[Some Aspects of Medical Activities to Overcome Consequences of Chernobyl Accident].

The results of the long term work of the Russian Scientific Centre of Roentgenology and Radiology on me- dical investigation of the participants in the liquidation of the consequences of Chernobyl power plant acci- dent have been summarized. It has been stated that circulatory system and tumor diseases occupy the leading position in the disease rate among the affected liquidators. The important role of cytogenetic investigation was pointed out. It allows us not only to determine the efficient impact on the human body but also to evaluate the effective dose of radiation, the information about which allows us to predict the development of distant post-irradiation pathology. The results of cytogenetic investigations testify to the interrelation between the level of chromosomal abnormalities and cardiovascular diseases and confirm the clinical data on the non- neoplastic.pathology among the liquidators of the accident.

[Results of surgical and combined treatment for nonsmall cell lung cancer with postoperative radiation therapy in a mode of hypofranctionation. Post II. Relapse-free survival and survival without locoregional recurrence].

Conducting postoperative radiotherapy in a mode of hypofranctionation with SFD-3Gy to TFD-36-39Gy (EQD2 = 43,246,8Gy) in combined treatment of patients with non-small cell lung cancer allows significantly increasing a 5-year disease-free survival at IIB-IIIB stages of the disease (pN1-2) as well as the central cancer, squamous cell morphological type of tumor after surgery in a volume of lob-bilobectomy. The clearest effect of postoperative radiotherapy is assessed by survival without locoregional recurrence where radiation therapy in the adjuvant setting allows achieving a statistically significant increase in local control of the disease to the level of 85-95% regardless of stage of the disease, tumor size, regional lymph nodes lesion and the surgical treatment.

[Adenocystic carcinoma of the trachea]. / Adenokistoznyi rak trakhei.

It is presented 40-years experience of tracheal adenocystic carcinoma diagnosis and management in 144 patients. Peculiarities of clinical course and choice of diagnostic and therapeutic measures are discussed in relation to stenosis and hypoxia degree and severity of accompanying inflammatory complications of trachea, bronchi and lungs. Technical tools and original methods of resection and reconstruction of trachea and it's bifurcation after extended lung resection are described. Surgical management is carried out in 96 patients: all patients underwent circular resection of trachea (77) or it's bifurcation (19). Morbidity rate was 22.9% and mortality - 3.1%. Additional radiotherapy was carried out in 50 patients. 41 patients underwent radiotherapy alone. Radiotherapy improves remote results of management. 5-and 10-year survival rate was 78.3±6.1 and 45.9±7.9% after surgery alone, 92.0±3.9 and 77.1±6.5% after combined treatment and 76.4±6.5 and 55.0±10.7% after radiotherapy alone respectively.

[Surgical and combined treatment for primary carcinoma of the trachea].

Our study was conducted in patients with primary squamous cell carcinoma of the trachea and adenoid cystic carcinoma (191) (radical surgery--90; combined treatment--101). The former pathology was relatively more aggressive. Combined treatment proved more effective as compared with surgery alone (5- and 10-year survival after surgery was 79 and 64%; combined treatment--92 and 79%, respectively).

[Radical radiotherapy of primary cancer of the trachea].

The paper deals with the importance of treatment of primary cancer of the trachea and, in particular, the experience of the Center in using radical therapy for inoperable squamous cell tumors and adenoid cystic carcinoma. An original system of tumor staging developed at the Center draws on international classifications (TNIVI) and methods of radiotherapy depending on tumor localization. It is shown that tracheal malignancies, especially adenoid cystic carcinomas, are characterized by relatively high radiosensitivity.

[Specifics of surgical treatment of stomach cancer in patients 70 years of age and older].

The paper deals with immediate and end results of surgical treatment of 435 elderly patients (70-years-old or older) with gastric cancer and the specifics of postoperative complications influencing the postoperative course of the disease. Metastasis to the regional lymph nodes appeared to be a prognostic factor of crucial importance in the latter period: 5-year recurrence-free (N0) survival was 60.3% +/- 5.2 vs. 17.6% +/- 10.3 (in 1-6 lymph nodes) and 5.2% +/- 5.0 (in 7-15 lymph nodes) (N1).

