[Chemotherapy of hormone-resistent cancer of the prostate].

A total of 59 patients with hormone-resistent prostatic cancer (HDPC) treated in 1999-2004 entered the trial. Three schemes of first-line chemotherapy were examined for clinical efficacy and toxicity in the above patients. Anticancer combined treatment vinorelbin + cycloplatam was given to 23 patients, mitoxantron + prednisolone--to 23 patients, mitoxantron+cysplatin+prednisolone--to 13 patients. The latter scheme was most effect and toxic. Partial regression of metastases and a 50% decrease in the initial PCA level were seen in 23% cases. Vinorelbin+cycloplatam was less effective and toxic: partial regression of metastases--13%, PSA regression-- 17.4%. The least efficacy and toxicity were observed in the treatment with mitoxantron+prednisolone --.7%. Thus, the above first-line HDPC therapy was most effective but has the highest toxicity in using the scheme mitoxantron+cysplatin+prednisolone.

[Results of a 5-year screening for prostatic cancer]. / Itogi 5-letnego skrininga raka predstatel'noi zhelezy.

The results of 5-year screening (1996-2000) for prostatic cancer in 1129 males 40 to 80 years of age are presented. The examination included: measurement of blood levels of prostate-specific antigen (PSA), finger rectal examination, transrectal ultrasonic examination (TRUE) and, on demand, biopsy of the prostatic gland. Prostatic cancer was diagnosed in 1.5, 2.2 and 16% patients having PSA levels of 0-4.0, 4.0-10.0 and 10.0-30.0% ng/ml, respectively. At finger rectal examination prostatic cancer was suspected in 8% examinees, only in 33% of them the diagnosis was verified morphologically. By TRUE evidence 7% examinees were suspected and in 44.3% of them prostatic cancer was confirmed. Thus, biopsy proved necessary in 172 cases of 1129 examinees. In 64 (5.7%) males prostatic cancer was diagnosed and confirmed. Early prostatic cancer in the screened men and those consulted in the outpatient department of the National Cancer Research Center was detected in 77.7 and 22% men, respectively. The conclusion is made that men over 50 years of age should undergo prophylactic examination of the prostatic gland once a year.

[Is maximal androgenic blockade necessary in the treatment of prostatic cancer?]. / Nuzhna li maksimal'naia androgennaia blokada v lechenii raka predstatel'noi zhelezy?

As the literature data give arguments both pro and contra wide use of maximal androgenic block (MAB) in the treatment of prostatic cancer, the authors studied MAB in 200 patients. They came to the conclusion that MAB can be applied in patients with symptoms of disseminated prostatic cancer as neoadjuvant therapy before prostatectomy and as neoadjuvant and adjuvant therapy in planning radiotherapy.

[Role of fluorescent control in raising radicality of surgical treatment for superficial bladder cancer]. / Rol' fliuorestsentnogo kontrolia v povyshenii radikalizma operativnogo lecheniia poverkhnostnogo raka mochevogo puzyria.

Solution of 5-aminolevulinic acid (5-ALA) and D-Light unit (Karl Storz GmbH & Co) were used for fluorescent control over radicality of transurethral resection (TUR) of the urinary bladder. TUR with the fluorescent control was performed in 85 patients. The new procedure allowed to remove tumors undetectable at standard TUR in 46(54.1%) patients. Sensitivity and specificity of the method was 98.7 and 76.3%, respectively. 5-ALA-induced fluorescence used to control radicality of bladder TUR reduced the number of recurrences within 12 postoperative months 2-fold.

[An analysis of preliminary results in screening for prostatic cancer]. / Analiz predvaritel'nykh rezul'tatov skrininga raka predstatel'noi zhelezy.

450 males aged over 50 years free of urological symptoms were screened for prostatic cancer using three techniques; finger rectal examination (FRE), transrectal ultrasound investigation (TUI), assay for prostatic specific antigen in the serum (SPSA). SPSA quantities under 4 ng/ml, 4-10 ng/ml, 10-20 ng/ml, over 20 ng/ml were registered in 206(45.8%), 135(30%), 69(15.4%) and 40(8.8%) patients, respectively. Detectability of prostatic cancer increases by 33,37.9, 45.5, 69.2% due to TUI, FRE, TUI + FRE, all the three methods, respectively. Prostatic biopsy was needed in 102 (22.7%) cases. From the 450 examinees, prostatic cancer was diagnosed in 25 (5.6%). SPSA was high in all of them, higher than 10 ng/ml in 92%. 20 (80%) of 25 patients with cancer had early stages of the disease (TI-2). The study is going on.

