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The aim of the study was to develop and validate a software package (SP) for computer simulation of the procedure for examining patients with lung cancer by SPECT/CT and assessing the accuracy of reconstruction of tumor lesions.Material and Methods. Lung scintigraphy for a patient with peripheral squamous cell carcinoma of the upper lobe of the right lung was performed using a two-detector gamma camera GE Discovery NM/CT 670 DR (USA) with high-resolution collimators for an energy of 140 KeV and a radiopharmaceutical (RP) 99mTc-Technetril (MIBI, Diamed, Moscow). The data obtained were subjected to computer processing using a specialized Xeleris 4.0 system from GE (USA). The SP included a program for generating a voxel phantom (“virtual patient”), a program for modeling the “raw” data acquisition (“virtual tomograph”) and an image reconstruction based on the OSEM algorithm (Ordered Subset Expectation Maximization). In order to validate the created SP, computer simulation of the above clinical case was performed. The semi-quantitative comparative image analysis was based on a tumor/background score.Results. There was a good correlation between clinical “raw” data recorded from a real patient and projection data calculated by the Monte Carlo method from a “virtual patient”. The results of the comparative analysis showed that the tumor/background assessment was underestimated in the reconstructed images.Conclusion. The problem of the accuracy of the tumor lesions reconstruction by using standard OSEM reconstruction algorithms has not been studied. This issue is important in the management of patients with tumor lesions of the lungs and requires study and systematization. The SP will be used in further studies to analyze errors and artifacts in images of tumor lesions, as well as to develop approaches to overcome them.

Aim. The aim of the study was to evaluate the ability of pMEL-TCI and pMEL-A0201 DNA-constructs encoding artificial polyepitope melanoma antigens to induce antitumor T cell immune response ex vivo. material and methods. Dendritic cells were obtained from peripheral blood mononuclear cells of HLA-A02:01-positive donors; DCs transfected with target DNA vaccine constructions were co-cultured with autologous T lymphocytes to stimulate anti-tumor effector T cells. Specific activity of ex vivo stimulated PBMC was assessed (1) by their ability to cause lysis of human melanoma Mel Is cells, and (2) by the level of their granzyme-producing activity. A recombinant plasmid encoding the full-length MART-1 melanoma antigen was used as a positive control. results. All DNA vaccine constructions as well as positive control construction were found to be able to stimulate specific anti-tumor immune responses of autologous PBMC ex vivo, and these PBMC were found to induce melanoma Mel Is cells lysis. Both the efficiency of induced cytotoxic responses and the level of granzymes production stimulated with DCs transfected with pMel-A0201 significantly exceeded those stimulated with DCs transfected with either pMel-TCI or with DNA construction encoding the full-length MART-1 protein. The cytotoxicity level correlates with the level of granzyme B production in CD8+ T lymphocytes. conclusion. DNA vaccine constructions encoding artificial polypeptides composed of tumor antigen epitopes can stimulate the antitumor cytotoxic response. This approach can be used as the basis for the development of new methods of immunotherapy for cancer.

Cancer is the second leading cause of death worldwide behind cardiovascular diseases. Late stage of cancer at diagnosis and low efficacy of traditional cancer treatments result in low survival rate in cancer patients. Modern techniques to kill tumor cells are therefore needed. Over the last decade novel anticancer treatments have emerged from advances in our understanding of tumor cell biology, and a number of molecular and biologic targets have been identified. Chimeric antigen receptor T cell (CAR-T cell) therapy is a novel adoptive immunotherapy, which is used predominantly in the treatment of hematological malignancies. Moreover, it has been evidenced that cells of the innate immune system are key players at initiating and regulating adaptive immune responses. Studies focusing on innate immune cells for cancer immunotherapy show promising results. In this review, we describe functions of natural killer cells and analyze the rationale for using natural killer cells in cancer therapy.

Background. Osteosarcoma is a high-grade malignant bone tumor that accounts for up to 6 % of all bone neoplasms. There are only a few published cases of primary sternal osteosarcomas, reflecting the rarity of these tumors. Recently, there has been a growing interest in performing radical excisions of chest wall tumors followed by combined single-stage reconstruction of the rib cage with implants made of biologically compatible materials. Material and methods. We present the case of a 49-year-old woman diagnosed with osteosarcoma of the sternum. The patient received a combined modality treatment including chemotherapy, radiotherapy and surgery. Titanium nickelid implants were used for the reconstruction of chest wall defects. Results. The multimodality treatment with reconstruction of postoperative chest wall defects allowed the achievement of the optimal quality of life for 21 months in the patient with very poor prognosis. Conclusion. The chest wall reconstruction using biocompatible materials from titanium nickelid appeared to be an effective and safe technique for the treatment of chest wall tumors.

