Vol 17, No 2 (2012)

The purpose of the study was to evaluate the efficiency of traditional versus low-dose postmastectomy chest radiation according to local control criteria, overall and relapse-free survival rates, and the frequency of postradiation cardiac complications. The efficiency of treatment was compared in two groups of patients with Stages II-IIIB breast cancer: 1) 129 patients who received normal-dose (50 Gy in 25 fractions applied to the chest) radiotherapy (RT) and 2) 82 patients who had low-dose (40 Gy in 20 fractions applied to the chest) RT. The latter followed Madden mastectomy in all cases. In all the patients, regional areas were irradiated with standard doses of 46-50 Gy concurrently with chest radiation. The frequency and quality of neoadjuvant and adjuvant chemotherapy were similar in the groups. The median follow-up was 111 and 95 months in each group, respectively. In the normal- and low-dose RT groups, 5-year actuarial local-regional progression rates were 6.2±2.1 and 3.7±2.1%, respectively (p = 0.4). In Groups 1 and 2, late metastases were detected in 34.6±4.2 and 19.5±4.4%, respectively (p < 0.05). Five-year actuarial relapse-free survival was 71.5±6.4% in the low-dose RT group and 53.5±5.4% in the normal-dose RT one, respectively (p = 0.07). Five-year overall survival was 65.3±5.6 and 72.2±6.3%, respectively (p = 0.08). The patients with a left-sided tumor process were noted to have late ECG cardiac changes in 55±11.1% of cases in the low-dose RT group and in 75±9.7% in the normal-dose RT one (p > 0.05). The findings suggest that there are no statistically significant differences in the rates of local-regional progression, overall and relapse-free survival in the normal- and low-dose RT groups. The proposed procedure for reduced postmastectomy chest radiation in combination with current chemotherapy regimens can reduce the risk of cardiac toxicity, without decreasing the therapeutic effectiveness characteristic of the traditional procedure.

Herzen Moscow Oncology Research Institute, Ministry of Health and Social Development of the Russian Federation Serous exudates with epithelial antigen BER-EP4 were studied using immunoperoxidase, immunofluorescence, and immunocytochemical methods and by a laser flow cytoflurometric technique. Up-to-date high-technologies make it possible to detect few tumor complexes in the exudate at early metastatic stages, which are undetectable by the routine cytological assay and to decrease the rate of hyperdiagnosis of a tumor process. The high efficiency and rapidity of immunofluorescence study of exudates are shown to establish the extent of the tumor process during urgent intraoperative studies.

The paper describes a rare case of mature mediastinal teratoma complicated by perforation into the lung. It shows the feasibilities of chest ultrasound study in the preoperative diagnosis of this complication. Radical surgical intervention is the method of choice for treating this category of patients.

Herzen Moscow Oncology Research Institute, Ministry of Health and Social Development of Russia The role of radiotherapy in treating head and neck tumors is on the increase, which is associated with a tendency for organ-saving treatment and with a need for a combination and comprehensive approach in case of locally advanced cancer. At the same time, only group prediction is already insufficient in clinical practice to define adequate treatment for these patients; and an individual approach to defining indications for radiotherapy is increasingly greater importance. Despite the fact that the generally accepted clinical and morphological parameters are rather informative in choosing an adequate local and systemic treatment; however, they are insufficiently individual. There is a need for putting into practice the new predictors of the efficiency of radiotherapy, which make it possible to optimize treatment policy, thus improving its results.

Breast cancer is the most common malignant neoplasm in women. Radical mastectomy is an integral component of its treatment, but this increases survival rates and the number of disabled persons. Emphasis has been recently made on the improvement of quality of life in patients with breast cancer. Today breast reconstructive surgery is an important component in the general treatment regimen. Breast reconstruction ameliorates psychological trauma associated with mastectomy; the women lose a feeling of mutilation, depression, and apprehension of their femininity. A variety of modifications and options for reconstructive interventions creates the choice problem to be solved together with the patient.

It has been suggested that there is an exceptional (unique) mechanism for incorporation into the genome of a reserve somatic cell during repair of radiation-induced DNA damages and that the latter cannot be included during replication. There are various cellular reproductive potentials (CRP) in different body anatomic systems, which differ in high radiosensitivity and resistance to carcinogenesis. As CRP is depleted and reproductive renewal is impossible, the reparative mechanism is used, which causes an increase in carcinogenesis rates. Whether carcinogenic signs can be involved with their verified presence in the human body and whether the cell genome contains new carcinogenic signs, such fibrolysis and osteolysis, are considered.