Cryosurgery and physical medicine n treatment of cancer

• Main Authors: М. О. Чиж, І. В. Бєлочкіна, Ф. В. Гладких
• Format: Article
• Language: English
• Published: National Academy of Medical Sciences of Ukraine. Grigoriev Institute for Medical Radiology and Oncology 2021-06-01
• Series: Український радіологічний та онкологічний журнал
• Subjects: cryosurgery; physical methods; destruction; oncology
• Online Access: https://ukroj.com/index.php/journal/article/view/93

Background. At the present stage of oncology development, cryosurgery is keeping up with other surgical options of treating malignant tumors. However, especially when using cryoapplication technique, radical low-temperature destruction of large tumors is challenged with uneven freezing of the tissue inside and on the periphery of the cryoablation zone resulting in insufficient complete destruction of all tumor cells. The long-term strategy of increasing the efficiency of cryogenic treatment, which will maximize the potential for exposure of biological tissues to low temperatures, is its combination with other physical methods. On the other hand, the preliminary cryotherapy of the tumor tissue can be used to increase the efficiency of antitumor therapy by other methods, in particular, physical ones. Purpose – to summarize and analyze the literature data on applying low temperatures in combination with other physical medicine techniques in order to assess the efficiency and the potential of those in uptodate oncology. Materials and Methods. The paper deals with analyzing the studies published within the period from 2000 to 2020 outlining the data on the impact of low temperatures on the biological tissues in combination with other physical medicine techniques. After keyword search against international and Ukrainian databases, the papers, focused on this subject area, were sorted out, analyzed and included in the references. Results. The review presents pros and cons of using cryosurgery in medical practice with due regard for pathogenetic mechanisms of low temperature impact on biological structures. Based on experimental and clinical studies data, a positive effect of cryosurgical approaches in combination with other physical medicine techniques when performing surgical interventions for ablation of malignant neoplasms has been shown. The paper included the contributions describing the findings on combining cryosurgery with: preliminary hemodilution; radiofrequency and microwave hyperthermic ablation; laser and photodynamic therapy;   electroporation. Additionally, a contemporary view of cryo-ultrasound therapy, cryonanoablation, cryo- radiation treatment and cryoelectrolysis was presented. Conclusions. Cryosurgery is an effective minimally invasive surgical method keeping up with other methods of treating malignant tumors, despite the fact that these days the research on optimizing the method of exposure of biological tissues to low temperatures is still ongoing. Cryosurgery in combination with other physical medicine techniques in case of tumor ablation can enhance the effectiveness of treating cancer patients.