Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

2021: Synthesis of Medicine, Pharmacy Sciences and Biological Researches: Analysis and Trends (1st edition)

Improving the selective treatment of thymus tumors using intra-arterial chemoembolization

DOI
https://doi.org/10.36074/smpsbr:at.ed-1.04
Published
2022-08-26

Abstract

Epithelial tumors of the thymus occur in the thymus and include thymomas and carcinomas of the thymus. Thymomas are the most common primary tumor in the anterior mediastinum, but are generally rare (1.5 cases / 1,000,000). Although thymomas can spread locally, they are much less invasive than thymic carcinomas. Patients with thymic carcinomas often have metastases. The 5-year survival of patients with thymoma reaches 90%. At the same time, the 5-year survival rate for thymic carcinoma is approximately 55% (NCCN Guidelines. Version 1.2020). Surgical treatment as an independent method can be used only when there are thymus tumors in encapsulated and minimally invasive tumors in the first degree, rarely in the second degree. In all other cases, patients are subject to combined, complex or conservative treatment. In combined and complex treatment, preference should be given to neoadjuvant methods, which allows to achieve regression of the tumor, reduces its volume, limits the invasion of surrounding tissues, as well as to transform the inoperable process into operability. Surgical treatment as an independent method can be used only when there are thymus tumors in encapsulated and minimally invasive tumors in the first degree, rarely in the second degree. In all other cases, patients are subject to combined, complex or conservative treatment. In combined and complex treatment, preference should be given to neoadjuvant methods, which allows to achieve regression of the tumor, reduces its volume, limits the invasion of surrounding tissues, as well as to transform the inoperable process into operability. Endovascular technologies, namely regional chemotherapy, in the preoperative period, as a preparatory stage, will increase the level of ablastics and antiblastics in surgical treatment of thymus and reduce the percentage of cytostatics on the whole body, as in intravenous administration. At patients with a paraneoplastic syndrome it is necessary to increase term of regression of displays of these syndromes. Intra-arterial administration of chemotherapeutics has certain advantages: • cytostatics in the arteries that supply blood to the tumor are injected directly into the affected area, which allows you to significantly increase the concentration of the drug in the tumor itself; • reduces the toxic effects of chemotherapy on the whole body; • longer action of drugs allows long-term contact of the cytostatic with tumor cells at all stages of the cell cycle.

References

  1. Ganul, A.V. (2009). Optimization of diagnosis and treatment of patients with malignant tumors of the mediastinum. Oncology, v.11, № 2, 131-135.
  2. Borisyuk, B.O. (2009). Intraarterial regional polychemotherapy in the complex treatment of malignant neoplasms of the mediastinum. Oncology, v.11, №2, 136-138.
  3. Rabkin, I.H. (1977). Guide to angiography. М.: Medicine
  4. Vetshev, P.S., Ippolitov, L.I., Merkulova, D.M. (2003). Surgical treatment of thymus in patients with generalized myasthenia gravis. Surgery, (10), 15–20.
  5. Granov, A.M., Davydov M.I., Tarazov, P.G., Granov, D.A., Dolgushin, B.I., Polysalov, V.N., Polikarpov, A.A. (2007). Interventional radiology in oncology (ways of development and technology): scientific and practical edition. SPb.: LLC «Publishing house FOLIANT».
  6. Klimenko, V.N., Barchuk, A.S., Lemekhov, V.G. (2005). Videothoracoscopy in oncological practice. SPb. : ELBI-SPb.
  7. Nikitenko, A.I., Nikitenko, E.G., Zhelannoe, A.M. (2006). Thoracoscopic thymectomy for myasthenia gravis. Endoscopic surgery, (2), 94–95.
  8. Seagal, E.I., Burmistrov, R.G., Hamidullin, R.G. (2005). Videothoracoscopy in the diagnosis and treatment of benign and malignant diseases of the chest: 10 years of experience. Endoscopic surgery, (1), 138–141.
  9. Trishin, V.M., Orzheshkovsky, O.V., Reshetov, A.B. (2001). Diagnosis and surgical treatment of mediastinal neoplasms. Bulletin of Surgery. Vol.160, (1), 11–14.
  10. Kharchenko, V.P., Sarkisov, D.S., Vetshev, P.S. (1998). Diseases of the thymus gland. M .: Triad X.
  11. Perevodchikova, N.I., Gorbunova, V.A. (2015). Guide to chemotherapy of tumors. 4th edition. "Practical Medicine".
  12. Dinkel, H.P., Mettke, B., Schmid, F., Endovasc, J. (2003). Endovascular treatment of malignant superior vena cava syndrome : is bilateral Wallstent placement superior to unilateral placement?, (10), 788–797.
  13. Jaretzki, A. (2003). Thymectomy for myasthenia gravis : analysis of controversies patient management. Neurologist, (9), 77–92.
  14. Lanciego, C., Chacon, J. L., Julian, A. (1998). Stenting as first option for endovascular treatment of malignant superior vena cava syndrome. Am. J. Med, (104), 78–84.
  15. Lisak, R. P. (1994). Handbook of myasthenia gravis and myasthenic syndromes. New York-Basel-Hong Kong : Marcel Dekker, inc.
  16. Mack, M. J. (2001). Video-assisted thoracoscopy thymectomy for myasthenia gravis II. Chest Surg. Clin. N. Am. Vol. 11 (2), 389–406.
  17. Masaoka, A. (2001). Extended transsternal thymectomy for myasthenia gravis. Chest Surg. Clin. N. Am, (2), 369–387.
  18. Mulder, D. G. (1996). Extended transsternal thymectomy. Chest Surg. Clin. N. Am., (6), 95–109.
  19. Avdosjev, Y. V., Beloziorov, I. V. (2020). Treatment of thymic tumors with the help of endovascular technologies. Interventional radiology in oncosurgery, 265-285.