Pathomorphosis as a prognostic indicator of complex treatment with combination of intra-arterial chemotherapy in non-epithelial malignant tumors of the maxilla, nasal cavity and paranasal sinuses

Background. To study a role of pathomorphosis as an index of the effectiveness of intra-arterial chemotherapy in non-epithelial malignancies of the maxilla, nasal cavity and paranasal sinuses.
Materials and methods. During the period 2000–2008 and in 2013–2015 48 patients with non-epithelial malignant tumors of the maxilla and the paranasal sinuses were treated. Patients depending on the method of treatment at the first stage were divided into 4 groups: 1) long intra-arterial chemotherapy with local UHF-hyperthermia and radiation therapy (10 patients); 2) long intra-arterial chemotherapy and radiation therapy (14 patients); 3) systemic chemotherapy and radiation therapy (12 patients); 4) radiation therapy with a subsequent operation (12 patients). After 3–4 weeks after completion of neoadjuvant treatment, the patients underwent surgery.
Results. A comparative study of the expression of the therapeutic pathomorphism in groups, it was found that the III–IV degree pathomorphosis in group 1 were detected in 4 (57%) patients in 2nd group – 5 (50%) in 3^d group – 4 (36%) and the 4^nd group – 2 (20%) patients. Analyzing the data by group, it shows that most pathomorphosisism stage III–IV was found in 1^st group, then in the 2^nd group of patients.
Conclusion. In patients who received neoadjuvant chemotherapy, a regional intraarterial direct morphological effect (degree pathomorphosisism) of treatment was greater than in patients who received systemic chemotherapy.