Vol 19, No 5 (2014)


Clinical application of proton beam radiation therapy in the tumor's treatment

Kubes J.


Despite the rapid technological development, standard photon radiotherapy still brings a number of issues. Main problems are: 1. lack of effectiveness for a number of indications; partly due to the inability to safely deliver the effective dose to the tumors; 2. late and very late side effects of treatment caused by the unwanted dose delivered to the surrounding healthy tissue. The aim of the new methods in radiotherapy is to maximally reduce the dose to healthy tissue and to deliver the dose to the tumors as accurately as possible. Proton therapy comes closest to this goal from the all available methods. The principle ofproton radiotherapy is use of accelerated hydrogen particles - protons, which are directed to the tumors. Due to the interaction of protons with the tissue, majority of the energy is deposed at a certain depth in tissue, in the so-called Bragg peak of absorption. The dose of radiation is very precisely delineated and there is no extra dose behind the tumors it. High-precise proton therapy requires a high-end technology within the whole radiotherapy chain. Tumor has to be examined and defined using combination of CT, MRI and PET. Reproducibility of the patient position requires special fixation devices. Each individual fraction of radiation must be done with image - guidance (IGRT) technology. The benefit of protons is minimizing the dose delivery to the healthy tissue. This applies for organs near the tumors and also for integral dose of organism. Therefore; proton therapy is most appropriate in situations where we expect a significant chance of curability in patient with expected long-term survival and high risk of side effects. Typical cases for proton radiotherapy are children with a malignant disease or brain tumors (meningioma, low-grade glioma) in young cancer patients. The second group of indications is cancers that are not curable with photon radiotherapy due to their location or low sensitivity to radiation. This group includes for example cancer of the pancreas or retroperitoneal sarcoma. Treatment results for various diagnoses will be presented. Proton radiotherapy is a new option in treatment of malignant tumors that pushes the limits of radiation oncology forward, onto a higher level.
Russian Journal of Oncology. 2014;19(5):4-10
pages 4-10 views

Some features of maintaining patients with malignant lungs tumors complicated by pulmonary bleeding

Shoykhet Y.N., Fokeev S.D., Maksimenko A.A., Korkin M.I., Kazantseva E.S., Sedov V.K., Kurtukov V.A., Ageev A.G., Lazarev A.F.


The first symptom of a lung cancer is pulmonary bleeding. This symptom indicates prevalence of primary process in majority of patients, and treatment consists of a palliative conservative stopping pulmonary bleeding therapy. Tube blockade by the endobronchial back pressure valve «Madlung» was carried out in 13 patients of the main group in relation to the group of comparison which reduced a lethality from bleeding. Besides in 4 patients with an inoperable lung cancer complicated by pulmonary bleeding due to a bronchoblokator «Madlung», the complex treatment including - endoscope bronchial occlusion with the subsequent chemotherapy therapy was carried out. This treatment increased patients ’ survival in comparison with the main group and comparison group.
Russian Journal of Oncology. 2014;19(5):11-14
pages 11-14 views

Features of selective densitometry of spherical formations in lungs by the multispiral computed tomography

Konovalov V.K., Kolmogorov V.G., Lobanov M.N., Leonov S.L., Shayduk A.M., Fedorov V.V., Shoykhet Y.N.


