Search

Background. Currently, the use of nanoparticles and nanostructures as components of tumor therapy is the subject of numerous scientific articles. To change the parameters of cell microenvironment in presence of nanoparticles and nanostructures is a promising approach to reducing the tumor cell viability. Aluminum hydroxides and oxides have a number of advantages over other particles due to their porous surface, low toxicity, and thermal stability.The purpose of the study was to investigate the influence of the acid-base properties of aluminum hydroxide structures with different phase composition on the tumor cell viability (Hela, mda, pymt, a549, B16F10).Material and methods. Aln/al nanoparticles were used as a precursor for obtaining structures with various phase compositions. The anoparticles were produced by electric explosion of an aluminum wire in a nitrogen atmosphere. Such nanoparticles interact with water at 60 °Ϲ, resulting in formation of porous nanostructures. They are agglomerates of nanosheets with a planar size of up to 200 nm and a thickness of 5 nm. The phase composition of the structures was varied by the calcination temperature. A change in the phase composition of nanostructures led to a change in the acid-base properties of their surface. To estimate the number of acidic and basic centers on the surface of nanostructures, the adsorption of Hammett indicators was used. The amount of adsorbed dyes was determined spectrophotometrically.Results. It was found that the differences in the acid-base characteristics of the surface of the nanostructures led to a change in their antitumor activity. Γ-al2o3 had 6.5 times more basic centers than acidic ones, which determined its ability to exhibit more pronounced antacid properties, i.e. Longer to neutralize protons secreted by tumor cells. This sample had the highest antitumor activity against all tested cell lines.Conclusion. The antitumor activity of synthesized structures was found to be related not only to an increase in the ph of the cell microenvironment, but also to the ability to maintain the alkalinity of the microenvironment for a longer time due to the adsorption of protons released by tumor cells.

Purpose of the study: to review the available data on the heterogeneity of colon cancer and to assess the prognostic significance of colon cancer subtypes.Material and Methods. Medline, PubMed, Cochrane library, elibrary databases were used to identify studies that characterized the current view on the problem of choosing the optimal postoperative treatment for colon cancer.Results. the review showed the results of international studies of colon cancer subtypes based on complex multomics characteristics. Particular attention was paid to the description of modern studies on the search for prognostic markers for colon cancer. The relevance of the study of immunohistochemical markers was confirmed by the analysis of the world literature. the outcomes will make it possible to classify colon cancer into molecular subtypes in real clinical practice and, as a consequence, significantly improve the effectiveness of adjuvant therapy.

The purpose of the study was to analyze and summarize data regarding a significance of PD -L1 expression in various molecular subtypes of colorectal cancer.Material and Methods. A systemic literature search was conducted in the electronic databases Medline, Cochrane Library, Elibrary, PubMed. Of identified and reviewed 201 full-text articles, we included data from 47 studies.Results. The literature review described the features of the molecular genetic classification of colorectal cancer and revealed the key characteristics of each of the molecular subtypes of this disease. Much attention was paid to the molecular mechanisms of anti-PD -1/PD -L1 therapy. The main problems associated with the standardization of methods for pathomorphological assessment of the expression of this marker and the difficulties of its interpretation in colorectal carcinomas were outlined.Conclusion. Analysis of the literature revealed problems associated with the assessment of PD -L1 expression in colorectal cancer, in particular, with the lack of generally accepted methods for interpreting research results and standardizing methods for pathomorphological diagnosis of malignant tumors of this localization. Further studies are needed for introducing the molecular genetic classification of colorectal carcinomas into a wide clinical practice and personalizing the approach to therapy of this disease.

Kartagener Syndrome (CS) is a rare autosomal recessive disease that is a part of primary ciliary dyskinesia (PCD), and is characterized by a triad of syndrome including bronchiectasis, polysinusitis and a complete mirror arrangement of the internal organs of the chest and abdominal cavities (situs inversus). In most patients, bronchiectasis in the lungs develops from the first years of life and progresses in time. The tardy diagnostic leads to a poor prognosis of the disease and adduce the development of persistent violations of the function of external respiration. Most often, patients with CS are observed by physicians and pulmonologists from early childhood, since respiratory infections often require annual hospitalization in specialized medical institutions due to abnormalities of the ciliary epithelium of the respiratory tract. However, to date, there are no generally accepted recommendations for the management and treatment of patients in this category. This article describes the case of a newly diagnosed CS in an older patient undergoing surgical treatment for gastric cancer. Despite the pronounced concomitant pathology on the part of the bronchopulmonary system, the perioperative period in the patient proceeded relatively satisfactorily and did not entail an increase in the length of hospitalization.

