Background. The cancer incidence in young adults has been steadily rising worldwide and in Russia. According to Globocan, the number of cancer cases in both men and women aged 20–44 years is expected to increase by 14 % in 2045 compared to 2022. Given the decline in the number of young adults in Russia, including the Siberian Federal District (SFD), the study of cancer incidence among them is of current interest. The purpose of the study was to assess the incidence of the most common cancers in young men and women aged 20 to 44 years in the SFD. Material and Methods. The study used data from the state medical statistics reports (form 7, “Information on malignant neoplasms”) of the SFD subjects, as well as data on the age and sex composition of the population of these territories for 2014–2023. The analysis was carried out using the z-criterion and regression analysis. Results. In 2023, in young men of the SFD, hemoblastosis was the most common cancer (14.6 %) followed by colorectal (10.7 %) and kidney (9.8 %) cancers. In young women, the most common cancers were breast (28.5 %) cervical (16.0 %) and thyroid (9.1 %) cancers. In young men of the SFD, the incidence rates increased (p<0.05) for hemoblastosis to 9.5 0/0000 (growth rate of 5.1 %), thyroid cancer to 3.8 0/ 0000 (+82.1 %), skin cancer to 5.0 0/0000 (+24.0 %) and decreased (p<0.05) for lung cancer to 3.8 0/0000 (decrease rate of 20.6 %), stomach cancer to 2.5 0/0000 (-29.4 %). Among young women of the SFD, the incidence rates increased (p<0.05) for breast cancer to 34.3 0/0000 (increase rate of 34.5 %), colon cancer to 6.4 0/ 0000 (+41.2 %), thyroid cancer to 13.30/0000 (+39.8 %), skin cancer to 6.3 0/0000 (+37.5 %), stomach cancer to 2.8 0/ 0000 (+41.2 %), oral cavity cancer to 1.2 0/0000 (+145.9 %) and decreased (p<0.05) for cervical cancer to 20.6 0/ 0000 (decrease rate of 22.3 %). Conclusion. The results of the study update the development of new organizational and clinical algorithms for medical observation of young men and women for the purpose of prevention or early diagnosis of tumor pathology, including for creating the feasibility of performing organpreserving treatment while preserving the reproductive potential of young patients.

Cancer imposes a heavy societal burden worldwide, and the development of the effective strategies for cancer prevention, diagnosis and treatment remains an important public health challenge. The purpose of this study was to analyze and assess the prevalence of cancer, cancer care and cancer-related deaths in various regions of Russia. Material and Methods. Changes in epidemiological characteristics (cancer incidence, quality indicators for cancer care) for 2021 were studied taking into account the data submitted within the framework of state reporting form No. 7 “Information on malignant neoplasms” of the constituent entities of the Russian Federation. A systematic review of the literature (PRISMA) was conducted. The search was carried out using Elibrary, PubMed, MEDLINE, and Google Scholar databases. Results. Regional analysis of cancer care and cancer mortality in Russia has revealed important trends and factors influencing the effectiveness of medical care. Cancers of the breast, uterine body, prostate, colon, lymphatic and hematopoietic tissue, kidney, cervix, thyroid, rectum, trachea, bronchi, lung and stomach are the most common cancers in Russia, accounting for 69.2 % of all cases. The results of the analysis emphasize the need to improve cancer care system, especially in regions with high morbidity and mortality, which include the Penza and Tyumen regions, the Republic of Mordovia, Lipetsk, Samara and Novgorod regions. The low incidence and mortality rates were observed in the Vologda region, the Republic of Tyva, Primorsky Krai, the Chechen Republic, Vladimir region and the Republic of Ingushetia. Conclusion. The results of this study show the increase in cancer incidence in Russia. The data obtained also indicate an improvement in the cancer care provided every year. Implement innovations is increase the success of treatment and the quality of life of patients.

