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Vol 25, No 3 (2020)

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Original articles

Cytological method of diagnostics of pleural effusion using immunocytochemical and molecular genetic techniques

Grigoruk O.G., Pupkova Е.Е., Bazulina L.M.


The aim of the study is to estimate the potentiality of using immunocytochemical and molecular genetic techniques in diagnosis of patients with pleural effusion. Materials and methods. The results of a cytological study of 580 patients with pleural effusion examined in the Altai Regional Oncological Dispensary in 2019 were evaluated. Immunocytochemical and molecular genetic techniques were applied using cytological specimens prepared from pleural fluid. Epidermal growth factor receptor (EGFR) gene status was determined. Results. Non-tumor pleural effusion was diagnosed in 378 cases (65%). Tumorous cells of 181 (31%) patients were found in pleural effusion. It was very difficult to diagnose a pathological process by cell composition in 21 (4%) cases because of the inability to distinguish histiocytes and mesothelial cells from tumor cells using light microscopy. Immunocytochemical researches of 105 patients with pleural effusion were used for specification of metastases and in uncertain diagnostic cases. EGFR gene mutation for the diagnosed pulmonary adenocarcinoma had been determined in 31 cases for proper assignment of the target medicines. Dotty L858R mutation and deletions 19 exon were detected. Conclusions: Light microscopy allowed us to differentiate tumor and non-tumor plural effusion in 96% of cases. Immunocytochemical technique revealed the primary tumor site in 95% of cases of pleural effusions. Cytological specimens are full-advantaged material for molecular genetic technique. Mutations were found in 19% of cases.

Russian Journal of Oncology. 2020;25(3):82-91
pages 82-91 views

Clinical investigations

Clinical results of radiation and chemoradiation therapy of locally advanced cervix cancer

Kravets O.A., Romanova E.A., Gorbunova V.A.


Aim. This study reported clinical results of patients with locally advanced cervical cancer who were treated with conformal radiotherapy and three-dimensional (3D) image-guided adapted brachytherapy and combinations of cytotoxic drugs.

Material and methods. This study included 190 patients with cervical cancer stages IIb, IIIb, and IVb (metastases in para-aortic lymph nodes) during 2011–2015 treated with definitive conformal radiation or chemoradiotherapy, with total dose for D95 50 Gy for 25 fractions. 3D brachytherapy high dose rate planning and dose reporting followed the GEC-ESTRO recommendations. Prescribing dose per fraction for HR-CTV D90 was 7.5 Gy weekly 4 fractions. Total dose HR-CTV D90 40 Gy (EQD2). Average total dose for HR-CTV D90 from the course of radiation therapy was 95.0 ± 0.67 Gy (EQD2).

Following four groups of patient were evaluated: group 1 – radiation therapy (n = 72), group 2 – chemoradiation therapy with cisplatin (n = 40), group 3 – chemoradiation therapy with a combination of irinotecan + cisplatin, two courses of adjuvant chemotherapy (n = 39), group 4 – chemoradiation therapy with a combination of paclitaxel + cisplatin, two courses of adjuvant chemotherapy (n = 39). Clinical outcomes including local control (LC), cancer-specific survival (CSS), overall survival (OS), and toxicity were analyzed.

Results. Three-year OS and CSS in all these groups were as follows: group 1 – 88.4% ± 4.5% and 64.4% ± 7.3%, respectively; group 2 – 77.7% ± 7.6% and 77.5% ± 7.1%, respectively; group 3 – 69.8% ± 9.6% and 66.3% ± 8.9%, respectively; group 4 – 81.3% ± 6.4% and 62.1% ± 8.0%, respectively (p > 0.05). The use of chemoradiotherapy in the groups did not increase the 3-year OS in cervical cancer stage IIIb: in group 1 – 84.0% ± 7.5%, group 2 – 76.2% ± 9.4%; group 3 – 77.2% ± 9.1%, and group 4 – 84.9% ± 7.0% (p > 0.05). However, CSS was higher on the first year of observation in group 3 – 96.3% ± 3.6% compared with group 1 – 74.2% ± 7.5% (p = 0.049), with a 3-year observation – 75.7% ± 9.6% and 59.0% ± 11.4%, respectively (p = 0.31). Combined chemoradiation therapy in patients with cervical cancer increases the time of progression from 9.5 months (in groups 1 and 2) up to 19.4 months and 16.4 months (in groups 3 and 4), respectively (p = 0.05). A decrease in the number of local relapses during 3 years was obtained in groups 2 and 4 compared with group 1 (100% vs. 90.3%, p = 0.05). LC within 3 years among 190 patients was 94.7% ± 1.6%. Gastrointestinal early toxicity was noted higher in group 3 compared to groups 1, 2, and 4 (recites G2–3 – 25.7% vs. 5.6%, 5.0%, and 2.6%, respectively, p = 0.05). Late cystitis G2–3 is higher in groups 2, 3, 4 compared with group 1 (15.4% vs. 4.2%, p = 0.07).

