RU2179000C1 - Method of combined treatment of cutaneous basaliomes - Google Patents

Abstract

FIELD: medicine, oncology. SUBSTANCE: the method suggests to start the treatment with an intake of human leukocytic interferon as ingalations per 20,000 U in a day, 20 procedures/course. At immunocorrective background one should conduct radiowave removal of basaliomes using Surgitron equipment produced by Ellman International, USA. EFFECT: higher quality of approach and efficiency of therapy, improved correction of immunological values, higher percentage of healing with no relapses and complications. 1 ex

Description

 The invention relates to medicine, namely to dermatology and oncology.

 Basal cell carcinoma is a skin cancer with locally destructive growth that arises from the epidermis or hair follicles and rarely metastasizes (according to WHO 1974). According to a number of authors (Shanin A.P. Skin tumors, their origin, clinic and treatment, L., 1969, S. 154-172), basal cell carcinoma occurs more often than other skin neoplasms and occupies an intermediate position between benign tumors and squamous cell carcinoma. It accounts for 77 to 90% of malignant epithelial skin tumors (Venkey T., Shuvgar J. Malignant skin tumors, Budapest, 1962, p. 12-15). Known methods for treating skin basal cell carcinomas: surgical excision, electrocoagulation, cryodestruction, radiation therapy, laser therapy, chemotherapy, external treatment with antitumor drugs (M. Kogan. Improving the treatment of multiple skin basal cell carcinomas based on the study of their immunomorphological features. . Sciences, M., 1984, 24 pp.) are not effective enough, cause relapses of the disease and are accompanied by late postoperative complications in the form of deep skin defects.

 An analogue of the claimed method, the authors propose a method for removing basal cell carcinomas using a continuous carbon dioxide laser apparatus with a radiation wavelength of 10.6 microns and a maximum output power of up to 30 watts. Two options for operations are used - more often photocoagulation with a focused or defocused beam, less often excision of the pathological process with a focused beam. The advantages of the method are determined by the good cutting and hemostatic effect of the laser beam and the creation of sterility on the cut line. However, the inconvenience of the method should be attributed to the inconvenience and, as a consequence, the need for the so-called aiming and the possibility of overshot the beam past the pathological process, the difficulty of adjusting the depth of the incision or coagulation and the long healing time of the postoperative defect (from 22 to 28 days) with the formation of a scar.

According to the authors, the prototype of the claimed is a method of treating skin basal cell with an argon laser (Zakia Ya. Clinical features of skin basal cell carcinoma and pathogenetic substantiation of therapy with an argon laser and immunocorrective drugs (T-activin and sodium nucleonate). Abstract. Cand. , M., 1992, 26 pp.). Under local anesthesia with chloroethyl, tumor tissue was coagulated using an argon laser with an output power of 4 W at the coagulation focus and the fiber was located at a distance of 6-8 cm from the irradiated object. The treatment course consisted of 1-3 procedures, the coagulation area up to 4-5 cm ² each time, the duration of the procedure is 2-5 minutes. Laser coagulation was carried out according to 3 basic principles of irradiation: stripe-shaped, mesh, point. The advantages of this method include the ability to visually control the area and depth of basal cell removal, as well as short healing times of 12-15 days. The disadvantages of this method of treatment are the lack of use of interferon preparations and frequent relapse of the disease.

 The authors propose their own method of complex treatment of basal cell carcinoma using radio wave surgery and preparations of human leukocyte interferon (CHLI). The treatment began with the intake of CHLI in the form of inhalations of 20 thousand units, every other day, 20 treatments per treatment course. Against the background of immunocorrection, radio-wave removal of basal cells was performed on the Surgitron apparatus manufactured by Ellman International (USA). Using the action of high-frequency radio waves (3.8 MHz), which are emitted by a wire electrode, the cells that are in direct contact with the electrode are “evaporated”, which results in less traumatic tissue splitting, with minimal lateral damage in the simultaneous mode of resection and coagulation. After that, using the multifunctional electrodes, the operational bed was fulgrated (tissue destruction by electric spark discharge).

