Determination of oxygen perfusion in the area of radiation-induced fibrosis of the skin in patients with breast cancer and its role in pathogenesis of late radiation injury.

AIM: Late radiation injury in the form of radiation-induced fibrosis (RIF) is one of the many complications of radiation therapy. The aim was to evaluate oxygen perfusion in the skin in the area of late radiation injury manifested as RIF in patients with breast cancer. MATERIALS AND METHODS: Based on our first-hand experience in treating late radiation injures of soft tissues in patients with breast cancer, we measured oxygen perfusion of the skin (tсрО2) in the area of late radiation injury using a transcutaneous monitor (oximeter) TCM 400 (Radiometer, Denmark). RESULTS: Partial oxygen pressure tcpO2 in the RIF area in patients with breast cancer didn't show any significant decrease compared to healthy tissue. Mean value of partial oxygen pressure tcpO2 in the RIF area was 42.650 ± 9.178 mmHg, in the healthy tissue it was 45.180 ± 8.025 mmHg. Maximal difference in tcpO2 between the damaged and healthy tissue was 30 mmHg. CONCLUSIONS: Results of the study suggest that there's no significant difference between oxygen perfusion (tcpO2) in the area of RIF and healthy tissue.

[FEATURES OF THE MIRIZZI SYNDROME TREATMENT].

Analysis of the possibilities of application of minimally invasive approaches in Mirizzi syndrome. Analyzed the treatment of 70 patients with the syndrome Mirizzi treated from 2002 to 2012. The study describes the features of the application of minimally invasive interventions in Mirizzi syndrome. Application of minimally invasive techniques in the treatment of Mirizzi syndrome is permissible when assessing the diagnostic characteristics obtained at the preoperative and intraoperative phases. Frequency conversion during minilaparotomic access at Mirizzi syndrome lower than for laparoscopic. Performing intraoperative cholangiography before main stages of the opera helps to concretize optimum volume of intervention.

[Postoperative intraperitoneal complications in colon cancer surgery].

The authors studied the clinical characteristics and terms of the development of postoperative intraperitoneal complications in patients undergoing colon cancer surgery. It was stated, that the diversity of clinical data depended on complication characteristics. Results of investigation allowed defining of the most dangerous terms of intraperitoneal complications and risk factors.

[Possibilities of surgical treatment for disseminated breast cancer].

More than in 10% of breast cancer patients distant metastases are detected at diagnosis. The results of treatment of 191 patients are presented. Removal of the primary tumor in case of newly diagnosed advanced breast cancer (oligometastatic) increases the mean duration of life from 26 months up to 38 months (p < 0.01). 3-year overall survival increases from 49% to 71% (p = 0.001), and a 5-year survival-from 18% to 47% (p = 0.001). 9% of patients with metastatic breast cancer who underwent mastectomy live 10 years and more. The relative risk of death in the presence of distant metastases after resection of primary tumor, on average decreases by 34%. By means of multivariable analysis the best results after mastectomy were obtained in the localization of distant metastases in the bones and soft tissues, high expression of steroid hormone receptors, the absence of overexpression of HER2/neu, luminal A type, positive response to preoperative systemic therapy and attaining free surgical margins.

[Perspectives in use of surgery for disintegrating breast tumor].

Fifty-one patients with decaying breast cancer without signs of distant metastasis were operated on at the Academy's Clinic (September 2004 - December 2009). According to the 3-year follow-up, 18 out of 27 (62.5%) survived for 3 years and longer.

[Adjuvant chemotherapy with anthracyclines in comparison with the standard combination of CMF in breast cancer with high risk of relapse]. / Antratsiklin-soderzhashchaia ad''iuvantnaia khimioterapiia v sravnenii s klassicheskoi skhemoi CMF u bol'nykh rakom molochnoi zhelezy s vysokim riskom retsidiva.

