Search

The purpose of the study: to present an experience of the N. N. Blokhin Russian Cancer Research Center in the treatment of relapses of gestational trophoblastic neoplasias (GTN). Materials and methods. We performed a retrospective analysis of medical case histories at the N. N. Blokhin Russian Cancer Research Center from 1996 until 2019. 545 patients with GTN were treated. Relapses occurred in 25 (4.6%) patients: 8 (2.1%) patients with low risk of resistance (6 (75%) early relapses and 2 (25%) late relapses) and 17 (10%) patients with high risk of resistance (11 (65%) early relapses and 6 (35%) late relapses). Treatment of relapses was done by standard chemotherapy regimens (Dactinomycin 500mcg in days 15, EMA-CO, EMA-EP). Different surgical interventions and radiosurgery were used in some cases additionally. Results. Out of 6 patients with early relapses of low-risk GTN, 5 were cured with chemotherapy and one patient by lung resection only. Two patients with late relapses of low-risk GTN were cured with chemotherapy (EMA-CO) and hysterectomy/resection of uterus to achieve complete remission. As a result, all patients with relapses of low-risk GTN were cured, mainly (88%) by chemotherapy. Among 11 patients with early relapses of high-risk GTN, complete remission was achieved in 6 (55%) cases: in 2 patients as a result of EMA-EP chemotherapy, other patients needed combined approaches (chemotherapy + surgery). Three patients with recurrent course continue treatment, two patients died of progression. Of the 6 patients with late relapses of high-risk GTN, 4 (66%) patients were managed mainly through combined treatment (surgery + chemotherapy) and were cured. One patient continues treatment for more than 4 years, and one patient died of progression. In total, out of 17 patients with high-risk relapses, complete remission was achieved in 10 (59%) as a result of combined treatment in the majority of cases (80%). Conclusion. The optimal method of treatment for patients with relapses of low-risk GTN is chemotherapy; and for high-risk GTN combined approaches (chemotherapy + surgery)

The research is devoted to the study of the contrasting properties of new iodinated oil drug Linoyodol (100% solution) by in vitro (monitoring: well-known contracter Omnipak and saline) and in vivo under intraarterial injection of 0.1-1.0 ml to a. femoralis of rats with a intramuscular tumor (n = 18) with the aid of X-ray and СT. In vitro contrasting was shown to be less intensive, than in Omnipak, and in vivo is manifested in a lethal dose of 1.0 ml of highly viscid solution. The conclusion was drawn concerning low contrasting of Linoyodol in vitro with the limitation of its administration of the viscid solution to rats into artery of rather small size. The last demands the use of larger laboratory animals with an artery of sufficient size and decrease of the viscosity of the injection solution.

Summary In a non-domized study the treatment results of 59 patients with disseminated seminoma were evaluated: 21 patients were treated with a VAB-6 combination and 38 with a CP (cyclophosphamide and cisplatin) combination. After VAB-6 CR was observed in 8 patients and 6 achieved CR with additional treatment: 1 with chemotherapy (PVB) and 5 with radiotherapy (RT). The final CR rate was 67%. At a median follow-up of 38 (11-70) months 15 (71%) are alive, and 11 of them (52%) are NED; 6 have died. Of the 38 patients treated with CP alone only 18 achieved CR and 9 had a CR after additional RT and 1 chemotherapy (VAB-6), the overall CR rate was 72%. The median follow-up is 24 (4-55) months, 28 (74%) are alive, 24 (66%) are currently NED, and 9 have died. Both regimens were well tolerated, the main toxicity being leukopenia: 48% (WHO grade 111-1V-5%) for VAB-6, and 59% (13%) for CP. Hearing loss was registered in 8 patients receiving CP and in 2 receiving VAB-6. There were no fatal toxicities. Thus, VAB-6 and CP regimens seem to have compatible and high activity in disseminated seminoma.

