не леченным ПКРК ПР была получена у 91,7% пациентов, ЧР – у 8,3%. При лечении рецидивов ПКРК ПР была получена в 59,3% наблюдений, ЧР – в 33,3%, отсутствие эффекта – в 7,4%. Проведение ФДТ внутрикожных метастазов меланомы и рака молочной железы позволило достичь лечебного эффекта (ПР+ЧР+Стабилизация) в 95 и 98% соответственно. ПР после ФДТ ранее не леченного рака губы была зарегистрирована у 86,0% больных, ЧР – у 14,0%. При лечении рецидивного рака губы число ПР составило 69,2%, ЧР – 30,8%.

Фотодинамическая терапия в лечении плоскоклеточного рака слизистой оболочки полости рта и нижней губы

Treatment outcomes in 82 patients with primary and recurrent oral and lower lip cancer after photodynamic therapy with photosensitizer Photolon alone or combined with other methods of cancer treatment are represented. According to type and extent of the tumor the single dose of Photolon for intravenous administration accounted for 0.8–2.5 mg/kg, light dose – 100–400 J/cm2 (with wave length of 661 nm). 57 patients had PDT alone; 5 patients – in combination with distant radotherapy; 11 – with distant radiotherapy and polychemotherapy; 9 – with 252Cf interstitial therapy and polychemotherapy. For these patients 3-year overall survival rates were 85.1±4.8%, 3-year reccurence-free survival – 72.2±4.7%. The PDT for recurrent tumors, in cases when other methods were exhausted or impossible, allowed complete tumor response in 82.9% of patients, in 72.9% of them – 3-year disease free survivance. For PDT combined with distant radiotherapy (including concurrent polychemotherapy) the complete response was observed in 100% of patients with primary tumor and in 66.7% of patients with recurrent tumor. For PDT combined with interstitial neutron therapy all patients had complete tumor response. The study showed that this combination allowed decreasing the total radiation dose and radiation dose on adjacent normal tissue, thus, decreasing radiation injury. Приведены результаты лечения 82 пациентов с первичным и рецидивным раком слизистой оболочки полости рта и нижней губы методом фотодинамической терапии (ФДТ) с фотосенсибилизатором фотолон как в самостоятельном варианте, так и в различных сочетаниях с другими видами противоопухолевой терапии. В зависимости от формы и распространенности опухоли доза фотолона для однократного внутривенного введения составляла 0,8–2,5 мг/кг массы тела, световая доза облучения – 100-400 Дж/см2 (на длине волны 661 нм). 57 больным ФДТ была проведена в режиме монотерапии; 5 пациентам – в сочетании с дистанционной лучевой терапией; 11 – в сочетании с дистанционной лучевой терапией и полихимиотерапией; 9 – в сочетании с внутритканевой терапией 252Cf и полихимиотерапией. После проведенного лечения трёхлетняя общая выживаемость пациентов составила 85,1±4,8%, трёхлетняя безрецидивная – 72,2±4,7%. Применение ФДТ при рецидивных новообразованиях, когда другие методы лечения были исчерпаны или невозможны, позволило у 82,9% больных достичь полной резорбции опухоли, из них у 72,9% – стойкого излечения в течение трех лет. При применении ФДТ в сочетании с дистанционной лучевой терапией (в том числе одновременно с полихимиотерпией) у 100% пациентов с первичной опухолью и у 66,7% пациентов с рецидивной опухолью эффектом лечения была полная резорбция. При сочетании ФДТ с внутритканевой нейтронной терапией полной регрессии опухоли удалось достичь у всех пролеченных пациентов. Исследования показали, что в таком сочетании ФДТ позволяет снизить дозу лучевой терапии и уменьшить лучевую нагрузку на здоровые окружающие ткани, то есть снизить вероятность развития лучевых повреждений.

Системная фотодинамическая терапия с фотосенсибилизатором фотолон в лечении онкологических больных с регионарными и отдаленными метастазами

