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Siberian journal of oncology

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No 6 (2013)
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CLINICAL STUDIES

5-8 532
Abstract
The new method of combined cryogenic and radiation therapy for patients with locally advanced buccal skin cancer was devised. The comprehensive analysis of results of cryoradiotherapy for 21 patients with basal cell and squamous cell buccal skin cancer (Т 2–4) and local recurrence was carried out. The treatment resulted in favorable long-term, cosmetic and functional results without local and general complications in these patients including elderly patients and patients with severe concomitant diseases
9-13 554
Abstract

This study presents the results of chemoradiotherapy (CRT) in 108 patients with muscle-invasive bladder cancer in whom surgery was contraindicated. The efficacies and toxicities of three variants of CRT were evaluated. Group 1 (neoadjuvant chemotherapy): 2–3 cycles of cisplatin-containing combination chemotherapy followed by a continuous course of external beam radiation therapy (EBRT). Group 2: concurrent CRT – cisplatin i.v., 70–100 mg/m 2 during the first and last weeks of continuous-course EBRT. Group 3: sequential neoadjuvant chemotherapy, 2–3 cycles and concurrent CRT. The comparative analysis of long-term outcomes following CRT indicated an improvement in survival rates in group 3 in which the 5-and 10-year cancer-specific survival rates were 42,3 ± 8,8 % and 31,3 ± 9,4 %, respectively, compared with 28,6 ± 9,7 % and 28,6 ± 9,7 % in group 1, and 29,5 ± 8,5 % and 14,8 ± 7,4 % in group 2, respectively (р=0,093). Acute toxicity (GU) Grade 1 or 2 arose more often from concurrent radiation and chemotherapy: in 40,0 % and 40,5 % of cases in groups 2 and 3, respectively, whereas in group 1 it occurred in 25,9 % of cases (р<0,2). Late radiation toxicity (GU) Grade 2 occurred more often in the concurrent CRT groups: 11,4 % and 11,9 % versus 3,2 % in the neoadjuvant chemotherapy group; Grade 3 was noted in 5,7 % and 2,4 % of patients in groups 2 and 3, respectively. The results indicated that chemoradiotherapy including neoadjuvant and concomitant chemotherapy improved the outcomes in patients with muscle-invasive bladder cancer in whom surgery was contraindicated. There was an acceptable rate of clinically significant complications.

14-19 618
Abstract

It has been recently proved that cells with impaired BRCA1function demonstrate high sensitivity to platinum-containing derivatives because they are not able to eliminate DNA disorders caused by these agents. Early studies showed that BRCA carriers had better odds of surviving ovarian cancer than do women without these mutations. The purpose of the study was to evaluate clinical significance of BRCA1 mutation carriage in response to chemotherapy as well as to life span in patients with advanced ovarian cancer. Treatment outcomes of 21 patients with advanced ovarian cancer with inherited BRCA1gene mutation, who were treated from January 2000 to January 2008, were analyzed. The control group consisted of 42 (1:2) cases with advanced non-inherited ovarian cancer matched by stage, histological type, age and the extent of primary cytoreductive surgery. All BRCA-positive patients responded to neoadjuvant platinum-containing chemotherapy. In non-inherited ovarian cancer patients, complete response was observed in 36 % (8/8 (100 %) vs 9/25 (36 %); OR 14,8; 95 % CI 1,78–100; p=0,002). In comparison with the control group patients, BRCA-positive patients had higher rates of complete response to the first-line platinum-containing chemotherapy (81 % vs 33,4 %; OR 8,50; 95 % СI 2,52–34,89; p=0,001) and to the second-line chemotherapy (62 % vs 21,4 %; OR 5,96; 95 % СI 1,76–22,50; p=0,004). After the third line chemotherapy, BRCA-positive patients had a tendency to better results (18,8 % vs 5,6 %; p=0,233). A statistically significant improvement in the median relapse-free survival time was observed in patients with BRCA1mutations after the first-line chemotherapy as compared to that observed in the control group patients (20,05 vs 7,21 months; p=0,005). Life span in BRCA-positive patients was significantly longer than in patients with non-inherited ovarian cancer (medium 9,3 years vs 3,4 years; p=0,001).

20-25 515
Abstract
In the article the characteristic of medico-demographic deaths caused by renal cancer among the population of Krasnoyarsk region is given. There are results of research with use of modern approaches of losses of health definition. The evaluation of medico-demographic deaths caused by renal cancer among the population of Krasnoyarsk region for the period 2010–2012 with using DALY method was produced. The largest difference in values of the indicator DALY was observed between male and female population in 2011 by a factor of 4,7. The maximum gap in DALY indicator between male and female population was observed in the group of 55–59 years. More than half of DALY deaths among male involve working age

