[Low dose-rate contact radiation therapy (brachytherapy) for prostate cancer using domestic I-125 seeds as a monotherapy and combined with pelvic lymphadenectomy].

INTRODUCTION: In 2014, the incidence of prostate cancer in the Russian Federation was 116.4 per 100,000 population. It is noteworthy that from 2004 to 2014, the proportion of patients with stage I-II prostate cancer increased from 35.5% to 52.5%, while that of patients with stages III and IV disease decreased from 38.4% to 29% and from 22.7% to 16.5%, respectively. All of this allows an increasing number of prostate cancer patients to be treated with radical treatment - low dose-rate brachytherapy. For the first time in this country, we report a clinical trial of low dose-rate brachytherapy for prostate cancer using domestically manufactured I-125 seeds. The successful results of this clinical trial are presented in this article. The aim of this work was to show the clinical efficacy and safety of domestically manufactured I-125 seeds for low dose-rate prostate cancer brachytherapy. MATERIALS AND METHODS: The clinical trial comprised 36 patients with stage T1-T2 prostate cancer. Patients were randomly assigned according to the risk of cancer progression. Low and intermediate risk groups comprised 30 (83.3%) and 6 (16.7%) patients, respectively. Patients of low risk group underwent brachytherapy alone with the minimum therapeutic dose of 145 Gy. I-125 seeds of two activities, 0.55 and 0.35 mCi per seed were used for implantation. Depending on the prostate volume, from 40 to 80 seeds, 57 on average were implanted. Mean implantation time was 85 minutes. In patients of the intermediate risk group brachytherapy was performed in combination with laparoscopic pelvic lymphadenectomy which was carried out 4-5 weeks prior to brachytherapy. RESULTS: Follow-up examination at 6 months after implantation showed that PSA decreased in all patients on average by 87% from the baseline. No adverse events were reported. CONCLUSION: The findings of the clinical trials of domestically manufactured I-125 seeds showed they are effective, safe and comply with international standards.

[Clinical efficacy of arbidol (umifenovir) in the therapy of influenza in adults: preliminary results of the multicenter double-blind randomized placebo-controlled study ARBITR].

AIM: To evaluate the efficacy and safety of Arbidol (umifenovir) in adult patients with influenza. SUBJECTS AND METHODS: The analysis of the preliminary results of the multicenter double-blind randomized placebo-controlled post-marketing study ARBITR was performed. A total of 293 adults aged 18 to 65 years with influenza or acute respiratory tract infection of no more than 36 hours' duration were enrolled in the study. Individuals were randomized into 2 treatment groups: oral umifenovir 200 mg four times daily for 5 days or placebo four times daily for 5 days. The efficacy endpoints were time to resolution of all symptoms, severity of symptoms and illness, durations of virus shedding. RESULTS: The efficacy of umifenovir was evaluated in the group of 119 (40.6%) patients with influenza: 45 patients with laboratory-confirmed influenza and 74 patients whom diagnosis of influenza was made based on clinical and epidemiological data. Umifenovir had influence on the time to resolution of all symptoms. All symptoms were resolved within the first 60 hours after therapy initiation in 23.8% patients with laboratory-confirmed influenza in the umifenovir group and it was 5.7 times greater compared to placebo group (4.2%) (p < 0.05). Severity of illness, catarrhal symptoms and intoxication was reduced with umifenovir compared to placebo, reducing of severity was most evidently observed within the first 2-3 days following the therapy initiation. Umifenovir had a significant effect on viral shedding. The proportion of patients still shedding influenza virus on day 4 was significantly reduced in the umifenovir group compared to placebo (25 vs 53%, respectively; p < 0.05). CONCLUSION: It was found that the effect of umifenovir in the treatment of influenza in adults is most pronounced in the acute stage of the disease and appears in the reduction of time to resolution of all symptoms of the disease, reducing the severity of symptoms of the disease and durations of virus shedding.

[Diagnosis and treatment of local recurrence of prostate cancer using hystoscanning and high-intensity focused ultrasound in patients after radical prostatectomy].

The study was aimed to the improvement of the diagnosis and treatment of patients with prostate cancer (PC). The study included 46 patients with recurrent prostate cancer after radical prostatectomy (RPE). The examination included contrast enhanced magnetic resonance imaging (endorectal coil 1.5T) and hystoscanning. All patients had local recurrence confirmed by the morphologically results of transrectal biopsy of the area of vesicourethral anastomosis. All patients underwent high-intensity focused ultrasound (HIFU). Before RPE, protate volume ranged from 21 to 102 cm3. The median age was 62 (46-68) years. PSA levels before a HIFU session ranged from 0.4 to 18 ng/ml. Nadir PSA level after 3 months of follow up was 0.1 ng/ml. Five-year disease-free survival in patients with locally recurrent prostate cancer after HIFU in the group of low cancer risk was 10 (81%), moderate risk--18 (57%), high risk--12 (42%). Contrast enhanced magnetic resonance imaging and hystoscanning are highly informative methods for diagnosis of local recurrence after radical prostatectomy, and HIFU can be categorized as highly effective treatment.

[Early diagnosis of prostate cancer using histoscanning device].

For the purpose of improving diagnosis of prostate cancer (PC), the authors used an innovative HistoScanning device. According to the standard procedure accepted at the clinic, 326 patients admitted with suspected prostate cancer were evaluated. Patients with elevated prostate-specific antigen (PSA) were divided into three groups depending on the degree of its increase, which ranged from 1.09 to 209 ng/ml; Group 4 (conventional control) consisted of patients with BPH, and Group 5 (control) consisted of healthy men aged 21 to 28 years. At the next step, histoscanning was performed with construction of maps of the prostate, which was used when performing a biopsy. The results of histoscanning were compared with data of morphological examination of biopsy material, and with the data of visual and morphological studies of surgical specimens in patients undergoing radical prostatectomy. High diagnostic value of histoscanning was demonstrated, as even in patients of Group 1 sensitivity was 89%, specificity--96%, in patients of Group 2 and 3--96 and 94%, 99 and 97%, respectively. False positive results occurred in 11% of cases, false negative--only in 0.6%.