Purpose: to study the immediate outcomes of pancreaticoduodenalectomy (PD) in multivisceral surgeries (MVS) with vascular resections. Material and Methods. The study included 145 patients who underwent pancreaticoduodenalectomy with resection of the major vessels, including the superior mesenteric vein, the portal vein, and the inferior vena cava. These patients were divided into two groups. The main group included 32 patients who underwent MVS with PD, and the control group consisted of 113 patients who underwent PD. Results. There were no statistically significant differences in the immediate outcomes between two groups. Pancreatic fistula developed more often in the MVS with PD group than in the PD group (25 vs 11.5 %, p=0.055). The incidence of resected vein thrombosis in the main group was 9.4 %, in the control group was 1.8 % (p=0.07). Postoperative intra-abdominal bleeding was 6.2 % vs 8 % (p=1.0). Postoperative mortality was 6.2 % in the MVS with PD group and 8.8 % in the PD group (p=1.0). True vascular invasion was confirmed by pathomorphological examination in 20 (64.5 %) cases in the MVS with PD group and in 81 (71.7 %) cases in the PD group (p=0.44). Conclusion. Although no statistically significant differences were observed between the two groups, venous resections in multivisceral surgeries involving pancreaticoduodenalectomy demonstrated a higher incidence of pancreatodigestive anastomosis complications and a higher frequency of venous thrombosis compared to pancreaticoduodenalectomy without resection of adjacent organs, which must be taken into account when planning surgery and managing the postoperative period of this category of patients.

Objective: to evaluate the effectiveness of surgical treatment in patients with stage II–III non-small cell lung cancer, who received neoadjuvant systemic chemotherapy or chemoimmunotherapy, as well as to assess radiological and pathological tumor responses to drug therapy. Material and Methods. The study included 22 patients with stage IIB, IIIA and IIIB non-small cell lung cancer, who received neoadjuvant systemic therapy in the period from May 2022 to June 2024. Of these patients, 12 received platinum-containing chemotherapy (neoChT group) and 10 received chemoimmunotherapy including pembrolizumab (neoChIT group). The median number of therapy courses was 4 in each group. Radical surgery was performed in 7 patients from the neoChIT group and in 12 patients from the neoChT group. Results. Radiological complete response was observed in 1 patient from the neoChIT group, and partial response in 6 patients from the neoChIT group and in 7 patients from the neoChT group. Pathological complete response was observed in 3 patients from the neoChIT group and in 2 patients from the neoChT group. Lobectomy was the most common type of lung resection in both groups: in 5 patients from the neoChIT group and in 10 from the neoChT group. The majority of patients (60 %, 9/15) underwent sleeve lobectomies. Postoperative complications were recorded in 2 patients from the neoChIT group and in 4 from the neoChT group. Postoperative mortality in the group of radical surgeries was 5.3 % (1 out of 19). The follow-up period was 25.2 months. All patients who underwent surgery, excluding postoperative mortality, are alive. The 2-year recurrence-free survival rate was 77.4 ± 15.2 %. Disease progression 5 and 16 months after surgery was observed in 2 patients from the neoChT, respectively. Conclusion. Neoadjuvant systemic therapy is a safe and promising approach in the treatment of patients with locally advanced non-small cell lung cancer. The surgical component is characterized by a high frequency of organ-preserving interventions, a non-increased frequency of complications and satisfactory long-term results. The preliminary data obtained are comparable with the available data in the world literature. Unambiguous conclusions require further accumulation of experience and more extensive research.

