Vol 20, No 3 (2015)

Articles

Primary refractory hodgkin lymphoma and autologous stem cell transplantation: results of the single-center prospective study

Petrova G.D., Melkova K.N., Chernyavskaya T.Z., Gorbunova N.V., Afanas'ev B.V., Demina E.A., Kostrykina V.N., Doronin V.A.

Abstract

Today the role of single or double Autologous Stem Cell Transplantation (ASCT) in patients (pts) with refractory Hodgkin Lymphoma (HL) is still unclear. Aim. To present the results of a single-center prospective trial which aim was to show the significance of single and double ASCT in patients with HL, who did not achieve complete response after first-line chemotherapy. Material and Methods. Between 2007 and 2014 62 patients were enrolled in the study. First ASCT was administered to 53 patients, 10 of those 53 patients received second ASCT. Results. 5-year overall survival (OS) and progression-free survival (PS) were 52 and 27% after single ASCT versus 38 and 30% after double ASCT respectively. According to our study extensive previous treatment (radiotherapy and chemotherapy) followed by ASCT had a negative prognostic impact on overall survival (OS) (p=0.03). Moreover, initial response to the first ASCT was found to be an independent prognostic factor of OS (p=0.004). According to our results, achievement ofpartial response or disease stabilization after the first ASCT was the main indication for double ASCT. In this case second ASCT is preferable to alternative treatment (p=0.004). Disease progression (PD) after the first ASCT seems to be a contraindication to the necessity of the second course of ASCT as low effectiveness and high level of toxicity do not improve treatment results in comparison to alternative treatment (p=0.6). Achievement of complete remission associated with disease free long-term survival and high quality of life. Achievement of complete remission was crucial at any treatment stage. Conclusion. ASCT is an effective treatment option for patients who never achieved CR. Second ASCT is a treatment of choice for patients with PR/SD after 1st ASCT. Nevertheless second ASCT does not improve outcome for patients with PD after 1st ASCT. Alternative variants of treatment are needed for this patient group.
Russian Journal of Oncology. 2015;20(3):4-11
pages 4-11 views

Treatment of fertile age patients with benign breast tumors

Karasjov V.Y., Dolgikh V.T., Leonov O.V.

Abstract

The article presents the results of the treatment of 85 fertile age women with breast fibroadenomas. They were operated either by partial mastectomy or by vacuum aspiration removal of fibroadenomas with En-Cor apparatus. The study evaluated therapeutic effect on the hormonal background of the women with breast fibroadenomas achieved by monophase microdose complex oral contraceptives (ethinyl estradiol at the dose of 20 pg) or by vacuum aspiration. The use of En-Cor apparatus was effective not only in total fibroadenoma removal, but also in excellent cosmetic results, reduction of the operation time, decrease of the in-hospital period, minimizing both early and long-term postoperative complications including the risk of recurrence.
Russian Journal of Oncology. 2015;20(3):12-16
pages 12-16 views

Ex vivo comparative study of probe-based confocal laser endomicroscopy and light microscopy in diagnostics of lung cancer

Danilevskaya O.V., Sorokina A.V., Averyanov A.V., Zabozlaev F.G., Urazovsky N.Y., Sazonov D.V., Sotnikova A.G.

Abstract

This study is an ex-vivo comparison of images obtained by probe-based confocal endomicroscopy (pCLE) examination of lung cancer samples and light microscopy specimens prepared from the same samples. This first ex-vivo study revealed endomicroscopic characteristics of different types of lung carcinoma.
Russian Journal of Oncology. 2015;20(3):16-23
pages 16-23 views

The role of ultrasonic diagnostics of liver metastates in designing surgical treatment strategy

Danzanova T.Y., Sinyukova G.T., Gudilina E.A., Sholohov V.N., Lepedatu P.I., Kostyakova L.A., Allahverdieva G.F., Berdnikov S.N.

