Step-wise (radiocryogenic) treatment of patients with primary malignant epithelial tumors of the eyelid skin

Introduction. Among all malignant tumors of the organ of malignant epithelial tumors (Theo) eyelid skin make up 68?75 %. Treatment of tumors of the eyelid skin has certain peculiarities. Along with the basic principles of oncology ? and radical ablation, is necessary to preserve the basic functions of the age ? protective, lac?rimal and cosmetics. Neglect of these principles leads to inappropriate treatment and, as a consequence ? to relapse and the need for excision. Purpose. Study of immediate and long-term results radiokriogennogo treatment (radiotherapy + cryosurgery) patients Theo eyelid skin stage T2b-3a N0 MO.Material and methods. Radiokriogennoe treatment was performed in 358pa?tients with primary Theo eyelid skin stage T2a-3a NOMO. There were 177 men (49.5 %) aged 33 to 85 years (median = 63.4), women ? 181 (50.5 %) aged 28 to 89 years (median = 67.3). In 246 (68.7 %) had a basal cell carcinoma, in 73 (20.4 %) ? squamous, 16 (4.5 %) ? metatipichesky and 23 (6.4 %) ? adeno?carcinoma. RTwas applied in the form of 'y ? RD therapy 2?2.2 Gy, SOD (34.6 ± 5,8) Gy and brachytherapy, RD 40 GR, SOD (288 ± 61,3) Gy. Immediate results. Of358patients after one course of treatment radiokriogennogo complete tumor occurred in 290 (81.0 %) patients: all 24 patients with tumor stage T2a, 122 (84.7 %) patients with T2B and 144 (76.2 %) c T3a stage. Partial re?sorption ? in 68 (19.0 %) cases: T2b stage in 22 (15.3 %) and in 46 (23.8 %) with stage T3a. In 43 (67.2 %) patients with partial resorption of the tumor (19 ? and 24 T2B stage ? with stage T3a) complete recovery occurred after additional CD held in the period from 3 to 11 months (median 4.7). Long-term results. Tumor recurrence appeared in 23patients (6.4 %). When tumors T2b N0 M0 stage recurrences appeared in 6 (4.2 %) cases in the period from 11 to 152 months (median = 36.9 months), and in tumors T3a stage ? in 17(8.9 %) during the period from 19 to 68.9 months (median 37months). Conclusion. Application of the first stage of treatment RT reduces tumor volume and the CD ? to preserve healthy tissue, skeleton structures century and tearful way. The method allows to reduce the total radiation dose is 1.5?2 times as compared with RT in pure form, expand the indications for treatment of patients with organ-running Theo eyelid skin T2a-bN0M0 stage and get a good functional and cosmetic result.