[Treatment of local Hodgkin's disease with massive mediastinal involvement]. / Lechenie bol'nykh limfogranulematozom I-II (lokal'nykh) stadii s massivnym porazheniem sredosteniia.

AIM: To define the scope of combined therapy in patients having local Hodgkin's disease (LHD) with massive mediastinal lesion. MATERIAL AND METHODS: From 1980 to 1997 the treatment was given to 75 LHD patients with massive lesion of the mediastinum (mediastinal-thoracic index, MTI, > or = 0.33). The patients have received combined chemoradiotherapy according to 3 cycle CVPP (cyclophosphamide 600 mg/m2, vinblastine 6 mg/m2, prokarbasin 100 mg/m2, prednisolone 40 mg/m2) with a 2-week interval + radiation to all the lymphatic collectors above the diaphragm with a single focal dose 2 Gy to total focal dose 36-38 Gy + 3 cycle CVPP. According to the size of the mediastinum the patients were divided into 3 groups: group 1--MTI = 0.33, 27 patients; group 2--MTI = 0.33 > 0.45, 32 patients; group 3--MTI > or = 0.45, 16 patients. The response was estimated according to the latest EORTC recommendations. Survival curves were plotted according to the E.L. Kaplan and P. Meier procedure. RESULTS: Complete remission was achieved in 93, 94 and 56% of group 1, 2 and 3 patients, respectively. 6-year recurrence-free survival reached 84, 71 and 32%, while survival free of treatment failure 80, 66 and 27%, respectively. 6-year overall survival and uneventful survival made up 94, 97 and 70%; 72, 66 and 27%, respectively. CONCLUSION: Treatment of LHD patients of group 1 is performed according to the standard scheme (6 cycles of first-line polychemotherapy plus radiotherapy). Patients of group 2 can be treated more intensively, while for patients of group 3 more intensive treatment is a treatment of choice.

[Potentials and outlook for radiation therapy of cancer patients on an outpatient basis]. / Vozmozhnosti i perspektivy luchevoi terapii onkologicheskikh bol'nykh v ambulatornykh usloviiakh.

The paper is devoted to the problems of the organization of radiotherapy in an outpatient setting. Irradiation outside a hospital was demonstrated on 2500 patients with different primary and metastatic tumor lesions by way of an example. Social and economic advantages of this type of care were shown.

[Conservative treatment of breast cancer]. / Konservatnoe lechenie raka molochnoi zhelezy.

The paper is concerned with clinical characterization of 81 breast cancer patients after conservative radio- and hormonotherapy. Of the total number of patients 47 suffered from inoperable tumors as a result of local spreading, 30 patients had serious contraindications for the operation, and 4 patients refused surgical intervention. Of the total number of patients 85% were aged over 50, 69%--over 60.41%--over 70, and 4 patients--over 80. The results of radiotherapy after a radical program and administration of antiestrogens (tamoxifen, zitosonium) were evaluated in 71 patients: in 42 tumors were undetectable, in 16 they were reduced by more than 50% of their primary size. An analysis of short-term results during 1-year follow-up showed that of 50 patients complete remission was observed in 24, stabilization of a tumor process was achieved in 8. The results should be regarded as promising with relation to the patients' age, status, tumor spreading, and concomitant diseases.

[An experience with the conservative treatment of breast cancer in middle-aged and elderly women]. / Opyt konservativnogo lecheniia raka molochnoi zhelezy u zhenshchin pozhilogo i preklonnogo vozrasta.

Advantages of conservative treatment of inoperable breast cancer in old and elderly age are discussed on the basis of an analysis of data on 30 cases. A split-course radical radiotherapy was combined with a prolonged tamoxifen treatment. Complete regression of tumor was registered in 16 out of 23 followed-up patients, while more than 50% regression--in I case. The study should be continued.

[Complex therapy of melanoma metastases in the lung]. / Kompleksnoe lechenie metastazov melanomy v legke.

The authors present the therapeutic results of 25 patients with melanoma metastases of the lungs: 9 of them received radiotherapy only, 16 radiotherapy combined with i.v. injection of the antitumor antibiotic dactinomycin. The technique of large field irradiation of the lungs was employed as a single exposure (depending on tumor spread) of the entire volume of one or both lungs. The treatment resulted in a decrease of metastases by more than 50% of the initial value in 2 out of 6 patients in the 1st group; in the 2nd group in 16 patients metastases disappeared, in 2 patients they decreased by 50%. Pulmonites prevailed in the group of multiple modality treatment. The authors conclude that dactinomycin raises to a higher power the degree of radiation exposure of melanoma metastases as well as the normal lung tissue.