Abstract

Aim. Determining the role of ultrasound examination in the diagnostics of liver metastases at the preoperative stage. Methods. 518 patients with secondary tumors in the liver underwent ultrasonic study (US). The results were compared with the data of other methods, biopsy, surgical palpation and histopathalogical study of the resected samples. Results. US strategy of metastasis diagnostics evaluates the number, size, and localization of lesions; the data remain valid for about a month. These data are used in surgery planning considering individual course of diseases and chemotherapy results. US metastasis diagnostics sensitivity, specificity and accuracy were 95.2%, 26.8%, 89.8%, respectively. We developed a methodology for accurate determination of lesion sites in the liver. The study showed that chemotherapy could worsen US results. The authors give practical recommendations for optimization ofpreoperative diagnostics. Conclusion. Ultrasound diagnostics demonstrated high effectiveness in determination of number, size, and precise localization of metastatic liver lesions that allows recommending this method for wide use in surgery planning.
Russian Journal of Oncology. 2015;20(3):23-27
pages 23-27 views

Expression and prognostic significance of bcl-2 apoptosis inhibitor in renal cell carcinoma

Cherdantseva T.M., Bobrov I.P., Lazarev A.F., Klimachev V.V., Avdalyan A.M.

Abstract

This articlepresents the study of prognostic significance of bcl-2 apoptosis inhibitor expression in renal cell carcinoma. Operation samples of 59 patients with renal cell carcinoma were studied. Average age of patients was 56,6 ± 1,3 years. 31 (52,5 %) were men , 28 (47,5 %)-women . Correlations were found between bcl-2, clinical cancer stage (r = 0,31; р = 0,02), size of tumor node (r = 0,29; р = 0,02), regional and distant metastasis ( r = 0,35; р = 0,005) and histologic tumor type (r = 0,41; р = 0,002). No correlation was found with patients ’ sex (r = 0,16; р = 0,22), age (r = 0,17; р = 0,22) and tumor grade by Furman (r = 0,19; р = 0,15). Absence of bcl- 2 expression in tumor cells can be considered as a marker of possible metastases. The results showed correlation between the marker expression and overallsurvival was. Low level of bcl-2 oncoprotein expression in tumor cells is apoorprognostic factor of fatient’s survival.
Russian Journal of Oncology. 2015;20(3):27-31
pages 27-31 views

The role of target therapy for mixed phenotype acute leukemia

Antipova A.S., Baranova O.Y., Frenkel M.A., Tupitsyn N.N.

Abstract

Aim was to study clinical and laboratory test results, cytogenetic and molecular characteristics and prognosis of mixed phenotype acute leukemia (MPAL) as well as the role of tyrosine-kinase inhibitors (TKIs) in treatment of Ph-positive MPAL (Ph+ MPAL). Material and methods. The rare MPAL diagnosis was determined in 5 (2.4%) out of 208 patients examined in N.N. Blokhin Russian Cancer Research Center (NNBRCRC) between 2000 and 2014. On the whole, the study group included 13 patients, 5 - from NNBRCRC and 8 - treated in four other hematological hospitals of Moscow. The diagnosis was established according to WHO classification, 2008. Results. High percentage of the complete remission (83.3%) and low early lethality (8.3%) was observed in the study group. However, the long-term therapy results were unsatisfactory. 3-year overall survival (OS) rate amounted 18.2% with the median of 14 months, and 3-year relapse free survival (RFS) was 12.8%, with the median of 16 months. Imatinib based treatment in combination with acute lymphoblastic leukemia (ALL) polychemotherapy of the patients with Ph+ MPAL associated with high immediate efficacy and better survival. Complete remission was achieved in all patients with Ph+ MPAL. 3-year OS of Ph+MPAL patients was 61% (median 36 months); RFS was low. Conclusion. Primary acute leukemia diagnostics should be complex and necessarily include immune phenotype evaluation, cytogenetic and molecular biological tests. 1-st or 2-ndgeneration TKIs should be included in Ph+MPAL treatment. TKIs may be more effectively combined with lower intensive ALL therapy regimens. The problem of Ph-negative MPAL patients ’ treatment remains unresolved. Further studies of cytogenetic and molecular biological profile of this acute leukemia type are necessary to develop optimal therapy regimens.
Russian Journal of Oncology. 2015;20(3):32-38
pages 32-38 views

Working scheme of errors in diagnostics of respiratory diseases

Lukyanenko N.Y., Shoykhet Y.N., Lazarev A.F., Lubennikov V.A.

