Possibilities of ultrasound examination with elastography in the diagnosis of recurrent rectal cancer.

The purpose of this study was to evaluate possibilities of complex ultrasound examination in the diagnosis of recurrent rectal cancer. The study included 40 patients with recurrent rectal cancer, 19 men and 21 women aged from 27 to 83 years, mean age was 60 +/- 7.9 years. In order to detect recurrence we performed ultrasound examination with elastography of possible sites of recurrences of rectal cancer. It was found that our study showed a high diagnostic efficiency of complex ultrasound examination with elastography in the early diagnosis of recurrences and the continued growth of rectal cancer.

[Immediate results of combined therapy for local recurrences of rectal cancer].

The purpose of this paper was to increase the effectiveness of radiation therapy (RT) of local recurrence of rectal cancer (MRRPK) by setting the preferred modes and dynamic medium dose fractionation irradiation MRRPK, assessing immediate outcomes, identifying the frequency and severity of early radiation reactions during radiation therapy. The study included 60 patients with a diagnosis of "local recurrence of rectal cancer." The median age was 67 years. Terms of recurrence after surgical treatment averaged 20 months. The histological structure of the tumor was presented adenocarcinoma in 57 (95%) patients. Radiation therapy (RT) was carried out in medium or dynamic fractionation. Chemotherapy used pelleted 5-fluorouracil. In group 1 (20 patients) received palliative radiotherapy course with a fractional dose of 3 Gy to 42 Gy SOD (SDeq 51 Gy). In group 2 (20 patients) underwent a course of radiotherapy using dynamic dose fractionation: fractional dose--4, 3 and 2 Gy to 51 Gy SDeq. In the third group (20 patients) underwent combined treatment using dynamic dose fractionation: fractional dose--4, 3 and 2 Gy to 56 Gy SDeq and chemotherapy--Xeloda or ftorafur. In group 1 complete regression was achieved in 1 patient, partial regression--15, stabilization--at 3, progression--at 1, that is clinical effect was observed in 19 of 20 patients. In group 2, complete regression of the tumor was diagnosed in 3 patients, partial regression--17, therefore, 100% of patients had received clinical effect. According to follow-up, 5 patients in this group were subsequently. In the third group of complete regression of the tumor was diagnosed in 7 patients, partial regression--13, ie, 100% of patients had received clinical effect. According to follow-up, 7 patients in this group were subsequently operated. Among the radiation reaction in group 1 nausea 1 tbsp. was observed in 3 patients, radiation Recto 1-2 degree--15, radiation epithelitis 1-2 degree--4 patients; in group 2, nausea 1 degree--At 7, radiation Recto 1-2 degree--At 7, radiation epithelitis 1-2 degree--In 6 patients and 6 reactions were observed; in the third group of nausea 1st. was observed in 7 patients, radiation Recto 1-2 degree--At 9, radiation epithelitis 1-2 degree--At 8 and 3 patients reactions were observed. Thus, when irradiated in the dynamic fractionation showed less pronounced dose response as beam during treatment, and after. Increasing the total dose with the addition radiomodification increases the frequency of complete responses with acceptable toxicity. As a result of treatment in all patients achieved a significant reduction in pain, relief of bleeding.

[Blood DNA Radiosensitivity May Be Predictive Marker for Efficacy of Radiation Therapy in Glioma Tumorbearing Individuals].

Animal and clinical studies were conducted to evaluate the association between the blood DNA radiosensitivity, assessed by determining the original S-index ex vivo, and the response of gliomas to irradiation in vivo. Possible modifications of the latter after administration of iron-containing water (ICW) in rats were also explored. The study was performed on the rats with subcutaneously implanted experimental glioma-35. The tumors were locally X-irradiated with a single 15 Gy dose as a radiation therapy (RT). ICW (60-63 mg · Fe 2+/l) was administered as a drinking water for 3 days before treatment. The animals underwent blood sampling for analysis of the DNA concentration and leukocyte count. The DNA index was estimated 24 h after RT. The S-index was evaluated within 4 h before RT. The mean initial S-index in the blood samples of glioma-bearing rats was 0.73 ± 0.05. Addition of ICW ex vivo resulted in a significantly increased S-index in a half of the samples. In general, the irradiated rats, which had been given pretreatment with ICW and demonstrated an ex vivo increase of the S-index to > 1.0, showed the most marked inhibition of tumor progression and the smallest tumor volume 25 days after irradiation. They also exhibited the lowest rate of growth and the longest survival. Determination of the biochemical S-index and evaluation of its changes ex vivo caused by ICW may be predictive of the response of experimental glioma to irradiation with radiomodification. The S-index may serve as a predictive indicator in clinic of the efficient evaluation of RT in patients with glioma.

