[The combined treatment of bladder cancer]. / Kompleksnoe lechenie raka mochevogo puzyria.

The paper presented the results of the combined multistage treatment of 60 patients with advanced carcinoma of the urinary bladder: intra-arterial chemotherapy, immunotherapy, radiation therapy and surgery. Intra-arterial chemotherapy was performed in total dosages of the following drugs: 5-fluorouracil, 3-4 g/m2, adriamycin, 100-120 mg/m2, methotrexate, 20-40 mg/m2, platidiam, 30-50 mg/m2. Immunotherapy was exercised through endolymphatic administration of BCG vaccine in a dose of 0.08-0.12 mg. The majority of the patients were exposed to a remote gamma-therapy in a total focal dosage of 50-54 gram-roentgen. The treatment resulted in a complete regression of the tumor in 26.7, partial regression in 43.3 per cent of the patients. 3-6 mos after the radiation therapy, 46.6 per cent of the patients were operated on, mainly with the use of organ-sparing techniques. A three-year survival rate reached 100 per cent in the patients with stage T2 disease, 85.2 in those with T3a and 58.6 per cent in those with stages T3b--T4. The analysis of the survival revealed higher mortality rates in patients with low-differentiated tumors.

Intra-arterial chemotherapy for advanced bladder cancer.

The results of prolonged intra-arterial chemotherapy in 61 patients with locally advanced bladder cancer (T3-T4) are discussed. Regional internal iliac artery infusion of chemotherapeutic agents was done daily for 5 or 7 days at a rate of 1 to 3 ml/h over an 18-20-h period. The total dosages of each course were 60-120 mg/m2 adriamycin, 2.5-3.5 g/m2 5-fluorouracil (5-FU), 20-40 mg/m2 methotrexate or 30-50 mg/m2 cisplatin. At 3 to 4 weeks after the completion of infusional chemotherapy the results were evaluated, based on data from control cystoscopy and sonography. One patient (1.6%) was free of tumor; an objective response of greater than 50% reduction in tumor size occurred in 26 (42.7%) patients; 34 (55.7%) demonstrated objective responses of less than 50%. No further increase in tumor size during the management was detected. Hematuria, dysuria and urine infection were controlled and pain was relieved. The use of cytostatics and prolonged iliac artery catheterization did not incur any serious complications.

[Results and prospects of preoperative irradiation of tumors]. / Rezul'taty i perspektivy predoperatsionnogo oblucheniia opukholei.

An analysis of the results of combined therapy of patients with cancer of different sites has shown a high efficacy of the method. The use of radiation therapy in combination with known surgical ablation methods results in a decrease in the number of local recurrences and distant tumor metastases as well as in an increase in the proportion of operable patients with locally spread tumors. These methods contribute to the prolongation of cancer patients' life.

[The role of lymphography in the choice and planning of treatment in patients with malignant tumors of the lesser pelvis]. / Znachenie limfografii v vybore i planirovanii lechebnykh meropriiatii pri zlokachestvennykh opukholiakh organov malogo taza.

Lymphographic studies were carried out in 1070 patients to identify patterns of lymphogenic dissemination of cancer of the cervix and corpus uteri, prostate, urinary, bladder and rectum. A direct correlation between the frequency and degree of metastatic spread and local extension of tumor process was established. The most frequent sites for metastasis were the external and common iliac lymph nodes. Whatever the site of primary tumor or the predominant direction of its growth, these lymph nodes on both sides of the pelvis and lumbar area were involved. The significance of lymphographic results for selecting and planning treatment modalities as well as indications for lymphography were identified.

[Ultrasonic scanning in determining the local spread of bladder cancer]. / Ul'trazvukovoe skanirovanie v opredelenii mestnogo rasprostraneniia raka mochevogo puzyria.

The results of ultrasound investigation were analysed in 48 patients with urinary bladder cancer. Potentialities of longitudinal intracavitary echography in the determination of the local dissemination of malignant urinary bladder tumors were studied. This method proved to be most informative for tumors sited in the cervix, basis and anterior wall of the bladder whereas transabdominal echography provided reliable diagnostic information for tumors of the lateral and posterior walls. In choosing methods for the determination of the local dissemination of urinary bladder cancer preference should be given to combined echography in view of its high accuracy, noninvasive and safe nature.

[Lymphography in cancer of the prostate]. / Limfografiia pri rake predstatel'noi zhelezy.

The frequency and area of lymphogenic metastasis with relation to the histological structure, differentiation and degree of local dissemination of a primary tumor were determined at lymphography of 114 patients with prostatic cancer. Lymph node involvement was often observed in poorly differentiated and solid trabecular adenocarcinoma, scirrhous cancer and locally disseminated tumors extending beyond the prostatic capsule. Metastases were usually located in the external and common inguinal lymph nodes. Lymphography was shown to be indicated to patients with a local spread of prostatic cancer (T2, T3 and T4).

[Results of gamma teletherapy of prostate cancer patients]. / Rezul'taty distantsionnoi gamma-terapii bol'nykh rakom predstatel'noi zhelezy.

The paper is concerned with the results of clinical examination of 44 patients with prostatic cancer and their distribution according to disease stages. The authors provide morphological evaluation of the data (cytological and histological confirmation of the diagnosis). In the data analysed most of the patients had T3 and T4-34 (77.3%), i. e. patients with poorly differentiated tumor forms. All the patients were given a radical course of gamma-beam therapy of the prostate, 19 of them took estrogens prior to irradiation. Moving gamma-beam therapy of prostatic cancer is well tolerated by patients. It can be used in any stage of disease and in the progression of disease as well. Radiation reactions in the form of epitheliitis of various degree in the inguinal region were noted in 15% of the cases at a dosage of 32-44 Gy. Short-term results of the treatment were good: subjective signs of improvement were observed in 99.7% of the patients, objective signs of a positive therapeutic effect in 21 (48.1%). The 3-year survival rates were 44.3% for patients after a radical course of radiotherapy and 32.6% in radiotherapy for patients with tumor progression.

[Histological structure of the prostate and its zinc content at various ages]. / Gistologicheskoe stroenie predstatel'noi zhelezy i soderzhanie v nei tsinka v razlichnye vozrastnye periody.

As it has been demonstrated by a morphological investigation of the prostate from 85 corpses of various ages, each age period defined has certain specific objective morphometric indices, histological peculiar features of epithelium and changes in zinc content. The prostatic epithelium is the most monomorphous and the least active in the prepubertal group. In persons 14-40 years of age, the epithelium is characterized by morpho-functional features of high activity with preservation of its histological peculiarities. This corresponds to zinc content within the limits 48.10+/-9.10-64.10+/- +/-6.10 mg/kg in dry tissue of the gland. The most outstanding feature of the prostatic epithelium during transitional period of age is polymorphism of its structure, which corresponds to the greatest zinc content (115.10 +/- 13.10 mg/kg). In elderly and old persons this index is somewhat decreasing.