[The main trends in a complex program of rehabilitation of children with oncological diseases]. / Osnovnye napravleniia kompleksnoi programmy reabilitatsii detei s onkologicheskimi zabolevaniiami.

The present-day therapeutical programmes allow physicians to cure as many as 70% of children with malignant neoplasms, in some tumor forms, the proportion of recovered children is much higher, which shows it urgent to elaborate comprehensive rehabilitation programmes required for the effective integration of prior patients of children's cancer clinics into a group. The paper presents a complex rehabilitation programme worked out at the Research Institute of Pediatric Oncology and Hematology, Russian Cancer Research Center, Russian Academy of Medical Sciences. The basic directions of the programme are medical, psychological, pedagogical, and social rehabilitation. For medical rehabilitation, phytotherapy, medical laser, climate therapy, and therapeutical exercises are widely used. Of particular value are physical and recreational activities, which include the use of therapeutical exercises, active recreational activities, participation in sporting events, and conditioning swimming. Psychological and pedagogical rehabilitation is aimed at solving personality and familial problems, at developing intellectual abilities, and at eliminating steady-state bad habits and behavioral deviations. A psychological and pedagogical programme is based on the work of art-therapeutical shops where a child realizes his/her strivings, which promotes the recovery of his/her mental and social status. The work of psychologists and psychotherapeutists with children's parents occupies a highly important place since correction of child-parent relations serves as a necessary basis for mental recovery in a child. The most important factor of social rehabilitation is an educational programme aimed at acquiring knowledge and at stimulating cognitive activities. To implement the comprehensive programme increases life quality in children who have sustained cancer diseases, improves their social adaptation and thus facilitates integration of these children in society.

[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).

[Experience in treating osseous sarcomas at the Research Institute of Pediatric Oncology, Cancer Research Center]. / Opyt lecheniia kostnykh sarkom v NII Detskoi Onkologii ONTs.

The paper presents clinical findings of 210 children with localized osteogenic sarcoma who have undergone various treatments. The authors consider neoadjuvant chemotherapy the method of choice, but by replacing tubular bone defects, endoprosthesis should be regarded the method of choice, which substantially reduces the time of rehabilitation and yields good (32.4%) and satisfactory (47.0%) functional results in most patients. In children with osteogenic sarcomas, the outcomes of treatment depend on its scope: 5-year survival was achieved in 68% of cases following multimodality treatment and in 36.2 and 14.0% after combined treatment and monotherapy alone, respectively. The retrospective analysis of treatment for morphologically verified Jung's sarcoma shows it expedient to implement a comprehensive program, including cyclic polychemotherapy, radiation of a damage focus in a dose of 57 Gy, obligatory surgical intervention into the operable sites, by assessing therapeutical pathomorphism and subsequent adjuvant polychemotherapy for at least 12-18 months.

[Sex and pituitary hormone secretion in adolescents with osteogenic sarcoma and retarded sexual development]. / Sekretsiia polovykh i gipofizarnykh gormonov u podrostkov, bol'nykh osteogennoi sarkomoi s zaderzhkoi polovogo razvitiia.

Basal levels of secretion of total testosterone, estradiol-17 beta, their free, albumin-binding and sex steroid-binding globulin (SSBG)--binding fractions, luteinizing hormone, follicle-stimulating hormone, prolactin and somatotropic hormone were measured in blood serum in the following groups of adolescents: (1) healthy, (2) suffering primary osteogenic sarcoma of the bone, (3) osteogenic sarcoma patients with pubertal retardation, and (4) pubertal retardation. A significant increase in total testosterone fraction, free androgen index and a decrease in blood SSBG level were established in osteogenic sarcoma patients as compared to corresponding controls, irrespective of pubertal status. No difference in the above indexes for estrogens was established between osteogenic sarcoma patients and controls in both pubertal status subgroups. The role of sex steroid hormones, particularly, androgens in the pathogenesis of osteogenic sarcoma is discussed.

[The characteristics of eicosanoid synthesis in osteogenic sarcoma in children at puberty]. / Osobennosti sinteza éikozanoidov v osteogennoi sarkome detei v pubertatnom periode.

Levels of prostaglandin E (PGE), prostaglandin F2 alpha, prostacyclin A2, thromboxan B2 and leucotriene B4 assayed radioimmunologically were compared in 42 samples of osteogenic sarcoma and 22 samples of benign tumors and tumor-like lesions from children at the pubertal period. In osteogenic sarcoma samples, PGE and prostaglandin F2 alpha levels were higher than those of thromboxan B2, prostacyclin A2 and leucotriene B4. Osteogenic sarcoma revealed higher levels of the eicosanoids as compared to benign tumors and tumor-like lesions of the bone. An inverse correlation was established between PGE level and time of dissemination of osteogenic sarcoma. The role of eicosanoids in the pathogenesis of growth and dissemination of osteogenic sarcoma is discussed. The use of non-steroid anti-inflammatory drugs in complex treatment of osteogenic sarcoma of children at the pubertal period is suggested.