[Clinical aspects of asymptomatic arrhythmia in elderly patients with left breast cancer at the stage of radiation therapy.]

Insufficient knowledge age peculiarities of the clinical course of cardiac arrhythmias occurring asymptomatically as a manifestation of cardiotoxicity in women with breast cancer at the stage of radiation therapy, determines the high demand for research on this problem. The aim of the study was to identify and evaluate asymptomatic cardiac arrhythmias in elderly women with left breast cancer at the stage of radiation therapy. 48 women without a history of severe cardiovascular disease with HER2neu negative cancer of the left breast at the stage of 3D conformal radiotherapy were examined. Mean age 67 (64; 69). All patients at the previous stages were carried out mastectomy Madden followed by therapy with doxorubicin. The examination included ECG registration, 24-hour ECG monitoring and echocardiography. Before radiation therapy, asymptomatic arrhythmias were detected in 43 (89,6%) patients. After radiation therapy significantly increased the number of pathological supraventricular and ventricular arrhythmias as a manifestation of cardiotoxicity.

[Age characteristics of risk cardiovascular complications in women with left breast cancer with preserved ejection fraction at the stage of chemotherapy and radiotherapy].

AIM: A study of the risk factors for middle-aged and elderly women HER2neu with negative left breast cancer and a normal ejection fraction at the stage of chemoradiotherapy in everyday clinical practice. Matherial and methods. 61 women with left breast cancer without severe cardiovascular pathology were examined at the stage of doxorubicin therapy and 3D conformal radiation therapy. Group 1 comprised 32 patients of middle age (49.8 ± 4.5 years). Group 2 comprised 29 elderly patients (68.3 ± 3.6 years). In addition to Score risk assessment, additional factors, including psychosocial factors, were studied. All patients underwent ECG, echocardiography and 24-hour ECG monitoring. Anxiety levels were assessed using the HADS scale and scale CH. D. Spielberger -Yu.L. Khanin. The study was conducted before the start of treatment, after the completion of the doxorubicin course and after the completion of the course of radiotherapy. Results with discussion. In middle-aged patients, moderate Score risk was found in 21.9%, in the elderly at 58.6% (p = 0.0043, RR 2.68, 95% CI 1.301-5.520). A high Score risk was found in 15.6% of middle-aged patients and 41.4% of elderly patients (p = 0.0438, RR 2.648, 95% CI 1061-6.607). The most common risk factors in the patients studied in addition to age were heredity, overweight, hypercholesterolemia and diabetes mellitus. All examined patients had moderate reactive anxiety. Patients of middle age have moderate personal anxiety, in elderly patients high personal anxiety. After treatment with doxorubicin in a cumulative dose not exceeding 360 mg/m2 , a reduction in the ejection fraction below 50% was found in 6 middle-aged patients and 17.2% in elderly patients. Asymptomatic diastolic dysfunction was detected in 31.3% of middle-aged patients and 55.2% of the elderly. In patients of both groups, after arranging treatment, arrhythmia was detected. CONCLUSIONS: The obtained data indicate to the need for in-depth examination of middle-aged and especially elderly patients with left breast cancer with an assessment of risk factors and conducting an in-depth examination using Echocardiography, 24-hour ECG monitoring and psychological testing to prevent and early detection of cardiovascular complications.

Possibilities of ultrasound examination with elastography in the diagnosis of recurrent rectal cancer.

The purpose of this study was to evaluate possibilities of complex ultrasound examination in the diagnosis of recurrent rectal cancer. The study included 40 patients with recurrent rectal cancer, 19 men and 21 women aged from 27 to 83 years, mean age was 60 +/- 7.9 years. In order to detect recurrence we performed ultrasound examination with elastography of possible sites of recurrences of rectal cancer. It was found that our study showed a high diagnostic efficiency of complex ultrasound examination with elastography in the early diagnosis of recurrences and the continued growth of rectal cancer.

[Blood DNA Radiosensitivity May Be Predictive Marker for Efficacy of Radiation Therapy in Glioma Tumorbearing Individuals].