[Surgical and combined treatment of lung cancer].

A 40-year experience of use of surgical and combined treatment of lung cancer is discussed (n=3,687; surgery--26.7%, combined treatment--73.3%). Eight protocols were used depending on stage of tumor, dose of radiation and fractionation pattern. Role and effectiveness of reconstruction surgery involved in lung cancer treatment are established and end results vis-à-vis main prognostic factors presented. Failed treatment and rationale for systemic chemotherapy as a component of combined treatment are evaluated.

[Features and risk factors of post-mastectomy, locally advanced breast cancer relapse].

Multivariate analysis of risk of locally-advanced breast cancer IA-IIIB progression was carried out in 444 patients 10 years after mastectomy in the framework of two randomized studies. Combination therapy (median 156.3 months) included mastectomy, different modalities of neoadjuvant and adjuvant chemohormonal and radiotherapy.

[Effect of metabolizable peptide p16INK4a on short-lived human tumor cultures].

The study was concerned with antitumor action of internalized peptide incorporating a fragment of p161INK4a using a model of short-lived human tumor cultures sampled from resected material. Renal cancer sample showed the greatest therapeutic interval.

[Postradiation and postchemotherapy complications in patients with urinary bladder cancer].

A comparison was made of chemoradiation lesions of lower urinary tract mucosa in urinary bladder (UB) cancer at stage T1-3N0-1MO and approaches to their treatment. An optimal algorithm of examination and treatment of the above patients with consideration of the disease stage and somatic status is proposed.

[Radiation diagnosis of urological complications in patients with endometrial and cervical carcinoma].

Patients receiving radical surgery or combined radiotherapy suffer from such grave postoperative urological complications as radiation-related cystitis, urinary bladder dysfunction, "shrunken" bladder, fistula, chronic renal failure, ureteral stricture and sexual disorders which affect the quality of life. Changes in function of the urinary tracts in patients with endometrial and cervical carcinoma were followed throughout the course of combined treatment. Complex examination comprised urological history, ureteral features, urinalysis, blood count, ultrasound, combined urodynamic study, nephroscintigraphy combined with excretory urography, and cystoscopy, when required. Due to all those measures, complication rates decreased while the quality of life improved.

[Cytotoxicity of chimera peptides incorporating sequences of cyclin kinases inhibitors].

The study is concerned with proapoptotic properties of chimera peptides which incorporate sequences of inhibitors of cyclin kinases p161NK4a and p21CIP/WAF1 as well as internalized sequences (Antp and tat). Sequences of the p16 type appeared to be more cytotoxic than the p21 one. Cytotoxic effect proved dependent on orientation with respect to the C or N terminal point of a polypeptide chain rather than on chimera sequence extent. Although p16 endogenous synthesis did not influence chimera peptide levels, apoptosis did not take place in certain cellular lines. Due to the rather unsophisticated nature of such synthesis, it might be used in designing individually-tailored chemotherapeutic drugs.

[Five-year outcome of a new combination chemotherapy with CEA/ABVD for advanced Hodgkin's disease with poor prognosis].

Data are presented on our 5-year experience with combination chemotherapy of stage II-IV Hodgkin's disease (110), the unfavorable prognosis group, using a novel regimen of chemotherapy--CEA/ABVD (belustin, etoposide, doxorubicin, bleomycin, vinblastine, dacarbazine). Complete remission after 4 courses of CEA/ABVD chemotherapy was reported in 31.8%, unconfirmed complete remission--45.5%, objective effect--100% and an 80% regression of tumor mass--93.2%. No chemo-resistant forms were identified. Five-year actuarial relapse-free survival was 96.4%; overall 5-year survival--97.7%. Death from complications recorded during medication period occurred in 2.3% (1 out of 44), recurrence--2.3% (1 out of 44). Recurrence-free survival rose by 25% (p < 0.05) while overall survival--by 20% (p = 0.04 in year 3), as compared with COOP(MOPP)/ABVD (179 patients with poor prognosis). Our regimen opens up new vistas in managing Hodgkin's disease.

