[Effectiveness of high-dose polychemotherapy with autologous hemopoietic stem cell transplantation in the treatment for malignant tumors of the central nervous system in children and young adults].

A total of 40 patients (median age 6 years, range 1-28 years) with high-risk malignant brain tumors received a single (n = 35) or tandem (n = 5) high-dose chemotherapy (HDCT) with autologous hemopoietic stem cell transplantation (auto-HSCT). The 2-year OS and DFS are 52% and 47%, accordingly, with median follow-up of 24 (range 2-96) months. The patients without complete response at the time of auto-HSCT had worst prognosis with 53% DFS in patients with partial remission and 25% in patients with disease stabilization (p = 0.001). Patients with relapsed tumor had worse prognosis, than high-risk patients in the first remission with DFS 26% and 62%, accordingly (p=0.02). The relapse rate also correlated with patient's age (38% DFS in patients younger, than 4 years and 60% in older patients, p = 0.005) and tumor morphology (63% DFS in patients with medulloblastoma, 60% in patients with germ-cell tumors, 45% in other embryonal CNS tumors, p = 0.05). The 4th-grade transplant-related toxicity and mortality rates were observed in 13% and 18% of patients, accordingly. Therefore, HDCT with auto-HSCT in young patients with high-risk CNS tumors is characterized by acceptable toxicity and allows improving overall therapy results.

[Combined therapy for children and adolescents with Ewing tumors (a 25-year experience)].

A total of 115 children (median age 10.5 years, range 2-17) with Ewing sarcoma family tumors (ESFT) received therapy in N.N. Petrov Institute of Oncology pediatric department from April 1985 till August 2013. These patients were divided into two groups depending on treatment tactics used: patients treated according to modified T9 protocol (n = 64) and patients treated according to EICESS-92 or Euro-Ewing 99 regimens (n = 51). Twenty four patients from the second group with adverse prognostic factors received high-dose chemotherapy with autologous stem cell transplantation. All patients received surgical treatment and/or irradiation for primary tumor local control. Five-year overall and disease-free survival was 39% and 37,9% in the first group. In the second group these values were significantly higher; 55% and 39.5%, accordingly (p = 0.03 and 0.25). All patients from the first group with primary metastatic ESFT died of disease progression, while in the second group OS and DFS reached 45.8% and 28.9%, accordingly. There was a statistically significant correlation between local relapse rate and irradiation dose biological equivalent (in TDF units). The local relapse cumulative rate was minimal (12,6%) in patients receiving 80 TDF.

[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.

[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.

[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.

[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.

[Progress and perspectives in pediatric oncology: 30-year experience of the clinic of pediatric oncology]. / Dostizheniia i perspektivy v onkopediatrii: 30 let raboty otdeleniia detskoi onkologii i gematologii.

Seventy percent of cases of Hodgkin's disease and 65% of those with kidney malignancies can be cured due to application of modern procedures of oncopediatrics. More intensive modalities have to be used for treatment of generalized forms of non-Hodgkin's lymphoma and sarcoma of Ewing. The rates of 3-year survival have risen to 70% in patients suffering acute leukemia following introduction of the new Protocol procedures. Infantile mortality from malignancies has been halved for the past 5 years (from 8.2/100,000 to 4.2/100,000) thanks to the taking of said measures and restructuring the oncopediatric service.

[Use of Navoban in pediatric oncology]. / Primenenie nabovana v onkologicheskoi praktike u detei.

In the course of treatment for tumors and recurrences, 86 children, aged 4-16 years, received polychemotherapy which induced excessive vomiting. Navoban (tropisetron) was administered to control vomiting. Total or partial control of nausea and vomiting was observed in 94.1%. No side-effects were registered.

[Type of acetylation in children with Hodgkin's disease]. / Tip atsetilirovaniia u detei bol'nykh limfogranulematozom.

Examination of a healthy European population showed 60% to be "slow" acetylators and 40% "rapid" ones. A similar distribution was established in pediatric controls. Among children with Hodgkin's disease, there were 4.1 times more slow acetylators. N-acetyltransferase activity was found to increase with tumor advancement. Conversion of acetylation pattern was observed in pediatric patients with Hodgkin's disease.