[Long-term results of surgery and preoperative hypoxyradiotherapy for colorectal cancer].

Combined treatment for colorectal cancer involving preoperative hypooxyradiotherapy was used to boost targeted irradiation of tumor cells. End results were significantly improved due to the decrease in the number of distant metastases even in cases of poor prognosis because of lymph node involvement.

[Problems of radiation therapy of patients with malignant tumors and modern ways of resolving them]. / Problemy luchevoi terapii bol'nykh zlokachestvennymi opukholiami i sovremennye puti ikh resheniia.

At the present stage of radiation oncology, treatment successes are mainly determined by improvement of multimodality therapy that utilizes benefits of each modality in individual patients. Radiotherapy is mostly empiric, as demonstrated by dose fractionation. Its significance in many situations is underestimated, which leads to unreasonably excessive irradiation or, vice versa, to its unreasonable refusal. So clinical searches for new knowledge of the actual role of radiotherapy in specific clinical situations are therefore continued. The advent of new-generation radiation therapy apparatuses opens up fresh opportunities for development of rational radiation methods by mathematically optimizing dosage fields of irradiation and creating its conformable conditions. The necessary conditions for further radiotherapy successes are continuation of research developments in rational simulation of spatial dosage distribution, in the use of radio sensibilizers and radio protectors, and in contact methods of radiotherapy and intraoperative irradiation.

[Multimodality treatment for retinoblastoma in children]. / Kompleksnoe lechenie retinoblastomy u detei.

A comprehensive programme was developed for the treatment of uni- and bilateral retinoblastoma in children with due regard to the disease stage by the TNM system. The use of the current sources of teletherapy and cyclic polychemotherapy expanded indications for organ-saving therapy at most common stages. Treatment by the program was performed in 202 patients, including 125 children with unilateral damage and 77 with bilateral damage. An attempt made treat 140 (75%) children at the first stage. More than 70% of cases were diagnosed as having disease stage T3 in one or two stage, while such patients underwent ocular enucleation. A complete or partial (more than 50%) tumor regression without signs of its progression for 2 years or more was achieved in 62% of cases. At the first stage of therapy, conservative therapy insignificantly affected the children's longevity in uncomplicated cases, which is particularly important in bilateral involvement, while this preserved the organ of vision in more than half the patients (62%). Five-year survival was 92 and 82% in unilateral retinoblastoma surgically treated and untreated, 83 and 84%, respectively. Adequate multimodality treatment brought about low incidence rates of recurrence and metastasis (10%) in conservative therapy and 7.7% among all patients.

[Preoperative hypoxia-radiotherapy in multimodal treatment of patients with stage III colonic cancer]. / Predoperatsionnaia gipoksiradioterapiia pri kombinirovannom lechenii bol'nykh rakom obodochnoi kishki III stadii.

The paper analyzes the results of surgical and multimodality therapies for 237 patients with Stage III colonic cancer, which were divided into 3 groups. Group 1 included 119 patients undergone only surgical management, Group 2 comprised 43 who were additionally treated with intensive radiation (4 Gy daily for 5 days) and Group 3 consisted of 75 patients who were irradiated in the presence of overall hypoxia evoked by breathing a gaseous mixture containing 9% oxygen. A five-year follow-up has indicated that there are significantly higher survival rates among those who have received a multimodality therapy rather than those merely operated on (82 +/- 5 and 53 +/- 9%, respectively). A short-term gaseous hypoxia has been found to reduce the incidence of systemic radiation reactions in patients during preoperative radiation and to fail to lower the efficiency of multimodality therapy.

[The possibilities for organ-preserving treatment in retinoblastoma in children]. / Vozmozhnosti organosokhrannogo lecheniia retinoblastomy u detei.

