[Soluble receptors for tumor necrosis factor and lipid metabolism as potential prognostic factors in patients with prostate cancer].

There was investigated the relationship of lipid metabolism, humoral immunity, high sensitivity C-reactive protein and soluble receptors for TNF-alpha with the presence, severity and prognosis of the disease in 85 patients with morphologically verified diagnosis of prostate cancer. Connection with the dynamics of change in PSA as a major predictor of the disease was observed for concentration sRI and sRII to TNF, PSA baseline, total cholesterol and LDL-cholesterol. During follow-up the relative risk of poor prognosis increased by 3 times, and death-in 8.7 times with increasing concentrations of soluble receptors for TNF. The concentration of soluble receptors for TNF may serve as an additional predictor of the presence and clinical course of disease in patients with prostate cancer.

[Clinical and prognostic significance of the doubling time of initial prostate-specific antigen in patients with prostate cancer].

UNLABELLED: Kinetic parameters of prostate-specific antigen (PSA) play a pivotal role in diagnostic and treatment of patients with prostate cancer (PCr). Assessment of PSA doubling time (PSADT) can be used for monitoring of treatment efficacy and predicting the outcomes of disease. The aim of the present paper is to analyze the PSADT in patients with different spread of PCr. Moreover, the initial PSADTs were studied with relation to overall survival. 336 PCr patients were included into the study. PSADT was measured usng two point method. Ill patients had localized PCr (T1-2N0M0), 90--regional-local PCr (T1-2N0M0) and 136 had generalized PCr (T1-4N1-2M1). RESULTS: Median PSADT in patients with generalized PCr amounted to 2,93 months and was significantly lower as compared to groups of patients with local and regional-local spread of disease--15,2 and 13,2 months respectively. Follow-up results revealed the link between PSADT and survival rates: the lower is PSADT, the worse are survival rates.

[Survival among patients with prostate cancer after distant radiotherapy and low-intensity near-infrared phototherapy].

The paper discusses the effect of photography with near-infrared photography on survival of patients with prostate cancer (PC) after distant radio- (DRT) and hormonal therapy (January 2000 - June 2007). The control group (n=251) were treated with standard radio- and hormonal therapy alone. Besides, patients of the study group (n=308) received phototherapeutic treatment to prevent radiation-induced injuries of the urinary bladder and rectum. The groups were compared relatively to PC cell differentiation, DRT and hormonal treatment. Survival was evaluated (Caplan-Meyer); log-rank test was used to compare the results. Overall survival in the study group of patients with localized (T1-2N0 M0) and generalized (T1-4N0-1 M1) tumors did not differ from that of controls (p > or = 0.05). In patients with locally advanced tumors (T3-4N0-1 M0, T1-4N1 M0), significant differences in survival between controls and study group were recorded beginning from year 3 of the investigation: 5-year survival rates were 67% and 89%, respectively (p < or = 0.05).

[Some kinetic characteristics of cervical cancer].

Proliferation parameters such as mitotic index, tumor growth rate and cell loss were identified in 1,048 squamous cervical carcinoma patients treated at the Center's Clinic (1951-1996). Mitotic indices ranged 0.2-5.1% (average 1.13 +/- 0.03%), Ki-67--4.1-97.8% (average 49.97 +/- 3.02%). A direct and significant correlation between the two latter parameters was established. Cell loss levels ranged 59-99.9% (average 97.2 +/- 0.002%). Our results suggest that the correlation between tumor growth rate and cell loss might be of the utmost importance among the other prognostic factors.

[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.

[Immunohistochemical study of the predictive value of oncoproteins p53, HER-2 and c-myc during radiotherapy for squamous cell carcinoma of the cervix].

Out of 80 patients with squamous cell cervical carcinoma (stage II-III), p53 expression was observed in 30% of tumors prior to treatment and 49% in the course of radiotherapy. A correlation between degree of p53 expression before treatment, on the one hand, and overall and recurrence-free survival, on the other, was identified: high expression of mutated gene-suppressor p53 was 53% while for absence or low expression, it rose to 67% (p=0.03). For overexpression, 20-month survival was 65%; absence--81% (p=0.01). Hence, p53 expression may be used as a predictive factor in radiotherapy for cervical carcinoma. No correlation was found between p53 expression, on the one hand, and such basal clinico-morphological parameters as stage, morphological pattern and tumor cell differentiation, on the other. HER2(3t) overexpression occurred in 2 (2.5%) which seems to point to its insignificant role in squamous cell cervical carcinoma. There was no relationship between c-myc expression and long-term results.