Detection calcificats in the spherical formations of lungs (SFL) by means of a multispiral computed tomography only confirms high sensitivity of this method to gradation of tissue density, but doesn’t increase differential opportunities. Their wrong interpretation as benign can entail inopportuneness of recognition and treatment. The radiological differential diagnostics of SFL based on the topological analysis of destruction cavities containing in them, allowing to specify a phase ofpathological process development, has a set of exceptions, signs aren’t constant and specific and therefore has no great diagnostic value. For the purpose of a comparative assessment of newly developed method of selective densitometry diagnostic opportunities at primary cancer, pneumonia and the infiltrative tuberculosis containing calcificats and/or cavities, 328 patients with SFL aged from 2 till 87 years are surveyed. In 131(39,9%) patients calcificats were visualized in SFL. In 77(23,7%) patients destruction cavities were visualized in SFL. Selective densitometry of SFL not containing and containing calcificats is carried out. Calcificats, containing in SFL, occur more often in infiltrative tuberculosis, than at primary cancer and pneumonia (p < 0,001) authentically more often. Again developed way of selective densitometry allows to carry out differential diagnostics of SFL, which aren t containing inclusions in a look calcificats (p < 0,001). Calcificats, containing in SFL, have specific (from densitometry positions) no criteria and their assessment doesn’t allow to carry out differential (p > 0,5). Inclusion containing in SFL calcificats and pathological process doesn’t allow to carry out differential diagnostics ofprimary cancer, pneumonia and infiltrative tuberculosis to the analysis (p > 0,5). The exception of the densitometrical analysis containing in SFL calcificats allows to carry out differential diagnostics of primary cancer, pneumonia and infiltrative tuberculosis (p < 0,001). At primary cancer of a lung statistically significant prevalence of cavities of destruction in comparison with pneumonia and infiltrative tuberculosis (p < 0,05) is defined. Destruction cavities, as a rule, settle down excentricly and have the wrong roundish form. Inclusion doesn’t allow to carry out differential diagnostics of primary cancer, pneumonia and infiltrative tuberculosis to the densitometrical analysis of sites of destruction containing in SFL (p > 0,5). The exception of the densitometrical analysis of sites of destruction containing in SFL allows to carry out differential diagnostics of primary cancer, pneumonia and infiltrative tuberculosis (p < 0,002; p < 0,001). Sensitivity at division of primary cancer - infiltrative tuberculosis made 91,1%, specificity - 88,6%, accuracy - 90,2%. Sensitivity at division of primary cancer - pneumonia made 90,4%, specificity - 74,5%, accuracy - 84,2%. Sensitivity at division of infiltrative tuberculosis - pneumonia made 79,5%, specificity - 80,8%, accuracy - 80,2%
Russian Journal of Oncology. 2014;19(5):14-23
pages 14-23 views

The correlation between different biomolecular breast cancer subtypes frequency and the menstrual state

Kit O.I., Shatova Y.S., Todorov S.S., Gudtskova T.N.


The dependence of the biomolecular subtype’s frequency from the reproductive state among the 850patients treated in the FSBD «RNIOI» Ministry of Health of RF in the period of2010-2013 was analyzed. By the St. Gallen’s recommendations they were divided into 4 groups by biological subtypes, and then, into 3 subgroups by the reproductive state. According to our results the biomolecular subtype development directly depends from women menstrual state. Totally the luminal B subtype was the most frequent (59,9%) and the Her2neu + subtype on the contrary (7,4%) (p < 0,05), and the majority of the patients were postmenopausal (52,4%) (p < 0,05). The part of the hormone-positive cancer (76,4%) prevails under the hormone-negative (23,6%) in all groups (p < 0,05), but in the reproductive group more than in others (79,8% against 20,2%). Consequently the Her2neu + and TNC frequency in these groups were the less (p < 0,05). In the postmenopausal group Her2neu + subtype was less common (7% against 9% in premenopausal group) (p < 0,05), but TNC on the contrary (18% against 12,8% in reproductive group) (p < 0,05). The luminal B subtype in premenopausal group was less common than in others (55,9% against 67,5% in reproductive group) (p < 0,05). Whereas the luminal A and Her2 + more frequent (19,3% against 12,3% in reproductive group and9% against 7% and 7,4% correspondingly) (p < 0,05). Thus, only TNC keep steadily growing by changing from reproductive state to postmenopausal. However, the tendency lines of other biomolecular subtypes frequency differ crucially. They have peaks in the premenopausal period and differently directed tendencies to the baseline after it. In order to this we estimate the premenopausal period as a special for the luminal and HER2neu + breast cancer subtypes development risk.
Russian Journal of Oncology. 2014;19(5):24-27
pages 24-27 views

Prostate cancer metastasis in young and middle-aged men

Ganov D.I., Varlamov S.A., Lazarev A.F.


For the first time detected prostate cancer in men up to the age of 60 years was identified in 638 patients, accounting for 9.4 percent of all patients with newly diagnosed metastatic prostate cancer before the age of 60 years. prostate cancer first identified before the age of 60 years, 20% of males has a metastatic nature. more than 73% of the patients are aged 54-59 years The localization of metastasis in men with newly diagnosed metastatic prostate cancer before the age of 60 years are the bones of the skeleton, more than 80% lesion is localized in the bones of the pelvis and lumbar spine.
Russian Journal of Oncology. 2014;19(5):28-30
pages 28-30 views

Relationship between clinical and morphological parameters and survival in non-small cell lung cancer with protein expression and gene HER2-neu amplification

Kobyakov D.S., Avdalyan A.M., Lazarev A.F., Lushnikova E.L., Nepomnyaschikh L.M.