The effectiveness of adjuvant therapy with adriablastin and doxorubicin for breast cancer has been compared to that of standard CMF. During 1985-1990, the study included 349 patients with T1-2N2M0 and T3N0-2M0 tumors; mean age--46 yrs; mean follow-up--96.7 months. Overall survival rate in the doxorubicin group was 73%, CMF--62%; relapse-free survival--62.1 and 55%, respectively. The absolute difference in overall survival rates (11%) proved barely significant (p = 0.056). However, the difference in overall survival (p < 0.05) after anthracyclines and CMF in patients with tumors T1-2N2M0 and T3N1M0 was significant and in favor of the former. As far as frequency and degree of side-effects is concerned, their patterns were practically identical in both groups, except for the significantly higher frequency of cardiotoxity and complete alopecia in doxorubicin therapy. Cardiotoxic complication rate was significantly reduced from 13.8 to 3.9% by cardioxane treatment.

Primary (neoadjuvant) chemotherapy and radiotherapy compared with primary radiotherapy alone in stage IIb-IIIa breast cancer.

BACKGROUND: A phase III randomized trial was activated to evaluate the efficacy of preoperative combined chemotherapy and radiotherapy as compared to preoperative radiation therapy alone, in patients with breast cancer presenting with a clinical stage of IIb-IIIa (TNM classification). PATIENTS AND METHODS: From 1985 to 1990, 271 patients, aged 27-55 years, with stage IIb-IIIa breast cancer were randomized to receive either one or two courses of thiotepa 20 mg (i.m. injection) on the days 1, 3, 5, 7, 9, 11 (total dose per course 120 mg), methotrexate 40 mg/m2, i.v. on days 1 and 8, and 5-fluorouracil 500 mg/m2, i.v. on days 1 and 8 (TMF regimen) plus radiotherapy (Group I, 137 patients), or preoperative radiation therapy only (Group II, 134 patients). After the preoperative treatment all patients underwent mastectomy and complete axillary clearance, and then received 4-6 courses of TMF. The trial was conducted in a single institution (N.N. Petrov Research Institute of Oncology, St. Petersburg). RESULTS: Histopathological assessment of the mastectomy specimens showed complete regression of the tumour in 29.1% of the patients in group I and in 19.4% of the patients e.c. in group II. The estimated 5-year overall survival percentages were 86.1% for group I, and 78.3% for group II (P > 0.05). 5-year disease-free survival percentages were 81.0% and 71.6%, respectively (p < 0.05). CONCLUSIONS: Despite the low number of the patients included in the trial, we were able to detect a significant improvement in treatment results with a combination of chemotherapy and radiation therapy given prior to mastectomy over those of local therapy alone with radiation therapy followed by mastectomy, for average- and high-risk patients with operable breast cancer.

[Neoadjuvant chemotherapy in combined treatment of breast cancer]. / Neoad''iuvantnaia khimioterapiia v kompleksnom lechenii raka molochnoi zelezy.

The paper deals with results of complex treatment of 387 patients with stage III breast cancer assigned to either neoadjuvant chemotherapy and preoperative radiotherapy or radiation alone. A study of immediate and end results showed combination of the two modalities to be more effective than each method alone in terms of degree of regression of primary tumor and, particularly, lymph node metastases and duration of recurrence-free period.

[The adjuvant chemotherapy of breast cancer]. / Ad''iuvantnaia khimioterapiiaraka molochnoi zhelezy.

A clinical trial undertaken at Surgical Department No. I of the Institute included the data on 569 cases of stage I-III breast cancer treated in 1985-1989. Adjuvant CMF or TMF chemotherapy failed to improved 5-year survival (chemotherapy 2--285.2%, no chemotherapy--84.8%) in patients with stage I-IIa (TO-2NOMO) disease. Adjuvant treatment with adrioblastin proved superior over CMF and TMF in terms of 5-year overall survival in patients with stage III (T3NO-IMO; TO-3N2MO) cancer (71.0 and 55.0%, respectively).