ORIGINAL ARTICLES
The results of a study of the clinical effectiveness of the correction of involutional changes in the skin by the method of photodynamic therapy (PDT) with the use of a photosensitizer gel (PS), the active substance of which is the trismeglumine salt of chlorin e6, are presented. The data of fluorescence spectroscopy for monitoring the level of PS fluorescence in order to determine the optimal time of its exposure are demonstrated. The study of the optimal exposure time involved 80 patients with different skin phototypes. The study of the effectiveness of PDT involved 42 patients aged 44–68 years with signs of chrono- and photoaging. The PDT procedure was performed by irradiating the entire surface treated with the PS with a power density of 100 mW/cm2, a light dose of 120–140 J/cm2, a laser radiation wavelength of 660 nm, and a light beam area of 400–800 cm2. It was found that exposure to PS for 10–20 min gives the highest fluorescence and does not depend on the skin phototype. The clinical effect of PDT was achieved in 85.7% of patients; there were no negative subjective sensations. Moisture metrics increased on the skin of the face by 53%, reaching the control values in young healthy volunteers, on the skin of the hands - by 64%. Elastometry indicators on the skin of the face and hands increased by 19% and 16%, respectively. Thus, the PDT procedure with PS based on chlorin e6 is an effective method for correcting involutional changes in the skin, leads to a pronounced clinical effect, improves the parameters of skin moisture measurement and elastometry, and passes without undesirable local reactions. Optical coherence tomography showed an increase in collagen ordering.
The article summarizes the results of studies of the effectiveness of photodynamic therapy using a new domestic photosensitizer liposomal borated chlorin e6 (LBC) after its parenteral administration (intraperitoneal and intravenous). Antitumor efficacy was evaluated in rats with M-1 sarcoma and PC-1 alveolar liver cancer and mice with B16 melanoma and Ehrlich’s carcinoma, which were transplanted subcutaneously into the thigh area of the animals. The aim of the study was to determine the optimal regimes of photodynamic therapy that would allow achieving the maximum antitumor effect up to 21 days after the photodynamic therapy. The therapy was carried out under the control of the accumulation of the photosensitizer in the tumor and surrounding tissues of the thigh by selecting the doses of the drug and the parameters of laser radiation (energy density and power density). The effectiveness of therapy was assessed by the inhibition of tumor growth, by the percentage of animals with complete tumor regression, by the absolute growth rate in animals with continued tumor growth compared to controls. The results of our studies have shown that the domestic photosensitizer liposomal borated chlorin e6 has high antitumor activity in vivo. In an experimental study of the photosensitizer under certain PDT modes, the maximum antitumor effect (complete tumor regression in 100% of animals) was obtained up to 21 days after PDT in all tumor models used.
This article analyzes domestic and foreign sources, regulatory documents of the Russian Federation, in order to determine the etiological factors of oral cancer, assess the statistical data on morbidity and mortality from malignant neoplasms of the maxillofacial region in the Penza region. The results of changing the routing, an interdisciplinary approach to treating patients with malignant neoplasms of the maxillofacial region in the Penza region are presented. The epidemiology, clinical manifestations, main diagnostic methods, routing, treatment and rehabilitation of patients with head and neck oncology are considered. The results of treatment of patients with oral cavity and lower lip cancer using photodynamic therapy (PDT), both alone and in combination with radiation and chemotherapy, are analyzed. The study showed that PDT of tumors of the lower lip and buccal mucosa in mono-mode made allowed achieving 100% efficiency. After the completed treatment, all participants in the experiment were provided with a complex of rehabilitation, including nutritional support, psychological assistance, exercise therapy, training in correct swallowing tactics, percutaneous endoscopic gastrostomy, and a course of oral cavity massage. An interdisciplinary approach to treating malignant neoplasms of the maxillofacial region is the most correct in modern practice.
LITERATURE REVIEWS
Oral mucosa cancer is a common disease with relatively low survival rates. The standard for the treatment of malignant neoplasms (MNO) of the oral mucosa is the surgical method, chemotherapy and / or radiation therapy. With the introduction of modern protocols and the improvement of current treatment methods, the increase in survival is insignificant due to the development of local and distant relapses, the appearance of simultaneous tumors of the oral cavity. Cosmetic and functional results in patients who have undergone complex treatment for oral cancer are often unsatisfactory. There is an obvious need to develop new approaches to treating patients with cancer of the oral mucosa. Photodynamic therapy (PDT) has similar properties. With the development of endoscopic and fiber-optic equipment, the fields of PDT application have significantly expanded. Foci in the oral cavity and oropharynx became available for PDT. The early stages of oral mucosal cancer are optimal for PDT because large surface defects can be treated with minimal complications. Preservation of subepithelial and collagen structures, which is typical for PDT, promotes healing without the formation of scar processes, thereby achieving an ideal cosmetic and functional effect. The use of PDT in the treatment of oral cavity cancer is not limited only to the initial stages in an independent version. It is possible to use PDT in combination with surgical and radiation treatment. In case of massive tumor processes, PDT is used for palliative purposes. The influence of the adaptive immune response under the influence of PDT is being studied.