Melanoma is one of the most dangerous forms of skin cancer. Aggressive growth with a high risk of distant metastasis is the cause of the high death rate from skin melanoma worldwide. Melanoma that has metastasized beyond the lymph nodes requires more aggressive treatment. The standard treatment modalities including surgery, radiation therapy and chemotherapy are not very effective for most patients. The aggressive nature of this disease sustains an urgent need for more effective treatment methods. Immunotherapy is currently one of the most promising approaches for fighting cancer cells. The review analyses the main immunotherapeutic approaches to melanoma treatment, including therapeutic vaccines based on tumor cells, synthetic peptides and polyepitopic immunogens. Many of these vaccines are currently being studied in various clinical trials.

Background. Dysphagia is the main clinical symptom in patients with locally advanced esophageal carcinoma and proximal part of the stomach. Esophageal stenting is a highly effective and safe method to restore esophageal lumen patency. Published data indicate a high rate of stent-related complications. Material and methods. A retrospective, two-centered study included 166 patients (102 males and 64 females), who underwent endoscopically-guided esophageal stenting from 2004 to 2015. The age of the patients ranged from 36 to 92 years. Expandable metal stents were used for all patients. In most cases (81.3%), drug-eluting stents (22 mm diameter, 120 mm length) were preferable. Treatment outcomes and complications were analyzed. Results. Complications during stent placement (incorrect stent disclosure) were observed in 7 patients. All these complications were eliminated by relocating the stent to the desired position. Postoperative complications were noted in 29 patients (stent migration in 9 patients, stent fracture and migration in 2 patients, stent obstruction in 1 patient, destruction of stent coating and fragmentation in 5 patients, and dysphagia recurrence due to continuing tumor growth in 11 patients). All stent-related complications were corrected by re-endoscopy. Conclusions. The data obtained indicate the need for lifelong surveillance of patients after stenting.

Background. Currently, the major purpose for pelvic surgery is to conduct a locoregional radical procedure while preserving a good quality of life. When performing periacetabular resections, the acetabulum and the hip joint are the most difficult areas to reconstruct. According to some authors, the acetabulum and hip joint reconstruction with modular endoprostheses for patients with periacetabular tumors would lead to better clinical outcomes. The paper presents our experience using this surgical technique.Methods. Between 2011 and 2015, a total of 23 patients underwent periacetabular resection with the acetabulum and hip joint reconstruction using a modular endoprosthesis. There were 10 (44 %) male and 13 (56 %) female patients aged from 20 to 64 years with a median of 44 years. The histological types were as follows: 12 (52 %) chondrosarcomas, 4 (17 %) giant-cell tumors, 2 (8 %) osteosarcomas and 1 Ewing’s sarcoma, 1 malignant fibrous hystiocytoma, 1 synovial bone sarcoma, 1 solitary metastasis from renal cell and gastric carcinomas. Stage Ib bone sarcoma was diagnosed in 8 patients and stage IIb in 6 patients.Results. In accordance with Enneking classification, type I-II-III resections were performed in 14 (61 %) patients and type II-III-IV resections in 7 (30 %) patients. The median duration of surgery was 320 min (240–520 minutes). The median intraoperative blood loss was 5 200 ml (1 000–20 000 ml). Negative resection margins (R0) were achieved in 20 (87 %) patients. Positive resection margin (R1) was observed in 3 (13 %) patients with G-I chondrosarcoma. The median follow-up was 32 months (3–48 months). Disease progression was diagnosed in 7 (30 %) patients at a follow-up from 6 to 18 months. The functional outcome after surgery was assessed according to the MSTS score, with the median value of 48% (15–78 %). Postoperative complications were diagnosed in 10 (43 %) patients.Conclusion: The use of the modular acetabulum and hip joint replacement systems allows one to achieve favorable functional outcome in the postoperative period and to reduce the time of postoperative rehabilitation.

The efficacy of the chest wall reconstruction with TiNi implants was assessed. Between 2007 and 2014, 21 patients with malignant tumors of the skin, soft tissues, ribs and sternum (sarcomas and metastases) underwent replacement of post-resection chest wall defects using the original Ti-Ni constructions. A total of 28 surgeries were performed including 19 single-stage reconstructions or 2 delayed reconstructions. The average square of the defect was 127 cm2 (40 to 323 cm2). results. Spontaneous breathing was restored on the day of surgery in 27 (96.4 %) cases. Chest carcass recovery was achieved in all cases. The amplitude reduction was observed in 10 (36 %) cases and complete elimination of pathological chest wall flotation was achieved in 18 (64 %) cases. Complications requiring surgery were observed in 3 (11 %) patients. At a long-term follow-up, 10 patients are alive. conclusion. The technique combining the use of TiNi alloy structures and complex autotissue grafts with axial type of blood supply allows chest wall cancer with extensive local spread to be successfully treated.

The review aimed to assess the role of local hyperthermia in combined modality treatment of soft tissue sarcoma. The recent randomized trials have shown significant benefits from local hyperthermia in patients with soft tissue sarcoma. When combined with radiotherapy, hyperthermia has a complementary and additive effect. Extensive researches have also shown that hyperthermia improves the efficacy of many chemotherapeutic agents. Besides the increased effectiveness of radiotherapy and chemotherapy, hyperthermia has many anti-cancer effects and improves treatment results in patients with soft tissue sarcomas.