Purpose. Study of the content ofprotein HER2 and gene HER2 , CEP17 in conjunction with clinical and morphological parameters and survival in non-small cell lung cancer. Material and methods. Investigated 218 surgery samples of non-small cell lung cancer. HER2 protein was determined by immunohistochemistry (clone 4B5, «Ventana») andgene HER2, CEP17 by hybridization in situ (SISH, «Ventana»). Results. Found relationship between the clinical and morphological parameters on the TNM system with protein HER2 status and CEP17 (for value N), protein HER2 status and gene HER2 amplification (for tumor histogenesis). Survival ofpatients with protein HER2 negative status better than positive status. Found better survival in the absence of gene HER2 amplification and increase CEP17 or gene HER2 amplification in conjunction with increase CEP17, the worse survival - gene HER2 amplification or increase CEP17. In univariate regression analysis protein HER2 status had an impact on survival. Multivariate regression analysis showed no relationship protein HER2 status and gene HER2, CEP17 with patient survival. Conclusion. The content ofprotein HER2 and gene HER2, CEP17 correlated with clinical and morphological parameters and survival of non-small cell lung cancer patients.
Russian Journal of Oncology. 2014;19(5):31-36
pages 31-36 views

Clinical value of KI-67 index in tumor tissue in patients with stage I and II ovarian cancer

Nikogosyan S.O., Baryshnikov A.Y., Stepanova E.V., Kuznetsov V.V., Karapetyan V.L.


Prediction of ovarian cancer (EOC) is dependent on a number of clinical, morphological, immunological and molecular biological factors. Thanks to the research findings indicate that Ki-67 is characterized by the most aggressive forms of ovarian cancer - ovarian serous cystadenocarcinoma, and that with a high index of Ki-67 in tumor tissue paired unfavorable prognosis even stage I and II disease, Ki-67 protein can be considered as an adverse molecular prognostic factors of ovarian cancer early stages.
Russian Journal of Oncology. 2014;19(5):36-41
pages 36-41 views

The indicators of the tumour proliferative activity and therapeutic responsiveness in adenocarcinoma in anal canal after complex treatment

Zenukova T.V., Perevoschikov A.G., Kuzmichev D.V., Barsukov Y.A.


Carcinoma of the anal canal is infrequent pathology. The morbidity registers in 5,2% among men and 4,8% among women. The purpose of this study was investigated the correlation among morphological characteristics of the tumors. Tumor regression grade and index Ki 67 are morphological indicators of the effectiveness of the complex treatment. In the 47,5% (n = 19) of both groups was exposed I-II tumour regression grade, IV tumour regression in grade 3,3 % (n = 2). Tumor regression grade positively correlated with the degree of the tumor invasion (coeff.corr. = +0,47) (p > 0.05).
Russian Journal of Oncology. 2014;19(5):42-46
pages 42-46 views

From pathogenesis of breast cancer and gynecological illness to a practical solution

Cherenkov V.G., Petrov A.B., Tverezovskiy S.A., Strozhenkov M.M.


The results of mammographic screening in 30 240 women over 40 years were studied. Detectability of early (palpable) cancers was 0.24% (excluding carcinoma in situ), treatment of whom allowed to reduce mortality after 5-7 years from the start of screening from breast cancer to 11.6per 100 000female population. However, the MS detects a wide range of node and diffuse dishormonal breast disease (60.1% of surveyed), most of which indicate premorbid-morbid diseases of the uterus and appendages (from 79.7% to 97.6%) . We show that this category of women, as well as patients with diabetes who are on the books at the endocrinologist, need examination and treatment by a gynecologist and purposeful (opportunistic) mammography screening.
Russian Journal of Oncology. 2014;19(5):47-51
pages 47-51 views

Molecular genetic features of peritoneal mesothelioma

Abdullaev A.G., Shakhpazyan N.K., Polockiy B.E., Mekheda L.V., Davydov M.I.


The article analyzes the molecular genetic features ofperitoneal mesothelioma in order to identify differential diagnostic signs of the disease, to identify the factors of tumor growth, as well as identifying ways to improve current treatments.
Russian Journal of Oncology. 2014;19(5):52-56
pages 52-56 views

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