CLINICAL STUDIES
The purpose of the study was to assess the immediate response to combination therapy including prolonged preoperative concurrent chemoradiotherapy with capecitabine as a radiosensitizer and local hyperthermia for patients with rectal cancer.
Materials and methods. A total of 25 patients received combined modality treatment. The proportions of patients with stages II (T3–4N0 M0 ), III (T1–4N1–2M0 ) and IVa (T1–4N0–2M1 ) were 3 (12 %), 13 (52 %) and 9 (36 %), respectively. The rectal ampulla was diagnosed most frequently (68 %). The patients received preoperative radiation therapy (1.3 Gy twice daily for 5 days per week to a total dose of 54 Gy) concurrently with capecitabine (825 мg/m2 , twice a day for 5 days a week) and local hyperthermia (3 times a week, 3 hours before irradiation session, at temperatures between 42–44°С, for 45–60 minutes, to a maximum of 10 sessions).
Results. Grade 1-2 radiation-induced skin reactions were observed in 3 (12 %) patients. By assessing immediate tumor response 6 months after completing radiotherapy, histologically confirmed complete regression was registered in 2 (8%) patients and partial regression in 23 (92%) patients. Rectal extirpation was performed on 8 (32%) patients and sphincter-preserving surgeries on 15 (68%) patients. Patients with complete regression were followed up. Postoperative complications were observed in 3(12%) patients. None of the patients died. No local recurrence and distant metastases were registered at the 12–18 month follow-up.
Conclusion. Short-and long-term outcomes of combined modality treatment including preoperative concurrent chemoradiotherapy with capecitabine as a radiosensitizer and local hyperthermia indicate that this treatment protocol is effective and safe for patients with stage II–IVа rectal cancer. Concurrent chemoradiotherapy results in a significant tumor regression, thus extending the indications for sphincter-preserving surgery.
Background. Currently, the major purpose for pelvic surgery is to conduct a locoregional radical procedure while preserving a good quality of life. When performing periacetabular resections, the acetabulum and the hip joint are the most difficult areas to reconstruct. According to some authors, the acetabulum and hip joint reconstruction with modular endoprostheses for patients with periacetabular tumors would lead to better clinical outcomes. The paper presents our experience using this surgical technique.
Methods. Between 2011 and 2015, a total of 23 patients underwent periacetabular resection with the acetabulum and hip joint reconstruction using a modular endoprosthesis. There were 10 (44 %) male and 13 (56 %) female patients aged from 20 to 64 years with a median of 44 years. The histological types were as follows: 12 (52 %) chondrosarcomas, 4 (17 %) giant-cell tumors, 2 (8 %) osteosarcomas and 1 Ewing’s sarcoma, 1 malignant fibrous hystiocytoma, 1 synovial bone sarcoma, 1 solitary metastasis from renal cell and gastric carcinomas. Stage Ib bone sarcoma was diagnosed in 8 patients and stage IIb in 6 patients.
Results. In accordance with Enneking classification, type I-II-III resections were performed in 14 (61 %) patients and type II-III-IV resections in 7 (30 %) patients. The median duration of surgery was 320 min (240–520 minutes). The median intraoperative blood loss was 5 200 ml (1 000–20 000 ml). Negative resection margins (R0) were achieved in 20 (87 %) patients. Positive resection margin (R1) was observed in 3 (13 %) patients with G-I chondrosarcoma. The median follow-up was 32 months (3–48 months). Disease progression was diagnosed in 7 (30 %) patients at a follow-up from 6 to 18 months. The functional outcome after surgery was assessed according to the MSTS score, with the median value of 48% (15–78 %). Postoperative complications were diagnosed in 10 (43 %) patients.
Conclusion: The use of the modular acetabulum and hip joint replacement systems allows one to achieve favorable functional outcome in the postoperative period and to reduce the time of postoperative rehabilitation.
LABORATORY AND EXPERIMENTAL STUDIES
Cachexia is a severe complication of cancer and currently there are no drugs that would effectively deal with exhaustion and intoxication in various diseases.
Materials and methods. In this paper a study and evaluation of the antitumor and anticachexia activities of the extract of Gratiola officinalis l. in rats with transplanted sarcoma 45 in experiment in vivo was conducted. Gratiola officinalis l. extract is received by patented method and is not toxic to animals. The study was conducted on 40 white male rats line Wistar weighing 150 ± 50 g. Animals were divided into 4 groups (10 rats per group): control group, comparison group with sarcoma without affecting, group with sarcoma with intramuscular and group with sarcoma with oral administration of the extract in a dosage of 110 mg/kg. The extract was administered intramuscularly or orally 72 hours after transplantation of sarcoma 45. The tumor volume and the weight of the animals were assessed daily.
Results. The extract of leaves and flowers of Gratiola officinalis l. obtained by patented method has a strong antitumor activity, reducing the growth rate of the tumor and causing marked changes in the tumor, as well as providing stable anticachexia effect. Index of tumor weight inhibition was 70.6 % on average. Intramuscular administration was more effective in reducing of tumor growth, but less effectively increases the weight of animals than oral administration. In both administration methods Gratiola officinalis extract has no toxic effect on peripheral blood. We have previously found that the extract has antioxidant activity so that anticachexia effect is pathogenic, meaning it occurs by reducing toxicity.
Conclusions. Gratiola officinalis extract has a broad spectrum of biological activity, in particular antitumor, anticachexia, it is not toxic, so it is advisable to investigate as a promising tool for the treatment of tumor diseases and cancer cachexia, and cachexia caused by other chronic diseases.
ONCOLOGY PRACTICE
REVIEWS
CASE REPORTS
CHRONICLE. INFORMATION
JUBILEES
OBITUARY
4 февраля 2016 года после тяжелой, продолжительной болезни на 76-м году ушел из жизни Фёдор Львович Киселёв, выдающийся вирусолог, ученый с мировым именем, долгое время руководивший отделом трансформирующих генов опухолей НИИ канцерогенеза Онкологического научного центра, профессор, член-корреспондент РАН, трижды
лауреат Государственной стипендии.
ISSN 2312-3168 (Online)