Vol 15, No 6 (2010)

The development of metachronous tumors was analyzed in patients with cancer of the cervix uteri after concomitant radiation treatment. A total of 3812 patients were followed up, 5% of them were found to have the second tumor after 3-10 years. The paper gives data on the site and extent of the second tumor and the efficiency of its treatment.

The paper presents the results of an epidemiological study, which have determined the territorial features of the prevalence of oncogenic human papillomaviruses (HPV) responsible for the development of precancer and cancer of the cervix uteri in women living in the Republic of Belarus. The got basic knowledge about the molecular epidemiology of HPV infection will enable one to determine new landmarks for the treatment and follow-up of patients, by taking into account detected HPV genotypes and their carcinogenic potential, and to assess the expediency and potential outlook of immunization with first-generation vaccines at the population level.

The paper presents the results of a study dealing with the determination of the impact of the specific features of a tumor on the variants of breast cancer metastazing to the lung and two groups of patients with early and late breast metastases to the lung are identified.

The authors give their experience with intraoperative photodynamic therapy used in 79 patients with Stages IIB, IIIA, B, and C breast cancer. When its procedure was being developed, the tissue distribution of alasens-induced protoporphyrin IX (PPIX) and photosens was studied in the normal tissue and tumor of the breast. The study showed the specific features of PPIX accumulation in the tumor in relation to the performance of neoadjuvant chemotherapy. Analysis of 3-year treatment results revealed no disease progression in 17 (50%) patients; 5 (14.7%) patients were diagnosed as having a locoregional recurrence; distant metastases were detected in 12 (35.5%). Intraoperative photodynamic therapy has prospects for treating locally advanced breast cancer in order to enhance intraoperative ablastics, devitalization of cancer cells of the wound surface and to prevent a local recurrence.

The results of treatment were retrospectively analyzed in 225 elderly and senile breast cancer (BC) patients aged 60-80 years. Of them 122 patients received only medical treatment comprising chemo-, radio- and hormonal therapies and 133 had multimodality treatment involving surgery, chemo-, radio-, and hormonal therapies. Examinations demonstrated that 5-year survival was 87.7% in the BC patients who had received medical treatment and 96.2% in those who had undergone multimodality treatment including surgery. Medical treatment may be the method of choice in treating elderly and senile women with comorbidity and in those who refuse to be surgically treated.

The paper describes the Russian opioid analgesic prosidol: its benefits and adverse reactions, its place in therapy for cancer pain. The authors consider the therapeutic equivalence and clinical efficacy of the drug from the results of its clinical trials and their experience. A pharmacoeconomic analysis of prosidol versus the similarly effective agent promedol is given, which emphasizes the economic expediency of prosidol therapy,is given

The paper presents the current morphological classifications of endometrial hyperplastic processes and their clinical value in choosing a treatment policy for patients with this pathology.

Organ-saving treatment for invasive cervical cancer, by applying radical trachelectomy, is as effective as radical hysterectomy. Despite careful selection of patients, there are indications for adjuvant treatment in an average of 10% of cases. The conventional approach for this category of patients is to use radiation or chemoradiation, which leads to irreversible fertility loss. There have been some cases when chemotherapy was employed as an alternative adjuvant therapy after radical trachelectomy or the patients followed up were untreated; however, data on the efficiency of these approaches are yet inadequate. The problem whether adjuvant treatment is performed after radical trachelectomy remains debatable calls for further studies. Since December 2005, the P.A. Herzen Moscow Research Oncological Institute has been performing radical abdominal trachelectomy (RAT), developed an original procedure for saving the uterine vessels. Modified trachelectomy was carried out in 72 patients; in 9 (12.5%) of them, the surgical volume was extended to radical hysterectomy with ovarian transposition from the data of a prompt histological study. A scheduled histological study after RAT revealed metastases to the pelvic lymph nodes in 4 (6%) of 63 patients. Thus, radical organ-saving treatment could be performed in 59 (82%) of the 72 patients selected for trachelectomy according to the results of a preoperative examination.