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Introduction: Prostate cancer (PC) is the most common oncologic disease among men. The number of patients with recurrent PC after primary radiotherapy is increasing, unfortunately, criteria for the choice among different treatment methods for these patients have not been defined yet. Salvage treatment options include prostatectomy, brachytherapy (BT), cryotherapy, thermoablation, and high frequency ultrasound. The lack of long-term evaluation of the toxicity and influence on the survival of patients after salvage high-dose-rate (HDR) BT is an important problem when considering this treatment option. In this study we have analyzed the treatment results of twelve patients who were diagnosed with local recurrent prostate cancer after primary radiotherapy and then treated with HDR BT. Materials and methods: Patients were treated with salvage HDR BT between January 2013 and February 2014 at the Institute of Oncology, Vilnius University. Results: Average age of the patients at the time of salvage treatment was 67.5 years (min 54 years, max 76 years). The PSA value at the salvage treatment was from 2.06 ng/ml to 9.20 ng/ml. The time from the initial diagnosis till the salvage treatment was from 33 months to 134 months. All 24 procedures were successful and without any early complications. Conclusions: HDR BT is a presumable and safe treatment option for local prostate cancer recurrence after primary radiotherapy. Prospective clinical trial is initiated to evaluate survival, long-term toxicity and predictive value of different biomarkers. [ABSTRACT FROM AUTHOR]

Background: Up to 95% of irradiated patients suffer from ionizing radiation (IR) induced early skin reaction, acute radiation dermatitis (ARD). Some experts think that additional skin hydration can reduce acute skin reactions. Individual radiosensitivity (IRS) determined from lymphocytes may help to predict acute radiation toxicity. The purpose of this study is to evaluate the clinical manifestation of ARD in different skincare groups during whole breast radiotherapy depending on IRS and other risk factors. Methods: A total of 108 early-stage breast cancer patients were randomized into best supportive care (BSC) and additional skincare (ASC) groups. IRS was evaluated using a G2 assay modified with caffeine-induced G2 checkpoint arrest. All patients received a 50 Gy dose to the breast planning target volume (PTV). Clinical assessment of ARD symptoms according to the CTCAE grading scale was performed once a week. Results: IRS was successfully determined for 91 out of 108 patients. A total of 10 patients (11%) had normal IRS, 47 patients (52%) were categorized as radiosensitive, and 34 (37%) as highly radiosensitive. There was no significant difference in the manifestation of ARD between patient groups by skincare or IRS. According to logistic regression, patients with bigger breasts were prone to more severe ARD (p = 0.002). Conclusions: The additional skincare did not improve skin condition during RT. A total of 89% of patients had increased radiosensitivity. IRS determined before RT did not show the predictive value for the manifestation of ARD. Logistic regression revealed that breast volume was the most significant risk factor for the manifestation of ARD. [ABSTRACT FROM AUTHOR]