One-hundred pediatric patients with uni- and bilateral retinoblastoma (140 tumors on the whole) received a combination of radio- and chemotherapy. Radiation was delivered by gamma-ray units and an electron accelerator. The single and total focal doses used were 1.5-2.0 Gy and 40-55 Gy, respectively, depending on tumor stage. Simultaneously, chemotherapy with vincristine, cyclophosphamide and adriamycin were given intravenously in standard doses. As a result, 85 out of 95 (89.5%) children including 43 cases of bilateral tumor are alive. Partial response or no change were registered in 72 tumors (51.4%). Progression was observed in 28 tumors (20%) at the average of 6-8 months following the start of treatment. Forty tumors (28.6%) responded completely, with remissions lasting for a follow-up period of 2-6 years. Not a single case of organ-sparing surgery developed distant metastases. To summarize, a combined treatment modality for retinoblastoma according to TNM stage was developed and indications for organ-sparing surgery outlined. The standard treatment modality for bilateral retinoblastoma was revised.

[Ambulatory radiation therapy of malignant tumors in children]. / Ambulatornaia luchevaia terapiia zlokachestvennykh opukholei u detei.

The potentialities of outpatient radiotherapy for pediatric solid tumors were studied in 41 such cases. Gamma teletherapy was given from a Rokus installation. Radiation treatment was expected to induce serious complications in patients with the involvement of blood vessels, hollow organs and vertebra, the said side-effects requiring inpatient management. Outpatient radiotherapy is indicated mostly in the postoperative period. Thanks to a transfer of 41 cases to outpatient treatment, another 23 primary pediatric patients could be admitted to hospital.

[Clinical problems of radiotherapy in pediatric oncology]. / Klinicheskie problemy radiatsionnoi detskoi onkologii.

The main principles of radiation therapy as well as the role of ratio Integral Dose/Total Dose in radiation treatment of malignant tumors in children are considered. Indications for radiation therapy of nephroblastomas and peculiarities of radiation treatment of haemangiomas are described. Expedience is proved of radiation of only the liver part affected by neuroblastoma. Tactics of radiation therapy of eosinophilic granuloma of bones in analyzed. Possibility of conservative therapy including radiation component in treatment of retinoblastoma in children is discussed.

[Long-term results of hyperfractionated radiotherapy in patients with stage III-IV oropharyngeal carcinoma]. / Otdalënnye rezul'taty mul'tifraktsionirovannogo oblucheniia bol'nykh rakom rotoglotki III-IV stadii zabolevaniia.

Radiotherapy was given to 139 patients with oropharyngeal carcinoma (stage III-IV) divided into two groups. Group I included 82 patients who received three daily equal fractions (1 Gy), at 4 hr interval, of a mean total focal dose of 80 Gy. Patients in group II (57) received a mean total dose of 68 Gy in 5 weekly standard fractions. Fractionated treatment was carried out in both groups in three stages at 17-day intervals. Complete remission was achieved in 50 (60.9%) patients in group I and in 31 (54.4%)--group II. Total 5-year and recurrence-free survival was 37.3 +/- 5.4 and 32.4 +/- 5.2% (group I) and 12.5 +/- 4.7 and 10.4 +/- 4.4% in group II, respectively. Radiation injury rates were nearly identical in both groups: 14% for standard radiotherapy and 12% for multiple fractions. The data point to high effectiveness of the latter.

[Problems of dose fractionation in radiotherapy of patients with locally advanced esophageal cancer]. / Problemy fraktsionirovaniia pri luchevoi terapii bol'nykh mestnorasprostranennym rakom pishchevoda.

Patients with local inoperable tumors of the esophagus received a radiation course consisting of three modalities--conventional, continuous accelerated and split fractionation using large single fractions. Significant overall beneficial effect--complete or partial remission--was registered more often in those treated with the two non-traditional modalities. Their application was followed by a 20% rise in palliative effect.

[Remote results of preoperative large fractionation gamma-therapy for breast cancer]. / Otdalennye rezul'taty krupnofraktsionnoi predoperatsionnoi gamma-terapii raka molochnoi zhelezy.