 The advantages of this method is that it achieves a slightly traumatic tissue splitting with slight lateral and thermal damage, quick healing (from 9 to 15 days) with minimal scar tissue formation. The ease of passage of the electrode through the tissue allows a very high accuracy of incision or excision. The practical absence of tissue damage along the incision line greatly facilitates the histological examination and allows the use of the radio wave method for biopsy.

 Under our supervision there were 56 patients. Of these, 32 (57.1%) are women and 24 (42.9%) are men. Foci of lesion were localized in the temporal areas in 5 (8.9%) patients, on the body in 17 (30.4%), on the cheeks and upper lip in 19 (33.9%), on the nose in 7 (12 , 5%), in the periorbital region - in 2 (3.6%), on the extremities - in 6 (10.7%).

 Previously, 48 (85.71%) patients underwent various treatment methods, but all had a relapse of the disease. The level of phosphatidylinositides on the membranes of peripheral blood lymphocytes (an indicator of early activation of lymphocytes) in all patients compared with donors was significantly reduced and amounted to 53.0 ± 5.2 mg /% (in donors 64.7 ± 2.8 mg /%).

 After the treatment, there was a rapid healing of the surgical wound within 9-12 days and the absence of a pronounced scar defect. The level of phosphatidylinositides on the membranes of peripheral blood lymphocytes in all patients reached normal values (65.2 ± 1.2 mg /%).

 Remote observations in the period from 1 to 2 years established the absence of relapse in all treated patients according to the proposed method.

 Thus, the method of radio-wave surgical removal using the Surgitron apparatus in combination with immunocorrection allows you to speed up and facilitate the rehabilitation of patients and reduce the number of relapses, as well as provide low-traumatic removal of skin neoplasms with fast postoperative healing, which ensures a high aesthetic effect during operations in cosmetically significant areas.

 Example: Patient S., 59 years old. I went to the clinic of the Regional Oncology Center on 10/18/2000 with complaints about the appearance of an education on the cheek.

 About 3 years ago, he drew attention to the appearance on the right cheek of a pea-sized formation of the color of the surrounding skin. Subjective sensations are not noted. Since April 1999, he began to notice an increase in the size of this education, which in June 2000 ulcerated. The patient did not go to the doctor, he was not treated on his own.

 When examined on the skin of the right cheek, it is a flat element of irregular shape with clear boundaries of 2.5x2 cm in size. The edges are slightly raised, on the periphery there is a thin roller consisting of separate small formations, its surface is brownish-pink, covered with numerous ulcers and layered peels.

 Clinical diagnosis: ulcerative basal cell carcinoma of the right cheek.

 Histological diagnosis: solid basal cell carcinoma.

 The level of phosphatidylinositides on the membranes of peripheral blood lymphocytes before treatment is 54.24 mg /%.

 As an immunocorrection, the patient received inhalation with interferon (20 thousand units), every other day, 20 procedures. Against this background, the patient, under local anesthesia, was removed the neoplasm in three modes (resection, coagulation, fulguration) on a Surgitron radio wave apparatus (Ellman International, USA) within the affected tissues. An intraepidermal suture is applied to the defect. After the intervention, the patient was worried about a burning sensation and pain, swelling and hyperemia were noted. A day after the operation, swelling was slight, hyperemia persisted. Sutures were removed on the 10th day.

 The level of phosphatidylinositides on the membranes of peripheral blood lymphocytes after treatment was 65.17 mg /%.

 Subsequently, after 1 month, a completely satisfactory scar was formed that did not rise above the skin level and did not differ in color.

Claims (1)

 A method of complex treatment of skin basal cell carcinomas, including immunocorrection, characterized in that immunocorrection is performed by human leukocyte interferon in the form of inhalations of 20 thousand units, every other day, on a course of 20 procedures and local exposure to high-frequency radio waves with a frequency of 3.8 MHz within the affected tissues .