Primary gastrointestinal melanoma is a rare tumor with a frequency of 1 new case per 5–7 years. Over the past 100 years, there have been no more than 25 reported cases of primary melanoma of the stomach and colon. The rarity of the disease and nonspecific clinical features pose diagnostic challenges. The tumor is characterized by an aggressive growth and early metastasis. Case description. We present a rare clinical case of primary gastrointestinal melanoma with metastatic involvement of the adrenal glands, liver and retroperitoneal lymph nodes. Conclusion. To date, treatment standards for primary gastrointestinal melanoma have not been developed and are the subject of debate. However, palliative chemotherapy used for the treatment of primary skin melanoma may lead to disease stabilization in patients with gastrointestinal melanoma.

A multicenter randomized trial was conducted to assess histopathological response to neoadjuvant chemoradiotherapy in patients with locally advanced gastric cancer.Material and Methods. Patients of the study group received conformal radiation therapy (total dose of 46 Gr/23 fractions) with concurrent chemotherapy consisted of capecitabine at a dose of 1850 mg/m2 twice daily during the whole course of radiotherapy, and oxaliplatin at a dose of 85 mg/m2 on days 1 and 21. After an interval of 4–6 weeks and a control examination, in the absence of disease progression, patients were scheduled for surgery (gastrectomy or D2 subtotal gastric resection) and 4 cycles of adjuvant chemotherapy according to the FOLFOX4 or CAPOX regimens.Results.The study included 70 patients, including of 35 patients in the study group. Men predominated (n=23), the age ranged from 22 to 76 years (median – 61 years). The middle third of the stomach was the most common tumor location (n=19); involvement of the entire stomach occurred in 5 cases. Ulcerative and diffuse infiltrative forms were the most common (n=29). Well-and moderately-differentiated adenocarcinoma was observed in 11 patients and poorly – differentiated adenocarcinoma in 24 patients, including signet ring-cell cancer (n=8). In accordance with the clinical T, N and M categories, patients were distributed as follows: T3 – 22 patients, T4a/b – 13; N0 – 13, N1 – 12, N2–3 – 10; M0 – 35; stage IIB – 12, and stage III–IVA – 23 patients. Gastrectomy was performed in 30 patients and subtotal resection of the stomach in 4 patients; D2 lymphodissection was performed in all cases. One patient was not operated on due to disease progression. Of the 47 patients achieving pathological response, 5 (14.7%) patients had a complete pathological response. Among patients achieving pathological response, a statistically significant predominance of less advanced tumors was found (in accordance with the ypT category and stage).Conclusion. In general, a decrease in the pathological tumor stage compared to clinical stage was registered in 62 % of patients. Taking into account the data available in the world literature on high survival rates in patients with pathological complete regression, the optimization and implementation of neoadjuvant therapy techniques is of great importance.

Introduction. There are high-thech methods of nanoparticle production with controlled morphology and physical and chemical properties. Alumina-based mesoporous nanostructures have low toxicity and biocompatibility. FDI recommends alumina for biomedical application. Alumina inhibits the grow of cancer due to positive zeta-potential and low solubility in water. We observed the synergistic effect of joint application of doxorubicin and nanostructures. This approach reduces drug concentration and its toxicity.Purpose: to synthesize nanostructures with different surface potentials and to study toxicity of these nanostructures alone and in combination with doxorubicin.Material and Methods. The alumina-based nanostructures were obtained by the hydrolysis of nanopowder. The morphology of nanostructures was investigated by transmission electron microscopy with an integrated system of energy dispersive analysis. The phase composition of the particles was determined by x-ray diffraction. The effect of the synthesized nanostructures on the viability of cell lines was determined using the MTT test.Results. The synthesized nanostructures have a low toxicity and can be used as an adjuvant for doxorubicin.Conclusion. The combined use of doxorubicin and bicomponent nanostructures leads to an increase in the damaging effect of doxorubicin on Neuro-2a cells.