The results of using large fractionation irradiation preoperatively in 131 breast cancer patients are reported. A focal dosage for a primary tumor was found to be 2400 rad (1350 ret) and 1800 rad (1100 ret) for axillary lymph nodes, which given by 600 rad in a day neither effect the course of surgical intervention nor increase the number of the postoperative complications. A five-year cure with stage I-II was 66,3 +/- 11,1%, with stage III--47,9 +/- 7,3%. The whole course of radical treatment lasted on the average for 41-46 days.

[Use of preoperative intensive irradiation in the combined treatment of patients with colon cancer]. / Ispol'zovanie predoperatsionnogo intensivnogo oblucheniia v komibinirovannom lechenii bol'nykh rakom obodochnoi kishki.

The paper discusses the results of preoperative intensive irradiation used in combined treatment for cancer of the sigmoid colon. Diagnosis was verified morphologically. Patients were randomly assigned for irradiation+surgery (group 1-97 cases) or surgery alone (group 2-111). Those undergoing radical operations only (in both groups) were included into the analysis. No difference was found between the two groups in rate of postoperative complications development (frequency of intestinal anastomosis failure included). The frequency of recurrence and metastasis development was significantly higher in the surgery only group. In patients with metastasis into regional lymph nodes, five-year survival was significantly higher among those who had undergone irradiation.

[Conservative therapy for early-stage breast cancer]. / K probleme organosokhraniaiushchego lecheniia bol'nykh rakom molochnoi zhelezy rannikh stadii.

An evaluation of the data on the treatment of 298 cases of breast cancer (stages IIa and IIb) showed that a reduced frequency of loco-regional recurrences, after post-operative irradiation as a component of conservative therapy, was followed by improvement in quality of life. This was particularly apparent in patients with pT2pN1 tumors. It was also found that after extended dissection of axillary lymph nodes at all three levels, a dose of 50 Gy was sufficient without additional irradiation of the cicatrix. Nor was it necessary to expose the axillary area in cases of three or less lymph node recurrences provided that at least 6 resected nodes were studied histologically. Following conservative therapy, 5-year survival was 97%, while relapse-free survival--82%.

[The use of artificial hyperglycemia in the radiotherapy of patients with rectal cancer]. / Ispol'zovanie iskusstvennoi giperglikemii pri luchevom lechenii bol'nykh rakom priamoi kishki.

A treatment modality employing radiotherapy with subsequent hyperglycemia induction was evolved in experiments on mice and then clinically tested in 32 cases of inoperable locally--extensive primary and recurrent cancer of the rectum. A 50% regression of tumor was registered in 14 (43.0%) out of 32 patients treated with radiotherapy in combination with hyperglycemia. Similar degree of regression was observed only in 6 (15.0%) out of 40 patients who received the same radiation treatment unaccompanied by hyperglycemia. The difference was statistically significant. No untoward side--effects developed. The results are encouraging and seem to open up new vistas of clinical research.

[Diagnosis and treatment of cancer of the skin of the perianal region]. / Diagnostika i lechenie raka kozhi perianal'noi oblasti.

Clinical course, diagnosis and treatment of 14 cases of perianal skin carcinoma are discussed. Perianal skin cancer is a rare disease with a specific clinical course. Radiotherapy is the treatment of choice. A combination of irradiation and microwave hyperthermia proved to be the best therapeutic option. All patients who had received proper treatment survived 5 years.

[Radiotherapy of malignant tumors in children]. / Luchevoe lechenie zlokachestvennykh opukholei u detei.

Radiation treatment is widely used in pediatric cancer patients. Much attention should be paid to preserve the function and structure of normal organs and tissues adjacent to tumor. To achieve this goal, optimal treatment modality should be chosen and closely followed. Certain peculiarities of irradiation of children, particularly, infants should be considered. These include the use of medication sleep. Drug combinations to be used to prepare patients for radiotherapy are discussed.

