[Evaluation of ovarian status in women who received anti-tumor therapy in childhood and adolescence].

The paper presents the results of a study of the ovarian reserve in young women who received treatment for malignant tumors in childhood and adolescence and are in complete clinical remission. The function of the reproductive system was evaluated by serum concentrations of gonadotropins, estradiol, anti-Müllerian hormone (AMH) and inhibin B. The results were compared to the treatment, patients' age at the beginning of therapy and at the time of the examination. AMH level in serum was the most informative indicator of ovarian reserve in patients treated for malignant tumors.

[Organ-preserving interventions in combined therapy of children and adolescents with osteosarcoma].

An analyzed cohort consists of 50 pediatric patients with osteosarcoma receiving combined therapy in N. N. Petrov Research Institute for Oncology (1999-2010). Thirty nine of them had localized disease, 11 patients had distant metastases. The treatment scheme included neoadjuvant therapy with cisplatin and doxorubicin, surgical treatment and adjuvant therapy depended on initial response and could include cisplatin, doxorubicin, high-dose methotrexate, ifosfamide, etoposide. Four-year overall and relapse-free survival in children with localized disease was 74.3% and 69.2% accordingly. In 62% of patients were performed organ-preserving surgical interventions, in 22 patients was performed endoprosthetics, in 4 patients the defect was replaced by a bone autograft on a vascular bundle. The effectiveness of initial treatment and secondary endoprosthetics were analyzed. Six patients with lung metastases received normotermic lung chemoperfusion, 4 of them are alive and disease-free for 8 to 24 months.

[The gastrointestinal stromal tumor of the stomach in child: characteristic of diagnostics].

The observation of stromal gastric tumor of 12 years old girl has been investigated. The diagnostics was carried out on tumor biopsy taken by a laparoscopy. An evident edema of stroma caused "pseudo-papillary" organization of epithelioid cell neoplasm prevented the right diagnosis established only by immunohistochemical staining of CD117 and CD34 markers. The absence of mutations in C-kit and PGFRA genes uncovered by molecular-genetic analysis is typical for stromal gastric tumors in child. The next gastric resection allowed to estimate tumor appearance and localization, histological organization, and to repeat immunohistochemical studying. This observation confirmed the correctness of diagnosis and established high level of Ki67 proliferative activity (12-15%) determined prescriptions of target medicamental therapy.

[Video-assisted thoracoscopy for diagnosis and therapy of pulmonary, mediastinal and pleural neoplasia in children and adolescents].

Data are presented on 30 cases of video-assisted thoracoscopy for different intrathoracic neoplasms in children and adolescents. Indications and contra-indications for use for diagnostic and therapeutic purposes as well as possible complications and their prophylaxis are discussed.

[Cytological diagnosis and prognosis in Ewing's sarcoma in children].

143 cytological studies of the material obtained from 98 children aged from 2 to 18 years with tentative diagnosis of Ewing's sarcoma were made. Histocytological correlations showed 96.2% cases to be of informative value, 87% of them with precise cytological diagnosis of the above sarcoma. The analysis of images specified mean values of square (S) and ploidity (P) of tumor cell nuclei in 21 children with a good (10), and bad (11) outcome of the disease. It was established that if ploidy is higher than expected one (p = 0.0357 S), bad prognosis can be supposed and a good prognosis in the opposite case. In case of good prognosis differentiated tumor cells with large clear nuclei are seen in the smears, and poorly differentiated cells with hyperchromic nuclei are observed in cases with bad prognosis.

[Treatment results in localized forms of reticulosarcoma and Ewing's sarcoma in children]. / Rezul'taty lecheniia lokalizovannykh form retikulosarkomy i sarkomy Iuinga u detei.

The results of treatment of 53 cases of pediatric localized Ewing's sarcoma and bone reticulosarcoma were analysed. Chemoradiotherapy is a procedure of choice in bone marrow sarcoma treatment: while overall five-year survival was 28.4 +/- 6.2%, it was as high as 64.9% in cases of combined treatment (total focal dose of at least 50 Gy + polychemotherapy). Two cases of osteo- and chondrosarcoma development in exposed bone are described.

[Cytologic diagnosis of retroperitoneal tumors in children]. / Tsitologicheskaia dignostika zabriushinnykh opukholei u detei.

Cytological diagnosis of retroperitoneal tumors in 173 children (1985-1996) has been evaluated, using aspiration biopsy (165), imprint smears (84) and cytohistological examination (128). Fine-needle biopsy data were confirmed in 99%; histological examination--97.3%.

[The results of cytologic diagnosis of bone tumors]. / Rezul'taty tsitologicheskoi diagnostiki opukholei kostei.

The results of bone tumor cytological diagnosis in 968 patients examined and treated at the Institute Clinic (1988-1997) were analyzed. Histological examinations were performed in 479 cases. The share of cytologically inconclusive findings was significantly higher with benign lesions (17.5%) than malignant tumors (9.0%; p(0.05). The sensitivity and specificity of cytological analysis were 94.7 and 93.4%, respectively; positive predictive value--96.7, negative--89.8 and overall diagnostic accuracy--94.3%. Histological pattern of tumor was correctly identified in 73.7% of malignancies.

[Correlation of cytologic and DNA ploidy evidence and prognosis in childhood Wilm's tumor]. / Sopostavleniia dannykh tsitologicheskogo issledovaniia i opredeleniia ploidnosti DNK s iskhodom zabolevaniia pri opukholi Vil'msa u detei.

