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.

The present paper is devoted to the major treatment modalities for generalized breast cancer. A detailed extensive analysis of recent studies was carried out with the aim to consider whether surgery as a part of multimodality treatment strategy is beneficial for patients with stage IV breast cancer. The study included 196 patients with generalized breast cancer, who were treated at P.A. Gertsen Moscow Oncology Research Institute between 2000 and 2012. All patients were divided into two groups. The first group consisted of 124 patients who underwent surgical resection as a part of multimodality treatment. The second group included 72 patients who received systemic therapy. The factors influencing on the prognosis and life quality of patients with generalized breast cancer, namely: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause) were also studied.

Lung cancer is one of the most common malignant tumors. As over 70 % of patients at diagnosis have locally advanced or generalized process, the majority of patients receive drug treatment only. We evaluated effectiveness and toxicity of pemetrexed (Alimta) in 24 patients with locally advanced and metastatic non-squamous cell non-small-cell lung carcinoma with the known EGFR mutation status. Pemetrexed 500 mg/m2 was administered as monotherapy (8 patients) or in combination with platinum-based drugs (15 patients). Three (12.5 %) patients showed complete regression, 7 (29.2 %) – partial regression, 10 (41.7 %) – stabilization, 4 (16.6 %) – progression. The median survival was 14.8 months. Non-hematological complications were registered, usually concerning the digestive system. Hematological complications included first-degree leukopenia – 27 (21.3 %), second- and third-degree thrombocytopenia – 1 case of each (0.8%). The complications did not require administration of drugs or were corrected medicamentally. We observed a high effectiveness of pemetrexed in patients with non-squamous NSCLC, as well as a low rate of complications and controlled toxicity.

Tomsk region refers to the areas of increased risk of malignancies, including laryngeal and upper respiratory tract cancers, which account for 2.0 % of all cancer cases. Approximately 83 new cancer cases (70 % in males) are annually diagnosed, with a tendency to increase. In 2014, the standardized incidence rate of upper respiratory tract cancer (URTC) was 7.7 per 100,000 men and women. The incidence rate was 6.7 times higher in men than in women. Laryngeal cancer was the most common malignancy in both men (67.7 %) and women (60.0 %). The age-standardized mortality rate of laryngeal cancer was 2.7 per 100,000 of population. Among patients registered at the end of 2014, 1.1 % patients were diagnosed with laryngeal cancer and 0.3 % with pharyngeal cancer. The laryngeal cancer incidence in the Tomsk region was lower than that in the Russian Federation as a whole. The rates of laryngeal and pharyngeal cancer detection at prophylactic medical examinations remain low (5.9 % and 1.5 %, respectively), and 1-year lethality rates are high (65.2 % and 28.6 %, respectively). Introduction of the program on pre-cancer and early laryngeal cancer detection into routine clinical practice allowed us to identify diagnostic errors in 16.3% of cases, verify laryngeal cancer and to form groups at high risk for laryngeal cancer in 20.6 % of cases.

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.

A new multimodality approach has been developed for management of locally advanced cervical cancer, including neoadjuvant chemotherapy with chemoembolization of two uterine arteries, a subsequent brachytherapy treatment at a dose of 10 Gy and type III hysterectomy or pelvic exenteration; this approach has made it possible to attain tumor resectability in 83.3 % of the cases, to avoid severe toxic, intraoperative and postoperative morbidities with a 90.5 % radicality of surgical intervention. This method produces satisfactory rates of 3-year overall observed survival, recurrence-free survival and metastasis-free survival being 82.3 %, 84.6 % and 88.4 % respectively.

A clinical economic analysis of the effectiveness of the use of different systems of venous access for chemotherapy in children with cancer has been carried out.

Treatment outcomes of 176 colorectal cancer patients with liver metastases were retrospectivelly analyzed. There were 86 men and 90 women in the age range 28 to 84 years. Multiple metastasis was detected in 79.5 % of patients and solitary metastasis in 20.5 % of patients. Cytoreductive surgery was performed in 30.7 % of patients and palliative surgery in 57.9 %. Surgical treatment was not performed in 5.1% of patients. The median survival time of patients after symptomatic surgeries was 10.8 months (1.5-26 months). Cytoreductive surgery increased the median survival time by more than 2 months (13 months, 2–44 months). Thus, radical surgery for colorectal cancer patients with liver metastases is justified by the increase in the median survival time of the patients.