Conclusion. The study showed high efficiency of treatment of patients with cervical cancer with the introduction in the clinic of modern technologies in radiation therapy with 3D visualization, as well as chemoradiotherapy programs with acceptable toxicity.

Russian Journal of Oncology. 2020;25(3):92-102
pages 92-102 views

The influence of tumor staging on life expectancy with the use of chemoradiotherapy in small cell lung cancer treatment

Fokeev S.D., Lazarev A.F., Kazantseva Е.А., Kapitulin S.U., Belokrylova Y.G.


Background. The treatment of small cell lung cancer is the subject of intensive research in the field of chemotherapy of malignant tumors. The use of radiation treatment and chemotherapy leads to 80–100% of the objective effect, and 50–70% of patients achieve complete remission, which is the main goal of combined therapy, although this treatment cannot help to prevent the growth of the tumor.

Aim. The aim of the study was to examine the relationship between the stage of primary tumor and the life expectancy of patients with small cell lung cancer on receiving complex chemoradiotherapy.

Methods. The study included 483 patients with small cell lung cancer who received chemoradiotherapy treatment between 1995 and 2015. Out of 483 patients, 439 (90.9%) were men and 44 (9.1%) were women. Total number of patients in the age group of 65–69 were 212 (43.8%). According to the tumor staging, they were distributed as follows: IA [T1N0M0] – 23 (4.1%) patients; IB [T2N0M0] – 86 (15.3%) patients; IIA [T1N1M0] – 33 (5.9%) patients; IIB [T2N1M– 88 (15.7%), T3N0M– 78 (14.0%)] – 166 (29.7%) patients; IIIA [T3N1M– 58 (10.4%), T1N2M– 37 (6.6%), T2N2M– 34 (6.1%), T3N2M– 46 (8.2%)] – 175 (31.3%) patients. The total of 31.3% of patients had stage IIIA. Metastases to regional lymph nodes N1 were detected in 155 (32.1%) patients, N2 in 101 (21%) patients, and N3 in 36 (7.5%) patients.

Results. The life expectancy of patients receiving complex conservative treatment primarily depends on the size of the primary tumor in the lung and secondarily on the presence of regional metastases. The average life expectancy for T1N0 is 30.2 months, which is 18 months more compared with T2N0 and 22.7 months more than T3N0, but these differences begin to decrease with the appearance of metastases in regional lymph nodes: T1N1 average life expectancy is 22.4 months, which is 14.9 months more than T2N1 and 20 months more than T3N1. The lowest average life expectancy is in patients with N2, so with T1 it was 11.4 months, which is 9 months more than with T2 and 9.8 months more than with T3; this means that the presence of mediastinal metastases in patients with T2 and T3 tumors have a negative predictive effect of the average life expectancy.

Conclusions. According to the results obtained, life expectancy in patients with T1–3N0–2M0 tumor staging receiving chemoradiotherapy depends primarily on the size of the primary lung tumor and secondarily on the regional lymph node metastases. Lung cancer treatment is much more effective when the disease is in its earlier stages, that is, T1N0–1.

Russian Journal of Oncology. 2020;25(3):103-107
pages 103-107 views

The epidemiology of prostate cancer in altai region

Ganov D.I., Ganova T.D., Fedoskina A.V., Malysheva M.V., Sheremetyeva I.I.


The article deals with the epidemiology of prostate cancer in the Altai region in the last 26 years. The incidence of prostate cancer in the Altai Krai from 1994 to 2019 had increased almost 4.7 times. More than 10.7% of men diagnosed with prostate cancer were of working age. Stable from year to year increases the 5-year survival of men after treatment of prostate cancer. Morphological verification, identifying at an early stage has increased significantly over the years.

Russian Journal of Oncology. 2020;25(3):108-112
pages 108-112 views

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