A retrospective evaluation of the clinical features, cytological, biological (DNA) and histological data on 29 children with Wilms' tumor. Two prognosis-related groups were identified: (1) good outcome (17)--all children, aged 4-15, had survived by end of follow-up; (2) bad outcome (12)--all children died within 4 months--4 years. Cytological examination by fine-needle biopsy of smears was carried out prior to preoperative neoadjuvant therapy in all 29 patients; in addition, print smears from resected tumor were taken from 21. Blastemal, stromal, epithelial and anaplastic cells levels were estimated by the semi-quantitative procedure (0, 1+, 2+, 3+). DNA ploidy was determined by image cytometry after destaining slides and re-staining them according to Feulgen. It was shown that favorable outcome could be expected when fine-needle biopsy of print smears identified DNA diploidy and marked drug-related pathomorphosis involving fewer blastemal cells and signs of cell dystrophy and tumor necrosis. When anaplastic and aneuploid cells were detected, matched by the absence of therapeutic pathomorphosis, outcome was poor.

[Evaluation of the anti-emetic effectiveness of two drug formulations of Ondansetron in combined chemotherapy for children with malignant tumors]. / Otsenka antiémetogennoi éffektivnosti dvukh lekarstvennykh form ondansetrona pri kombinirovannoi khimioterapii zlokachestvennykh opukholei u detei.

A double-blind randomized comparison (protocol S3AB4003, Glaxo Wellcome, Great Britain) carried out in a group of 52 children showed that the 5-HT3-receptor antagonist ondansetron (in syrup) effectively prevented vomiting, nausea and loss of appetite caused in combination chemotherapy with highly- or moderately emetogenic cytostatic drugs in 92.3; 69.3 and 81.0%, respectively. Treatment was given to patients who were on dexamethasone. With intravenous injection of ondansetron plus dexamethasone, per os, said indices were 88.5; 73.2%; 73.2%, respectively, thus showing no significant differences. No side-effects were observed with either regimen.

[Malignant non-Hodgkin lymphoma in children: factors of prognosis and results of therapy]. / Zlokachestvennye nehodzhkinskie limfomy u detei: faktory prognoza i rezul'taty lecheniia.

The analysis included 187 cases of infantile non-Hodgkin's disease. It has identified Ann Arbor System stage and histological pattern of tumor (Lukes-Collins and Kiel) as a reliable and significant factor of prognosis.

[Results of therapy in Wilms' tumor]. / Rezul'taty lecheniia opukholi Vil'msa.

Two hundred seventeen patients (aged under 14) with histologically confirmed Wilms tumor were treated and followed up in 1965-1995. Until 1976 this condition was treated according to the national standard procedures of the time. The SIOP program approach has been introduced ever since. In a study group of 154 cases treated at the Institute's Clinic alone, the actuarial 20-year survival was 63%. It rose to 72% whenever the SIOP protocol was strictly observed.

[Comprehensive therapy of localized bone marrow sarcoma in children]. / Kompleksnoe lechenie lokalizovannykh kostnomozgovykh sarcom u detei.

The retrospective analysis included the results of the treatment of 67 children suffering from localized sarcomas of bone (Ewing's sarcoma, lymphosarcoma). The advantage was demonstrated in patients, received combination of chemotherapy and radiotherapy on the involved bone. The resection of the primary tumor in combination with radio-chemotherapy improves the 10-year survival.

[The use of Cardioxane in chemotherapy of malignant neoplasms in children]. / Opyt primeneniia Kardioksana pri khimioterapii zlokachestvennykh novoobrazovanii u detei.

Treatment with anthracycline antibiotics may have a toxic effect on the myocardium. The report deals with the results of application of a cardioprotector--cardioxan--in 38 children, aged 2-13 years, with malignant tumors treated, among other drugs, with doxorubicin. These data were compared with those on 33 pediatric patients who had received anthracycline antibiotics until 1994. No cardioxan-related complications were recorded whenever the instructions on the use were followed. The results are inconclusive because of the short duration of the study and examination being still incomplete.

[Evolution of diagnostic and therapeutic methods in childhood Hodgkin's disease]. / Evolutsiia metodov diagnostiki i lecheniia limfogranulematoza u detei.

A retrospective analysis of the results of treatment of 467 cases of primary Hodgkin's disease (aged under 15) (1968-1992) has been undertaken. As such invasive diagnostic procedures as lower direct lymphography and laparotomy with splenectomy were being abandoned, polychemotherapy plus irradiation of zones of involvement alone at all stages were introduced. Although generalized forms of tumor (stage III-IV tumors in 69% of cases) were in evidence and risk-adapted therapy procedures were used, the 5-year survival for 1988-1992 was 88%, the recurrence-free survival rate in the treated cases being 67%.

[Results of therapy for osteogenic sarcoma in children: perspectives of improvement]. / Rezul'taty lecheniia osteogennoi sarkomy u detei: perspektivy uluchsheniia.

A retrospective analysis of treatment of 67 children suffering localized osteogenic sarcoma received at the Institute's Clinic (1977-1995) has been carried out. The best 5-year survival results were obtained with the COSS-91 and PECOSS programs and those for pre- and post-operative COMBAP chemotherapy (77.8 and 70.0%, respectively). Another randomized comparative study of the effectiveness of different polychemotherapy and pre-operative radiation schedules are being planned.