[Radiation assisted diagnosis and complex treatment of penile carcinoma].

Recurrence-free survival rate after conservative treatment of penile carcinoma was as high as 81%. The best results were obtained with use of combined radiotherapy (monotherapy and telegamma therapy concurrent with penile resection or circumcision) (91.6 and 75%, respectively). Organ-saving treatment was most effective in T1-T2 penile carcinoma while MRI yielded the most reliable diagnostic evidence on depth of primary tumor invasion and regional lymph node involvement.

[Novel approaches to combination therapy of Hodgkin's disease].

Data on 668 patients receiving 4-8 cycles of chemotherapy were used to suggest the following approach to complex therapy of Hodgkin's disease: devise a simplified model for Hodgkin's disease, develop a new modality of chemotherapy, demonstrate feasibility of only four chemotherapy cycles in the poor prognosis group, partial response as the ultimate goal of chemotherapy as well as the importance of subtotal dosage under 26-36 Gy sufficient for irradiation of the entire lymphatic collector. Said measures will, in their totality, offer fresh opportunities in treatment of Hodgkin's disease.

[Chondroid syringoma (borderline type)]. / Khondroidnaia siringoma (pogranichnyi tip).

An overall morphologic evaluation of a case of facial skin chondroid syringoma (CS) provided evidence for CS classification as borderline. Histologically, CS showed signs of cellular elements polymorphism, contained structures typical for CS whereas electron-microscopically there were two types of cells: epithelial and myoepithelial.

[Bronchoalveolar neoplasms]. / Bronkhoal'veoliarnyi rak.

This review concerns the development and progression of one of the forms of peripheral lung cancer--bronchiolo-alveolar carcinoma (BAC). The study is based on the comparison of roentgenological, histological, immunohistochemical examinations and results of surgical treatment of 482 patients with this tumor. Morphological and clinical variants of BAC are defined. It is confirmed that their biological behavior may vary within the forms and differ from common adenocarcinoma. A close correlation exists between clinicoroentgenological picture and histological form of BAC.

[Urgent morphologic diagnosis of tracheal tumors in the course of roentgeno-endoscopic study]. / Srochnaia morfologicheskaia diagnostika opukholei trakhei v protsesse rentgenoéndoskopicheskogo issledovaniia.

84 tracheal tumors the correct diagnosis of which was established during roentgenoendoscopical investigation combined with urgent cytological diagnosis are reported. Cytological fast diagnosis can be considered a reliable method of morphological diagnostics.

[Development of methods of local hyperthermia to achieve more marked tumor pathomorphism]. / Razvitie metodov lokal'noi gipertermii dlia dostizheniia bolee vyrazhennogo patomorfoza opukholei.

Regular investigations on application of hyperthermia in oncology have been carried out since the second half of the 1950s. The usage of distant tissues heating faces considerable difficulties in maintenance of therapeutic temperature in the whole volume of the tumor. Thus, the use of interstitial hyperthermia is promising, especially, ferromagnetic hyperthermia which causes damage not only to central but also to peripheral zones of tumors. Light and electron microscopies have not revealed specific features of cell damage by which ferromagnetic hyperthermia might differ from other methods of antitumor treatment.

[The differential diagnosis of peripheral lung formations (cytological research)]. / Differentsial'naia diagnostika perifericheskikh obrazovanii legkikh (tsitologicheskoe issledovanie).

The following pulmonary lesions were studied: carcinoma, carcinoid, tuberculoma, chondromatous hamartoma, chronic non-specific inflammatory process. Material was obtained through fiber bronchoscopy and roentgeno-endoscopical examination. Pappenheim staining in the modification of Astrakhantsev-Nechaeva and Ziehl-Neelsen staining were used. 80 cases within 1993 were studied, among them 71 peripheral lung carcinomas. 3 carcinoids, 3 tuberculoses, 1 non-specific inflammation. Basic cytological criteria are summarized which will improve the quality of the presurgical diagnosis.