[Treatment modalities and results of comprehensive therapy for extended retinoblastoma in children]. / Lechebnaia taktika i rezul'taty kompleksnogo lecheniia retinoblastomy u detei v rasprostranennykh stadiiakh zabolevaniia.

New procedures of laser therapy and chemotherapy have extended the scope of application of organ-saving treatment at advanced stages of retinoblastoma in childhood, thus making it possible to preserve the eye fully functional or cosmetic. Not having to perform such mutilating procedures as ophthalmectomy or eye socket exenteration contributes to psychological and physical rehabilitation. At the same time, as a comparison of the results of surgery carried out at initial stages and surgery-free treatment showed that palliative therapy is characterized by impressive rates of 5-year survival. New vistas have opened of in the management of pediatric retinoblastoma, particularly in cases of stage III tumor and bilateral involvement.

[Changes of lipid peroxidation parameters in children being treated for cancer]. / Izmenenie pokazatelei perekisnogo okisleniia lipidov v protsesse lecheniia detei, stradaiushchikh razlichnymi onkologicheskimi zabolevaniiami.

Lipid peroxidation (LP) occurring in pediatric cancer patients receiving polychemotherapy has been investigated. Plasma level of malonic dialdehyde in children with retinoblastoma (Rtb) was found to drop while it remained unchanged in patients with acute lymphoblastic leukemia (ALL). The treatment caused different changes in the red cell catalase levels in said groups: the enzyme concentration increased in the Rtb patients in the course of therapy and decreased in the ALL group. A slight decline in alpha-tocopherol and retinol levels the Rtb group was matched by a relevant rise in blood-plasma in the ALL group. To adjust LP regulation and improve resistance, antioxidants should be given to pediatric cancer patients suffering peroxidation-related stress.

[Multimodality treatment for retinoblastoma in children]. / Kompleksnoe lechenie retinoblastomy u detei.

A comprehensive programme was developed for the treatment of uni- and bilateral retinoblastoma in children with due regard to the disease stage by the TNM system. The use of the current sources of teletherapy and cyclic polychemotherapy expanded indications for organ-saving therapy at most common stages. Treatment by the program was performed in 202 patients, including 125 children with unilateral damage and 77 with bilateral damage. An attempt made treat 140 (75%) children at the first stage. More than 70% of cases were diagnosed as having disease stage T3 in one or two stage, while such patients underwent ocular enucleation. A complete or partial (more than 50%) tumor regression without signs of its progression for 2 years or more was achieved in 62% of cases. At the first stage of therapy, conservative therapy insignificantly affected the children's longevity in uncomplicated cases, which is particularly important in bilateral involvement, while this preserved the organ of vision in more than half the patients (62%). Five-year survival was 92 and 82% in unilateral retinoblastoma surgically treated and untreated, 83 and 84%, respectively. Adequate multimodality treatment brought about low incidence rates of recurrence and metastasis (10%) in conservative therapy and 7.7% among all patients.

[The possibilities for organ-preserving treatment in retinoblastoma in children]. / Vozmozhnosti organosokhrannogo lecheniia retinoblastomy u detei.

One-hundred pediatric patients with uni- and bilateral retinoblastoma (140 tumors on the whole) received a combination of radio- and chemotherapy. Radiation was delivered by gamma-ray units and an electron accelerator. The single and total focal doses used were 1.5-2.0 Gy and 40-55 Gy, respectively, depending on tumor stage. Simultaneously, chemotherapy with vincristine, cyclophosphamide and adriamycin were given intravenously in standard doses. As a result, 85 out of 95 (89.5%) children including 43 cases of bilateral tumor are alive. Partial response or no change were registered in 72 tumors (51.4%). Progression was observed in 28 tumors (20%) at the average of 6-8 months following the start of treatment. Forty tumors (28.6%) responded completely, with remissions lasting for a follow-up period of 2-6 years. Not a single case of organ-sparing surgery developed distant metastases. To summarize, a combined treatment modality for retinoblastoma according to TNM stage was developed and indications for organ-sparing surgery outlined. The standard treatment modality for bilateral retinoblastoma was revised.

[Evolution of drug treatment of rhabdomyosarcoma in children]. / Evoliutsiia lekarstvennogo lecheniia rabdomiosarkom u detei.

Rhabdomyosarcoma is the most frequently occurring type of malignant solid tumors in children. The tumor site, aggressive growth, proneness to recurrence, metastatic spreading, and high neglect predetermine the negligible share of the surgical method in multimodality treatment of rhabdomyosarcomas. Of importance are the development and the use of different types and schemes of drug therapy which can be employed in combination with radiotherapy. Drug therapy of rhabdomyosarcomas has large practical potentialities which rise from year to year.

[Rhabdomyosarcoma in children]. / Rabdomiosarkomy u detei.