Introduction. Stomach cancer remains one of the most common malignancies with an unfavorable prognosis. It is the 5-th most frequent cancer and the 3rd leading cause of cancer death worldwide and in Russia as well. Combined modality treatment including radical surgery and perioperative / adjuvant therapy is the current therapeutic strategy for locally advanced gastric cancer. New approaches to combined modality treatment including neoadjuvant chemoradiotherapy for locally advanced gastric cancer were developed at A. Tsyb Medical Radiological Research Center (Obninsk, Russia) and tested in a phase 2 randomized clinical trial. The results obtained showed the safety and high efficiency of the method. To objectify the results, a multicenter randomized trial was initiated in 2016. the main objective of the study was to assess the immediate efficacy and safety of neoadjuvant chemoradiotherapy using pathological response criteria and to evaluate the frequency/severity of toxic reactions and postoperative complications. Additional objectives of the study were to assess the accuracy of preoperative staging of gastric cancer; tumor regression grade of the primary tumor and regional lymph node metastases according to CT findings; treatment outcomes according to the criteria of frequency and time to recurrence/metastasis; 1-, 2 -, and 3-year survival rates. Material and methods. The study included 70 patients with equal distribution between the treatment groups. There were more males than women; the median age was 62 years. The main criterion for inclusion of patients into the study was morphologically confirmed gastric cancer of сT2–4N1–3, сT3–4N0–3; сМ0, IIA-IIIC stages. Patients of the first (investigated) group were treated with neoadjuvant chemoradiotherapy (total dose of 46 Gy in 23 fractions and chemotherapy with capecitabine and oxaliplatin) followed by surgery (gastrectomy/subtotal resection of the stomach with D2 lymph node dissection) and 4 cycles of adjuvant chemotherapy. Patients of the second (control) group underwent surgery (gastrectomy/subtotal resection of the stomach with D2 lymph node dissection) followed by 6 cycles of adjuvant chemotherapy. Results. The tumor was localized in the middle and lower thirds of the stomach in most cases. There were mostly low-grade adenocarcinomas (47 patients). None of the patients showed the presence of distant metastases; 2B and 3 clinical tumor stages were mostly observed. The comparison of clinical and pathomorphological stages in the control (surgical) group showed that a comprehensive examination, including CT and laparoscopy, allowed the correct assessment of the tumor stage and formation of the control group according to the main inclusion criteria in more than 90 % of patients. Comparison of patients between the study and control groups showed that they were well balanced on the main prognostically important factors. The differences between all parameters were not statistically significant (p>0.05).

Due to the lack of specific symptoms of colon lipoma, the disease is often complicated by invagination, bleeding, or colonic obstruction. The article presents a clinical case of successful treatment of complicated lipoma of the hepatic flexure of the colon.

intraduction . Gastric cancer is the most prevalent malignancy in the world. the common metastatic sites of gastric cancer include liver, lymph nodes and peritoneum. testicular metastasis from gastric cancer occurs extremely rare. there are only 15 reports in literature describing cases with testicular metastasis from gastric cancer. Case report. We first report a clinical case of a man presented with metastasis in the left testis and locally advanced gastric cancer. the patient underwent gastrectomy with resection of the transverse colon and left-sided orchofuniculectomy. Postoperative morphological and immunohistological examinations revealed gastric cancer with metastasis into the testis. He had received 6 cycles of chemotherapy, with no evidence of recurrence within a 9-month follow-up period.

