[Magnetic resonance imaging in the diagnosis of secondary vaginal tumor involvement].

OBJECTIVE: To estimate the capabilities of magnetic resonance imaging (MRI) in revealing and estimating the extent of secondary vaginal involvement. MATERIAL AND METHODS. Thirty patients with secondary vaginal tumor involvement underwent contrast-enhanced MRI. Examinations were made using a 1.5 T MRI. The protocol encompassed T2- and T1-weighted, diffusion-weighted, and dynamic contrast-enhanced MRIs. To smooth out vaginal wall rigosity, the examination was made using an intracavitary MR-compatible applicator. RESULTS: Vaginal metastatic involvement was detected in 30 patients with sustained malignancies at various sites. The largest group consisted of 16 (53.3%) patients with uterine corpus metastases. Secondary vaginal involvement was observed in 11(36.7%) patients with cervix uteri cancer, in 2 (6.7%) patients with progressive ovarian cancer, and in 1 (3.3%) patients with rectal cancer. With a significant tumor volume giving rise to thickening of the vaginal wall or its impaired slice differentiation, the portion of an inhomogeneously increased MR signal portion during T2-weighted MRI, which intensively accumulated the paramagnetic in an arterial and venous phase of dynamic contrast-enhanced MRI, was detected. There were no T2-weighted images of a hypointense muscular layer and paravaginal fat streaks during an invasive process. In our investigation, vaginal metastatic tumors which were enclosed by the mucous membrane and evident as shallow erosion, as shown by the data of clinical and histological examinations, had no specific MRI signs in any of the pulse patterns, which is likely to be associated with the resolution of this technique. CONCLUSION: The proposed protocol of comprehensive magnetic reso nance imaging makes it possible to clearly localize a tumor process into the vagina and to determine the volume and pattern of involvement in most patients, including whose who have a history of antitumor treatment.

[Current strategies in radiotherapy for cervical and endometrial carcinoma].

We used combinations of taxan-based neoadjuvant and adjuvant full-dose chemotherapy and aggressive combined radiotherapy including clinical target volume extension, increased total dosage, hyperthermia, cryo- and local chemotherapy as radiosensitizers, for treatment of invasive and locally-advanced breast cancer or endometrial carcinoma with poor prognosis. 3D-ultrasound/CT/MRI--based designing of radiotherapy and monitoring of dynamic definition of target volume and "high risk volume" in organs at risk in cases of tumor progression was an indispensable measure. As a result, no local recurrence was reported in 73% for 36 months.

[Improvement of postoperative radiotherapy in the complex treatment of stage II-III cervical cancer].

Clinical data on the management of squamous-cell cervical carcinoma stage II-III FIGO are presented. At stage I, treatment included neoadjuvant polychemotherapy (NACT)--cisplatin 100 mg/m2, carboplatin 450 mg/m2 in conjunction with 5-FU 250 mg/m2 or paclitaxel 135 mg/m2. According to protocol, two identical courses of NACT were given, at 21-28 day interval, followed by extended extirpation of the uterus (Wertheim). Immediate results and complications caused by preoperative radiotherapy, important for postoperative one, were evaluated, concepts and strategies for postoperative intracavitary and distant radiotherapy worked out. To optimize radiotherapy, dosage was reduced by 10% or daily single target dose of intracavitary and distant irradiation split per 24 hrs, indications for preoperative radiotherapy variants were extended, and local dosage escalation in areas of lymphocyst or hematoma renounced. Overall survival was 85%, recurrence-free--77.5%.

[Automated radiotherapy in the combined treatment of locally advanced and disseminated ovarian cancer]. / Avtomatizirovannaia luchevaia terapiia v kompleksnom lechenii mestorasprostranennykh i disseminirovannykh form raka iaichnikov.

The paper deals with the results of treatment of 110 patients with advanced ovarian cancer showing signs of tumor progression following polychemotherapy with two regimens which included radiotherapy. Variants of distant and contact irradiation individually-tailored to suit the types of tumor are discussed. Details of single and repeated courses of chemoradiation are presented. Such beneficial effects as longer survival and better quality of life were registered in 76%.