Breast cancer (BC) remains one of the leading causes of cancer mortality among women. Luminal BC subtypes, which are characterized by the expression of hormone receptors, account for about 70 % of all breast cancer cases. However, despite sensitivity to endocrine therapy, some patients demonstrate disease progression, which is associated with the molecular features of the tumor. The study of prognostic markers such as ROR1, BMI-1, and PIK3CA mutation is essential for understanding the mechanisms of resistance to therapy and metastasis. The aim of the study was to evaluate the prognostic significance of ROR1, BMI-1 protein expression and PIK3CA gene mutation in patients with luminal BC, who received hormone therapy with aromatase inhibitors, as well as their impact on clinical outcomes, including 5-year relapse-free survival. Material and Methods. The study included 80 patients with primary resectable luminal Her2-negative breast cancer (T1–2N0–1M0). All patients received adjuvant hormonal therapy with aromatase inhibitors. The expression of ROR1, BMI-1, cyclin D1 (immunohistochemistry), and PIK3CA mutation (real-time polymerase chain reaction) were assessed in tumor tissue. Results. Positive ROR1 expression was detected in 57.5 % of cases, BMI-1 in 82.5 %, and cyclin D1 overexpression in 37.5 %. The PIK3CA mutation was identified in 30 % of patients. ROR1 expression was observed in 100 % of cases with the luminal B subtype (14 out of 14) and in 48 % of cases with the luminal A subtype (32 out of 66), p=0.001. Cyclin D1 overexpression was observed in 58.7 % of patients with ROR1 expression and in 8.8 % of patients without ROR1 expression, p<0.0001. A high level of ROR1 expression (>50 %) was associated with cyclin D1 overexpression in 100 % of cases, p=0.044. Similarly, a high level of BMI-1 expression (>50 %) was associated with cyclin D1 overexpression in 64.7 % of patients compared to 31.6 % in those with low expression, p=0.03. Patients with PIK3CA mutations demonstrated significantly lower 5-year disease-free survival (p=0.03); disease progression was observed in 29 % of cases with the mutation versus 13 % in those without it (p=0.07). Conclusion. The study confirms the significance of ROR1, BMI-1 and PIK3CA mutation as potential prognostic markers in patients with luminal breast cancer. The identified relationships with cyclin D1 and molecular subtypes emphasize their role in tumor progression. The data obtained can be used for further personalization of treatment, including combination approaches with PI3K inhibitors and hormonal therapy.

Immune targeted therapy (ITT) including pembrolizumab, an immune checkpoint inhibitor, and lenvatinib, a targeted drug that blocks receptor tyrosine kinases, is one of the main treatment strategies for advanced endometrial cancer (aEC) patients with proficient mismatch repair (pMMR) and microsatellite stable (MSS). Since immunological mechanisms are involved in the implementation of the therapeutic effects of pembrolizumab and lenvatinib, it is likely that the current state of the patients’ immune system affects the efficacy of ITT. The purpose of the study was to investigate changes in peripheral blood immune parameters depending on the response to therapy in aEC patients who received therapy with pembrolizumab and lenvatinib. Material and Methods. The study included 12 patients with stage II–IV (T2–4N0–2M0–1) aEC with pMMR and MSS, who received therapy with combination of pembrolizumab and lenvatinib. All patients were divided into 2 groups: 1) with disease progression within 6 months of starting ITT (n=4), 2) without signs of progression for more than 6 months (n=8). The immune parameters (the number of VEGFR+ monocytes and VEGFR expression on monocytes, the number of PD-1+ cells in peripheral blood and PD-1 expression on them, the lymphocyte subsets) were evaluated by flow cytometry before starting ITT, 2 and 6 months after therapy. The control group consisted of 39 patients with newly diagnosed EC prior to anticancer therapy. Results. ITT resulted in significant changes in the number of VEGFR+ monocytes and VEGFR expression on monocytes, as well as in the number of PD-1+ cells in peripheral blood and PD-1 expression on them, along with alterations in the lymphocyte subsets. Changes in the immune parameters were related to the response to ITT. At the point of outcome (during disease progression or in the case of long-term response to therapy) the difference in the parameters reached the level of statistical significance. In the case of effective ITT, the immune parameters approached the values observed in control group patients with EC being newly diagnosed. Conclusion. Changes in immune system parameters of aEC patients treated with pembrolizumab in combination with lenvatinib were found to be related to response to therapy.

The aim of this study was to investigate the potential of compounds from the breadfruit tree (Artocarpus altilis) as anti-breast cancer agents using in silico techniques. Material and Methods. The methods used in this study include molecular docking and ADMET (Absorption, Distribution, Metabolism, Excretion, and Toxicity) predictions to evaluate the interactions with Estrogen Receptor alpha (ERα). Results. Among the 22 compounds tested, Cycloaltisin-7 exhibited the most favorable binding affinity, with a free energy of -10.25 kcal/ mol and an inhibition constant of 30.89 nM. Additionally, Cyclocommunol and Cudraflavone B demonstrated significant binding interactions, with free energies of -9.61 kcal/mol and -9.53 kcal/mol, and inhibition constants of 90.82 nM and 103.50 nM, respectively. For comparison, the standard compound 4-Hydroxytamoxifen showed superior binding characteristics, with a free energy of -12.36 kcal/mol and an inhibition constant of 867.83 pM. ADMET predictions indicate that Cycloaltisin-7, Cyclocommunol, and Cudraflavone B meet essential drug-like criteria, suggesting their potential as viable candidates for further development as breast cancer therapeutics. Conclusion. These findings highlight Cycloaltisin-7 as a particularly promising compound, with Cyclocommunol and Cudraflavone B also showing considerable potential. This research provides valuable insights for the advancement of plant-based treatments for breast cancer.