To determine the maximum tolerated dose (MTD), and therapeutic efficacy of carboplatin (CBDCA) in combination with etoposide and bleomycin (CEB) as initial chemotherapy for poor prognosis germ cell tumors, a CBDCA dose escalation supported with GM-CSF had been performed. Twenty four untreated patients were treated with CBDCA 400 mg/m2 on day 1, etoposide 100 mg/m2 on days 1 to 5 and bleomycin 30 mg on days 1, 3, 5. Four cycles were scheduled at 21-day interval. The first cohort of 6 patients received only initial chemotherapy regimen. In the subsequent cohorts of six patients, the CBDCA dose was increased by 100 mg/m2. A fixed dose and schedule of GM-CSF at 5 micrograms/kg subcutaneously was given on days 6 through 15. Myelosuppression, with neutropenic fever and hemorrhages, was the dose-limiting toxicity at the 600 mg/m2 dose level. The recommended dose of CBDCA is 500 mg/m2. Overall complete response (CR) rate was 71% and with median follow up of 25 (16-34) months, 58% of patients are alive and have no evidence of disease (NED). A higher number of CR was achieved with CBDCA dose higher than 400 mg/m2 compared with CBDCA dose of 400 mg/m2 (92 vs. 50%, p = 0.03), as well as a higher proportion of patients who are alive and with NED (75 vs. 42%, p = 0.1). Despite GM-CSF support, the MTD of CBDCA could not be increased beyond 500 mg/m2 (50% of the dose escalation), due to severe myelosuppression. The treatment outcomes obtained with CEB in our study are no better than the standard cisplatin-based chemotherapy. Further studies of this regimen, where CBDCA dose should be calculated according to the patients glomerular filtration rate are warranted.

Summary Background In an attempt to reduce the toxicity of chemotherapy in good-risk testicular cancer patients the two drug combinations, cisplatin plus etoposide (EP) and carboplatin plus etoposide (EC), have been compared. Methods Good risk was defined according to the MSKCC and IU criteria. 39 Patients have been treated with EP (cisplatin 20 mg/m2 i.v. and etoposide 100 mg/m2 i.v. on days 1 to 5), and 23 patients received EC (carboplatin 350 mg/m2 on day 1 and etoposide 100 mg/m2 on days 1 to 5). Four cycles of chemotherapy were given at 21- and 28-day intervals, respectively, with delays of up to 7 days in istances of leukocyte counts less than 3.0 × 109/l or platelet counts less than 100 × 109/l. Results In the EP group 34 (87%) of 39 patients achieved CR (26 with chemotherapy alone, 8 with additional surgery). After a median follow-up of 26 (12–58) months 3 (9%) patients relapsed from CR. Currently 38 patients are alive, and 37 (94%) are NED. In the EC group 20 (87%) of 23 patients achieved CR (15 with chemotherapy alone and 5 with additional surgery). After a median follow-up of 45 (26–57) months 6 (30%) patients relapsed from CR. Currently 19 patients are alive and 17 (74%) are NED. There was no difference in survival between the two groups (p = 0.13), but in the EC group the relapse rate was higher (p = 0.052) and the proportion of patients with NED was lower (p = 0.03) in comparison with EP. Toxicity in both groups was mild and similar, but 3 EP-treated patients presented hair loss. Conclusions The study suggests that carboplatin-etoposide combination therapy is inferior to cisplatin-etoposide in patients with good-risk germ cell tumors.

The radiographic computerized tomography (CT) has been performed in 115 patients aged 34-63 treated in the clinic in 1980-1985 for determination of local spread of bladder cancer. CT results were compared in all cases with pathohistological findings. A number of criteria have been elaborated to define the gradations of the degree of local spread for urinary bladder cancer. The reliability of the criteria has been defined. The sensitivity of radiographic CT in defining the stage of cancer invasion at T1, T2, T3, T4 was respectively, 73, 68.2, 84.6, 97.7%. The radiographic CT is a highly informative noninvasive technique with no contraindications in the diagnosis of the degree of urinary bladder cancer local invasion.

The authors present the results of preoperative diagnosis of metastases to the liver and retroperitoneal lymph nodes in colon cancer patients using computerized tomography (CT). Comparing CT and liver scanning the first method proved to be four times more effective. False positive and false negative results in CT were obtained in 11%, in liver scanning in 25.7%. CT made it possible to specify not only the dissemination of a tumor process but also to detect some concomitant diseases. CT can be used for a dynamic control over the efficacy of the treatment of cancer patients.

The proton beam of the 157 MeV synchrotron of the Institute of Theoretical and Experimental Physics was modified for irradiation of prostatic cancer patients. Patient's topometric preparation and method of transperineal irradiation were described. A method of radiotherapy with proton beam boost was applied to 17 patients with different clinical stages of disease. After 6-20 months of the follow-up all the patients have been alive without clinical signs of tumor. In most of the patients radiation reactions of the critical organs were regarded as mild ones. Chronic and long-term radiation injuries were not detected in the patients who lived over 1 year.