[Rare localization of prostate cancer single metastasis. Clinical case and literature review].

The most common sites of prostate cancer metastases are lymph nodes, bones, lungs. The bladder is in 4th place in terms of the frequency of metastasis. We present a case of a rare single metastasis of prostate cancer to the bladder 8 years after the first diagnosis of prostate cancer T3N0M0. Patient A., 83 years old, complained of blood in the urine, frequent urination, nocturia. PSA level 5.4 ng / ml. During cystoscopy, a villous tumor on a broad base was totally resected. On histological examination, poorly differentiated adenocarcinoma 10 points according to Gleason (5 + 5).

[Polymorphism of glutathion-S-transferase genes in patients with prostatic cancer].

The study of polymorphic variants of GSTT1, GSTM1 and GSTP1 genes from 61 patients with prostatic cancer (PC) has shown that incidence of 0/0 genotype GSTT1 and GSTM1 in PC patients was significantly higher of that in healthy men (n = 100) (34.4 and 15% in p = 0.007 and 60.7 and 43% in p = 0.04, respectively). PC risk in carriers of a GSTT1 deletion form was 2.97, CI95%--1.3-6.84, GSTM1--2.04 in CI95% 1.02-4.1. The analysis of combinations of pathological genotypes of xenobiotic biotransformation enzymes has demonstrated that 89.8% PC patients have a mutation in one of the genes GSTT1, GSTM1 or GSTP1.

[Neoadjuvant chemotherapy of invasive cancer of the urinary bladder].

We studied efficacy of a combination of intraosseous and systemic administration of drugs in patients with invasive cancer of the urinary bladder (UB). A total of 20 patients aged 54-79 years with verified had recurrence, 2 had tumors with continuous growth. T2N0M0 UB carcinoma was diagnosed in 7 patients, T3N0M0--in 12, T6N0M0--in 1 patient. All the patients received systemic chemotherapy with gemzar in a single daily dose 800-1000 mg/m2 on day 1, 7 and 14. On day 2 a single intraosseous 100 mg eloxatin was given. A total of three courses of combined chemotherapy with 4-week interval was used. Intravenous gemzar administration was accompanied with mild leukopenia in 4 patients, moderate leukopenia--in 1, allergic reaction--in 2 patients. This required gemzar discontinuation. No side effects were seen in response to intraosseous administration of eloxatin. The combined chemotherapy produced complete regression of UB cancer in 3 of 18 patients, partial regression--in 12, stabilization--in 3 patients. Neither local nor long-term tumor progression was found. Short-term therapeutic efficacy of combined therapy was 70%. Fifteen patients with partial regression or stabilization have undergone transurethral resection. Duration of a recurrence-free period reached 5 to 72 months (mean 17 months). The neoadjuvant chemotherapy proposed by us allows achievement of a high percentage of regression in patients with invasive UB cancer located in UB cervix and provides concervative surgery including patients over 70 years of age.

[Radiologic follow-up and prognosis of efficiency of systemic Sr-89 Cl-2 therapy of bone metastases in prostate cancer]. / Kompleksnaia luchevaia otsenka i prognozirovanie éffektivnosti sistemnoi radioterapii 89SrCl2 pri kostnykh metastazakhraka predstatel'noi zhelezy.

We evaluated possibilities of bone scintigraphy with 99mTc-methylendiphosphonate (99mTc-MDP) and magnetic resonance imaging (MRI) in follow-up and prediction of effect in patients with extensive bone metastatic disease treated with betha-emitter 89SrCl2. 24 patients with prostate cancer and extensive metastatic involvement of skeleton were referred for the study. 89SrCl2 was injected as single injection of 150 MBq (4 mCi), in eighteen from Amersham plc., England, as Metastron, in six--from Medradiopreparat, Russia). In all patients bone scintigraphy with 99mTc-MDP and MRI study of metastatic regions were performed before and in 3 months after 89SrCl2 injection. Patients treated with Metsatron were also studied in 6 months after injection. Quantitative analysis of data comprised count and anatomic dimensions of metastatic areas and calculation of indices [metastasis/intact bone] both for scintillation count of 99mTc-MDP bone scans and signal intensity of T1-weighted MRI scan. Henceforth, we conclude the data of bone scanning with 99mTc-MDP and of MRI give evidencies for significant regress of bone metastases in patients treated with 89SrCl2 besides symptomatic suppression of pain syndrome. 99mTc-MDP bone scanning is also of predictive value for the prognosis of therapeutic effect of systemic radiotherapy with 89SrCl2 in prostate cancer.

[Bladder wall permeability to to topically administered cisplatin]. / Pronitsaemost' stenki mochevogo puzyria dlia tsisplatina pri mestnom primenenii.

The aim of the study was quantitation of cisplatinum in the wall of normal urinary bladder, tumor tissue, inflamed mucosa and blood in intravesical administration of cisplatinum. The samples of the tissue were radiated in the flow of heat neutrons 5 x 10(12)-5 x 10(13) neut/cm followed by radiochemical purification of the material and platinum assay in the tissue using analyser LP-4900 with semiconductor radiation detector. The samples were taken from 32 patients with transitional cancer of the bladder. Tumor tissue contained platinum in amounts 33.7 times exceeding those in normal tissue after intravesical administration of 100 mg of the drug. After intravenous administration of 100 mg cisplatinum normal bladder tissue and tumor tissue contained almost similar quantities of the drug. Thus, tumor tissue absorbs more cisplatinum than normal tissue of the bladder in intravesical administration.

[Radiologic diagnosis of bone metastases recurrence in patients with prostate cancer treated strontium-89]. / Luchevaia otsenka regressa kostnykh metastazov u patsientov s rakom prostaty pri sistemnoi radioterapii 89SrCl.

Aiming to evaluate efficiency of 89SrCl (Metastron) in patients with metastatic lesion of the skeleton in prostate cancer we have performed a follow-up scintigraphy of the skeleton with 99mTc-methylendiphosphonate (MDP) and MRI with quantitative study of metastatic foci. 12 patients with prostate cancer (on the average 11 +/- 6 bone metastases were examined using scintigraphy of the skeleton with 99mTc-MDP and MRI study in T1, T2 and proton density modes. Investigations were performed before injected as a single dose of 150 MBq (4 mCi). At all the stages there was made a quantitative study of foci of pathological uptake of 99mTc-MDP compromising numbers of foci, focus parameters, intensity of 99mTc-MDP accumulation in the pathological part relatively the contralateral region as well as quantification of MRI signals from metastatic areas in signal intensity units. In 3 month 4 patients with extensive metastatic skeletal lesion (> 12) showed a considerable decrease of number of foci of pathological 99mTc-MDP uptake (on average to 6 +/- 3). In the remained metastatic foci there was noted a decrease of dimensions and 99mTc-MDP uptake intensity at an average by 29.8 +/- 15%, improvement in T1 intensity by 113 +/- 55.6 units. In 2 patients who initially presented a "superscan" pattern on 99mTc-MDP bone scintigraphy the 89SrCl treatment converted this of low intensity had demonstrated their complete regression. Results of radiologic follow-up of bone metastases in prostate cancer using MRI and bone scintigraphy with 99mTc-MDP argue that systemic radiotherapy with 89SrCl induces significant regress of metastatic process that involves all volume of the metastases.