Introduction. In kidney masses of a high nephrometric index, a variant of renal ischemia is mostly needed, and to increase the time of compression of the renal artery, the cold renal ischemia may be relevant. Advantages of intra-arterial cold perfusion (IACP) are: good visualization and uniform cooling of the entire thickness of the renal parenchyma. This approach is not without its own set of challenges and potential complications during and after surgery. Purpose: to describe complications during kidney resection under IACP and options for their resolution with the practical recommendations based on literature data and clinical cases from our center. Material and Methods. The study included 14 patients with kidney masses of a high nephrometric index (RENAL 10 or more), who underwent kidney resections as an experimental technique under IACP from 2021 to 2024 at P.A. Hertzen Moscow Cancer Research Institute. Results. We identified both intra- and postoperative complications in 6 cases: perforation of the renal artery (n=1), brachial artery thrombosis (n=1), thrombosis of the renal artery (n=1), air embolism of segmental branches of the renal artery (n=2), urine leakage (n=1). Conclusion. The IACP-associated intraoperative complications in our cohort diminished over time as familiarity with the technique improved. The IACP is workable, efficient, and holds promise, indicating its appropriateness for large, well-equipped centers. In patients with just one functioning kidney and high nephrometric index masses needing prolonged ischemia during removal, this technique could become a lifesaving option as expertise grows.

The aim of the study was to analyze the results of endoscopic diagnosis and treatment of patients with duodenal neuroendocrine tumors. Material and Methods. From 2012 to 2024, 20 patients diagnosed with duodenal neuroendocrine tumors were examined, and some of them were treated at the Endoscopy Department of P.A. Herzen Moscow Oncology Research Institute. The median age of the patients was 61 years. Tumors were assessed by the following parameters: location, size, pit and vascular pattern, presence of subepithelial vessels, endosonographic structure, depth of invasion, tumor grade, and the type of treatment. Results. The mean tumor size was 8 ± 5.6 mm [95 % CI: 5.4–10.6]. The duodenal bulb was the most common tumor location (87 %) [95 % CI: 69–100 %]. Only in 13 % of cases, tumor was located in the ascending part of the duodenum [95 % CI: 0–30 %]. In the duodenal bulb, tumors were located on its anterior wall in 70 % of cases [95 % CI: 49–90 %], on the medial wall in 18 % of cases [95 % CI: 2–37 %], and on the posterior wall in 12 % of cases [95 % CI: 0–23 %]. Narrow-band imaging endoscopy revealed that 45 % of tumors had an irregular pit pattern and vascular pattern [95 % CI: 23–66 %], and 30 % of tumors consisted of dilated tortuous subepithelial vessels [95 % CI: 9–50 %]. Endoscopic ultrasonography was used to determine the depth of tumor invasion. In most cases, tumors were localized within the second layer corresponding to the muscular plate of the mucosa. Some patients underwent radical endoscopic treatment (EMR and ESD). Conclusion. In our retrospective analysis of clinical cases, we have identified some trends that are consistent with results of other large studies. Endocopic resection is safe and effective treatment option for duodenal neuroendocrine tumors with no evidence of muscle layer invasion and regional and distant metastases.

