[Comprehensive analysis of the efficacy of personalized rehabilitation programs in patients with breast cancer]. / Kompleksnyi analiz effektivnosti personalizirovannykh programm reabilitatsii bol'nykh rakom molochnoi zhelezy.

The concept of the personalized rehabilitation is based on the principle of applying physical and rehabilitative medicine techniques depending on the factors that mostly influence on rehabilitation efficacy in a particular patient - determinant of effectiveness. Current achievements in the diagnosis and treatment of breast cancer (BC) significantly increased overall patients' life expectancy, updating rehabilitative treatment stage, which is often unmet. OBJECTIVE: To perform the comprehensive analysis of the efficacy of personalized rehabilitation programs in patients with BC. MATERIAL AND METHODS: The combined comparative multi-centre randomised trial of rehabilitation program efficacy in patients with breast cancer was done. The study included 219 patients aged from 30 to 45 years (median 39.4 year), who were divided into 2 groups. The rehabilitation by programs, that included current personalized rehabilitative techniques (RT) with proved efficiency, based on scientometrical analysis of evidential research was performed in the first group patients. In the second group aftercare was done according to the standard programs. The comprehensive evaluation of treatment efficacy was conducted in several stages: 1) performance analysis of rehabilitative programs; 2) verification of the effectiveness' determinant of rehabilitation; 3) factor analysis to assess the mechanisms of therapeutic effects in experimental groups; 4) comparative analysis of alternative strategies for selecting rehabilitation programs. RESULTS: The use of rehabilitative programs, based on recommended RT, changes the rehabilitation structure, significantly increasing its efficacy by 17%. Furthermore, the percentage of high-efficiency usage of this type programs increases by 17% compared with standard programs. The main determinants, affecting the efficacy of rehabilitation programs, based on selected RT, are anamnestic data, parameters of exercise tolerance and physical activity and ultrasound parameters of upper limb blood flow. The therapeutic effects of personalized rehabilitation programs are realized by correction of clinical rates, increasing exercise tolerance and physical activity, as well as psychophysiological parameters. CONCLUSION: The use of the evaluation system of anamnestic, clinical, functional and psychophysiological features of patient (the effectiveness' determinant) in realization of personalized rehabilitation programs for women with BC, allows to predict and manage the efficacy of RT applying.

[The role of comprehensive geriatric assessment in the treatment of cancer patients in elderly and senile age.]

Modern approaches to the organization of diagnosis and treatment of elderly and senile patients with malignant tumors allow to maintain the necessary level of health, improve the quality of life and increase life expectancy. Assessment of geriatric status in Oncology allows: to predict complications during the complex treatment, including drug treatment; to modify treatment to reduce the risk factors of adverse outcomes; to select patients for specialized treatment using standard schemes. So, timely assessment of geriatric syndromes and their correction can expand the indications for specialized treatment of elderly and senile patients.

Diagnosis and treatment of phylloides tumors of the breast.

Phylloides tumors (PT) are a rare and the least studied pathology of the breast. Data on physical examination and imaging methods of diagnostics in most cases do not allow accurate diagnosing at the preoperative stage as there are no clear characteristics that allow differentiating benign from malignant variants of PT or other benign breast diseases. Surgery is the main treatment of PT. Chemotherapy and radiation therapy of malignant variants of PT in the adjuvant setting do not significantly improve survival rates. In recurrent or metastatic forms of PT these methods can be effective in some cases. Currently there are identified molecular signaling pathways that play an important role in the pathogenesis of PT. Thus there are prerequisites for the study of the effectiveness of targeted therapies for this pathology.

[Efferent therapy in the treatment of solid tumors].

Endogenous intoxication and immune insufficiency accompany neoplastic process. Complex therapy for cancer worsens these pathologic conditions by its adverse effects (AE) and thus complicates treatment. Efferent therapy can provide continuity of antineoplastic therapy with normalization of hemostasis and decreasing the rate of AE and their intensity. Efferent therapy meaningfully increases patient's quality of life and decreases the needed drug support when used as a part of complex therapy. Proper use of efferent therapy can markedly increase efficacy of surgical treatment, radiation therapy and drug therapy.