Targeted therapy of metastatic colorectal cancer lacks predictive markers with positive predictive value, i.e. the selection of potentially responsive patients remains highly complicated. In contrast, there are very reliable markers indicating resistance to the therapy by anti-EGFR antibodies. Assessment of such markers is mandatory when EGFR targeting is considered. An analysis of tumor DNA for mutations in coding regions of KRAS and NRAS genes has become a standard procedure; the occurrence of these mutations is within 45-65%. Nevertheless, exclusion of KRAS/NRAS-mutated cases remains insufficient for the reliable selection of potential responders. There is a continuing search for novel predictive biomarkers. Multiple evidences support the role of BRAF V600E mutation in determining non-response to anti-EGFR therapy. Some data suggest an impact of PIK3CA, PTEN, EREG, AREG, IGF2 mutations and/or expression changes, as well as the significance of MET and HER2/neu gene amplifications. Further progress in this field is expected to improve clinical and economic efficacy of colorectal cancer treatment.

Solitary fibrous tumor (SFT) of the head and neck is a quite rare disease. Because the number of clinical reports is scarce, to draw definite conclusions on management of SFT is quite difficult. However, certain regularities were observed. Patients’ age varies from 20 to 70 years. No age and ethnic predominance in the disease development and tumor progression is observed. SFT is typically benign slow growing tumor, its malignant variant occurs rarely. Modern diagnostic methods, such as magnetic-resonance imaging, positron-emission tomography, X-ray computed tomography, ultrasound examination are not sensitive enough to detect specific signs of the tumor. Modalities used for treatment of SFT can be conditionally divided in two types: radical and palliative. Surgical and endoscopic approaches, as well as variety of ablation techniques may be considered as radical treatment. Delayed results of surgical treatment are very good. If radical surgery or non-radical resection are impossible in certain cases, radiation therapy is used as palliative treatment. In most cases the definite diagnosis can be made on the basis on results of morphological analysis, immunohistochemical tests of the removed tumor and assessment of tumor angioarchitecture.

The paper presents a case of a 52-year-old female patient with pleomorphic malignant fibrous histiocytoma/ undifferentiated pleomorphic sarcoma of the left atrium. One year after surgical resection of the primary tumor, microsurgical removal of the right parietal lobe metastatic tumor was performed. PET/CT with 11C-methionine and 18F-FDG performed 2 months after surgical resection of brain metastasis revealed local recurrence of sarcoma in the left atrium and left lateral ventricle metastases. This clinical case demonstrates high diagnostic accuracy of PET/CT with 18F-FDG and 11C-methionine in detecting local recurrence of cardiac undifferentiated sarcoma, however, PET/CT with 11C-methionine appears to be superior to PET/CT with18F-FDG in detecting brain metastasis.

A rare clinical case of synchronous cervical adenocarcinoma and primary squamous cell ovarian carcinoma has been presented. Epidemiological and treatment aspects have been analyzed.

Клинические рекомендации подготовлены на основании материалов научно-практической конференции Проблемной комиссии «Опухоли головы и шеи» Научного совета по злокачественным новообразованиям Отделения медицинских наук Российской академии наук и Министерства здравоохранения РФ, посвященной памяти профессора Александра Ильича Пачеса, «Актуальные вопросы диагностики и лечения рака ротоглотки» (25 июня 2015 г., г. Архангельск).

Геннадий Андреевич Кожевников является одним из основоположников онкологической службы Челябинской области и родоначальником реанимационно-анестезиологической помощи онкологическим больным. Свою трудовую медицинскую деятельность Г.А. Кожевников начал в 1958 году в качестве медицинского брата в Челя- бинском областном онкологическом диспансере, в котором он продолжил работать врачом-онкологом после окончания Челябинского государственного медицинского института в 1960 г.

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.