Introduction. The incidence of colorectal cancer (CRC) is steadily increasing in Russia. Patients with cancers of extra-intestinal malignancies are at increased risk of developing CRC. However, currently, there is no a science-based screening system for synchronous primary-multiple CRC among this group of patients. The aim of the study was to analyze features of synchronous CRC among patients with extra-intestinal malignancies. Material and Methods. The medical records of 53 cancer patients registered at the Kursk Oncology Research and Clinical Center named after G.E. Ostroverkhov were analyzed. The inclusion criteria were: the presence of histologically verified newly diagnosed cancer of extra-intestinal location, detection and histological verification of CRC between 2018 and 2022, and the interval between the detection of malignancies of more than 6 months. The decision to conduct an additional examination was made on the basis of complaints of the patients, medical history, physical examination and diagnostic imaging findings. The decision of complex examination was based on complaints, anamnesis and physical data. Results. Among patients with synchronous multiple primary CRC, there were more men (60.4 %) than women. The median age of the patients was 67 years. The risk group for synchronous multiple primary CRC included patients with urological, gynecological, skin, gastric, breast and lung cancers. Examination of the colon in patients with urological, gynecological, skin, gastric and lung cancers (p <0.05) resulted in the detection of synchronous stage I CRC in the distal colon within a month after histologically verified extra-intestinal malignancies in 50.9 % of cases (p<0.05). Conclusion. We recommend the following examination protocol: all primary patients with urological, gynecological, skin, gastric and lung cancers should undergo animmunochemical quantitative fecal occult blood tests no later than 7 days after verification of an extra-intestinal cancer. Such strategy will allow timely detection of multiple primary synchronous CRC.

Patients with acute leukemia are characterized by a high risk of infectious complications due to severe neutropenia, which occurs in most cases of modern treatment regimens. Despite the improvement in cytotoxic and concomitant treatment, infectious remain the main cause of induction mortality. Aim of the study: to analyze the frequency and structure of infectious complications in patients with acute leukemia, who received different chemotherapy regimens. Material and Methods. The retrospective analysis included 40 patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). 30 patients with AML underwent 97 chemotherapy courses which included 7 + 3 program (n=53), low-intensity protocols: azacytidine in combination with venetoclax (n=26), Aza-Ida-Ara-C (n=13), low doses of cytarabine (n=3) and high-dose anti-relapse chemotherapy programs (n=2). 10 patients with ALL received 43 chemotherapy courses: ALL-2009 program (n=41), anti-relapse protocols (n=2). The frequency and duration of myelotoxic agranulocytosis, episodes of infections and the variety of microorganisms in different loci were analyzed. Statistical analysis was performed using the Statteсh v. 4.1.2 program. Results. The median duration of myelotoxic agranulocytosis was significantly higher in patients with AML, treated with 7 + 3 protocol, especially during courses of induction of remission. The most common infectious complications were pneumonia, sepsis, febrile neutropenia, and mucositis. Necrotic enteropathy and stomatitis were significantly more common for AML patients compared to ALL patients (22.7 and 7.0 %, (p=0.025); 18.6 and 2.3 %, (p=0.01), respectively). The most common etiologic factors of infections in patients with acute leukemia were gram-negative microorganisms from Enterobacteriaceae family (40.57 %) and non-fermenting bacteria (15.66 %). The detection rate of metallo-beta-lactamase-producing enterobacteria was 12.45 %. The first-line antibacterial therapy (third-generation cephalosporins with beta-lactamase inhibitor) was effective in 21.62 %, and the secondline therapy effectiveness did not exceed 8.2 %. The choice of third and subsequent line antibiotics in most cases was made taking into account the results of microbiological tests, which increased its effectiveness to 41.54 %. The greatest effectiveness was demonstrated by a combination of two carbapenems (17.07 %), and cefoperazone/sulbactam or carbapenem + co-trimoxazole (19.51 %). Conclusion. Thus, patients with acute leukemia have a high prevalence of carbapenem-resistant gram-negative infections.

Cervical cancer remains a significant global health challenge, particularly in low- and middle-income countries where access to preventive measures and early detection is limited. This review aims to summarize current evidence on cervical cancer prevention, screening, and treatment, emphasizing the emerging role of artificial intelligence (AI) in improving diagnostic and therapeutic approaches. Material and Methods.A comprehensive literature review was conducted using peer-reviewed articles from Google Scholar, PubMed, and Scopus. The search focused on human papillomavirus (HPV) vaccination, cervical cancer screening methods, treatment strategies, and AI applications in cervical cancer management. Results. Despite advancements in prevention and early detection, cervical cancer remains a leading cause of cancer-related mortality in women, particularly in underdeveloped regions. Screening methods such as Pap smears, HPV DNA testing, and visual inspection with acetic acid (VIA) have been instrumental in reducing incidence rates in developed countries. Additionally, HPV vaccination programs have significantly decreased the prevalence of high-risk HPV infections, contributing to a decline in cervical cancer cases. However, disparities persist due to limited healthcare infrastructure and access to routine screening. AI-driven technologies, including deep learning algorithms and machine learning models, are emerging as valuable tools in cervical cancer detection, risk assessment, and treatment planning. These innovations have the potential to enhance diagnostic accuracy, reduce human error, and improve patient outcomes, particularly in resource-limited settings. Conclusion. The integration of HPV vaccination, advanced screening techniques, and AI-based diagnostic tools represents a transformative approach to cervical cancer prevention and management. Addressing healthcare disparities through the implementation of these innovations is essential for achieving equitable global cervical cancer control. Future research should focus on optimizing AI applications for broader clinical use and ensuring accessibility in low-resource regions.

