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AbstractDO.24.04 The original cryosurgical method in the treatment of epithelial malignant tumors of eyelids, stage T3. Part II: combined treatment radiotherapy and cryosurgery Bouiko A. S., Safronenkova I. A., Yelagina V. A.
V.P.Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine Objective: This work continues a series of our reports about cryogenic treatment of eyelid's epithelial malignant tumours (EMT). The first series were presented on DOG 2005-2006.
Purpose: to minimize the number of destructive and successive reconstructing operations of named tumor.
Methods: We have treated 169 patients with EMT of eyelids at stage T3 between 1990 and 2001. Mean age of patients was 64.6±10.5 SD, median-64.0. Tumor invased the subcutaneous tissue (18.3%), tarsus and conjunctiva (55.7%), eyelids canthus (26.0 %).112(66.3%) patients have primary tumors, 57 (33.7%)-recurranted tumors.The tumor form was: nodular-48(28.4%), ulcerous-109 (64.5%), superficial-12 (7.1%). The maximal tumors diameter was: M=21.3±9.1 SD mm, Median-20.0. BCC was in 101 (59.8%) patients; SCC-39 (23.1%), adenocarcinoma-19 (11.2%), metatypical carcinoma-7 (4.1%), sebaceous carcinoma-3 (1.8%). Cryosurgery was combined with three modes of radiotherapy: external X-ray (43.2%), gammatherapy (46.6%), brachytherapy (14.2%). Analysis was carried out in November 2006.
Results: The total tumors resorption was achieved in 153 cases (90.5%) after the first course of combined treatment. 16 patients (9.5%) with big sizes of primary tumor (diameter>40 mm) needed the additional session of cryosurgery after 2-3 months.Average follow up was 31.0±31.9 SD months, mediana-24.5. The contact with 8 patients was lost. Recurrences were observed in 15 patients (8.9%) in term from 2 to 5 years. All recurrences were treated by repetitive cryosurgical intervention. The additional reconstructive operations didnt needed. This combined treatment provides the diminuation the level of total dose of radiotherapy on 30-35%. It permits to avoid the beam complication on skin and eye.
Conclusions: Combined treatment of EMT of eyelid provide good clinic and aesthethic results and could be concerned as the serious alternative to the pure surgical approach.
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