[Neoadjuvant chemoradiotherapy in the combined treatment of patients with stage IB2-III cervical cancer].

There are provided own observations on the use of cisplatin and capecitabine in schemes of combined treatment of patients with cervical cancer. Their efficiency as radiosensitizing agents is showed. There are discussed possible indications for the use of cisplatin and capecitabine in cervical cancer patients with metastatic lymph nodes.

[Basic principles and results of brachytherapy in gynecological oncology].

The fundamental basics of contact radiation therapy (brachytherapy) for gynecological cancer are presented. During brachytherapy the principles of conformal radiotherapy should be implemented, the aim of which is to sum the maximum possible dose of radiation to the tumor and decrease the dose load in adjacent organs and tissues, which allows reducing the frequency of radiation damage at treatment of primary tumors. It is really feasible only on modern technological level, thanks to precision topometry preparation, optimal computer dosimetrical and radiobiological planning of each session and radiotherapy in general. Successful local and long-term results of the contact radiation therapy for cancer of cervix and endometrium are due to optimal anatomical and topometrical ratio of the tumor localization, radioactive sources, and also physical and radiobiological laws of distribution and effects of ionizing radiation, the dose load accounting rules.

[Results of treatment for recurrent cancer of the uterine cervix].

The investigation involved 285 patients suffering from recurrences and distant metastases of uterine carcinoma cases of 24% of all (primary tumor). All recurrences generally occurred 12-20 months after the beginning of specialized therapy in 3.3-40%, with 78.3% detected within the first 24 months. Relapse was reported mostly in groups in which a single modality was used: surgery (32.4%) or radiotherapy (24.7%). Local recurrence rate for primary squamous cell tumor was 53.6%, adenocarcinoma - 6.3% and poorly-differentiated cell carcinoma - 4.9%. Complete regression of relapse following combined treatment was reported in 19% versus 14% and 4% after radiotherapy and chemotherapy, respectively. Moreover, more apparent responses were registered as a result of combinations of modalities (69%) as compared with 26% and 20% for radio- and chemotherapy, respectively.

[Assessment of effectiveness of preoperative chemoradiotherapy in patients with T1B-2ABN0-1M0 cervical cancer]. / Otsenka éffektivnosti predoperatsionnoi khimioluchevoi terapii bol'nykh rakom sheiki matki T1B-2ABN0-1M0.

The potential of preoperative radiochemotherapy in combined treatment of cervical carcinoma T1B-2ABN0-1M0 has been investigated. The use of cisplatin raised the feasibility of radical surgery from 69 to 87%, as compared with radiation alone, and increased 2-year overall and relapse-free survival to 92.6% and 89.4% vis-a-vis 80.8% and 77.8%, respectively. No increase in complication rates in the blood, rectum or bladder during or shortly after treatment was reported.

[Experience with tantum rosa treatment for the prevention and management of radiation-induced proctitis and vaginitis in uterine and vaginal cancer]. / Opyt ispol'zovaniia preparata tantum roza pri profilaktike i lechenii luchevykh rektitov i vaginitov u bol'nykh rakom matki i vlagalishcha.

The investigation has been concerned with the efficacy of Tantum Rosa (Angelini Francesco, Italy) in the prevention (21) and therapy (87) of early- and late-onset radiation injuries of the rectum and vagina in patients exposed to radiation for cervical, uterine or vaginal carcinoma. Rectal tenesmus and pain subsided following 3-4 administrations at early stages of radiation rectitis. Intestinal discomfort was avoided when Tantum Rosa was used for prophylaxis. Therapeutic effect was reported after 7-10 administrations for moderate radiation vaginitis. Therapy for pannicular epithelite lasted less than two weeks.

[Current methods in brachytherapy of female genital malignancies]. / Sovremennye aspekty brakhiterapii zlokachestvennykh opukholei zhenskikh polovykh organov.

The procedures of computed brachytherapy using Co-60; Cs-137 and Ir-192 sources of radiation are discussed. The standards for designing contact radiotherapy, including three-dimensional systems, and principles of monitoring chosen schedules are presented. Criteria for identifying equivalent radiation doses on the basis of the existing radiobiological schedules involved in brachytherapy using different dosage are evaluated. The results of radiation treatment of cervical and vaginal cancers versus tumor process extension are presented.

[Indirect radionuclide lymphography in the evaluation of the completeness of iliac lymphadenectomy and the diagnosis of postoperative lymphatic cysts in uterine cancer]. / Nepriamaia radionuklidnaia limfografiia v otsenke radical'nosti podvzdoshnoi limfadenéktomii i diagnostike posleoperatsionnykh limfaticheskikh kist pri rake matki.