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The aim of this study was to improve the survival and local control of patients with primary or recurrent rectal cancer treated by combined external photon and intracavitary neutron radiation therapy. Analysis of this group of patients was undertaken to assess the survival, local control and complication rate in comparison with external photon therapy alone. Materials and methods. Fifty-six patients (Co-Cf group) with rectal malignancies (T2-7 pts, T3-33 pts, T4-7 pts, 1 with melanoma and 8 with rectal carcinoma recurrence) were treated by combined radiation therapy: external 60 Co gamma irradiation (2 Gy per fraction, 3-5 fractions/ week, mean total dose 37.2 Gy ) and 252 Cf neutron high dose rate (HDR) remote afterloading brachytherapy (0.7-2.1 Gy per fraction, 2 fractions/ week, mean total dose 5.4 Gy). This group was compared with historical Co group of 52 patients (T1 - 1 pt, T2 - 12 pts, T3 - 39 pts, T4 - 2 pts; 8 with rectal carcinoma recurrence) treated by external photon radiation therapy (2 Gy per fraction, 5 fractions/week, mean total dose 62.6 Gy). The follow-up for these patients ranged from 7.5 to 12.5 years. Results. Complete response was achieved in 19.2% and partial response in 59.6% of the cases among Co-Cf group patients. The mean total brachytherapy dose for patients with NR was less than 4.0 Gy. Acute reactions (Grade 2-4 RTOG) and late complications (Grade 2-4 RTOG) in the rectum and adjacent tissues after a 4 year follow-up were observed in 21.4% (12/56) versus 30.0% and 16.0% (8/50) versus 29.0% cases in the Co-Cf and Co groups, respectively. The one-, two-, three-, four-, five- and six-year survival was 80.4%, 53,6%, 42.7%, 25.6%, 17.7%, 11.8% versus 71.6%, 41.8%, 20.9%, 10.5%, 3.0%, 1.5% for the Co-Cf and Co groups of patients respectively (a statistically significant difference of survival from one to six years). Conclusions. The results achieved by the use of 252 Cf neutron brachytherapy are encouraging to improve the treatment results in selected groups of patients with locally spread primary or recurrent rectal cancer. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the results of hemorrhagic radiation proctopathy treatment with a 4% formalin application., Methods: A prospective study was performed. Over a three-year period, 38 patients underwent 4% formalin application under perianal anesthetic infiltration for hemorrhagic radiation proctopathy. All patients included in the study were irradiated for prostate cancer. The patients ranged in age from 56-77 years (average 70 ± 5 years). All of the patients were referred for formalin therapy after noninvasive management had failed. Twenty-four (63.2%) patients underwent a single application, 10 (26.3%) patients underwent 2 applications, and 4 (10.5%) patients underwent 3 applications., Results: Two to 36 mo (average 12 ± 3 mo) following treatment, 34 patients were interviewed (four were lost to follow-up). Twenty (58.8%) subjects reported complete cure, 8 (23.5%) subjects reported significant improvement, and 6 (17.7%) subjects reported no change. One patient (who underwent a colostomy at a regional hospital with no specialized services available for previous bleeding episodes from radiation proctopathy) was cured, and the colostomy was closed. One patient (2.6%) developed rectal mucosal damage after the second application., Conclusion: A 4-min application of 4% formalin for hemorrhagic radiation-induced proctopathy under perianal anesthetic infiltration in patients who have received external radial radiation therapy for prostate cancer is simple, reasonably safe, inexpensive, generally well tolerated, and effective.

The aim of this article was to review the available literature regarding to the use of strontium-89 in the palliation of osteoblastic bone pain. The data of many researchers showed that approximately 80% of patients with pain from osteoblastic lesions resulting from prostate or breast cancer experience significant pain relief by administration of strontium-89, with only mild levels of hematotoxicity. The duration of pain relief in some cases exceeded 3-6 months. Indications for administration of strontium-89, effectiveness and duration of the treatment, side effects are reviewed in this article.

Taking into account the possibility of interaction of immune and antioxidant systems, the aim of this study was to investigate the changes in the parameters of immune and antioxidant systems in patients with cervical cancer and to compare them with the corresponding data obtained from healthy women. Ninety-four women with cervical cancer at II and III stage comprised the patient group and 69 healthy women were taken as the control group. The investigation results showed that the cellular immunity functions of patients with cervical cancer were suppressed in comparison with the same of healthy women. Though with respect to age, in 35-49-year-old women group with cervical cancer, some immune system indices were suppressed (quantity of T-, B-lymphocytes, NK); however in order to maintain the immune homeostasis of the organism other immune system functions were compensatorily stimulated (neutrophils and its phagocytic activity, CD8(+), IgG and IgA concentration were higher). The activity of the antioxidant system in patients with cervical cancer was impaired: the concentration of lipid peroxidation products was increased, the level of the endogenous antioxidant vitamin E and the activity of the antioxidant enzyme superoxide dismutase were decreased in comparison with the control group.