Objective. The location of the rectum in the space limited by the rigid frame of the pelvic bones has determined the priority of combined modality treatment for locally advanced rectal cancer with a significant role of preoperative therapy. Over the past three decades, radiation therapy has become an increasingly integral component of neoadjuvant treatment of rectal cancer. Research activities aimed at increasing the effectiveness of perioperative radiotherapy in preventing local recurrence have been ongoing. Material and Methods. This article provides an overview of the results of current studies of various neoadjuvant therapy regimens for locally advanced rectal cancer, as well as promising options for optimizing preoperative irradiation. The search for publications on the topic of the review was performed using the Web of Science and PubMed databases. Out of 202 studies, 36 were selected for literature review. Results. The question of the advantage of large fraction radiotherapy over prolonged chemoradiotherapy still remains open. Improvements in neoadjuvant treatment outcomes in rectal cancer are associated with various options for increasing the radiation dose. In addition, the review examines the use of preoperative chemotherapy as an alternative to radiation therapy or as a component of combined modality treatment for rectal cancer. Conclusion. It is assumed that the strategy of total neoadjuvant therapy will not only improve local disease control, but also reduce the risks of systemic relapse. Currently, a multidisciplinary approach is of great importance in optimizing the treatment strategy for patients with rectal cancer.

Objective: to summarize current data on anaplastic thyroid cancer (ATC), one of the most aggressive forms of solid tumors. Material and Methods. A scientific literature review was conducted using the Medline, Cochrane Library, and E-library databases, primarily focusing on studies from the last 10 years. Out of 153 articles, 45 were selected for this review. Results. The primary clinical manifestations of ATC are associated with compression of structures in the neck, rapid growth, and the development of distant metastases. Although surgery remains the mainstay of treatment, it is often unfeasible due to the advanced stage of cancer at the time of diagnosis. Targeted therapy for BRAFV600E-muted ATC shows encouraging results and is considered a promising strategy for improving survival outcomes. Conclusion. This review highlights the importance of a multidisciplinary approach to the management of ATC, with a focus on surgery and neoadjuvant therapy. Neoadjuvant therapy may improve the prognosis for patients with unresectable tumors at the time of diagnosis. Further research is required to refine optimal treatment strategies and enhance the efficacy of existing therapies.

The purpose of the study was to compare the methods of mechanical reduction of blood flow in the right branch of the portal vein: portal vein embolization (PVE) and portal vein ligation (PVL) as a neoadjuvant treatment before extended hepatectomy to induce hypertrophy of the future liver remnant (FLR) for the prevention of post-resection hepatic failure (PRHF). Material and Methods. A total of 28 publications from PubMed and ScienceDirect databases, the International Hepato-Pancreato-Biliary Association, monographs and guidelines for physicians, covering the period from 2001 to 2004, were analyzed. The search for articles in the PubMed database was conducted using the key words: “portal vein embolization” and “portal vein ligation” with the parameters “Free full text”, “Review”, “5 years”. 22 articles were selected as relevant. Conclusion. In general, no clear and unanimous opinion was found among the authors regarding the rate of FLR hypertrophy between the PVE and PVL methods. However, most authors recommended PVL. As for the time interval from PVE/PVL to the second stage of surgery, the opinions were equally bipolar. Many authors recommended additional segment IV embolization to enhance the regenerative potential, which is associated with technical difficulties and requires advanced skills. The problem of post-occlusion tumor progression was widely reported, the highest percentage of cases was described after PVE. This fact is explained by hemodynamic restructuring, stimulation of cytokine and growth factor production. The cases of insufficient FLR hypertrophy due to the development of intrahepatic collaterals, especially after PVL, were described. Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) was proposed as an alternative to prevent this complication. Complications after PVE/PVL were poorly described, with isolated reports of contralateral embolization, intra-abdominal choleraemia or hemorrhage, and distant periportal fibrosis. To date, PVE remains the gold standard as the first stage of two-stage extensive liver resections, as a prevention of post-resection liver failure.