The purpose of the study was to provide current data about various methods of treatment of early and locally advanced esophageal cancer.Material and Methods. A search was made on available literature sources published in the Pubmed, Medline, Elibrary, Cochrane Library, CyberLeninka, Global Health and other databases. 123 articles published from 2001 to 2018 were found and analyzed to write this review.Results. Esophageal cancer is the 7-th most common cancer worldwide. Esophageal cancer has a favorable prognosis only in patients with early stage cancer. The use of endoscopic technology provides a minimally invasive approach to the treatment of esophageal cancer and significantly increases survival of patients. Surgical resection remains the mainstay of treatment for esophageal cancer. For patients with locally advanced esophageal cancer, a multimodal approach is required, including a rational combination of radical surgery with chemo and/or radiation therapy. In many countries, preoperative chemotherapy has entered the standard of treatment for II–III stages of esophagus cancer. However, the development of novel approaches to the treatment of esophageal cancer is of great importance. For advanced cancer patients, palliative chemo- or chemoradiotherapy remains the main treatment modality.Conclusion. The choice of the treatment option for esophageal cancer remains a challenging clinical problem and depends on the particular type of cancer, tumor stage, functional status of patients.

Introduction. Cutaneous melanoma is a challenge to treat due to rapid progression of disease and acquired resistance to therapy. Autophagy and the epithelial-to-mesenchymal transition (EMT) are closely interrelated and play a key role in tumor progression. Targeted co-inhibition of MEK and mTOR kinases is a potential target for melanoma therapy by downregulatoin of the EMT.Objective: to study the effect of MEK and mTOR co-inhibition on cell viability, ability to form 3D-spheroids and migratory capacity of melanoma cell lines, and correlation of these changes with EMTand autophagy-related markers.Material and Methods. Melanoma cell lines Mel Z and Mel MTP were derived from patients, who were treated at the N.N. Blokhin National Medical Research Center of Oncology. The antiproliferative effect of binimetinib and/or rapamycin was studied by the MTT -test. 3D spheroids were formed using RGD peptides. Cell migration and invasion were assessed by a Boyden chamber migration assay. The expression levels of autophagy and EMT markers were investigated by immunocytochemistry or immunoblotting.Results. Rapamycin increased cytotoxicity of binimetinib in both 2D and 3D melanoma cell line cultures. At the same time, binimetinib and rapamycin reduced invasion, but not migration capacity of melanoma cells in vitro. The effectiveness of the combination was associated with a decrease in the EMT markers (N-cadherin and β-catenin) and autophagy markers (Beclin 1, p62/SQST M1 and LC3BII ) in melanoma cells.Conclusion. Inactivation of autophagy and EMT leads to overcoming the resistance to current anti-melanoma therapy and can be considered as a promising target for the treatment of melanoma.

Background.Currently, the indications for multivisceral pelvic resections have increased dramatically. However, short-and long-term outcomes after these resections for locally advanced rectal cancer remain a subject of debate.The purposeof the study was to evaluate short-term surgical and oncological outcomes after multivisceral pelvic resections in patients with locally advanced rectal cancer.Material and methods. We analyzed surgical outcomes in 32 patients (13 men and 19 women) aged 44-69 years, with locally advanced rectal cancer, who were treated between 2010 and 2016. Of the 32 patients, 28 (87.5 %) had rectal cancer with invasion into adjacent organs (posterior wall of the bladder - 13, uterus - 10, ureters - 5, prostate - 4, vagina - 3; simultaneous damage to more than 2 organs - 14, multiple primary malignant tumors: rectal cancer + bladder cancer - 2, rectal cancer + endometrial cancer - 1, rectal cancer + rectal GIST - 1.Results.Total pelvic evisceration was performed in 6 (18.8 %) cases, combined resection of the rectum and adjacent organs was performed in 26 (81.2 %). Urinary tract resection was performed in 24 (75.0 %) patients. Of these patients, 13 (40.6 %) had primary plasty of the bladder and/or ureters. Postoperative surgical complications were observed in 11 (34.4 %) patients, of whom 7 (21.8 %) patients needed re-surgery. In 1 patient (3.1 %), who died in the early postoperative period, the cause of death was thrombosis of the right iliac vessels with subsequent acute renal failure. For patients with locally advanced rectal cancer, long-term outcomes were as follows: the overall and recurrence-free 2-year survival rates were 75 % and 56.3 %, respectively. All patients with multiple primary malignant tumors were alive with no evidence of disease recurrence at a follow-up of >24 months.Conclusion.Multivisceral resection in patients with locally advanced rectal cancer is a complex surgical procedure requiring the multidisciplinary team of surgeons. Despite high operative morbidity, proper perioperative management of the patients helps to achieve satisfactory immediate treatment outcomes. Long-term outcomes allowed us to consider such resections as a method of choice for locally advanced and multiple primary rectal cancers.