LABORATORY AND EXPERIMENTAL STUDIES

26-30 527
Abstract
Comparative analysis of the relationship between the character of dysregeneratory changes occurring in the bronchial epithelium adjacent to the tumor and the development of recurrence of squamous cell and grandular carcinomas of the lung was carried out. The study showed no any relationship between such parameters as tumor size, presence of lymphogenic metastasis, tumor stage and tumor recurrences. The incidence of recurrence in non-small cell lung cancer indirectly related to the character of dysregeneratory changes in the respiratory epithelium of the bronchial mucosa outside the tumor. High incidence rates of squamous cell carcinoma and adenocarcinoma of the lung were observed in cases with combination of basal cell hyperplasia and squamous metaplasia (BCH+SM+).
31-35 427
Abstract
The thyroid gland of 30 4-month-old male Wistar rats was studied. The control group consisted of 5 rats. Twenty-five rats received whole body ionizing radiation with γ-quantum in sublethal dose using the gamma therapeutical apparatus AGAT R1. Animals were killed 2, 5, 10, 15 и 30 days after irradiation (n=5). Histomorphometric analysis included measurements of external follicle diameter, nuclear diameter and area, colloid area, follicular epithelium area, Braun index, nuclear/cytoplasmic ratio and follicular/colloid index. At the end of the experimental study, all morphometric criteria were higher than the control values, especially nuclear area, indicating neoplastic transformation of thyroid. Histograms of distribution of thyrocyte nuclear area were dome-shaped in all days of the experimental study except day 2 characterizing follicular and papillary thyroid cancers. The given work is a prospective experimental-morphological study of radiation-induced neuroendocrine cancers
36-39 486
Abstract

The NАDН-dehydrogenase, succinatedehydrogenase and cytochromoxidase activities of mitochondries of blood peripheral leukocytes were studied in rats with transplanted Gerena’s carcinoma. It was shown that in dynamics of Gerena’s carcinoma growth, NАDН-dehydrogenase activity was inhibited, while succinate dehydrogenase activity was activated. The level of cytochromoxidase activity remained within the control values at the terminal stage of tumor growth

ONCOLOGY PRACTICE

40-43 587
Abstract
Gastric cancer remains the most common cancer both worldwide and in the Russian Federation. Gastric cancer is the 3-rd most common cancer in men, comprising 9,1 % of all cancer cases and the 4-th most common cancer in women comprising 5,8 % of all cancer cases in Tomsk region in 2011. From 2000 to 2011, the crude and age-standardized gastric cancer incidence rates decreased by 13,4 % and 25,7 %, respectively in males and increased by 22,6 % and 11,1 %, respectively in females. In addition, the increase in gastric cancer incidence rate was observed in both male and female elderly population of Tomsk region.
44-47 510
Abstract
Application Degarelix ADT patients who underwent combined radiotherapy, already on the first results showed the high efficiency and low toxicity. For patients with localized prostate cancer with intermediate factors and a poor prognosis, as well as for patients with locally advanced disease, we recommend a hormone antagonists of gonadotropin-releasing hormone (GnRH) Firmagon (Degarelix) not only during concomitant radiation therapy, but also as neoadjuvant and adjuvant treatment.

REVIEWS

48-55 616
Abstract
Discovery of tyrosine kinase inhibitor sensitizing mutations in lung cancer (LC) appears to be the main event in clinical oncology of the last decade. Activating lesions in epidermal growth factor receptor (EGFR) gene almost guarantee tumor response to gefitinib, erlotinib or afatinib.ALK translocations are strongly associated with efficacy of crizotinib or otherALK inhibitors. Instances of success of targeted therapy have been demonstrated for LC harboring mutations in ROS1, RET, HER2, BRAF and KRAS oncogenes. Whole genome sequencing of LC-derived DNAhas revealed a number of novel potentially druggable molecules. Rapid progress in understanding of lung cancer molecular pathogenesis allows to expect that several new targeted agents for LC treatment will become available already within this decade.
56-63 669
Abstract
This article is the review of issues of the literature for the past 10 years and is dedicated to the analysis of the radiopharmaceuticals and efficacy of the novel nuclear medicine technologies for the diagnosis, staging and prognosis of neuroendocrine tumors. Diagnostic efficacy of a scintigraphy and a positron emission tomography for detection of gastroenteropancreatic and lung carcinoid, medullary thyroid cancer, pheochromocytoma and haraganglioma and choice of radiopharmaceuticals were demonstrated by the results of the clinical studies. The causes of false positive and falce negative results were specified.
64-69 956
Abstract
Abnormalities of DNA methylation play a significant role in initiation and progression of tumors. In this regard it is necessary to study these aberrations in order to better understand the malignant transformation pathogenesis. For this purpose the adequate and objective methods are required. The principles and possibilities of application of basic methods of DNA methylation analysis are reviewed in the paper

CASE REPORTS

70-72 500
Abstract
A clinical case of metastatic diseases of pelvic bones with a large soft tissue component in a patient with poorly differentiated follicular thyroid cancer was presented. Partial tumor regression and pain relief were achieved after chemotherapy.
73-76 542
Abstract
A case of successful surgical treatment for peripheral lung cancer with concurrent coronary artery bypass for ischemic heart disease has been presented.

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ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)