[10-year results of using segmental pelvic irradiation combined with local irradiation of the prostate in patients with prostate cancer with multiple bone metastases].

The objective was to show the importance of external beam radiotherapy (EBRT) to increase the effectiveness of treatment and improve the quality of life of patients with generalized prostate cancer (PC). From 1992 to 2005 at our institution 205 patients with morphologically verified generalized (stages T1-4N0-1M1b) PC received EBRT. EBRT was conducted against the background of hormone therapy. Irradiation was begun with segmental pelvic irradiation with consistent reduction in the volume of exposure to locoregional and local irradiation of the prostate. The total tumor dose on the prostate was adjusted up to therapeutic level (66-72 Gy). In case of PC generalization with a primary lesion of the pelvis and lumbosacral spine, palliative EBRT according to the proposed method was justified. EBRT not only improved the quality of life of patients but also increased its duration.

[First experience of using positron emission tomography with 11C-choline in prostate cancer (PC)].

Introduction into clinical practice of combined positron emission technology and computer tomography (PET/CT) allows in one study to identify structural and functional abnormalities. The study involves 32 patients who underwent PET/CT with "C-choline, including 5 patients with prostate cancer (PC), 3--with chronic prostatitis and 24--with biochemical PC recurrence. PET/CT with 11C-choline has a high diagnostic efficacy in detection of local recurrence and PC metastases in patients with biochemical PC recurrence. The results of visual analysis do not permit to distinguish PC from benign prostate diseases.

[Main results of research reported by the Center's Department of Innovation in Radiotherapy].

The efficacy of multimodality conservative treatment for prostate and bladder cancer and cervical carcinoma was improved due to integration of such modem modalities as intra-arterial chemotherapy, local hyperthermia and hyperglycemia and combination of local and systemic radiomodifiers. Our methods use criteria of actual survival and are intended to raise it.

[Combined radiotherapy and endovascular x-ray therapy for invasive cancer of the urinary bladder].

The data are presented on treatment of 131 patients with transitional cell carcinoma of the urinary bladder. Radiotherapy was received by 57, regional intraarterial chemotherapy (RIAT)--27. Radiotherapy was combined with RIAT and selective hyperglycemia (HG) in 18 cases. Local super high-frequency (SHF) hyperthermia was given additionally to another 29 patients. Radiotherapy alone was followed by primary clinical cure, a 9.6-months relapse-free period and 3-months survival (36.8%), mean survival time being 26 months. In the RIAT group, these indices were 29.6%, 10.8 mos, 51.9% and 36 mos, respectively. Combination of radiotherapy, RIAT and selective HG yielded significantly improved indices: complete response--44.4%, relapse-free period--13.6 mos, 3-year survival--66.7% and mean survival time--43 mos. After addition of SHF hyperthermia, complete response rose to 69.0%, relapse-free period--18.2 mos, 3-year survival--75.8% and mean survival time--61 mos. Joint use of radiotherapy, RIAT, HG and SHF hyperthermia caused more damage to tumor, stimulated complete response and increased 3-year survival and mean survival time.

[Current methods of radiation therapy in patients with prostatic cancer: subtotal body radiation, local hyperthermia]. / Sovremennye metodiki luchevoi terapii bol'nykh rakom predstatel'noi zhelezy: subtotal'noe obluchenie tela, lokal'naia gipertermiia.

The paper deals with the preliminary data of treatment of patients with prostatic cancer by using unconventional methods of radiation therapy (RT), such as subtotal radiation of the body (STRB) and thermoradiation treatment (TRT). Out of 72 patients receiving RT, 16 and 8 had STRB and TRT, respectively. Systemic and local drug therapies were made to prevent radiation reactions and injuries. In all cases, STRB and TRT showed a significant objective and subjective effect. To evaluate the long-term results of treatment needs further studies.

[Intravital study of lymph outflow in rectal cancer]. / Prizhiznennoe izuchenie ottoka limfy pri rake priamoi kishki.

Methods of life-time studies of lymph drainage in the rectum using lymphoscintigraphy were developed. The normal rectum was found to fall into two segments with a border at the level of 5 cm above the anus which revealed essentially different pathways of lymph drainage: mainly to inguinal and internal iliac lymph nodes (distal segment) or to superior rectal and inferior mesenteric lymph nodes (proximal one). Rectal cancer involves the switching-on of reserve and collateral pathways of lymph drainage from the organ which is determined by the local-regional extension of tumor.

[Radionuclide visualization of the superior rectal and inferior mesenteric lymph nodes in rectal cancer]. / Radionuklidnaia vizualizatsiia verkhnykh priamokishechnykh i nizhnikh bryzheechnykh limfaticheskikh uzlov pri rake priamoi kishke.

Scintigraphic image of the superior rectal and inferior mesenteric lymph nodes 7-8 cm up from the anus was obtained by presacral administration of finely divided 99mTc-colloid (close to the posterior rectal wall). The results of radiometry of the lymph nodes dissected at radical operation for rectal cancer have shown that due to the above method the radioactive indicator is accumulated in these groups of lymph nodes. Several variants of a scintigraphic picture were defined on the basis of analysis of scintigrams of 23 patients with extrarectal tumors and nontumorous diseases and 40 rectal cancer patients. Evaluation of the lymphoscintigraphy results compared with the morphological findings of the lymph nodes dissected at operation in 32 rectal cancer patients, has shown that the overall accuracy of the above method is 0.81, specificity--0.63, sensitivity--1.0.

[Diagnostic significance of lymphoscintigraphy in cancer of the rectum]. / Diagnosticheskoe znachenie limfostsintigrafii pri rake priamoi kishki.

Lymphoscintigraphic data were compared with the results of morphologic examination of resected regional lymph nodes in 51 cases of rectal cancer. Radionuclide method accuracy proved to be 80%, specificity--65% and sensitivity--96%. Correct diagnosis of metastasis was made in 73% while absence of metastases was reliably confirmed in 94%.