Issues in diagnosis and complex treatment of pediatric rhabdomyosarcoma were studied in 198 patients with morphologically verified disease. Tumors most often developed in the genitourinary organs (36.6%), head and neck (37%) and--less frequently--on the trunk and extremities (26.4%). The diagnostic workup included instrumental methods, ultrasonography and computed tomography. All modern modalities of cancer treatment, viz. surgery, drug and radiotherapy were used in those patients. As a rule, treatment was either combined or complex. Two-year-survival rate ranged from 83% for rhabdomyosarcoma of the orbit to 50% for those of the trunk and extremities and 47% for head and neck neoplasms. Two-year survival for patients with rhabdomyosarcoma of non-genitourinary sites was 54%.

[Diagnosis and treatment of malignant tumors of the eye and orbit in children]. / Diagnostika i lechenie zlokachestvennykh opukholei glaza i orbity u detei.

The paper deals with an evaluation of potentialities of diagnostic procedures (computer tomography and thermography) and complex treatment of retinoblastoma and sarcomas of the orbit. Electron- and 60CO teletherapy as components of complex treatment appeared to be superior to X-rays cutting down incidence of radiation injury and producing better results, including stage III. Also, these procedures allowed to avoid enucleation in stage I retinoblastoma and bilateral tumors. Optimal schemes of chemotherapy for retinoblastoma and sarcomas of the orbit at different stages were developed. Prophylactic chemotherapy is required within the first 18-24 months.

[Thermography in the diagnosis of retinoblastoma in children]. / Termografiia v diagnostike retinoblastomy u detei.

The authors presented the results of thermographic examination of children with suspected retinoblastoma (30 primary examined patients and 30 patients examined to assess therapeutic efficacy). The results of the examination showed the relationship of the intensity and extent of the hyperthermia zone with tumor stage. The usefulness of the thermographic method for efficacy assessment was shown.

[Radiotherapy in the multimodality treatment of retinoblastomas in children]. / Luchevaia terapiia v kompleksnom lechenii retinoblastom u detei.

The results of multimodality therapy of 50 children with uni- or bilateral retinoblastoma were assessed. Gamma-beam therapy with the application of a special protective collimator and polychemotherapy were used as modalities supplementing eye extirpation. Some patients were irradiated prior to operation, the others following it. Despite a slight decrease in a tumor radiation dose in the first group, 2-year survival rates in both groups were the same. Of 32 patients 30 (94%) in both groups have been alive for 2 yrs. without signs of disease after multimodality therapy. Patients with Stage I retinoblastoma were subjected to chemo- and radiotherapy; 16 out of 18 patients have been alive for 2 yrs. It has been stressed that radiation therapy is an important component in multimodality therapy. It can be used as a modality of the combined method of tumor surgical removal or as a method of radical therapy in early forms of the disease.

[Radionuclide and thermographic diagnosis of head and neck neoplasms]. / Radionuklidnaia i termograficheskaia diagnostika novoobrazovanii golovy i shei.

Radionuclide and thermographic studies using 67Ga-citrate and 111In-bleomycin were performed in 129 patients with laryngeal cancer, chemodectoma of the neck, retinoblastoma, rhabdomyosarcoma of the orbital and facial soft tissues and cancer of the tongue. Elevated amounts of the radiopharmaceutical drug were found in patients with tumors. In thermographic studies higher thermogenic activity corresponding to the tumor was noted. Radionuclide thermographic studies extend diagnostic opportunities for head and neck tumors.

[Chromosome disorders in retinoblastoma cells]. / Khromosomnye narusheniia v kletkakh retinoblastomy.

The karyotype of 7 unilateral retinoblastomas was studied. Loss or a gain of chromosomes and structural chromosomal changes were observed in all tumors. Modal chromosome number was pseudodiploid in four and near-diploid in three tumors. There were no sex chromosomes (X or Y) in 3 tumors. Four tumors were characterized by the presence of an identical marker chromosome--i(6p). Two other markers--lp+ and 17q+ (probably, not quite identical)--were present in 4 and 3 tumors, respectively. The cells of two retinoblastomas contained both i (6p) and 17q+ markers.

Similar chromosomal abnormalities in several retinoblastomas.

The study of banded chromosomes of nine sporadic unilateral retinoblastomas revealed near diploid karyotypes with multiple numerical and (or) structural abnormalities in all tumors. An identical marker i(6p) was noted in cells of the modal class of six retinoblastomas. Extra copies of the short arm of chromosome 6 were observed in seven tumors: +i(6p) in 6 and +6q-in one. Less regular but repeated findings were a loss of one sex chromosome, and markers 1p+ and 17q+. The structure of these markers was not identical in different tumors. Abnormalities of chromosome 13 were not observed in tumor cells, nor in blood lymphocytes stimulated by PHA.