Animal and clinical studies were conducted to evaluate the association between the blood DNA radiosensitivity, assessed by determining the original S-index ex vivo, and the response of gliomas to irradiation in vivo. Possible modifications of the latter after administration of iron-containing water (ICW) in rats were also explored. The study was performed on the rats with subcutaneously implanted experimental glioma-35. The tumors were locally X-irradiated with a single 15 Gy dose as a radiation therapy (RT). ICW (60-63 mg · Fe 2+/l) was administered as a drinking water for 3 days before treatment. The animals underwent blood sampling for analysis of the DNA concentration and leukocyte count. The DNA index was estimated 24 h after RT. The S-index was evaluated within 4 h before RT. The mean initial S-index in the blood samples of glioma-bearing rats was 0.73 ± 0.05. Addition of ICW ex vivo resulted in a significantly increased S-index in a half of the samples. In general, the irradiated rats, which had been given pretreatment with ICW and demonstrated an ex vivo increase of the S-index to > 1.0, showed the most marked inhibition of tumor progression and the smallest tumor volume 25 days after irradiation. They also exhibited the lowest rate of growth and the longest survival. Determination of the biochemical S-index and evaluation of its changes ex vivo caused by ICW may be predictive of the response of experimental glioma to irradiation with radiomodification. The S-index may serve as a predictive indicator in clinic of the efficient evaluation of RT in patients with glioma.

[Effectiveness of the correction of hepatotoxicity during combined chemoradiotherapy for cancer patients].

In 29 patients with various malignant tumors there was carried out an estimation of Thiotriazoline efficacy in the treatment of hepatotoxicity in the process of combined chemoradiation therapy. It has been showed that ten-day application of Thiotriazoline in double dose (2,5% solution intravenously by 4,0 ml twice within 24 hours and 1 tablet (100 mg) twice within 24 hours) in patients with I and II degree of hepatotoxicity at the background of combined chemoradiation therapy enabled to remove completely manifestations of cytolysis in 100% of patients, without changing regimen of chemotherapy. To normalize levels of biochemical indices of blood in III degree of hepatotoxicity, more a long intake of Thiotriazoline (about 4 weeks) was required. Regimen of chemoradiation therapy in the period of Thiotriazoline application was not changed.

[Regional chemoinfusion and radiation therapy to patients with breast cancer metastases to the brain: preliminary results].

Effectiveness and safety of regional chemoinfusion in combination with radiation therapy in patients with breast cancer with metastases to the brain was clinically assessed. Cerebral angiography with chemoinfusion was fulfilled in six patients. The procedure could not be fulfilled completely in one patient because of transient vascular and neurological disorders. In the other five patients the regional superselective chemoinfusion was fulfilled successfully to the arteries feeding the metastatic foci in the brain with Carmustin in dosage 100 mg in combination with radiation therapy that was fulfilled in all six patients before the planned total focal dose. The incomplete response (n=5) to the treatment and stabilization of the process (n=l) were noted in six observations.

[Combined treatment of glyal and metastatic tumors of the brain].

Combined treatment of glyal and metastatic tumors of the brain allows prolongation of survival with the saved high physical and social level of the patients following the algorithm of the treatments: operative intervention with the minimal injury of the brain substance and preservation of all functionally important zones; chemotherapy with nitrosourea with the preferable bringing to the tumor zone; exposure to radiation.

[Combined treatment of brain stem tumors].

During the two recent decades the introduction of new technologies to neurosurgery resulted in certain progress in diagnosis and combined treatment of brain stem tumors which still remain the most complex problems of neurooncology. Using the present-day diagnostic complex including a thorough dynamic neurological examination, neurophysiological investigations, and visualization methods allowed not only to detect the primary forms of brain stem tumors and their sizes but also to reveal the topographoanatomical interrelationships with the stem structures that allowed to determine the chances of surgical, combined treatment or the radiation and chemotherapy treatment only. The article gives an analysis and the clinical course of the diagnosis and combined treatment of 333 children and adult patients with primary, secondary and peri-trunkal tumors of the brain stem.