[Thermoradiotherapy in locally extensive soft tissue sarcoma]. / Termoradioterapiia bol'nykh mectnorasprostranennymi sarkomami miagkikh tkanei.

The report discusses 138 cases of soft-tissue sarcoma: 92 patients initially received thermoradiotherapy, 46-radiotherapy. Local electromagnetic hyperthermia was found to potentiate the antitumor effect of ionizing radiation and to be followed by a significant increase in the frequency of complete and considerable regression of tumor, as compared with exposure to total doses of 30-32 Gy (66-70 Units). As a result, 5-year survival rate in cases of post-thermoradiotherapy conservative surgery rose to 54 +/- 5.2%, as compared with 26 +/- 6.8% after conservative surgery + radiotherapy. The percentage of patients who survived more than 5 years after conservative surgery + thermoradiotherapy or radiotherapy was 37 +/- 7 and 23 +/- 7.8, respectively.

[First experience with hypothermia in radiotherapy for locally advanced skin cancer of the face]. / Pervyi opyt ispol'zovaniia gipotermii pri luchevom lechenii bol'nykh mestnorasprostranennym rakom kozhi litsa.

An original method of cryotherapy is presented. After each exposure during standard fractionation regimen tumor was cooled to 0-5 deg C in 20 patients with locoregional skin cancer of the face. Complete remission was registered in 18 cases of good cosmetic effect. Recurrence was reported in 2 cases during 9 month--10 year follow-up.

[Hypoxyradiotherapy of malignant tumors: experience and perspectives]. / Gipoksiradioterapiia zlokachestvennykh opukholei: opyt i perspektivy razvitiia.

The results of the randomized treatment of 1,280 cancer patients (hypooxyradiotherapy (HRT)--923, radiotherapy as a control procedure--357) are discussed. HRT was administered pre-operatively to cases of stomach cancer, colonic carcinoma and breast cancer. Owing to reduced radiation injury caused by HRT, pre-operative dosage was increased by 50% (single dose--6 Gy; total dose--30 Gy; 54 isoGy) in stomach cancer patients, and by 25% (single dose--5; total dose--25 Gy; 40 isoGy) in colonic cancer patients. The time of pre-operative irradiation with a single HRT dose of 10 Gy (28 isoGy) for breast tumors was reduced 4 times. As a result of HRT application, dosage rose by 25-42% in treating pancreatic carcinoma and non-organ retroperitoneal tumors.

[Treatment modalities and results of comprehensive therapy for extended retinoblastoma in children]. / Lechebnaia taktika i rezul'taty kompleksnogo lecheniia retinoblastomy u detei v rasprostranennykh stadiiakh zabolevaniia.

New procedures of laser therapy and chemotherapy have extended the scope of application of organ-saving treatment at advanced stages of retinoblastoma in childhood, thus making it possible to preserve the eye fully functional or cosmetic. Not having to perform such mutilating procedures as ophthalmectomy or eye socket exenteration contributes to psychological and physical rehabilitation. At the same time, as a comparison of the results of surgery carried out at initial stages and surgery-free treatment showed that palliative therapy is characterized by impressive rates of 5-year survival. New vistas have opened of in the management of pediatric retinoblastoma, particularly in cases of stage III tumor and bilateral involvement.

[Metastatic lung tumors in children (clinical course, diagnosis, prognosis)]. / Metastaticheskie opukholi lëgkikh u detei (klinika, diagnostika, prognoz).

According to data available at the Institute (1985-1999, approx. 1,200 patients), the lung is the most frequent site of cancer dissemination (up to 75%). Such most frequent pediatric children tumors as Wilms' tumor, neuroblastoma, rhabdosarcoma, osteogenic sarcoma and that of Ewing disseminate to lung in 85%, particularly, at advanced stages.