Indirect radionuclide lymphography was performed in 152 women in the next 1-2 weeks after operation on the iliac lymph nodes. In 136 of them a radiopharmaceutical (198Au-colloid, 113mIn-coind, 113mIn-coinol) was accumulated in the inguinofemoral lymph nodes only, being in favor of radical iliac lymphadenectomy. X-ray lymphographic control confirmed in all cases that the iliac lymph nodes had been completely removed. Lymphatic cysts were detected in 16 out of 152 patients and verified in all the cases. Thus radiolymphography is indicated in early terms after lymphadenectomy for the assessment of its efficacy and diagnosis of lymphatic cysts.

[Combined radiodiagnosis of the lymphogenic spread of the process in uterine cancer]. / Kompleksnaia luchevaia diagnostika stepeni limfogennogo rasprostraneniia protsessa pri rake matki.

The data obtained by indirect lower radiolymphography with 113mIn--containing radionuclides, direct X-ray color lymphography, serial renal scintigraphy and intravenous urography were compared with the results of a histologic examination of the iliac lymph nodes in 102 cases (81.3%) of cervical cancer. Radiolymphography appeared to be of high diagnostic value in assessing the status of the pelvic lymph nodes in this type of cancer. A high incidence of urodynamic disturbances (34.2%) was observed in cases of retroperitoneal lymph node involvement. Indications for radionuclide and X-ray examination of regional lymphatics in cervical cancer were established.

[Indirect radionuclide lymphography using In-113m in patients with uterine cancer]. / Nepriamaia radionuklidnaia limfografiia s 113m In-koindom u bol'nykh rakom matki.

Indirect lower lymphography with 113m In-coind was performed in 112 patients with uterine cancer. Its diagnostic informative value, as was shown by the results of morphological verification, was 73 +/- 1.2%. In the interpretation of the scintigraphic image of the lymph nodes a small number of false negative results (8.6%) was noted. Comparison of the results of direct radiopaque lymphography with those of a morphological study of the lymph nodes in 42 patients brought about coincidence in 75% of the observed cases. Identical results of radionuclide lymphography and chromolymphography were observed in 92.1% of the cases. The analysis has shown that scintigraphy of the lymph nodes with 113m In-coind and radiopaque lymphography are almost identical by their informative value.

[Clinical application of 113mIn-chloride for indirect lower radionuclide lymphography in cancer patients]. / Klinicheskii opyt primeneniia 113mIn-khlorida dlia nepriamoi nizhnei radionuklidnoi limfografii u onkologicheskikh bol'nykh.

Carrier-free applications of 113mIn-chloride for indirect lower radionuclide lymphography were studied in 90 cancer patients. The period of radiolabel semiexcretion from site of injection (initial interdigital spaces of foot) ranged 25-74 min. 131mIn-chloride application provided a distinct visualization of retroperitoneal lymph nodes. The results of a radionuclide lymphographic study of 43 patients with uterine carcinoma were confirmed by postoperative histological examination of resected lymph nodes in 88%. The informative value of the pictures of retroperitoneal lymph nodes obtained by gamma chambers and scanners using 131mIn-chloride was essentially identical.

[Radionuclide methods in planning treatment for uterine cancer]. / Radionuklidnye metody v planirovanii lecheniia raka matki.

Indirect low radionuclide lymphography with 113mIn-coindium and serial renoscintigaphy with 131mI-hippuran were done to 103 patients with cancer of the uterus. A high diagnostic value of radionuclide methods was shown. In a comparative analysis of radiolymphography and direct roentgenocontrast lymphography with the results of a morphological study of the lymph nodes the informative value was 70.7% for the radionuclide and 75% for the x-ray studies of the lymphatic system. A higher sensitivity of serial renoscintigraphy as compared to excretory urography (34.2% and 27.6% respectively) was shown in the diagnosis of pathology of the urinary system. Taking into account the absence of counterindications to and the simplicity of radionuclide studies it is recommended that they should be included in the complex of diagnostic procedures for patients with cancer of the uterus.

[Comparative evaluation of the informativeness of computed serial renoscintigraphy and excretory urography in uterine cancer]. / Sravnitel'naia otsenka informativnosti komp'iuternoi seriinoi renostsintigrafii i ékskretornoi urografii u bol'nykh rakom matki.

Computerized serial renoscintigraphy and excretory urography were carried out in 112 patients with uterine carcinoma. It was found that, in diagnosis of pathology of the urinary system, the effectiveness of radionephrologic procedure is higher than that of intravenous urography (31.7 and 27.6%, respectively). Also, computerized serial renoscintigraphy proved to be an objective means of assessing the recovery of urinary system function at various stages after therapy. Moreover, nephroscintigraphy plays an important role in timely detection of recurrences.