[Growth receptor factor and steroid hormones: their diagnostic value in differential diagnosis of neoplasms in children]. / Informativnost' pokazatelei -- retseptorov faktorov rosta i steroidnykh gormonov -- v differentsial'noi diagnostike onkologicheskikh zabolevanii u detei.

The distribution of epidermal growth factor receptors (EGFR) and receptors for steroid hormones--androgens (RA), estrogens (RE) and glucocorticoids (RG) was studied in malignant (MT) and benign (BT) tumors in children. The distribution and mean levels of some receptors in normal tissues were statistically different from those in MT and BT. The absence of RA and the high levels of RE > 20 fmol/mg protein and RG > 50 fmol/mg protein were typical of MT whereas BT might be characterized by the high levels of EGFR > 300 fmol/mg protein. In MT with and without metastases, the following parameters were significantly different (p < 0.001): RG = 81 and 18 fmol/mg, respectively, and EGFR = 160 and 58 fmol/mg protein, respectively. The most informative parameters for distinguishing BT and MT appeared to be RA (0.086 dit), RE (0.043 dit) and EGFR (0.037 dit). The most sensitive parameter for MT was RG, which, however, is least specific; RA is most specific (75%). The optimal amount of three parameters: RA + RE + EGFR (88.4%) is most exact for differential diagnosis.

[The drop in toxicity and the rise in the effectiveness of antineoplastic chemotherapy by correcting the activity of liver monooxygenases: from the experiment to the clinical practice]. / Snizhenie toksichnosti i povyshenie éffektivnosti protivoopukholevoi khimioterapii putem korrektsii aktivnosti monooksigenaz pecheni: ot éksperimenta -- v kliniku.

The paper reviews both the data available in the literature and the authors' own results of long-term experimental and clinical investigations of the involvement of hepatic monooxygenases (HMO) in the biological activity of antitumor drugs. It reports data of evaluation of HMO activity in pediatric and adult cancer patients, which has shown a decrease in HMO activity in one third of patients without clinical signs of hepatopathy and two thirds of those with toxic hepatic damages after prior chemotherapy. Decreased HMO activity has been found to be stimulated with the enzyme inductor zyxorin. Altered biochemical parameters, such as total bilirubin, ALT and AST, can be corrected with HNO, even if they show a 10-fold deviation from the normal physiological level. The efficacy of zyxorin was tested in patients with advanced cancer and concomitant toxic or viral hepatic disorders (grades II-IV by the WHO classification). Stimulation of inhibited HMO activity allows both decrease and prevention of the manifestations of hepatic toxicity due to anticancer chemotherapy providing a beneficial effect, the dose of cytostatics being not reduced. The authors concluded that the findings provide strong evidence for their assumption that the efficiency of antitumor chemotherapy can be enhanced in patients with concurrent hepatic abnormality by stimulating monooxygenases whose activity is diminished in the majority of these patients.

[Osteosarcoma: biochemical and endocrinological studies as a basis for its pathogenetic treatments]. / Biokhimicheskie i éndokrinologicheskie issledovaniia pri osteosarkome -- osnova patogeneticheskikh metodov lecheniia opukholi.

The paper considers data of the long-term studies of androgen metabolism, baseline serum levels of reproductive steroid hormones and their receptors in the tumor, in the blood concentrations of sex steroid-binding globulin and pituitary hormones, the expression of epidermal growth factor, its receptors and ligands, soluble Fas-antigen, vascular endothelial growth factor, angiogenin, and the content of calmodulin, cAMP in the osteosarcoma in 300 patients aged 14 to 56 years, which were made at the N. N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences. Analyzing the findings identified some lines in the study of new pathogenetic treatments for osteosarcoma, aimed at regulating androgen metabolism, correcting the cyclooxygenase pathway of arachidonic acid, the expression of receptors of epidermal growth factor and its ligands, the processes of neoangiogenesis in the tumor. A role of the above parameters in the pathogenesis of osteosarcoma is discussed.

