LONG-TERM OUTCOMES OF SENTINEL LYMPH NODE BIOPSY VERSUS LYMPH NODE OBSERVATION IN MELANOMA PATIENTS. / ВІДДАЛЕНІ РЕЗУЛЬТАТИ БІОПСІЇ СТОРОЖОВОГО ЛІМФАТИЧНОГО ВУЗЛА В ПОРІВНЯННІ ЗІ СПОСТЕРЕЖЕННЯМ ЗА ЛІМФАТИЧНИМИ ВУЗЛАМИ У ПАЦІЄНТІВ З МЕЛАНОМОЮ.

OBJECTIVE: evaluating the influence of sentinel lymph node biopsy without following completion lymph node dissection independent on sentinel lymph node status on the outcome in patients with skin melanoma. MATERIALS AND METHODS: Three hundred nine patients with a primary skin melanoma were randomly assigned to wide excision of the primary tumor and sentinel lymph node biopsy without following completion lymph-node dissection independent on sentinel lymph node status or to wide excision of skin melanoma. Low-dose interferon was administrated in the adjuvant setting. RESULTS: 5-year disease-free survival rate was (85.1 ± 3.0) % in the wide excision and sentinel lymph node biopsy group and (78.4 ± 2.4) % in the wide excision group (hazard ratio, 0.69; p = 0.006). 5-year overall survival rates were similar in the two groups: (88.6 ± 3.0) % vs. (85.1 ± 2.4) %, respectively; hazard ratio, 0.97; p = 0.42. CONCLUSION: Sentinel lymph node biopsy in patients with skin melanoma increases disease-free survival rate without influence on overall survival, confirming the diagnostic, not therapeutical, value of this procedure.

PLASTIC SURGERY OF WOUND DEFECTS WITH FREE GRAFTS AFTER MALIGNANT SKIN TUMORS EXCISION: A PILOT STUDY.

AIM: To evaluate the effectiveness of applying negative pressure bandages (VAC bandage) in patients with malignant skin tumors after closing defects with free skin grafts and to compare it with fixation of skin grafts by the ordinary ointment bandages. MATERIALS AND METHODS: 61 patients with malignant skin tumors who underwent surgical treatment at the National Cancer Institute from 2019 to 2023 were included in the study. For the wound defects closure, the split skin grafts were applied in all patients. At the time of surgery, after closing a wound defect by a split skin graft, a negative pressure dressing (VAC bandage) was applied in 41 patients for 7 days (group 1). In 20 patients, a transplanted skin graft was fixed after surgery by an ordinary ointment pressure bandage (group 2). The immediate results were evaluated one week after surgery. RESULTS: Complete engraftment of the flap in group 1 was observed in 53.7 ± 7.8% cases, in group 2 this result was achieved in 5.0 ± 4.8% patients (p = 0.002). The complete graft necrosis occurred in 1 case in group 1 vs. 2 cases in group 2 (p = 0.496). CONCLUSION: The results of the engraftment in postoperative wounds were significantly better in the VAC-bandage group in terms of the number of the complete engraftments compared to the conventional pressure ointment bandage group.

Estimation of radionuclides global fallout levels in the soils of CIS and eastern Europe territory.

This study is devoted to the estimation of radionuclides global fallout levels in the soils of Commonwealth of Independent States (CIS) and Eastern Europe territory as a result of nuclear explosions. 58 standard soil samples were used, which were selected in different soil and climatic areas of the territory of CIS and Eastern Europe in 1978-2018. All samples were measured by gamma spectrometry. Determination of plutonium isotopes and strontium was performed according to the method of the joint determination of these radionuclides from one sample. IN the samples considered in this work, the content of 60Co, 154Eu, 155Eu was below the detection limits, which were 0.4; 1.0 and 1.0, respectively. Natural radionuclides analysis results indicated that the obtained samples are typical soil samples without its abnormal contents. The content of 137Cs, 90Sr, 239+240Pu in a 20 cm soil layer due to global fallout is (3.9 ± 1.7), (2.2 ± 0.8), (0.18 ± 0.08) Bq/kg respectively, which considering the distribution of these radionuclides by depth and average soil density is (1.2 ± 0.5) kBq/m2 for 137Cs, (0.42 ± 0.15) kBq/m2- 90Sr and (55.0 ± 24.0) Bq/m2- 239+240Pu. The isotopic ratios137Cs/90Sr and 137Cs/239+240Pu for the territory of CIS and Eastern Europe are at the level (2.0 ± 0.71) and (25 ± 15), respectively.

