[Treatment of neoplastic lesions of the central bronchi and trachea using endotracheobronchial surgery, intraluminal brachytherapy, combined radiotherapy and chemoradiotherapy].

There are summarized the foreign and domestic references of recent years devoted to methodology and the efficiency of the use of intraluminal high-dose radiation brachytherapy in patients with lesions of the central bronchi and trachea caused by primary and metastatic malignant tumors. It is presented own experience of applying this method in 207 patients. It is showed that in some patients to ensure the delivery of the radiation source to the area of interest it is advisable to perform firstly endotraheobronhial surgery with recanalization of the lumen of the respiratory pathways. The best is the use of intraluminal brachytherapy with high dose radiation. Palliative intraluminal irradiation of inoperable patients allowed achieving a good immediate results (65-95%), a significant reduction of the main symptoms--hemoptoe (87-95%), dyspnea (75-90%), obstructive pneumonia phenomena (50-85%), and significantly increasing survival median from 1-3 to 9-14 months. Following performance of chemoradiotherapy permitted increasing the survival median up to 15-20 months. The number of complications of intraluminal high-dose radiation brachytherapy was small, usually--pulmonary hemorrhage (2-7%) more likely developing when using large fractions--more than 10 g for 1 session.

[Lines of research in the field of cellular technologies and its application in military medicine].

The paper presents an overview of cellular therapy products and medical tissue engineering of the leading countries of the world (including the US) and identifies lines of research in the field of cellular technology application in the interests of national military medicine. The authors gave information concerning practical implementation of the achievements of biomedical research in the field of regenerative cellular products and technologies in Russia as different products, which may be used at the stages of medical evacuation. The authors presented results of research, which was, performed on the model of mine blast injury in accordance with principle possibility of the usage of cellular technologies products (multipotent mesenchymal stromal cells) in medical practice.

[A comparison of efficacy of different modalities of treatment for locally-advanced and metastatic non-small lung cancer].

The paper evaluates the efficacy of different modalities of treatment for locally-advanced and metastatic non-small lung cancer (NSLC) (1,316 pts.). Adjuvant chemotherapy was followed by an elevation of median of survival from 14 to 21.5 months at stage III. Combined treatment appeared more effective than distant one (survival of 21 months vs. 18 at stage IIIA and 35 months vs. 21 at stage IIIB); comparatively fewer cases of complications and radiation-related injuries were reported. The highest rates of survival were characteristic of conservative therapy as a component of chemoradiation (median of survival of 15 months at stages IIIA, IIIB and IV). Survival under 3 months was registered among patients without such therapy. Survival rates for timely adequate conservative therapy at stages IIIB and IV of NSLC were similar or higher than those in surgical cases alone (median of survival of 15 months vs.14 and 12.5, respectively). All procedures of specialized antitumor treatment of locally-advanced and metastatic non-small lung cancer were followed by significant increase in quality of life (+10-50%) while the latter parameter was falling dramatically in those without such therapy (15-30% per month). "Latency of process" calls for further research in methods of treatment because it was chiefly responsible for unsatisfactory results of surgery use for NSLC.

[Use of endoscopic surgery and combined radiotherapy for inoperable cancer of the esophagus].

A comparative evaluation of the efficacy of combined radiotherapy (112 - group 1) carried out in conjunction with a battery of procedures of endoscopic surgery plus combined radiotherapy (76 - group 2) for inoperable cancer of the esophagus was conducted in 118 patients. Maximum local regression was reported in group 2 (77.6%) as compared with only 33.9% in group 1. Relatively longer relapse-free period (133 days) and lower residual growth incidence (44.6%) were in group 2, too, as compared with 107 days and 63.5% in group 1. Mean survival duration was nearly identical in both groups - ca.15 months. Similarly, survival rates in groups 2 and 1 were: 69.2 and 58.8% (year 1), 22.2 and 22.3% (year 2), and 11.3 and 12.9% (year 3), respectively. It was concluded that combinations of endoscopic surgery and combined radiotherapy for inoperable cancer of the esophagus improved immediate results and reduced the rates of residual tumor incidence. However, no significant differences in mean duration or rates of survival were observed.

[Combined radiotherapy for inoperable esophageal cancer].