[Organization of management of and role of clinical prognosis in the childhood oncological service of Russia]. / Organizatsiia upravleniia i rol' klinicheskogo prognozirovaniia v detskoi onkologicheskoi sluzhbe Rossii.

Cancer control service cannot be managed without having a clear idea of trends and changes in the incidence of malignant neoplasms and associated death rates. These studies become a basis for setting up oncological facilities for both children and adults, having an adequate infrastructure (final fund, the profile of units, a list of staff, the volume of work). Pediatric oncological rooms to collect statistics, to make a primary diagnosis, a follow-up, and outpatient chemotherapy in children with malignant neoplasms, and to do methological work with pediatric and non-oncological specialized children's out- and inpatient units have been opened in most administrative, regional, territorial, and republican centers. Notification is much more complete where specialized pediatric oncological rooms (Moscow) register such children. Unfortunately, such rooms are still few and so such ill children are registered by regional and city oncological dispensaries (and, as shown, 50% of the patients are outside registration).

[Modern prospects for polychemotherapy of solid neoplasms in children]. / Sovremennye vozmozhnosti polikhimioterapii solidnykh zlokachestvennykh opukholei u detei

To improve life quality and to increase survival in children with solid tumors, emphasis is placed on chemotherapeutical treatments along with other existing ones (surgery, radiation). By taking into account the fact that most malignant tumors in children are highly responsive to chemotherapy, programme treatment in children with neoplasms included the new drugs iphosphamide, vepeside, cisplatin, carboplatin, melfalan, bleomycin. The results of therapy with these drugs alone or in combination with well-known effective anthracycline antibiotics and plant preparations are presented. Whether more rigid modified schemes for administration and increment of dosage can be used is shown. This investigation opens new vistas for treating patients with not only localized, but disseminated forms of tumors, such as nephroblastomas, germinogenic tumors, soft tissue tumors, tumors of the bone, head, and neck. Regular assessment of the existing programmes in order to amend them, the use of new drugs, the increase of dosage and administration regimens enhance promises in treating malignant tumors in children.

[ES-IPO-97 treatment protocol for prognostically poor Ewing's sarcoma forms in children: results of implementation]. / Rezyl'taty provedeniia protokola ES-IPO-97 lecheniia detei s prognosticheski neblagopriiatnymi formami sarkomy Iuinga.

The paper shows the high efficiency and moderate toxicity of inductive treatment in children with Young sarcoma and primitive neuroectodermal tumors by ES-Ipo-97 protocol that includes alternate chemotherapy by the scheme: vincristine, 1.5 mg/m2/day, on days 1, 8, 15; adriamycin, 37.5 mg/m2/day, on days 1 and 2 as 24-hour infusion; cyclophosphanum, 2.1 g/m2/day, on days 1 and 2 (Block A); iphosphamide, 2.4 g/m2/day on days 1 to 5, etoposide, 100 mg/m2/day, on days 1-5 (Block B). It provides evidence for that this therapy is promising and awaits further developments.

[Organ-preserving surgical interventions in unilateral nephroblastomas in children]. / Organosokhraniaiushchie khirurgicheskie vmeshatel'stva pri monolateral'nykh nefroblastomakh u detei.

The paper presents data available in the literature and the authors' own findings of organ-preserving treatment of 9 children with unilateral nephroblastoma. It proposes absolute and relative indications for organ-preserving treatment in this pathology.

[Low-intensity lasers in pediatric oncology]. / Nizkointensivnye lazery v detskoi onkologii.

The paper outlines the outcomes of treatment for complications associated with chemo- and radiation therapy in children with malignant neoplasms by using low-intensity laser radiation. The use of this therapy may reduce the duration of treatment of these complications by 1.5-2 times. The use of low-intensity laser radiation in the treatment of other complications that are common in pediatric oncological care is briefly described.