Objective: to summarize global and personal experience in the application of embolization techniques in the surgical management of benign and malignant skull base tumors, comprehensively analyzing associated risks and complications to improve treatment approaches and minimize negative outcomes. Material and Methods. An analysis of scientific publications from international medical databases (PubMed, Cochrane Library, Elibrary and others) covering studies over the past 20 years, as well as a retrospective analysis of our own clinical data on embolization for skull base tumors was conducted. Specific details and features of embolization techniques, materials used, and criteria for complication assessment, including classifications developed by international expert societies, were thoroughly examined. Results. The analysis revealed that outcomes from embolization techniques in skull base tumor surgery remain controversial, with a wide range of complications from minor reactions to severe and disabling conditions. Major complications identified included stroke, cranial nerve dysfunction, tissue necrosis, and death. Determination of the optimal timing interval between embolization and subsequent surgical resection is critical, as premature surgery does not fully exploit embolization potential, whereas delayed surgery increases the risk of recanalization and progression of perifocal edema, exacerbating neurological deficits. Particular attention was given to the postembolization neurological syndrome (PENS), which may result in persistent and irreversible neurological impairment. Conclusion. Despite potential benefits in reducing intraoperative blood loss and facilitating surgical procedures, the use of embolization technologies requires careful evaluation of risks and potential complications. Decisions regarding embolization should be individualized and based on a multidisciplinary approach considering the specifics of each clinical case.

The purpose of the study was to analyze and summarize the available literature data on the potential value of radiation therapy for locally advanced cervical cancer and to present alternative treatment options when conventional treatment is not feasible. Material and Methods. A literature search was conducted using PubMed and Cochrane Library databases as well as databases of clinical materials from the Ministry of Health of the Russian Federation, ASCO (American Society of Clinical Oncology), and National Comprehensive Cancer Network (NCCN). Literature sources and publications from 2004 to 2021 were included into the review. Results. The review outlines the basic principles of classical treatment of locally advanced cervical cancer (external beam radiation therapy followed by brachytherapy boost). Alternative treatment options for patients not eligible for brachytherapy have been shown. Methods of using stereotactic treatment as an alternative to brachytherapy have been described. The results of researches who applied a new treatment method, namely, two-stage stereotactic body radiation therapy for patients with locally advanced cervical cancer have been demonstrated. Conclusion. The use of modern devices for radiation therapy, such as the linear electron accelerator and modern planning stations for medical physicists, may make it possible to use a new option in the treatment of patients with locally advanced cervical cancer – the use of stereotactic boost. This issue is still controversial and requires further study.

Introduction. Cytotoxic corpus callosum syndrome (CLOCC syndrome) is a rare neurological pathology, the pathogenesis of which has not been fully studied. The CLOCC syndrome, which develops in cancer patients, is a serious concomitant pathology that complicates anti-cancer treatment. Description of the clinical case. A 34 year-old female patient was admitted to the A. F. Tsyba MRRC in August 2023 with a diagnosis of stage IV plasmoblastic lymphoma established at her place of residence. Taking into account the severity of the patient’s disease, EPOCH chemotherapy with intrathecal administration of cytostatics was immediately initiated to prevent neuroleukemia. Infectious complications (febrile neutropenia and enterocolitis) that developed during therapy caused neurological disorders, which together with MRI findings, were assessed as CLOCC syndrome. These changes regressed over several days during desmopressin treatment and massive dehydration therapy with crystalloid and glucose solutions. Histological re-examination of the first biopsy specimen and immunohistochemical studies revealed B-lymphoblastic lymphoma, which led to a correction of the further therapy plan. Conclusion. The cause of the development of CLOCC syndrome in this patient can be assumed to be a combination of the damaging effects of cytostatics on brain tissue and electrolyte imbalance.