Among 112 patients with inoperable esophageal cancer treated with high-dose intraluminal brachytherapy and distant irradiation, objective response was in 84.8%. Predominantly local complications were reported in 78.6%. Recurrences were detected in 63.5% during follow-up, with mean relapse-free period being 107 days. Mean survival time was 15.3 months (1-, 2- and 3-year survival--58.8; 22.3 and 12.9%, respectively) which was comparable to similar results of palliative esophagectomy for gastric cancer.

[Endoscopic argon-plasma coagulation and combined radiotherapy for short (up to 3 cm) esophageal cancers].

The immediate and 3-year results were evaluated of application of combined radiotherapy and/or endoscopic argon-plasma coagulation carried out for esophageal cancers 3 cm long or less in 39 patients. Recurrences were reported, in 31.4% ca. 4 months later. Joint use of the modalities was followed by an up to 5-months rise in relapse-free period. Mean survival time was 20.2 months, and it was significantly higher in radiation-treated patients without metastases. One-year survival was 96.6% in those without distant metastases, 2-year--72%, and 3-year--47.6%. Our data point to new vistas in application of our techniques, particularly, for short (up to 3 cm) inoperable esophageal cancers.

[Current approaches to radical surgical and combined treatment of rectal cancer]. / Sovremennye podkhody k radikal'nomu khirurgicheskomu i kombinirovannomu lecheniiu raka priamoi kishki.

The article gives an analysis of the 30 years experiences with treatment of more than 3200 patients with rectum cancer at a specialized oncological department. Postoperative lethality was 7.3%. In recent years this figure has been decreased (5.2%). The individual programs of treatment were associated with the degree of growing the tumor through the bowel wall and with the metastatic damage of the regional lymph nodes. These factors show that careful as well as extended and combined operations are justified. The advantages of combined methods of treatment and functionally saving surgical interventions have been revealed.

[Current trends in the diagnosis and therapy of colorectal cancer]. / Sovremennye napravleniia v diagnostike i lechenii kolorektal'nogo raka.

The report deals with the 30-year experience gained by the Department in the treatment of nearly 5,500 cases of tumors of large bowel. Radical surgery for colonic tumor was followed by lethality in 3.0 and 5-year survival-80.8%; rectal tumor resection-5.3 and 58.2%, respectively. Individually-tailored modalities have been devised for a spectrum of cases of colonic wall invasion and metastatic lesions in regional lymph nodes. A choice of sparing, extended and combined surgical procedures vis-a-vis these factors has been developed, the latter offering most advantage. Therapeutic strategies for hepatic metastasis have been worked out on individual basis.

[Lymph node topography and various features of the metastasis of malignant kidney tumors]. / Topografiia limfaticheskikh uzlov i nekotorye osobennosti metastazirovaniia zlokachestvennykh opukholei pochek.

Due to investigations of 102 renal preparations performed on corpses of mature persons, topographic peculiarities of the lymph nodes, getting lymph from the left and right kidneys, are revealed. Every lymph node of the left kidney gets greater amount of lymphatic vessels than every node of the right kidney. The lymph, running from the right kidney, usually gets through a less number of the subsequently arranged nodes up to the thoracic duct, as compared to the lymph, that runs from the left kidney. A typical position for the node, which the renal lymphatic vessels get into, is the fatty tissue in the area of the angle formed by the aorta edge and the inferior wall of the corresponding renal artery. The lymphatic nodes of the right kidney are arranged in the fatty tissue more compact than the left ones. These peculiarities, revealed by morphological investigations, are proved by analysis of 114 case histories of persons suffering from malignant neoplasms in the kidneys.

[Surgical approach to the upper-thoracic segment of the esophagus in cancer]. / Operativnyi dostup k verkhnegrudnomu otdelu pishchevoda pri rake.

The clinical and topographo-anatomical data have shown that the right-side antero-lateral thoracotomy fails to meet the principles of oncological radicalism. The posterolateral thoracotomy in the IVth right intercostal space is thought by the authors to be the optimal access.

[Diagnosis and the surgical treatment of tumors of the anterior abdominal wall]. / Diagnostika i khirurgicheskoe lechenie opukholei perednei briushnoi stenki.

In 1015 patients with various diseases of soft tissues the pathological process was localized in the anterior abdominal wall in 64 patients (6,3%): desmoids were found in 41 patients, sarcomas -- in 12, benign tumors -- in 5 and non-tumor diseases -- in 6 patients. Dissection of the tumor must be performed not less than 2 -- 3 cm further than the pulpated borders. When plasty with local tissues is not possible, it is expedient to employ synthetic (terylene) prostheses.