[Adriamycin (doxorubicin) in the combined treatment of patients with the edematous-infiltrative form of breast cancer]. / Adriamitsin (doksorubitsin) v kompleksnom lechenii bol'nykh s otechno-infil'trativnoi formoi raka molochnoi zhelezy.

Twenty-one female patients with edematous infiltrative cancer of the breast without distant metastases not given specific therapy before were treated with vincristine, adriamycin, methotrexate and irradiation of the mammary glands and regional areas in accordance with the splitted course procedure. If the positive estrogen receptors were present in the tumor tissue, the patients with preserved menstrual function and menopause of not more than 5 years were subjected to ovariectomy. The suggested induction scheme of the treatment provided pronounced objective results in 80.9 per cent of the patients. The tumor regression by less than 50 per cent was observed in 14.3 per cent of the patients. Only 1 patient had the signs of the disease progress. No threatening leukothrombopenia or cardiotoxicity signs were recorded during the treatment period. It allowed the recommending of this method for the treatment of outpatients.

[Radiation and combination treatment of breast cancer metastases to the lungs]. / Luchevoe i kompleksnoe lechenie metastazov raka molochnoi zhelezy v legkie.

The authors describe methodological and clinical results of the so-called large field irradiation of 56 patients with breast cancer metastases to the lungs. Of these, 46 received radiotherapy alone, 10 radiotherapy in combination with polychemotherapy using the CMF scheme (cyclophosphamide, methotrexate and 5-fluorouracil). As a result of radiotherapy (46 women), a noticeable objective response was achieved in 44% of the cases; among 10 patients on multimodality therapy it was achieved in 4. Average remission was 9 mos. in the 1st group and 8 mos. in the 2nd group. The patients were treated in the outpatient department. Proceeding from our experience radio- and multimodality therapy can be used as conservative therapy for patients with breast cancer metastases to the lungs.

[Conservative methods of treating breast cancer metastases to the lungs]. / K voprosu o konservativnykh metodakh lecheniia metastazov raka molochnoi zhelezy v legkie.

An analysis is presented of different routine methods of treatment (radiotherapy, mono- and polychemotherapy; chemo-radiation treatment) used in 77 patients with breast cancer metastases in the lung. According to the data obtained positive results were gained in 53% of cases, a considerable effect being noted in 46% of patients.

[Radiotherapy of metastases of malignant neoplasms into the lungs]. / Luchevaia terapiia metastazov zlokachestvennykh opukholei v legkie.

The results of radiation therapy in 800 patients with lung metastases of different malignant neoplasms are reported. Metastases were multiple--in 53 cases, single--in 7, solitory--in 14. In 6 patients metastatic nodes were noted in the pleura. Total irradiation was employed (of one lung in 36 patients, of both lungs--in 44). In 15 patients an additional local irradiation of separate metastatic foci was performed. As a result of the treatment an immediate objective effect was gained in 44 of 80 patients (55%), metastases completely disappeared in 12 cases (15%). The period of remission ranged from 1 month to 2.5 years, making 8 months on the average. The data obtained indicate the rationality to further improve the technic concerned and to study simultaneously the opportunities of using radiotherapy, supplemented with the use of different antitumor drugs, taking into account the sensitivity of some or other malignant tumor to them.

[Palliative radiation therapy of malignant tumor metastases to the bones]. / Palliativnaia luchevaia terapiia metastazov zlokachestvennykh opukholei v kosti

The results obtained in irradiation of 106 patients with metastases of different malignant tumors in the skeleton are reported. Radiotherapy was carried out on a distance gamma-apparatus by two fractions, with a single dose of 650 or 850 rad. As a result of the therapy, pains disappeared in 32 patients, and in 60 patients these were diminished considerably. A prompt therapeutic effect of the method, its simplicity and effectiveness (an opportunity to raise the capacity of the apparatus and clinic where a patient stays) made it possible to recommend it for practical purposes of palliative irradiation.