 The results of photodynamic therapy (PDT) in 76 patients with tumors of different sites and with regional or distant metastases are represented. Sixty three patients were under combined or multimodal therapy, 13 patients had systemic PDT as monotherapy. The technique of PDT was as follows: the solution of photosensitizer photolon was administered intravenously at dose of 0.8–1.4 mg/ kg body weight. Laser blood irradiation was performed simultaneously (wavelength of 662 nm, output power of 20 mW, irradiation time of 50 min). Stabilization of the disease defined as the absence of new tumor foci was observed in 55% of treated patients: among them in 47% of patients with disseminated melanoma during 6–10 months after treatment, in 65% patients with breast cancer – for 3–6 years after treatment, and also in 100% of patients with cancer of other sites (colorectal, pancreatic, cervical, ovarian, lung and stomach cancer, retroperitoneal neuroblastoma) – for 10–12 months after treatment. According to ultrasound data the shrinkage of most of metastases up to its complete disappearance was observed. The authors consider that effects of systemic PDT are due to decrease of circulating tumor cells in blood and also due to beneficial impact of this modal of treatment on immune status of cancer patient. Intravenous PDT was shown to improve treatment results and quality of life in patients with metastases of malignant tumors. The approved technique is of considerable interest and requires further investigation of its efficiency including its combination with methods of combined and multimodal treatment. Приведены результаты применения фотодинамической терапии (ФДТ) у 76 пациентов с опухолями различной локализации и наличием регионарных или отдаленных метастазов. Шестьдесят три пациента находились в процессе комбинированного или комплексного лечения, 13 пациентам системная ФДТ проводилась как монотерапия. Методика проведения ФДТ заключалась в следующем: внутривенно вводили раствор фотосенсибилизатора фотолон в дозе 0,8–1,4 мг/кг массы тела. Одновременно проводили лазерное облучение крови больного (длина волны 662 нм, мощность лазера на выходе 20 мВт, время облучения 50 мин). Стабилизация процесса в виде отсутствия новых очагов опухоли наблюдалась у 55% пролеченных пациентов: в том числе у 47% больных с диссеминированной меланомой в течение 6–10 мес. после лечения, у 65% больных раком молочной железы – в течение 3–6 лет после лечения, а также у 100% больных с онкологической патологией другой локализации (рак прямой и ободочной кишки, поджелудочной железы, шейки матки, яичников, легкого и желудка, нейробластома забрюшинного пространства) – в течение 10–12 мес. после лечения. По данным УЗИ, отмечено уменьшение размеров большей части метастатических очагов вплоть до их полного исчезновения. Авторы считают, что реализация эффектов системной ФДТ происходит за счет уменьшения циркулирующих в крови опухолевых клеток, а также вследствие положительного влияния данного вида лечения на иммунный статус онкологических больных. Показано, что применение внутривенной ФДТ позволяет улучшить результаты лечения и качество жизни больных с метастазами злокачественных новообразований. Апробированная методика представляет значительный интерес, что требует дальнейшего изучения ее эффективности, в том числе, в сочетании с методами комбинированного и комплексного лечения.

Photodynamic therapy alone and in combined modality treatment for locally advanced basal cell skin cancer

Outcomes after photodynamic therapy (PDT) in 33 patients with basal cell skin cancer Т3-Т4N0M0 primary stage are represented in the article. The irradiation was performed distantly 3h after intravenous injection of photosensitizer photolon with dose 0.8-1.0 mg/kg; light dose accounted for 200-400 J/cm2. Distant PDT was applied as monotherapy or in combination with electrochemical lysis, radiotherapy or interstitial PDT. 84.6% of patients with Т3N0M0 stage basal cell skin carcinoma had complete regression, 15.4% of patients – partial regression. The treatment for Т4N0M0 stage basal cell skin carcinoma was palliative and in 100% of cases it allows to shrink the tumor (defined as partial tumor regression), retard the progression time, improve quality of life. Interstitial PDT and electrochemical lysis improved the efficacy of distant PDT (increased volume of tumor destruction) and, thus, allowed to decrease treatment period. Combination of PDT with radiotherapy allowed to decrease radiation dose for 20-30% and, thus, to decrease the risk of radiation-induced complications

Photodynamic therapy: development of methods and clinical applications in FCI MRCC MOH

This article is dedicated to clinical experience of photodynamic therapy (PDT) in Medical Radiological Research Center. Authors represent the results of treatment in 156 patients with primary untreated tumors of different localizations as follows: basal cell skin cancer (BCSC) in 156 patients, squamous cell carcinoma of the skin (SCCS) in 24 patients, cancer of upper and lower lips in 30 patients. The other group of patients included recurrent and metastatic diseases: recurrent BCSC were in 127 patients, recurrent or continued growth of SCCS – in 27, recurrent or continued growth of lip cancer – in 13, intracutaneous metastases of skin melanoma (62 patients) and breast cancer (46) – in 108. PDT was performed with photosensitizers Photosense (2.0 mg/kg), Photolon (0.9–2.5 mg/kg), and Photoditazine (0.7–0.8 mg/kg). The light irradiation dose was 100–600 J/cm2. After PDT of previously untreated BCSC the complete regression (CR) of tumor lesions was in 96.8% of patients, partial regression (PR) – in 3.2% of patients; for PDT of recurrent BCSC in 76.4% and 23.6%, respectively. After PDT treatment in patients with previously untreated SCCS CR of tumor lesions was achieved in 91.7% of patients, PR – in 8.3% of patients. For treatment of relapses in SCCS CR was achieved in 59.3% of cases, PR – in 33.3%, absence of regression was reported in 7.4% of cases. PDT of intracutaneous metastases of skin melanoma and breast cancer provided positive treatment effect (CR + PR + stabilizing) in 95 and 98% of cases, respectively. CR in primary lip cancer after PDT was reported in 86.0% of patients, PR – in 14.0%. For PDT of recurrent lip cancer CR accounted for 69.2%, PR – 30.8%. </p