Safety profile and clinical outcome of adjuvant radiation therapy and intermediate-dose interferon in comparison with intermediate-dose interferon alone in patients with melanoma metastases in regional lymph nodes and unfavorable prognostic factors.

AIM: To assess the safety profile and efficacy of adjuvant radiation therapy and intermediate-dose interferon in comparison with intermediate-dose interferon alone in patients with synchronous and metachronous skin melanoma metastases in regional lymph nodes with unfavorable prognostic factors. MATERIALS AND METHODS: 96 patients with synchronous and metachronous skin melanoma metastases in regional lymph nodes (stage III according to American Joint Committee on Cancer) and unfavorable prognostic factors were randomized in 2 groups: one of them (n = 45) received regional radiation therapy 50-55 Gy and intermediate dose of α2b-interferon (RT + IFN) in adjuvant setting and another one (n = 51) intermediate dose of α2b-interferon alone (IFN). RESULTS: The most common adverse events in both groups were pyrexia and fatigue but grades 3-4 were observed more frequently in the RT + IFN group than in the IFN group (24.4 and 42.2% vs 11.8 and 27.5% respectively). 3-year recurrence-free survival was 78.5% in the RT + IFN group and 73.8% in the IFN group (p = 0.72), 3-year progression-free survival was 63.2% in the RT + IFN group comparing with 57.2% in the IFN group (p = 0.59) and 3-year overall survival was 77.1% and 66.7%, respectively (p = 0.29). Median of recurrence-free, progression-free and overall survival was not reached in any group. CONCLUSIONS: Radiation therapy and intermediate-dose interferon in adjuvant setting tends to improve recurrence-free, progression-free and overall survival comparing with intermediate-dose interferon alone in patients with synchronous and metachronous skin melanoma metastases in regional lymph nodes and unfavorable prognostic factors but it needs further investigation in larger groups of patients.

Burden of malignant melanoma in Ukraine in 2002-2013: incidence, mortality and survival.

BACKGROUND: The malignant melanoma (MM) incidence rates were increasing and later stabilizing in many regions of the world, while in South-Eastern Europe incidence rates are uniformly increasing and mortality rates are higher. AIM: To describe burden of MM in Ukraine in terms of incidence, mortality and survival by sex, age and stage for the period 2002-2013 and compare with European countries. MATERIALS AND METHODS: Database of the National Cancer Registry of Ukraine was used to extract MM incidence cases; number of MM deaths was obtained from the official mortality statistics. Age-standardised and age-specific incidence and mortality rates were calculated by sex, age groups (15-39, 40-59 and 60+); estimated annual percent of change was used to describe trends. Proportions of new cases by stage of disease and calendar period (2002-2007 vs 2008-2013) were compared as well as net survival estimates. RESULTS: In Ukraine, MM was more common in females (age-standardised 5.3 per 100,000 in 2013; annual percent of change 3.5%) than in males (5.1 per 100,000; 4.1%); around 50% of them diagnosed in the age group 60+. The observed increase in proportion of new cases with early stage (I-II) was due to stage II cases. The slight increase in mortality rates in males or stability in females were not accompanied with increase of survival. Net MM survival was consistently lower comparing to European countries. CONCLUSION: More resources should be targeted to increase the capacity of healthcare in diagnostics and treatment of malignant melanoma, but also in promoting healthcare and education in Ukraine.

Non-linear dynamics theory and malignant melanoma.

Chaos theory (nonlinear dynamics) defines cancer as a complex adaptive system in which each cyclic point corresponds to the bifurcation at which changes in signaling pathways emerge. Quantitative assessment of chaos in digital medical images such as electron microscopy, histology and cytology sections collected from patients with malignant cutaneous melanoma employed the following calculation parameters: the irregularity of external contours, internal heterogeneity based on brightness distribution of macromo-lecules, chromosomes, organelles, inclusion bodies, cells and tissues, kurtosis, entropy and the asymmetry coefficient. The present study undertook a nonlinear analysis of the chaotic hierarchy of malignant melanoma. However, considerably more studies will need to be carried out to determine the exact interrelationship between different levels of the hierarchy in the biological system. Multidisciplinary collaborations are therefore essential to find evidence to answer questions that remain open to researchers and oncologists.

[Modification of silicon nanoparticles with silver or gold attenuates its biocompatibility in vitro].