In recent years, especially in developed countries, there has been an increase in the incidence of pancreatic cancer. Only 20% of tumors at the time of diagnosis are evaluated as resectable, but in these cases, the prognosis of the disease is unfavorable. The overall 5-year survival rate does not exceed 5%. Pancreatic cancer was described in the 1760s by Giovanni Battista Morgagni in his classic book “De Sedibus et Causis Morborum per Anatomen Indigatis”. Over the next 200 years, pathologists significantly improved our understanding of the macro- and microscopic features of this disease. At the same time, morphological research remained the basis of diagnostics for centuries. The introduction of immunohistochemical studies into clinical practice in the late 1970s and early 1980s radically changed our approach to diagnosing this disease. Evaluation of morphological features, as well as features of expression of markers that determine the invasive potential of such neoplasms, can serve in the future as a fundamental basis in solving questions concerning possible factors of prognosis upon malignant tumors of such a localization. Aim of research — to study the morphological and immunohistochemical features of ductal pancreatic adenocarcinoma. Materials and methods. The study included 84 patients with pancreatic cancer T1-4N0-2M0-1 stage, aged from 37 to 83, who underwent surgical treatment. Morphological study of the operating material was carried out. The condition for inclusion in the study was a histotype of the tumor, namely ductal pancreatic adenocarcinoma. Posting of the material, preparation of histological preparations, coloring, immunohistochemical examination were carried out according to a standard procedure. Results and conclusion. The study made it possible to characterize the tumor morphology, as well as the features of expression of markers associated with more evident invasive characteristics of the tumor. The results of this work may be of interest in terms of their further comparison with the parameters of various forms of progression upon pancreatic cancer.

Preservation of the rectal sphincter during surgery for rectal cancer is necessary in order to maintain control of bowel function. For this purpose, novel approaches for combining sphincter-saving surgeries with neoadjuvant radiotherapy regimens are extensively developed. There are active discussions on the effectiveness of radiosensitization with the inclusion of chemical and physical components, one of which is local hyperthermia. This article reviews the worldwide experience in treating rectal cancer patients using local hyperthermia combined with radiation therapy. A wide variety of methods, as well as facilities for the procedure, is discussed. It should be noted that the selection of patients with rectal cancer for thermochemoradiotherapy and the choice of optimal irradiation volume remain a challenge.

The purpose of the study was to evaluate the anesthetic effect of the combination of xenon and dexmedetomidine during surgery for gastric cancer. Material and methods. The prospective randomized study included 53 patients with operable II–III stage gastric cancer. The age range was from 26 to 75 years. The patients underwent gastrectomy (n=21) and subtotal distal gastrectomy (n=32). The study group comprised 27 patients who received anesthesia with xenon and dexmedetomidine combined with epidural analgesia. The control group consisted of 26 patients who received anesthesia with sevoflurane in combination with epidural analgesia. Intraoperative patient monitoring was performed according to Harvard intraoperative monitoring standards. Plasma levels of ACTH, STH cortisole, IL-1β, IL-6, and CRP as well as cytokine profile were used to evaluate the effect of two anesthetic methods. Results. In the perioperative period, the combination of xenon and dexmedetomidine in combination with epidural analgesia was characterized by significant inhibition of systemic inflammatory reactions and a lower release of stress hormones as components of a surgical stress response expressed by a lower level of pro-inflammatory cytokines and somatotropic hormone. The frequency of postoperative inflammatory complications was lower in the xenon group than in the control group. Conclusion. The use of the combination of xenon and dexmedetomidine during surgery for gastric cancer provides a more adequate course of the perioperative period.

