[Aspects of encephalopathy in oncologic patients after chemotherapy].

OBJECTIVE: To study clinical presentations and neuroimaging results in post chemotherapy encephalopathy. MATERIAL AND METHODS: We examined 27 patients with cancer after chemotherapy (n=16) or chemoradiation (n=11). RESULTS AND CONCLUSION: All patients complained of memory impairment, sluggish mentality, moderate headache, fatigue, sleep disorder, irritability. Their neurologic status included different organic symptoms. Post chemotherapy encephalopathy is characterized by the combination of severe cerebral asthenia and different organic neurologic symptoms with moderate cephalgic syndrome. MRT showed single and multiple loci of gliosis in the white matter.

[The quality management in clinical diagnostic laboratory in conditions of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary)].

The article presents experience of clinical diagnostic laboratory of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary) in the area of quality management of medical laboratory services on the basis of evaluation of efficacy and effectiveness of processes. The factors effecting quality of functioning of clinical diagnostic laboratory are indicated. The criteria and indicators of efficacy of work of employees of clinical diagnostic laboratory are presented.

[Clinical characteristics and treatment of polyneuropathy developed after chemotherapy].

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the main problem of modern cytotoxic therapy. Drug dose reduction, delay or even complete stopping of chemotherapy until the regression of CIPN symptoms impair treatment effectiveness and patients' survival. We studied 44 cancer patients with CIPN developed after polychemotherapy. We suggested a treatment regimen that included a complex of allopathic, homeopathic drugs and hydrotherapy. The treatment resulted in a subjective and objective regression of neuropathy symptoms and improving of quality of life in all patients. Patients who had to delay chemotherapy were able to restart it.

[Optimal doses and timing for tele-irradiation of bone metastases in patients with life expectancy more than 3 months].

The aim of the current study was to improve the bone metastases irradiation parameters in patients with life expectancy more than 3 months. The current randomized study included a total of 333 patients with bone metastases (breast cancer metastases in 71% of cases) receiving 488 courses of photon irradiation. Irradiation effect was observed in 95.8-100% of cases regardless of fraction number and irradiation regimen. The rate of complete effect was the same for all irradiation regimens, but raised gradually from 33.3% to 50.4% and 65.9% respectively when irradiation was given by 2, 3 and 4 fractions, 6,5 Gy each (p < 0.03); 78.4% (p < 0.01) cases of complete effect were observed in patients receiving irradiation by multiple small fraction compared to the groups receiving irradiation by 2 or 3 fractions of 6.5 Gy. The complete effect was more often observed in breast cancer (67%) and prostate cancer (63%) patients in comparison to lung cancer (47%) and renal cancer (30%) patients (p < 0,05) independent of metastases localization. The mean frequency of pain recurrence in irradiated area was 8.2% in all primary tumor and metastases localizations, irrespective of irradiation dose and regimen. Based on above results we recommend for breast cancer and prostate cancer patients with bone metastases and life expectancy more than 3 months the irradiation with 19.5 Gy given by 3 fractions. The patients with metastasizing lung and renal cancer should receive 26 Gy irradiation by 4 fractions 6.5 Gy each given once every 5.

[Neoadjuvant therapy of breast cancer using Newcastle disease virus].

The role of Newcastle disease virus and neoadjuvant therapy was assessed in 84 cases of breast cancer T1-4N0-2M0 (2005-2008). Combined use of the virus vaccine and chemotherapy (group A), therapy with the vaccine alone (group B) and chemotherapy regimen identical with that used in group A (group C) were compared. Histological pattern of tumor and stage were identified using expression of receptors of steroid hormones, oncoproteins Her2/neu and p53 as well as proliferation activity (marker Ki-67) before and after therapy. It was shown that the efficiency and safety of Newcastle disease virus (apathogenic strain La-Sotha) met specific immuno- and neoadjuvant therapy standards.

[Current strategies in radiotherapy for cervical and endometrial carcinoma].

We used combinations of taxan-based neoadjuvant and adjuvant full-dose chemotherapy and aggressive combined radiotherapy including clinical target volume extension, increased total dosage, hyperthermia, cryo- and local chemotherapy as radiosensitizers, for treatment of invasive and locally-advanced breast cancer or endometrial carcinoma with poor prognosis. 3D-ultrasound/CT/MRI--based designing of radiotherapy and monitoring of dynamic definition of target volume and "high risk volume" in organs at risk in cases of tumor progression was an indispensable measure. As a result, no local recurrence was reported in 73% for 36 months.

[Certain aspects of neoadjuvant therapy of locally advanced breast cancer]. / Nekotorye aspekty neoad"iuvantnoi terapii mestnorasprostranenogo raka molochnoi zhelezy.

The paper presents the results of a complex investigation of patients with locally-advanced breast cancer who received neoadjuvant chemotherapy or chemoradiation at initial stage. The clinical and pathomorphological effects, nature of neoadjuvant therapy and number of courses were followed up for 5- and 10-year periods. A direct correlation was found between number of courses for chemotherapy-sensitive patients, on the one hand, and greater effect, more intensive medicinal pathomorphism and longer recurrence-free survival, particularly, at later stages, on the other.

[Automated radiotherapy in the combined treatment of locally advanced and disseminated ovarian cancer]. / Avtomatizirovannaia luchevaia terapiia v kompleksnom lechenii mestorasprostranennykh i disseminirovannykh form raka iaichnikov.

The paper deals with the results of treatment of 110 patients with advanced ovarian cancer showing signs of tumor progression following polychemotherapy with two regimens which included radiotherapy. Variants of distant and contact irradiation individually-tailored to suit the types of tumor are discussed. Details of single and repeated courses of chemoradiation are presented. Such beneficial effects as longer survival and better quality of life were registered in 76%.

[Some prognostic factors in the combined therapy of locally advanced breast cancer]. / Hekotorye prognosticheskie faktory v kompleksnom lecheniie mestnorasprostranennogo raka molochnoi zhelezy.

A relationship between the dynamics of growth and pathological response of tumor cells and the number of neoadjuvant chemotherapy courses was established. As a result, there was no correlation between increase in overall and disease-free survival, on the one hand, and stage, on the other. An interval between neoadjuvant chemotherapy and surgery longer than 4 weeks had a negative effect on overall tumor response and duration of disease-free period.