The effects of crystalline silicon nanoparticles covered with gold or silver on the viability and state of organelles of cultured human peripheral blood mononuclear cells have been investigated. Exposure to nanosized Si, Si/Ag, Si/Au provoked an increase in the leved of reactive oxygen species in the cells, but did not cause significant reduction in cell viability. Si/Au nanoparticles reduced activity of lysosomes and mitochondria, Si/Ag--only mitochondria. We have concluded that the surface modification by gold or silver may reduce the biocom-atibility of the crystalline silicon nanoparticles.

[Recombinant α-2 interferon in preventing the progression of melanoma].

A brief history of interferon application in the treatment of cutaneous melanoma is represented.

Nanostructured biocides for means of rehabilitation.

In this work, the description of technology of intercalation of montmorillonite by ions of biometals is submitted. Laboratory techniques of definition of a mass fraction of silver and copper in montmorillonite are resulted The manufacturing regulations of obtaining of nanodispersed powders of intercalated montmorillonite are submitted. Bases of technology of obtaining and manufacturing of cosmetic means on a basis of nanomaterials; technologies of antibacterial processing of textile materials, obtaining of antimicrobic properties by medical polymers are described in the report. Bases of technology of obtaining of biocidal and fungicidal coatings (paints, varnishes) on a basis of nanomaterials are described. The estimation of biocidal and properties of nanomaterials on a basis of intercalated montmorillonite by an integral disk-diffusion method is resulted. High efficiency of application of nanosystems on a basis of intercalated montmorillonite for obtaining of antimicrobic properties in paint and varnish materials is shown.

[Treatment tactics in intussusception in children].

Results of treatment of 235 patients with intussusception are analyzed. The treatment tactics in different period of disease is described in details, the role of echography is emphasized. For the first time the conception of functional (reversible) intussusception was offered, treatment tactics were determined. Results of treatment were studied, conservative and surgical tactics of treatment were substantiated.

[Primary multiple malignant neoplasms in patients with skin melanoma].

The problem of primary multiple malignant tumor (PMMT) of skin melanoma in Ukraine is analyzed. During the period from 2000 to 2006, 16760 cases of skin melanoma have been diagnosed, and in 873 patients from them PMMT has been registered. So, the part of the patients with multiple tumors among all patients with skin melanoma was 5.2%. Most often PMMT appears in the case of skin melanoma of head and neck (6.6 +/- 0.4%). Most commonly skin melanoma is accompanied by other skin malignant neoplasms (40.9 +/- 1.6% of all PMMT cases). Upon malignant skin melanoma, PMMT occurs more often in males (5.7 +/- 0.7%) than in females (4.9 +/- 0.7%). Most often the diagnosis of skin melanoma at PMMT is detected synchronously (48.3 +/- 1.6%), and simultaneous detection of PMMT predominates in all polyneoplasms and in all age groups. The most favourable course of skin melanoma is characteristic for metachronous cancer of II type when melanoma is diagnosed after manifestation of other malignant tumor.

Generation of Cherenkov superradiance pulses with a peak power exceeding the power of the driving short electron beam.

Theoretical investigation of a short electron beam (extended bunch) interaction with a backward wave propagating in a slow wave structure demonstrates the possibility of producing ultrashort superradiance pulses with a peak power which exceeds the power of the driving beam (conversion factor K>1). It is shown that a nonuniform slow wave structure with optimized profile is beneficial in order to increase the conversion factor. The results of theoretical analysis are confirmed by the experiments. At X band using the SINUS-150 accelerator (4 ns, 330 kV, 2.6 kA) 0.6-0.8 ns superradiance pulses with a peak power of 1.2 GW and a conversion factor of 1.5 were obtained. Similar experiments at Ka-band based on the RADAN-303 accelerator (1 ns, 290 kV, 2.5 kA) demonstrated production of the superradiance (SR) pulse with duration 200 ps and peak power about 1 GW (conversion factor of 1.4).

[Cases of primary multiple metachronous skin melanoma].

The article presents medical cases of primary multiple metachronous skin melanoma, which is rarely come across in oncological practice and presents interest for oncologists.

[Recombinant interleukin-2 (roncoleukin) in therapy of the patients with skin melanoma].