[Personalized treatment of tumor-bearings after prediction of radio and chemoradio-therapy efficacy by means of blood DNA radiosensitivity].

Ongoing studies on the tumor and non-tumor samples carried out worldwide give evidence that some apoptotic indexes, DNA-based microarray molecular profiling analysis as well as determination of single nucleotide polymorphisms in the genome of a patient's tumor can serve perspective markers of radiosensitivity for the response prediction in individual patients to intendedradiation therapy. Over the last years there has been an increasing interest in radiogenomic and characterization of DNA array molecular profiles that can predict the response to irradiation in tumor and non-tumor tissues. Now a technology of the short-term and inexpensive determination of indices aimed at an objectively based use of radiation therapy in experiment or clinic after evaluation of blood DNA radiosensitivity has been developed.

[Effectiveness of the correction of hepatotoxicity during combined chemoradiotherapy for cancer patients].

In 29 patients with various malignant tumors there was carried out an estimation of Thiotriazoline efficacy in the treatment of hepatotoxicity in the process of combined chemoradiation therapy. It has been showed that ten-day application of Thiotriazoline in double dose (2,5% solution intravenously by 4,0 ml twice within 24 hours and 1 tablet (100 mg) twice within 24 hours) in patients with I and II degree of hepatotoxicity at the background of combined chemoradiation therapy enabled to remove completely manifestations of cytolysis in 100% of patients, without changing regimen of chemotherapy. To normalize levels of biochemical indices of blood in III degree of hepatotoxicity, more a long intake of Thiotriazoline (about 4 weeks) was required. Regimen of chemoradiation therapy in the period of Thiotriazoline application was not changed.

[Use of hydrogel tissues with 5-fluorouracil and sodium alginate, "COLETEX-5-FTUR," for radiomodification in cancer patients receiving radiation therapy].

Radiomodification is one of the most available and repeatable methods of amplification of the tumor damage in radiotherapy. The application of 5 FU hydrogel tissues for colorectal and breast cancer patients enables to complete the surgery, increase performance of radiation treatment, reduce the relapse frequency.

[Experience of local radiation therapy and total irradiation of the skin by electron beam in patients with primary B and T-cell lymphomas of the skin].

The problem of the treatment of primary malignant lymphomas of the skin is now becoming increasingly important due to the increase of cases among people of working age and disability of these patients. In most cases lymphomas of the skin have a T-cell origin, the most common of skin lymphoma is mycosis fungoides. It is poorly studied the role of electronic radiation therapy in local and systemic skin lymphomas as well as methodological questions of its application, so research in this field is actual. Therefore the aim of the study is improving of the efficiency of therapy in patients affected by non-Hodgkin's lymphoma with skin lesions by the use of local radiation therapy and total skin irradiation by electron beam.

[Regional chemoinfusion and radiation therapy to patients with breast cancer metastases to the brain: preliminary results].

Effectiveness and safety of regional chemoinfusion in combination with radiation therapy in patients with breast cancer with metastases to the brain was clinically assessed. Cerebral angiography with chemoinfusion was fulfilled in six patients. The procedure could not be fulfilled completely in one patient because of transient vascular and neurological disorders. In the other five patients the regional superselective chemoinfusion was fulfilled successfully to the arteries feeding the metastatic foci in the brain with Carmustin in dosage 100 mg in combination with radiation therapy that was fulfilled in all six patients before the planned total focal dose. The incomplete response (n=5) to the treatment and stabilization of the process (n=l) were noted in six observations.

[Brain metastasis in breast cancer].

Brain metastasis is an important issue in modern neurooncology. Our results of combined treatment of brain metastases are presented and available approaches to brain irradiation and chemotherapy are discussed. There is strong evidence to suggest that maximum combinations of approaches might improve treatment efficacy and extend median overall survival to as long as 6 months (p < or = 0.05).

[An investigation of extracellular HER-2/NEU domain level in blood serum from breast cancer patients].

A series of 159 tests on HER2 ECD in blood serum from breast cancer patients established the following correlations: enhanced levels of the marker occurred more often in patients with multiple metastases to different organs alongside those with bone metastases; patients in loco-regional relapse tended to show elevated levels too. It is suggested that the method be used for prognosis and monitoring.

[Intra-arterial chemotherapy and chemoembolization in the combined treatment for locally advanced carcinoma of the head and neck].