[Maximal androgen blockade in the treatment of patients with disseminated cancer of the prostate]. / Maksimal'naia androgennaia blokada v lechenii bol'nykh disseminirovannym rakom predstatel'noi zhelezy.

Up-to-date approaches to treatment of disseminated prostatic cancer are discussed, including the experience of the use of maximum androgen blockade in 120 patients. The procedure may be recommended to start hormonal therapy in such patients with.

[Cycloplatam in the treatment of patients with disseminated prostatic cancer]. / Tsikloplatam v lechenii bol'nykh rasprostranennym rakom predstatel'noi zhelezy.

A 22% response rate was achieved in clinical trials of Russian drug cycloplatam in disseminated and hormone-resistant cancer of the prostate. In 80% of cases the drug has improved quality of life of patients with prostatic cancer stage III and IV. Antitumor effect and low toxicity make cycloplatam applicable in combined therapy of prostatic cancer.

[The comparative efficacy of radiation and thermoradiation treatments in prostatic cancer]. / Sravnitel'naia éffektivnost' luchevogo i termoluchevogo lecheniia raka predstatel'noi zhelezy.

Short- and long-term results of stage-III and -IV prostatic cancer treatment were compared in 147 patients without distant metastases. 38 patients were exposed to radiation, 109 patients underwent radiation treatment and local microwave hyperthermia. The response of the primary tumor was evaluated at palpation, ultrasonic investigation and computed tomography. Adjuvant local hyperthermia enhanced antitumor activity of the treatment raising the rate of a complete response from 69% on radiotherapy alone to 94% on thermoradiotherapy, 5-year survival in prostatic cancer stage III and IV increased also from 48 to 65%.

[An experimental study of the antitumor activity of preparations in a model of prostatic cancer]. / Eksperimental'noe izuchenie protivoopukholevoi aktivnosti preparatov na modeli raka predstatel'noi zhelezy.

A trial of a newly developed experimental model of prostatic cancer showed its convenience in simulating clinical symptoms and response to treatment. The model is effective in the studies of anticancer drugs with various mechanisms of action with special emphasis on immunomodulators as a promising adjuvant modality.

[The prognostic value of flow cytometry in prostatic cancer]. / Prognosticheskaia znachimost' protochnoi tsitometrii pri rake predstatel'noi zhelezy.

DNA quantitation by flow cytometry was made in 36 patients with morphologically diagnosed prostatic cancer (PC) in stage II, III and IV (4, 14 and 18 patients, respectively). All the patients received adequate treatment. Aneuploid tumours were found in 25 patients (group 1), diploid ones in 11 patients (group 2). A 3-year survival in group 1 made up 65.5%, in group 2 all the patients survived 3 years. The recurrence-free survival was 22.2% and 78.8%, respectively. The above findings make it possible to regard flow cytometry DNA estimation as a reliable prognostic indication in PC.

[Changes in the mechanical integration of transitional epithelial cells and in the immune status of patients with bladder tumors]. / Izmenenie mekhanicheskoi integratsii kletok perekhodnogo épiteliia i immunnogo statusa bol'nykh s opukholiami mochevogo puzyria.

Mutual adhesiveness of urothelial tissue cells have been studied in healthy donors and patients with benign and malignant bladder tumors. The decreased mutual adhesiveness has been shown not only for tumors, but for surrounding urothelial tissue as well. Urothelial tissue integration, T-cell immunity and parameters of leukocyte integrins were affected most of all in bladder tumor stage T2 and T3. Basing on these findings, the authors recommend conservative therapy only in superficial bladder cancer.

[The antiandrogen treatment of patients with prostatic cancer and bone metastases]. / Lechenie antiandrogenami bol'nykh rakom predstatel'noi zhelezy s metastazami v kosti.