A simple approach for isolation of exosomes from the blood plasma, which allows to obtain highly purified preparations of microvesicles no larger than 100 nm has been proposed. The presence of different subpopulations of exosomes in the blood plasma of healthy donors and cancer patients has been recognized. We found the presence of the universal markers CD9, CD24 and CD81 on exosomes isolated from blood plasma that can be used to their routine typing.Predlozhen uproshchennyĭ sposob vydeleniia ékzosom iz plazmy krovi, pozvoliaiushchiĭ poluchit' vysokoochishchennye preparaty mikrovezikul razmerom ne bolee 100 nm. Ustanovleno nalichie razlichnykh subpopuliatsiĭ ékzosom kak v plazme krovi zdorovykh donorov, tak i onkologicheskikh bol'nykh. Universal'nye markery CD9, CD24 i CD81 mogut byt' ispol'zovany dlia rutinnogo tipirovaniia ékzosom.

Objective. To compare the functional activity of natural killer cells in peripheral blood and ascites from patients with different stages of colorectal and ovarian cancers and benign ovarian tumors. Material and methods. The study included 10 patients with stage IIIC ovarian cancer (FIGO, 2009), 5 patients with benign ovarian tumors (BOTs), and 15 patients with colorectal cancer (T2–4N0–2M0 ). The control group consisted of 5 healthy donors. To evaluate the number and functional activity of NK-cells in peripheral blood and ascites, the FACS Canto II Flow Cytometer was used. Results. In peripheral blood of patients with ovarian and colorectal cancers, the relative number of activated NK-cells capable of secreting granzyme B (GB) (CD56 + CD107a + GB + PF-) was significantly lower and the proportion of degranulated NK-cells (CD56 + CD107a + GB- PF-) was higher than those of healthy donors. Low total NK-cell counts in peripheral blood were a distinctive feature of ovarian cancer patients (p< 0.05). The proportion of activated peripheral blood NK-cells, containing granules of cytolytic enzymes GB and perforin (PF) increased with tumor growth. However, lymph node metastasis in patients with colorectal cancer did not affect the level and activation of NK-cells. The comparative analysis of NK-populations in patients with benign and malignant ovarian tumors revealed that the level of CD56 + cells was significantly higher in tumor ascites compared to peripheral blood. In patients with BTs, the levels of CD56 + CD107a + and activated CD56 + CD107a + GB-PF-degranulated cells was higher in ascites than in blood. In patients with ovarian cancer, the level of degranulated cells was higher in peripheral blood than in malignant ascites. Conclusion. The tumor cells and tumor microenvironment were found to affect the number and the functional activity of NK-cells. The accumulation of free fluid within the peritoneal cavity in patients with both benign and malignant ovarian tumors resulted in significantly decreased levels of NK-cells in peripheral blood and increased levels in ascites. The differences in the functional activity of NK-cells in ascites and peripheral blood of patients with ovarian cancer require further investigation of the lymphocyte receptor status and possibly cytokine-producing function of NK-cells.

Pancreatic cancer is one of the most unfavorable malignancies. Approximately 20 % of patients with pancreatic cancer have resectable disease at the time of diagnosis, however the prognosis of the disease in these patients remains poor, and the overall 5-year survival rate is only 5 %. The evaluation of morphological features, as well as features of the expression of markers that determine the invasive potential of such neoplasms, can serve in the future as a fundamental basis in solving problems concerning prognostic factors in pancreatic cancer. The purpose of the study was to evaluate morphological and immunohistochemical features of pancreatic ductal adenocarcinoma. Material and methods. The study included 84 patients with stage T1–4N0–2M0–1 pancreatic cancer. The age range was from 37 to 83 years. Surgery was the main treatment option. Morphological examination of surgical specimens showed that the tumor histotype corresponded to pancreatic ductal adenocarcinoma. The preparation of histological specimens and immunohistochemical staining were carried out according to standard procedures. Results and conclusion. This study allowed us to determine the features of tumor morphology, as well as the features of expression of markers associated with more pronounced invasive properties of the tumor. The results of this study may be of interest in terms of their further comparison with the parameters of various forms of progression in pancreatic cancer.