[Epidermal growth factor receptors in malignant and benign tumors in children]. / Retseptory épidermal'nogo faktora rosta v zlokachestvennykh i dobrokachestvennykh opukholiakh u detei.

The radioligand technique was used to study the amount of epidermal growth factor receptors (EGFR) in malignant and benign tumors in 32 children aged 8 months to 17 years. The membranous fraction of 11 of the 32 tumors studied showed EGFR equal to 10.1 to 1327 fmol/mg (163.0 +/- 117.5 fmol/mg, median 38.0 fmol/mg). The greatest amount of EGFR was found in breast fibroadenomas. There was no clear relationship of the frequency and level of EGFR expression to a nosological tumor entity in children. A possible role of the EGFR system in tumors in children is discussed.

[Radiologic diagnosis of malignant tumors of the pelvic bones in children]. / Rentgenologicheskaia diagnostika zlokachestvennykh opukholei kostei taza u detei.

An analysis of the data on radiodiagnosis of malignancies of pelvic bones in 50 patients, aged 10-15, is presented. Diagnosis was morphologically confirmed in all the cases: Ewing's sarcoma (41)--82%, primitive neuroectodermal tumor (6)--12% and chondrosarcoma (3)--6%. The leading clinical syndrome was pain in the loin. The significantly most frequent site was the iliac bone. X-ray imaging of tumor site and adjacent areas using standard direct, lateral and oblique projections, ultrasonography, X-ray contrast tomography, radioisotope examination, puncture and open biopsy (when indicated) proved useful.

[Metastatic lung tumors in children (clinical course, diagnosis, prognosis)]. / Metastaticheskie opukholi lëgkikh u detei (klinika, diagnostika, prognoz).

According to data available at the Institute (1985-1999, approx. 1,200 patients), the lung is the most frequent site of cancer dissemination (up to 75%). Such most frequent pediatric children tumors as Wilms' tumor, neuroblastoma, rhabdosarcoma, osteogenic sarcoma and that of Ewing disseminate to lung in 85%, particularly, at advanced stages.

[Diagnosis and therapy of rhabdomyosarcoma in children]. / Diagnostika i lechenie rabdomiosarkomy u detei.

An analysis of 24-month relapse-free survival in 62 patients with rhabdomyosarcoma (S.I.O.P.-89) is presented. All children with rhabdomyosarcoma (RMS) stage I have survived; stage II--90, and stage III--62%, i.e. twice as many as compared with those treated before 1993. RMS sites included retroperitoneal space, spatium perinei, urinary bladder, testicle, abdominal and thoracic cavity. Diagnosis was based on clinical, instrumental, laboratory, X-ray, radionuclide, ultrasound and morphological data. Recommendations for examination of RMS suspects were worked out for different levels of expertise.

[Ultrasonography in the comprehensive diagnosis and evaluation of treatment effectiveness in retroperitoneal neuroblastoma in children]. / Ekhografiia v kompleksnoi diagnostike i otsenke éffektivnosti lecheniia zabriushinnoi neiroblastomy u detei.

Neuroblastoma and ganglioneuroblastoma of adrenal (17) and extra-organ (60) origin and retroperitoneal extra-organ neoplasia (18), infrequent in childhood, were identified in 109 children referred to the Institute's Clinic with diagnosis of retroperitoneal tumor. Ultrasound characteristics of retroperitoneal tumors of the sympathetic nervous system and predictive value of ultrasound for involvement of adjacent organs and vessels were defined and classified. Similar criteria for differential diagnosis between retroperitoneal neuro- and ganglioblastoma and rare pediatric retroperitoneal tumors were worked out. Dynamics of evidence in the course of conservative treatment of tumors and the role of ultrasound tomography in evaluating retroperitoneal neuroblastoma were established. Predictive value of sonography, computed tomography and angiography in certain applications was compared.