[Ki-67 expression as a predictor of the effectiveness of radiotherapy and of outcome in locally advanced squamous cell carcinoma of the uterine cervix (immunohistochemical study)].

Retrospective immunohistochemical assay of antigen Ki-67 in tumor tissue was carried out prior to and in the course of radiotherapy (TFD - 14-20Gy) in 89 patients with squamous cervical carcinoma. Index of proliferation, i.e. number of Ki-67-positive cells per 1,000 of all cells, was found. Prior to therapy, the index was on the average 49.7%, during irradiation it decreased and its mean value was 24%. There was a correlation between proliferation level tumor progression and the former influenced the immediate effect of radiotherapy. Ki-67 expression in cervical carcinoma exceeded the median. It correlated with unfavorable end-results and was followed by higher relapse incidence. No significant proliferation index difference was reported visa-vis histological pattern, tumor cell differentiation or age. Yet, the drop in proliferative activity during therapy was significant, regardless of outcome. Our results pointed to the high prognostic significance of proliferative activity as far as therapy and outcome were concerned.

[Combined use of local and systemic radiomodifiers as a new modality of cervical carcinoma therapy].

A cooperative study included 643 cervical carcinoma patients (stage II-III). Radiotherapy used such local and systemic radiomodifiers as DMSO-dissolved metronidazole, which inhibited allopurinol DNA reparations, and dipyridamol, an inductor of interferon synthesis. A 13-15% rise in survival matched the results of combined treatment for cervical carcinoma, yet the simplicity of operation, accessibility, high efficiency and stability of results of our modality made it quite competitive in therapy of the disease.

[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.

[Local application of dimethyl sulfoxide at different concentrations to the prevention of radiation-induced damages in patient with cancer of the cervix uteri].

OBJECTIVE: to study the efficacy of dimethyl sulfoxide ((DMSO) at different concentrations in preventing radiation-induced rectal and urinary bladder damages in patients with cervix uteri cancer (CUC). MATERIAL AND METHODS: combined radiation therapy (RT) was performed in 807 patients with CUC. In the control group (n = 221), RT was made, without applying radio-modified agents. An hour prior to a session of intracavitary irradiation, 10% DMSO solution was instilled into the rectum and urinary bladder in 113 patients and applications of metronidazole (MN) dissolved in 100% DSMO were made in 473 patients. Teleradiotherapy was performed, by using megavolt irradiation sources in the conventional fractionation mode; the total focal dose (TFD) was increased up to 40-46 Gy. Intracavitary irradiation was carried out on "AGAT-V" and "AGAT-VU" devices once weekly; the single focal dose in point A was 7 Gy; TFD was 49-56 Gy. RESULTS: 10% DMSO instillations reduced the incidence of late radiation-induced damages to the rectum and urinary bladder. In the control group, the incidence of these conditions was 19.0 and 9.5%, respectively; with the use of 10% DMSO, that was 8.8 and 7.1%. Applications of MN dissolved in 100% DMSO reduced the incidence of late radiation-induced damages to 1.7%. CONCLUSION: Local application of DMSO is a method for preventing late radiation-induced damages to the rectum and urinary bladder in patients with CUC. When the concentration of DMSO is increased, its preventive effect increases.

[Results of modified radiotherapy in the treatment of patients with uterine cancer]. / Rezultaty modifitsirovannoi luchevoi terapii bolnykh rakom matki.

A ten year experience gained in radiotherapy with radio modifiers of 480 patients with cancer of the cervix uteri and of 189 ones with endometrial cancer carried out at the Central Research Roentgeno-Radiological Institute of the Russian Academy of Medical Sciences is analyzed. Local administration of metromidasole with dimethysulfoxide essentially enhanced the detrimental effect of radiation on the tumor. This is reflected in a higher incidence of local control in radiotherapy of patients with cancer of the cervix and corpus uteri. A reduced incidence and degree of radiation injury to organs adjacent to the uterus was observed.