The article deals with a problem of combined use of interferon (laferon) and interleukin in patients with skin melanoma. Recombinant interleukin-2 (rIL-2) was included into the worked-out scheme. Patients with primary-localized skin melanoma (T(2-4)N0M0) have been studied. Three groups were chosen. 901 patients of the control group underwent excision of tumor (e/t); 34 patients of the first study group (e/1) were given endolymphatic interferontherapy (ift); 35 patients of the second study group were subjected to excision of tumor followed by endolymphatic interferontherapy. One-year relapse-free survival among patients of the control group reached 57.6+/-1.6%, 1st study group--70.5+/-7.8% and 2nd study group--83.6+/-6.7%. Total one-year survival among patients of the control group was 92.1+/-0.9%, in the 1st study group--97.0+/-2.9%, in the 2nd study group--92.7+/-5.0%. Thus, the combined use of recombinant interferon (laferon and interleukin (ronkoleukin) in treatment schemes of malignant skin melanoma was proved to be perspective.

[Use of local magnitothermia in the treatment of patients with primary-confined skin melanoma]. / Opyt primeneniia lokal'noi magnitotermii pri lechenii bol'nykh s pervichno-ogranichennoi melanomoi kozhi.

We studied modifying potentialities of high temperatures in treatment regimens with adjuvant endolymphatic chemo- and interferontherapy of malignant melanoma of the skin. We had previously obtained enough evidence for expediency of adjuvant endolymphatic therapy of primary-localized melanoblastoma of the skin. Added to the preventive treatment regimens were sessions of local magnetothermia. The study was done in patients diagnosed as having primary-localized melanoma of the skin T(2-4) No Mo. A 3-year recurrence-free survival in the control group was (38.2 +/- 1.6)%, in the first study group--(54.2 +/- 5.8)%, in the second study group--(44.3 +/- 13.5)%. The general 3-year survival in the control group was (67.7 +/- 1.5)%, in the first study group--(70.8 +/- 5.5)%, in the second one--(91.7 +/- 5.7)%. In this way, the expediency has been proved of employment of local magnetothermia in treatment regimens to deal with malignant melanoma of the skin.

[Long-term results of treatment of patients with bone tumors using hydroxyapatite and calcium phosphate ceramic implants]. / Viddaleni rezul'taty likuvannia khvorykh z pukhlynamy kistok z vikorystanniam keramichnykh implantativ na osnovi gidroksylapatytu ta trykal'tsiifosfatu.

On the basis of experimental-and-clinical investigations it has been found out that the home-produced hydroxylapatite (HA)- and tricalciumphosphate(TCP)-based ceramic material is capable owing to specificities of its chemical structure and osteoinductive action of stimulating the reparative osteogenesis and is accompanied by angiogenesis. No ill effects have been noted in its use in bone plastic surgery. An apparent clinical effect has been shown to occur in postsurgical patients (n = 120) presenting with giant cell tumour, benign tumours and tumour-like affections of the bones, with the expediency having been ascertained of employment of the HA- and TCP-base ceramic material in the treatment of the above patients. The use of the above materials implants versus allotransplants promotes decline in the percentage of complications (1.66 vs 27.2), shortening of time of medical rehabilitation of patients by two to three months as compared to allotransplantation as well as hospital stay duration (by 10 to 12 days).

[Experimental studies on the effect of ceramic materials on cellular and humoral immunity]. / Eksperymental'ni doslidzhennia vplyvu keramichnogo materialu na reaktsiï klitynnogo ta gumoral'nogo imunitetu.

It has been established in an experimental setting in laboratory animals through testing a number of reactions such as active skin anaphylaxis reaction, mast cell degranulation reaction, specific leucocyte lysis reaction, delayed hypersensitivity reaction, and graft-versus-host reaction that ceramic preparations hydroxilapatite M and osteogel-7 have no sensitizing effects; osteogel-7 is not endowed with immunomodulating activity, which fact suggests to us its immunological inertness.

[Systemic enzymotherapy as a method of prophylaxis of postradiation complications in oncological patients]. / Systemna enzymoterapiia iak metod profilaktyky promenevykh uskladnen' u khvorykh na onkolohichni zakhvoriuvannia.

Set out in the paper are results of treatment of those patients with carcinoma of the lung, uterine cervix, hysterocarcinoma, breast cancer, malignant thymomas, malignant non-Hodgkin's lymphomas, and lymphogranulematosis having been administered combined, chemoradiation or radiation treatments against the background of a complex of accompanying therapy involving systemic enzymotherapy. Polyenzymic drugs were found to be capable of improving results of treatment of acute radiation reactions and preventing postradiation fibrous changes in the lungs, skin, fatty tissue, soft tissue, liver, kidneys. Thus, systemic enzymotherapy is capable of improving the quality of life and results of treatment of oncological patients.