Radiothermometric personalisation of chemo-and radiotherapy for patients with advanced (Iii, iva and ivb) stages malignant lesions of oral cavity, throat and epiglottis

Abstract

Objective: optimization of treatment of patients with advanced malignant lesions of oral cavity, throat and epiglottis by means of radiothermic control and personalisation of the induction radio sensitizing polychemotherapy prior to radiotherapy or by applying both methods simultaneously. Materials and methods. Study is based on the results of treatment 280 patients with morphologically confirmed cancer of mucosae of oral cavity, throat and epigloittis staged III, IVA and IVB without remote metastases were divided into 6 groups depending on a type of a radiotherapy applied. Each group was divided into a treatment and a control subgroup. A choice of treatment for control subgroups was done on the basis of RECIST 1.1. scale; a decision for treatment subgroups was done based on obtained radiothermic (RTM) personalisation data in tumours or metastases.The treatment program included follow-ups according to established guidelines, radiothermic measurements, immunology investigations, statistical analysis (cumulative survival by Kaplan-Meier). Results. Groups of patients with tumours of oral cavity and epigloittis with intra-arterial polychemotherapy (IA PCT) prior to radiotherapy demonstrated improved mean 3 years survival rate. Groups with malignant tumours of upper laryngeal tract demonstrated opposite results. A comparison of mean survival rates between groups that were treated with systemic radiochemotherapy but using different combinations of different chemotherapy agents has shown that a use of polyplatilen is superior to combinations with cisplatin. A further study showed that all treatment groups had demonstrated better survival rates compared to control groups. Conclusions. The obtained results allow us to conclude that the therapy personalisation based on radiothermic personalisation significantly improves quality and outcomes for patients with localized cancer of oral cavity, throat and epiglottis. RTP can be used as a treatment control method of above mentioned lesions together with standard treatment pathways. The application of intra-arterial polychemotheray followed by a radiotherapy of tumours of oral cavity and throat shows better outcomes compared to standard treatments only. The use of induction polychemotherapy with polyplatilene for patients with tumours of epiglottis is superior to intra-arterial polychemotherapy and a chemotherapy with cisplatin.