In 1980-1990 the treatment for prostatic cancer in the urological department of the National Cancer Research Center was administered to 383 patients. In 208 of these the tumour disseminated to the bones. Metastases to the bones were identified by radioisotope scintigraphy of the skeletal bones, x-ray evidence being false-negative. Clinical response was achieved in 87 patients treated with nonsteroid antiandrogens, anandron administration, in particular, brought about a subjective effect in 97.1%, an objective one in 50% of the patients. Flutamid treatment proved effective subjectively in 90.5% and objectively in 42.4% of the patients. For niphtalid administration subjective and objective effects were 85% and 30%, respectively. Compared to estrogens, antiandrogens caused no serious complications. The authors recommend the drugs studied for a wide clinical application.

[The prognostic significance of determining androgen receptors in prostatic cancer]. / Prognosticheskoe znachenie opredeleniia retseptorov androgenov pri rake predstatel'noi zhelezy.

The role of androgen receptors (ARs) registration in cytosol tumor fraction has been investigated in 86 new cases of prostatic cancer. The frequency of occurrence and mean ARs levels in the tumor were found dependent on the disease stage and tumor differentiation. Well-differentiated against moderately and poorly differentiated prostatic cancers contain ARs in 73% and 39% of cases, respectively, in concentrations 10-100 fmol/mg protein and 100 fmol/mg protein, respectively. Patients with well-differentiated prostatic cancer at stage T1-4N0M0 and 10-100 fmol/mg protein ARs in the tumor tend to achieve longer remissions compared to patients with ARs-free tumors or tumor comprising ARs in concentrations surpassing 100 fmol/mg protein. No significant correlation exists between remission duration in patients on radiation treatment combined with estrogen therapy and the presence, levels of ARs in the tumor.

[The clinical use of the prostate-specific antigen in patients with prostatic cancer]. / Klinicheskoe ispol'zovanie prostaticheskogo spetsificheskogo antigena u bol'nykh rakom predstatel'noi zhelezy.

Radioimmunoassay determination of prostatic-specific antigen (PSA) was conducted in 71 patients with prostatic cancer varying in stages. 85 serum samples were investigated. Of 21 newly diagnosed cases PSA was elevated in 16 (76.2%). No significant elevation of the marker was noticed in stage II patients, while at stage III and IV PSA levels were universally increased. The mean PSA level for stage III was 149.5 ng/ml, for stage IV 291.4 ng/ml. Two stage II patients in remission out of ten presented with high PSA concentrations, while in partial remission this was observed in 3 cases out of 9.50% occurrence of PSA elevated level was registered for stage III patients in remission, 100% occurrence in progression. Prostatic cancer stage IV manifested high PSA levels in 33% of cases under stabilization and in 100% in progression.

[Radiation exposure and local hyperthermia in the treatment of prostatic cancer]. / Luchevoe vozdeistvie i lokal'naia gipertermiia v lechenii raka predstatel'noi zhelezy.

During the recent two decades, radiation therapy has become a major intervention for prostatic cancer, especially in patients without remote metastases. Most recently local hyperthermia has been recruited for selective potentiation of radiation effects on the tumor. This study involved 81 patients with the prostatic cancer T2-4NxM0. All patients had adenocarcinoma of variable malignant potential. Group 1 (n = 24) received only megavoltage radiation therapy while Group 2 (n = 57) was additionally treated with local microwave hyperthermia. A Yalik-F device (USSR) with electromagnetic frequency 460 MHz was used. Special intracavitary irradiating aerials were designed and employed. While symptoms of neoplasia are lacking 2 years following radiation therapy in 13 of 24 patients of Group 1, this response was obtained in 10 of 12 patients of Group 2 (54 +/- 5% and 83 +/- 10%, respectively). Two-year survival rates after radiation and thermoradiation therapy were 81 +/- 8% and 92 +/- 8%, respectively. Asymptomatic progress is seen in 40 +/- 10% and 75 +/- 12% of the patients. These results suggest that local hyperthermia as an adjuvant to radiation therapy will improve the efficacy of therapy in patients with prostatic cancer.