Investigation of non-Newtonian behavior of dusty plasma liquid

AbstractThe paper presents experimental investigation of flow of dusty plasma medium formed by macroparticles in argon plasma. The dependences of the coefficient of shear viscosity of such liquid on the external force causing the flow of dusty plasma liquid and on the pressure of plasma-generating gas are studied. It is found that the viscosity of the dusty plasma medium decreases with increasing shear stress and increases with increasing pressure of buffer gas. An experimental investigation of the dynamics of macroparticles in an unperturbed liquid dusty plasma medium as a function of coupling parameter is performed; in so doing, formations of particles whose motion is correlated are observed in the region of high values of coupling parameter. It is assumed that the non-Newtonian pattern of dusty plasma liquid may be due to the emergence of crystal-like dusty plasma clusters in the ‘liquid’ phase. An experimental investigation of a crystalline dusty plasma structure under the effect of laser radiation is performed; in so doing, a macroscopic flow of the crystalline dusty plasma structure is observed under the effect of shear stress. The mechanism of formation and subsequent annihilation of edge misfit dislocations is observed and the threshold pattern of such flow is established; the threshold value of power of laser radiation is determined.</jats:p

Photodynamic therapy for cutaneous metastases of breast cancer

Breast cancer is the most common cancer and the leading cause of cancer death in w omen. Cutaneous metastases are observed in 20 % pa- tients with breast cancer. 36 breast cancer patients with cutaneous metastases were treated with photodynamic therapy in the de partment of laser and photodynamic therapy MRRC. Complete regression was obtained in 33.9 %, partial — in 39 % of cases, the stabilization achieved in 25.4 %, progression noted in 1.7 %. The objective response was obtained in 72.9 % of cases, treatment effect — in 97.4 %. Photodynamic therapy has good treatment results of cutaneous metastases of breast cancer with a small number of side effects

Photodynamic therapy for squamous cell oral and lower lip carcinoma

Treatment outcomes in 82 patients with primary and recurrent oral and lower lip cancer after photodynamic therapy with photosensitizer Photolon alone or combined with other methods of cancer treatment are represented. According to type and extent of the tumor the single dose of Photolon for intravenous administration accounted for 0.8–2.5 mg/kg, light dose – 100–400 J/cm2 (with wave length of 661 nm). 57 patients had PDT alone; 5 patients – in combination with distant radotherapy; 11 – with distant radiotherapy and polychemotherapy; 9 – with 252Cf interstitial therapy and polychemotherapy. For these patients 3-year overall survival rates were 85.1±4.8%, 3-year reccurence-free survival – 72.2±4.7%. The PDT for recurrent tumors, in cases when other methods were exhausted or impossible, allowed complete tumor response in 82.9% of patients, in 72.9% of them – 3-year disease free survivance. For PDT combined with distant radiotherapy (including concurrent polychemotherapy) the complete response was observed in 100% of patients with primary tumor and in 66.7% of patients with recurrent tumor. For PDT combined with interstitial neutron therapy all patients had complete tumor response. The study showed that this combination allowed decreasing the total radiation dose and radiation dose on adjacent normal tissue, thus, decreasing radiation injury. </p

Phonological skills as predictors of dyslexia (Dorofeeva et al., 2022)

Purpose: The main purpose of this study was to investigate whether the performance on each of seven phonological processing (PP) tests from the Russian Test of Phonological Processing (RuToPP), with their varying levels of linguistic complexity and composite phonological indices, are significant predictors of developmental dyslexia (DD) and can reliably differentiate children with and without reading impairment. Additionally, we examined the general contribution of phonological skills to text reading fluency in children with various levels of reading performance. Method: A total of 173 Russian-speaking 7- to 11-year-old children participated in this study: 124 who were typically developing (TD) and 49 who had been diagnosed with DD. We assessed reading fluency with a standardized reading test and PP with the RuToPP. We investigated the potential of phonological skills to predict the presence or absence of a dyslexia diagnosis using multinomial logistic regression, receiver operating characteristic (ROC) curve analysis, and calculations of the sensitivity and specificity of each test and index. The contribution of phonological skills to reading fluency was also assessed in a mixed group of children. Results: Six of seven RuToPP tests were significant predictors of dyslexia. However, while the RuToPP correctly identified 93%–99% of TD children, for children with dyslexia, it ranged from 4% to 47% depending on the test. In a mixed group of children with and without dyslexia, performance in the more complex phonological tests was a stronger predictor of reading fluency. Conclusions: Our findings are consistent with the literature on predictors of literacy skills and dyslexia while uniquely demonstrating the impact of the complexity level of the phonological tests on the classification outcome. PP is a significant and necessary predictor of reading skills, but it is not sufficient for diagnostic purposes. Supplemental Material S1. The factor and the correlation analyses for the behavioral data of children with dyslexia.  Supplemental Material S2. Boxplots for the results in the reading test and in all Russian Test of Phonological Processing (RuToPP) tests. Dorofeeva, S. V., Iskra, E., Goranskaya, D., Gordeyeva, E., Serebryakova, M., Zyryanov, A., Akhutina, T. V., & Dragoy, O. (2022). Cognitive requirements of the phonological tests affect their ability to discriminate children with and without developmental dyslexia. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2022_JSLHR-21-00687</p