Vol 22, No 6 (2017)

Major advances in the treatment of non-small-cell lung cancer (NSCLC) patients are associated with the targeted therapy. It is both highly effective in the presence of activating mutations in the tumor and generally well-tolerated. Serious adverse events are recorded much less than with chemotherapy. There are significant differences in the toxicity profile. Both early detection and proper and timely correction of complications of targeted therapies are necessary for the successful long-term treatment of metastatic NSCLC patients.

The problem of the quality of life of elderly gastric cancer patients after surgical treatment, is still insufficiently studied. Functional results of the management of 91 patients, underwent surgical treatment at the age of 75 years and older, are represented. 35 patients underwent gastrectomy, 56 patients - subtotal distal resection. The quality of life was assessed at the second year after surgery according to both the Performance Scales for the Karnofsky & ECOG Scores, as well as the modified form of EORTC QLQ-STO 22. Only 40% of patients were fully recovered after total gastrectomy and 57.1% of cases - after gastric resection. 28.6% and 35.7% of patients respectively were incapable for full activity and required support. Patients with severe disability and cases needed a significant care amounted to 28.6% and 2.8% in the group of patients after gastrectomy and only 3.6% in the group of cases after the gastric resection. Thus, in elderly patients with gastric cancer after surgical treatment, a significant deterioration of the quality of life is observed, and therefore the tactic of minimization of the radical surgical intervention in this age group is reasonable.

Introduction Planning the medical care management for cancer children is based, inter alia, on epidemiological data: morbidity and mortality rates in children with malignant neoplasms. Material and methods. The data of the public health care executive authorities of the constituent entities of the Russian Federation have been analyzed. These reports included data on morbidity, mortality, one-year mortality rates, and the period of the medical care delivery for children with oncological diseases in subjects. Results. Over past 6 years, the number of primary patients, identified annually (by 2011 - 3230, 2016 - 3875) increased by 20%; the number of patients under observation was increased by 34.8% (2011 - 17,958, 2016 - 24,207). The incidence increased by 9.8%: from 12.2 per 100,000 (0-17 years) in 2011 to 13.4 in 2016. The standardized mortality rate in 2011-2013 was 4 (per 100 thousand. 0-19 years), in 2014-2016 - 3.6 (per 100 thousand. 0-17 years). The one-year mortality rate decreased by 2%: from 10.8% in 2011 to 8.8% in 2016, the number of actively identified patients increased by 1.4% (in 2007 - 3.8%, in 2016 - 5.2%), the one-year mortality rate decreased by 5.9% (2007 - 14.7%, 2016 - 8.8%). Among causes of death the first place was occupied by leukemia, the second one - by tumors of the brain and spinal cord, the third - sarcomas of soft tissues. Conclusion. The noted dynamics demonstrates an increase in the detectability of oncological diseases in children, therefore, it indicates to the improvement of diagnostic methods. Taking into consideration the average world morbidity rate to account of 15 per 100 thousand children, it is possible to forecast a further increase in the incidence (detectability) of up to 4 500 primary patients by 2022. Thus, at present, an annual underreport is about 700(16%) patients. A low percentage of actively identified children shows the insufficient training of primary care physicians (district pediatricians) in pediatric oncology.

In article the comparative characteristic of a morbidity rate of the breast cancer (BC) of urban and rural female population of the Republic of Khakassia in 1999-2013 is given. The main tendencies of the dynamics of a BC prevalence rate are revealed: the more pronounced gain in the morbidity rate of the urban population (Abakan), the significant growth in the prevalence rate in the female population of districts of the Republic; the increase of the number of cases in working-age women

The given review is devoted to the problem of the cardiotoxicity of chemotherapeutic agents. Modern cytostatics cause clinically significant manifestations of cardiotoxicity - myocardial injuries, reducing both quality and life expectancy of oncological patients. Many of chemotherapeutic agents can cause cardiovascular complications such as the development of the left ventricular dysfunction and heart failure, myocardial ischemia, arterial hypertension, thromboembolism, QT prolongation and arrhythmias. The toxic influence of the most often used chemotherapeutic agents on heart (antimetabolites, alkylating agents, platinum compounds, taxanes, vinca alkaloids, monoclonal antibodies, anthracycline antibiotics, topoisomerase and protein kinase inhibitors, immunomodulatory agents and cytokines) has been described. The results of recent studies on etiology, epidemiology, classification and pathogenesis are presented in the first part of review. Most attention is paid to recent research in pathogenesis of chemotherapy induced cardiotoxicity. Given the numerous aspects of cardiotoxicity are not completely studied yet, obviously the further researches are needed in this field.