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Vol 26, No 4 (2021)

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Clinical investigations

Effects of modern antitumor drug therapy possibilities to skin melanoma on oncological and epidemiological indicators in the Krasnoyarsk region

Zukov R.A., Safontsef I.P., Klimenok M.P., Eremina E.N.

Abstract

BACKGROUND: Deevelopment of new diagnostics and treatment of malignant neoplasms methods increase their efficiency, and safety is one of the most urgent tasks of modern oncology. Currently, targeted and immunotherapy contributes to the treatment of malignant neoplasms. One of the examples is the treatment of skin melanoma.

AIMS: This study aimed to investigate the influence of therapeutic tactics on epidemiological indicators in the morbidity of the skin melanoma.

MATERIALS AND METHODS: The study used data of the Krasnoyarsk territory cancer-register.

RESULTS: In the Krasnoyarsk territory from 2016 to 2020 registered 65,042 cases of malignant neoplasms, of which 30,532 cases (46.9%) reported among men and 34,510 cases (53.1%) among women. In the same period, registered 899 cases of skin melanoma, 343 cases among men (38.2%) and 556 cases among women (61.8%). The most important stage in the treatment of skin melanoma is the disease stage, because only favorable prognosis characteristic for early stages of the disease.

CONCLUSIONS: Routine using modern antitumor drug therapy in everyday clinical practice has significantly changed the results of skin melanoma treatment.

Russian Journal of Oncology. 2021;26(4):111-120
pages 111-120 views

Improving the quality of diagnosis and verification of peripheral lung neoplasms by using a modified biopsy technique for ultrasonic bronchoscopy (EBUS)

Pushkarev E.A., Vazhenin A.V., Kulaev K.I., Yusupov I.M., Zuykov K.S., Popova I.A.

Abstract

BACKGROUND: The problem of diagnosis and treatment of malignant neoplasms of the lungs is extremely relevant. Verification of the malignant process in the case of peripheral localization of the neoplasm in the lung when using ultrasound bronchoscopy does not exceed 70.6%.

AIMS: This study aimed to improve the effectiveness of ultrasound bronchoscopy in the State Medical Institution Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine by introducing into clinical practice a modified biopsy technique for ultrasound bronchoscopy. The technique is patented, patent for invention no. RU2719666 C1.

MATERIALS AND METHODS: From 2019 to 2021, a study was conducted based on the endoscopic department of the State Medical Institution Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine, which included 137 patients. The patients were divided into two groups: the main group included 66 patients in whose examination FBS with endoussis with biopsy by a modified technique was used; the comparison group included 71 patients who underwent ultrasound bronchoscopy with biopsy by a standard technique. The time of biopsy manipulation according to the standard procedure ranged from 14 to 41 min, averaging 30±5 min. Ultrasound bronchoscopy with biopsy by a modified technique lasted from 16 to 45 minutes, on average 31±5 min.

RESULTS: In the main group, where FBS with ENDOUSSI with biopsy was used in the diagnosis of patients using a modified technique with endosonographic control of the position of the endoscopic instrument in the pathological focus, the diagnosis of malignant neoplasm was verified in 52 patients (in 78.8% of cases). In the comparison group, where the standard biopsy technique was used in patients with ultrasound bronchoscopy, the diagnosis of malignant neoplasm was verified in 41 patients (in 57.7% of cases). Thus, the verification of peripheral lung malignancies when using a modified biopsy technique increases by 21.1% (p <0.05). FBS with endoussis with biopsy using a modified technique is satisfactorily tolerated by patients and is a relatively safe manipulation.

CONCLUSION: modified biopsy technique developed by us with endosonographic control of the position of the endoscopic instrument in the pathological focus during ultrasound bronchoscopy makes it possible to increase the percentage of verification of peripheral lung malignancies by 21.1% (p <0.05). The introduction and widespread use of the modified biopsy technique for ultrasound bronchoscopy in the diagnosis of peripheral lung malignancies will reduce the time of examination of patients and prescribe antitumor treatment earlier.

Russian Journal of Oncology. 2021;26(4):121-128
pages 121-128 views

Reviews

Risk factors for thyroid cancer

Lazarev A.F., Zayarova I.M., Petrova V.D.

Abstract

Thyroid cancer (TC) is the most common tumor among endocrine malignant neoplasms all over the world. Over the past 20 years, there has been not only an increase in the indicators of true morbidity (not associated with active detection) of TC, but also the absence of a decrease in mortality and disability in this pathology. The identification of causal factors is important for clinical and scientific purposes, as it is the main requirement for the development of preventive measures and early diagnosis, forecasting the dynamics of the incidence of TC. The article provides an overview of known risk factors for the development of TC using sources of foreign and domestic literature, where preference is given to the results of large-scale scientific research. The article presents a wide range of causes of the development of TC: ionizing radiation, genetic factors, dietary characteristics, background diseases, and others.

Russian Journal of Oncology. 2021;26(4):129-144
pages 129-144 views

Case Reports

The effect of the surgical treatment in the complex management on life expectancy of thymic Hodgkin's lymphoma

Fokeev S.D., Lazarev A.F., Kapitulin S.Y., Kazantseva E.S., Kapitulina E.K.

Abstract

The result of treatment of primary Hodgkin's lymphoma lesion of the thymus gland of a 26-year-old patient is presented. At the preoperative stage of examination, “tumor maligna” cells were obtained during puncture of mediastinal formation. The diagnosis is malignant tumor of the mediastinum. Considering this, a surgical treatment was performed-radical removal of the mediastinal tumor. After the study of the postoperative drug, a clinical diagnosis was made: lymphogranulomatosis, a massive (bulky) tumor lesion of the mediastinum, stage IIХ, after surgical treatment. First course of ABVD chemotherapy was performed 28 days after the operation. When performing the second course of chemotherapy according to the same scheme, the patient developed complications in the form of moderate leukocytopenia (leukocytes, 0.9×109/l) and stomatitis. Special treatment was discontinued, and the patient was observed by an oncologist in the polyclinic of an oncological dispensary.

At the next examination, which was performed 11 months later, a relapse of the disease was identified. Considering the preservation of persistent leukopenia (leukocytes, 3.0×109/l), it was decided to conduct six courses of ABVD polychemotherapy with prednisone, against the background of G-CSF. At this stage of oncology, the main method of treating Hodgkin's lymphoma is chemo-hormone therapy in combination with radiation therapy. The performed non-standard complex treatment is radical surgical removal of a mediastinal tumor followed by polychemotherapy. It allowed 4 years after the completion of treatment to know motherhood, which did not affect the patient's health. As indicated by the long relapse, free period of the disease is 16 years, and life expectancy is 18 years.

Russian Journal of Oncology. 2021;26(4):145-150
pages 145-150 views


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