[Primary multiple malignant lung tumors. References and a clinical observation].

The problem of primary multiple tumors is relevant to current clinical oncology because of increasing of number of patients with multiple malignant tumors and unsolved issues of treatment. Primary multiple malignant lung tumors is a common oncological situation requires an individualized, differentiated approach to treatment. The results of treatment are associated with the prevalence of the process, stages of tumor development, spare capacity of patients. There is presented clinical example of a patient with metachronous primary multiple malignant tumors of one lung.

Prophylaxis and treatment of radiation oral cavity mucositis by hydrogel preparations in patients with oropharyngeal cancer.

Development of radiation mucositis in patients with oropharingeal cancer who are treated by radiation therapy leads to constrains breaks, decreases of the quality of life and makes the radiation dose in target insufficient. All above mentioned increases recurrence risk. Since 2010 there was developed and introduced the method of prophylaxis and treatment of radiation injuries of oral cavity in patients with oropharingeal cancer which gives an ability to improve radiation treatment outcomes and the quality of life of patients.

[Results of complex treatment of patients with squamous cell carcinoma of the anal canal using advanced radiotherapy technologies].

During recent decades radiotherapy is the basis, on which it is built a medical complex that is the first-line treatment of patients with squamous cell carcinoma of the anal canal. An increase of overall and disease-free survival and quality of life of patients with squamous cell carcinoma of the anal canal at the present stage of development of a comprehensive medical treatment is largely due to the improvement of technical equipment of radiotherapy departments of oncology clinics. The use of modem linear electron accelerators and systems of computer dosimetric planning to create a 3D program of isodose distribution, diagnostic devices (computed tomography and magnetic resonance imaging) as well as a number of other conditions permit accurate summarizing of proposed dose, reducing of absorbed dose to critical structures, diminishing unplanned interruptions in chemoradiotherapy course by means of modern technologies of conformal radiotherapy (3D CRT, IMRT, VMAT). The paper presents the preliminary results of a comprehensive medical treatment of 14 patients with squamous cell carcinoma of the anal canal.

[Radiation pneumonitis in the treatment of early-stage breast cancer].

Despite of improvement of radiotherapy techniques and increasing usage of conformal radiation therapy which provides decrease of dose for normal tissues and organs, cases of radiation-induced injuries are still registrated. The aim of this study is to determine frequency and severity of lung toxicity in 513 breast cancer patients with Tis-2N0-2M0 disease after breast conserving surgery and chemotherapy depending from radiation therapy technique and irradiation volume. It is quite clear that in breast cancer patients frequency of lung toxicity after breast conserving surgery and RT increases from 20-24% when irradiating only breast to 37-41% when irradiating breast and regional lymph nodes. In our analysis the frequency of lung toxicity was quite similar for 2D conventional therapy (27,4%) and for 3D conformal therapy (28,7%). The risk of developing radiation pneumonitis increases dramatically with extension of V20 for ipsilateral lung more than 30%, mean lung dose more than 18 Gy, in patients with initial small volume of the lung (less than 110 cm3).

[Complex treatment of breast cancer patients with brain metastases].

Brain metastases in breast cancer develop for 24-32 months after the detection of the primary tumor. The study included patients with brain metastases who were divided into three groups: the first group--with early chemoradiotherapy (CRT) without induction chemotherapy (IC) by capecitabine; the second group--with delayed CRT with 4 or 8 courses of IC by capecitabine; the third group (a historical control) who received only whole brain radiation therapy. The median time to progression of intracranial metastases was 15.3, 12 and 5 months, respectively. The median time to the intracranial progression significantly less in the third group (5 months) compared with the first (15.3 months) (p = 0.0007) and the second (12 months) (p = 0.027) groups. The overall survival rate was 22.1, 15.1 and 6.8 months in three groups, respectively.

[Primary mediastinal (thymic) large B-cell lymphoma: review of the literature and author's own data].

AIM: To study morphoimmunological and clinical features of primary mediastinal large B-cell lymphoma (PMLBCL). MATERIAL AND METHODS: We analysed the results of biopsy material study and treatment of 86 PMLBCL patients, effects of different factors on the disease prognosis, efficacy of some therapeutic programs and overall therapeutic efficacy. RESULTS: PMLBCL manifests mainly with massive lesions of anterior upper mediastinum with involvement of adjacent organs and tissues, absence of bone marrow involvement, frequent affection of CNS. Many primary patients have resistance to treatment, sensitive patients have no late recurrences. CONCLUSION: PMLBCL is an independent extranodal variant of non-Hodgkin's lymphoma with special clinical and morphoimmunological characteristics. Criteria are proposed for differential diagnosis of different variants of PMLBCL. New approaches to PMLBSL patients' management are outlined.