The purpose of the study was a review of available data on the role of autophagy and angiogenesis in the development, progression and prognosis of colorectal cancer. Material and methods. Databases searched were Medline, Cochrane Library and Elibrary. Of 340 studies, 48 were used to write a systematic review. Results. To date, there is a variety of prognostic markers used in the study of pathogenesis, diagnosis and treatment of colorectal cancer. The review describes the molecular mechanisms of the participation of various proteins of autophagy and angiogenesis in the pathogenesis and progression of colorectal cancer, and the potential importance of their use in clinical practice is presented. Conclusion. Many of the existing markers can be used not only in assessing the prognosis, but also sensitivity to chemotherapy. However, the contradictory results of studies with respect to certain proteins require further study, validation, and subsequent introduction into practice.

The review presents the mechanisms involved in the biological behavior of rectal cancer cells. The tumor response to neoadjuvant chemoradiotherapy was evaluated. The characteristics of proliferative activity, apoptosis, cell adhesion, and migration of rectal cancer cells influenced by chemotherapy were described. The relationship between molecular genetic markers and prediction of response to chemoradiation in rectal cancer was shown.

Introduction. Stomach cancer remains one of the most common malignancies with an unfavorable prognosis. It is the 5-th most frequent cancer and the 3rd leading cause of cancer death worldwide and in Russia as well. Combined modality treatment including radical surgery and perioperative / adjuvant therapy is the current therapeutic strategy for locally advanced gastric cancer. New approaches to combined modality treatment including neoadjuvant chemoradiotherapy for locally advanced gastric cancer were developed at A. Tsyb Medical Radiological Research Center (Obninsk, Russia) and tested in a phase 2 randomized clinical trial. The results obtained showed the safety and high efficiency of the method. To objectify the results , a multicenter randomized trial was initiated in 2016. the main objective of the study was to assess the immediate efficacy and safety of neoadjuvant chemoradiotherapy using pathological response criteria and to evaluate the frequency/severity of toxic reactions and postoperative complications. Additional objectives of the study were to assess the accuracy of preoperative staging of gastric cancer; tumor regression grade of the primary tumor and regional lymph node metastases according to CT findings; treatment outcomes according to the criteria of frequency and time to recurrence/metastasis; 1-, 2 -, and 3-year survival rates. M aterial and methods . The study included 70 patients with equal distribution between the treatment groups. There were more males than women; the median age was 62 years. The main criterion for inclusion of patients into the study was morphologically confirmed gastric cancer of сT2–4N1–3, сT3–4N0–3; сМ0, IIA-IIIC stages. Patients of the first (investigated) group were treated with neoadjuvant chemoradiotherapy (total dose of 46 Gy in 23 fractions and chemotherapy with capecitabine and oxaliplatin) followed by surgery (gastrectomy/subtotal resection of the stomach with D2 lymph node dissection) and 4 cycles of adjuvant chemotherapy. Patients of the second (control) group underwent surgery (gastrectomy/subtotal resection of the stomach with D2 lymph node dissection) followed by 6 cycles of adjuvant chemotherapy. R esults . The tumor was localized in the middle and lower thirds of the stomach in most cases. There were mostly low-grade adenocarcinomas (47 patients). None of the patients showed the presence of distant metastases; 2B and 3 clinical tumor stages were mostly observed. The comparison of clinical and pathomorphological stages in the control (surgical) group showed that a comprehensive examination, including CT and laparoscopy, allowed the correct assessment of the tumor stage and formation of the control group according to the main inclusion criteria in more than 90 % of patients. Comparison of patients between the study and control groups showed that they were well balanced on the main prognostically important factors. The differences between all parameters were not statistically significant (p>0.05).

Аim. The incidence of cardioesophageal cancer has been steadily increasing over the past few decades, posing significant diagnostic challenges. Materials and metods . X-ray examination remains the primary imaging modality for the initial diagnosis of gastric tumors. However, the modern imaging techniques, such as ultrasound (US) and spiral computed tomography (SCT) are needed to assess the extent of tumor invasion into the gastric wall and adjacent organs as well as lymph node involvement and metastatic spread. Conclusion. The role of US and SCT in diagnostic imaging of cardioesophageal cancer was studied and the examination algorithm using US and SCT with conventional X-rays was offered.