We evaluated the role of intra-arterial chemotherapy and/or chemoembolization, intravenous systemic chemotherapy and radiotherapy in combined treatment for locally advanced unresectable carcinoma of the head and neck. Transfemoral approach for catheterization with chemoinfusion/chemoembolization of the external carotid artery branches with carboplatin (300 mg/m2), 5-fluorouracil (1000 mg/m2) and gelatin sponge was attempted in 25 patients. Out of that number, 18 received additional radiotherapy. Bleeding episodes and relevant high risk in the future were indications for embolization treatment. There was complete (2) and partial (8) tumor regression or stabilization (5) (83%), progression (3) (17%). Arterial and systemic chemotherapy without irradiation resulted in one partial response, 3 cases of stabilization (57%), and 3 cases of progression (out of 7) (43%). There were no episodes of chronic tumor-related bleeding (7). Hence, combined treatment for locally advanced carcinoma of the head and neck including intra-arterial chemotherapy, chemoembolization, intravenous systemic chemotherapy and radiotherapy can be safely delivered with high response rates and low systemic toxicity. Since all these measures are accompanied by relatively low risks of chronic bleeding a choice of palliative or radical dosage of radiation is possible.

[Prediction of relapse-free period after radio- and chemotherapy in patients with breast cancer].

The study was carried out in 55 females with breast cancer stage III-IV, aged 35-77 yrs. The patients received radiation and standard courses of CMF, or CAF, or CMF+trastuzumab, or carboplatin+vepesid, or taxotere+epirubicin, or mustoforan. Radiation was administered in fractionated single focal doses of 3 Gy. S-index was determined before treatment started by an original short (ca. 4 hrs) method of evaluating apoptotic leukocyte DNA disintegration after ex vivo test irradiation as described by Ivanov S.D. et al., 2003. The index ranged 0.40-1.44 rel. units thus correlating with 2-100 month relapse-free period. Direct correlations were identified between S-index and relapse-free period for different regimens of radiochemotherapy. S-index level in excess of 0.95 involved relatively longer relapse-free survival. In summary, our method offers means of predicting the effectiveness of a particular regimen prior to treatment thus making individualization possible.

[Knowledge of lung cancer patients about their disease and their psychological adaptation].

Among 42 patients with primary lung cancer, 11 refused, 20 admitted while 11 admitted partially the fact of their disease. Later on, compensatory mental dysadaptation in the first group was followed by inadequate attitude to the disease. The growing awareness of the disease involved neurotic symptom enhancement which was an adequate response under the circumstances. On the other hand, adequate self-assessment and finding ways of self-expression promoted psychological adaptation. The better the patient was informed of his or her condition, the more their sense of responsibility for it was stimulated.

[Effect of radiotherapy on heart rate stability in cancer patients].

Heart rate variability at rest and in active orthostatic test (AOT), before and after radiotherapy (STD 3Gy; TTD 30Gy), was studied in 4 left-breast cancer patients and 8 cases of esophageal (middle third) cancer. AOT involved by decreased baroreflective activity (7) and parasympathetic reactivity. Sympathoadrenal fraction was relatively prominent in 6 patients against the background of average declined heart rate (3). Prior to radiotherapy, average heart rate was low in all patients, and continued to fall in 10 patients after treatment. While tumor process inhibited functional status and systemic reactions of adaptation, they were still further depressed by radiotherapy resulting eventually in failure of such response.

[Effectiveness of repeated systematic radiotherapy for generalized prostate cancer].

Examination of 127 patients with generalized prostate cancer established a low prophylactic effect of systematic treatment with strontium-39 chloride: it failed to alleviate pain in metastatic cancer, nor was it followed by longer mean survival. Repeat systematic radiotherapy is not indicated when palliative measures such as hormonal therapy, local radiotherapy and chemotherapy are still effective.

[Prognostication of hematotoxicity for radio- and chemotherapy in patients with breast cancer]. / Prognozirovanie gematotoksichnosti pri luchevoi i khimioterapii u bol'nykh rakom molochnoi zhelezy.

The effectiveness of radiation and chemotherapy for breast cancer depends on individual response to drug-induced toxicity. The response can be evaluated by means of myelodepression. To this end, changes in leukocyte DNA level after ex vivo gamma radiation test were used as a criterion. Patients, aged 29-78, with tumors stage IIIB-IV received standard radiotherapy (50 Gy) or cyclophosphamide-methotrexate-5-fluorouracil (CMF). Clodronate alone was given to 26 patients and prior to a CMF course. The method proved prognostically effective since it revealed a significant inverse relationship between S-index and leukocyte nadir for both modalities. However, chemotherapy resulted in more pronounced leukopenia. With clodronate administration, the correlation was not significant. When clodronate was supplemented with CMF chemotherapy involved a significant relationship was observed between the two factors.