[Conformal radiotherapy for prostate cancer].

Data are presented on a retrospective comparison of the results of remote radiotherapy and combined treatment of prostate cancer (T2T4NxM0) (88) at the Center's Clinics (1999-2003). Diagnosis was confirmed by morphological evidence: T2NxM0 (group 1)--18.2%, T3aNx M0 (group 2)--53.4%, T3bNx M0 (group 3)--18.2%, T4NxM0--10.2% (group 4). In group 1 (n=37), contemporary radiotherapy was administered--TTD--up to 44 Gy (stage I) and up to 66-70 Gy (stage II). In group 2 (n=51), contemporary radiotherapy was supplemented with inhalation of radioprotector GGS-9--TTD--up to 44 Gy plus GGS-9 (stage I) and up to 72-76 Gy plus conformaton radiotherapy (3D CRT) (stage II). When GGS-9 was used at stage I the rate of acute radiation injury dropped from 56.7% in group 1 to 11.7% in group 2, (p=0.0001). The frequency of late-onset injury was also lower in patients receiving 3D CRT (13.5 and 3.9%, respectively) (p=0.01). Local and biological relapse occurred frequently after contemporary radiotherapy (27%) as compared with conformation one (5.8%). The latter treatment was followed by higher 5-year recurrence-free survival (94.2%) as compared with contemporary radiotherapy (73%), (p=0.0001). Owing to use of 3D CRT, dose distribution was improved as volume and dosage for organs at risk of irradiation decreased, while TTD increased up to 72-76 Gy unaccompanied by a rise in early-onset injuries. On the contrary, late-onset radiation damage fell down.

[Effectiveness of treatment of single cerebral metastasis depending on prognostic groups (RPA RTOG)].

Our investigation was aimed at establishing a relationship between single metastases in the brain and a set of prognostic factors. It involved 278 patients treated at the Center in 1983-2003. The whole brain was irradiated in 273 while 159 of them (58.2%) received additional local irradiation of the brain. Single dosage of 2-2.5 Gy was administered to 158 (57.9%), 115--3Gy and more (42.1%). Mean total dosage was 36 Gy per metastasis for the whole brain and 46 Gy--for total plus local exposure. Among patients with favorable prognosis (RPA) were those aged up to 65, Karnofsky's index > or = 70%, with cured or controllable tumor and without extracranial metastases; poor prognosis--Karnofsky's index < or = 70%, irrespective of any other prognosticators, and intermediate prognosis--the remaining cases. The following four treatment modalities were used: 1) surgery --> radio- or radiochemotherapy (40); 2) chemotherapy > or = radiotherapy --> chemotherapy successively (56); (3) radiotherapy alone (110) and (4) simultaneous radiochemotherapy (72).

[The development of radiotherapeutic techniques at the beginning of the 21st century in Blokhin Russian Oncological Research Center of Russian Academy of Medical Sciences].

The article describes the development of radiotherapeutic techniques in Blokhin Russian Oncological Scientific Center of Russian Academy of Medical Sciences at the end of the 20th and the beginning of the 21st centuries. Such developmental directions in radiation oncology as the development of non-conventional modes of radiation dose fractioning, the development of new radiotherapeutic techniques based on volumetric 3D dosimetric radiotherapy planning, the perfection of combined (contact plus distant) radiotherapy, the use of multidirectional radiomodifying agents, the application of radiotherapy as a part of combined and complex treatment with chemotherapy and surgery in different tumoral sensitivity to conservative treatment, are considered in the article. Immediate and long-term results achieved at the institution by the use of radiotherapy alone or as a part of combined or complex treatment in cases with certain malignant tumor localizations are described.

[Thermoradiotherapy as a component of desmoid tumor management: 10-year experience].

Data on radio- and thermoradiotherapy of 83 patients with extra-abdominal desmoid tumors are discussed. In a group of 57 patients followed up for 10 years or less, the relapse-free survival rates, in thermoradiotherapy-treated cases, were significantly higher (74.4% and 28.6%) than in those receiving radiotherapy (9.3% and 57.1%). Monitoring tumor temperature during local hyperthermia is a factor of relapse-free survival of vital importance.