Abstract

The design of working scheme of errors in diagnostics of respiratory system diseases that lead to delayed establishment of the thoracic diagnosis (later than 14 days after the first visit to the doctor) involved the following: incorrect interpretation of clinical data (23.1% to 48.9%), poor performance status ofpatients, which prevented examination (2.0% to 6.4%), method limitation (2.0% to 13.9%), incorrect interpretation of X-ray diagnostics data (45.9% to 62.8%), inadequate physician’s qualification (16.4% to 43.2%), violation of standard examination (91.0% to 100.0%), low quality of X-ray images (15.7% to 34.8%), inadequate examination method (38.6% to 53.8%), difficult case (4.4% to 20.5%).
Russian Journal of Oncology. 2015;20(3):39-42
pages 39-42 views

Preclinical results of gemcitabinebased regimens for preoperative chemotherapy of spontaneous feline breast cancer

Treshalina E.M., Yakunina M.N., Antar M.O., Borisova J.A., Smirnova G.B., Raichlin N.T.

Abstract

Comparative preclinical study of chemotherapy regimen doxorubicin (DOX) + gemcitabine (GEM) for preoperative chemotherapy of spontaneous feline breast cancer and standard monochemotherapy with DOX alone was performed on transplantable murine mammary adenocarcinoma Ca55 in BDF1 hybrid mice model. The total GEM doses of 100 and 200 mg/kg for the triple course in combination with the single injection of 7.5 mg/kg of DOX were chosen to treat the established Ca755 tumor of 595.5 mm 3 average volume (preoperative treatment modeling). The combined chemotherapy showed an advantage of DOX + GEM regimen with GEM course dose of 200 mg/kg (70, 70 and 60 mg/kg, accordingly) as compared to other groups in terms of Tumor Growth Inhibition (TGI max=100% versus 96%; number of complete remissions (CR) 30% versus 0%, and enhanced Life Expectancy (LE) 163% versus 84-85%). The most effective regimen demonstrated dose-dependent therapeutic pathomorphism of grade II-III with 1.5-fold decrease of cell polymorphism and increase of cell differentiation. At the same time, the number of cells in mitosis decreased in 3-4 times and the number of apoptotic cells increased in 5-10 times. The results suggest that DOX + GEM combination with the unchanged components doses ratio has good potential for preoperative chemotherapy of locally advanced feline breast cancer and may be recommended for clinical study of this disease.
Russian Journal of Oncology. 2015;20(3):43-48
pages 43-48 views

Level of certain serum hormones in experimental liver metastasis

Frantsiyants E.M., Kaplieva I.V., Trepitaki L.K., Cheryarina N.D.

Abstract

Studying tumor and metastasis biology is an important challenge of both biology and medicine, since only an experiment may reveal fine mechanisms of pathogenesis. We analyzed the dynamics of serum hormones in a model of rat liver metastates designed by our group, which excluded toxic carcinogen effects, sharp surgical influence and narcosis. The results showed that liver metastases were associated with the following: 1) hyperthyroidism developing at early stages of metastatic process was replaced by latent hypothyroidism after 5 weeks of the carcinogenesis as a result of autoimmune thyroiditis; 2) the increase of progesterone, LG and prolactin levels after 5 weeks of tumor metastasis in liver after the 2 weeks ’ initial decrease; 3) sexual hormones metabolism activation: after a week - increase offree testosterone level, after 2 weeks -rise of estrone and total testosterone and the decrease of estrogen levels after 5 weeks of carcinogenesis; 4) adrenal gland activation leading to the enhancement of serum stress hormone corticosterone and its antagonist DHEA.
Russian Journal of Oncology. 2015;20(3):49-52
pages 49-52 views

Target medical screening as the basis for regional cancer care development

Cerenkov V.G., Petrov A.B., Tveresovskiy S.A., Strogenkov M.M., Ivanchenko O.G.

Abstract

The problem of visually localized tumors, in particularly breast cancer (BC), may be resolved by an integrated approach combining mammographic screening and minimally invasive resection of the detected tumors, which is performed both for diagnostics and prophylactics (removal of potentially dangerous lesions). 25.5% of the patients with surgical intervention had organ preserving or reconstructive surgery, which improves patients ’ quality of life and gains women’s motivation for mammographic screening in the region. Such examples are the most convincing. The integrated approach to solve BC problem resulted in decreasing lethality by 28.8±2.1%.
Russian Journal of Oncology. 2015;20(3):53-56
pages 53-56 views

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