POSSIBILITIES OF USING RADIODIAGNOSTIC METHODS IN THE STAGING OF URINARY BLADDER CANCER AND IN THE DETERMINATION OF ITS TREATMENT POLICY

The urgency of the study was determined by the unsolved problems in the radiation evaluation of the local extent (stage) of a tumor and related surgical treatment policy. The results of a preoperative complex radiation study of 217 patients with urinary bladder cancer, including 134 men and 83 women, are presented. Based on the data of comprehensive preoperative examination, the authors define clear criteria for choosing a surgical treatment. A functional procedure for ultrasonography in varying urinary bladder filling is proposed to evaluate the degree of tumor invasion

«У радиофармпрепаратов в отечественной медицинской практике большое будущее»

.В последние несколько лет российская ядерная медицина существенно шагнула вперед. Сегодня ряд крупных российских медицинских центров, уходя от зависимости от иностранных поставщиков, активно занимается разработкой, синтезом и внедрением в повседневную клиническую практику радиофармацевтических препаратов, что позволяет добиваться успеха в комбинированном и комплексном лечении самых сложных больных с онкопатологией и значительно улучшать качество жизни пациентов. Одним из ведущих медицинских учреждений в Российской Федерации в области диагностики и лечения онкологических заболеваний является ФГБУ  «Национальный медицинский исследовательский центр радиологии» Минздрава России, руководит которым академик Российской академии наук, член Президиума РАН, главный внештатный специалист-онколог Минздрава России, практикующий хирург, человек, хорошо известный не только в отечественной медицине, но и далеко за пределами России, Андрей Дмитриевич КАПРИН

Fluorescence Diagnostics of Colon Malignant and Premalignant Lesions Using 5-Aminolevulinic Acid

Improvement of colon cancer diagnosis is a very important medical problem. Methods of fluorescence diagnosis (FD) with 5-aminolevulinic acid (5-ALA) have been used in detection of early cancer on the surface of mucosa. The objective of the study was to estimate the effectiveness of FD with 5-ALA in the detection of malignant lesions in the colon. From 2008 to 2010 full examinations have been performed in 78 patients suffering from colon polyps. For the study we used drug Alasens based on 5-ALA. Fluorescence colonoscopy with Alasens was made using the visual assessment of fluorescence images in combination with local fluorescence spectroscopy. The results of FD were compared with those of final histopathological study. The application of the method during colonoscopy allows specifying diagnosis, identifying areas of colon tumors transformation, and also showing a place for targeted biopsy. Sensitivity and specificity of FD with Alasens were 94.9% and 62.5%, respectively. The application of local fluorescence spectroscopy as a step of the combined approach allows increasing the specificity of fluorescence colonoscopy from 62.5% up to 93.7%

Фотодинамическая терапия больной с впч–ассоциированной lsil шейки матки (клиническое наблюдение)

The article describes a clinical example of timely, safe and effective photodynamic therapy (PDT) in a patient diagnosed with human papillomavirus (HPV) CIN I-associated cervical cancer after ineffective vaccination with 4-valent Gardasil vaccine. Clinical case demonstrates the low effectiveness of HPV vaccination in patients with established HPV infection. In this patient, the lack of adequate treatment for about 1.5 years led to the development of HPV associated CIN I of the cervix. Center for Laser and Photodynamic Diagnostics and Therapy of Tumors and MRI P.A. Herzen, the patient underwent a course of antiviral PDT with the achievement of complete regression of dysplasia and complete eradication of HPV viruses. The patient tolerated the treatment well, without complications. The period of relapse-free follow-up is 19 months.В статье описывается клинический пример проведения своевременной, безопасной и эффективной фотодинамической терапии (ФДТ) у пациентки с диагнозом ассоциированной с вирусом папилломы человека (ВПЧ) СIN I шейки матки после неэффективной вакцинации 4-валентной вакциной гардасил. Клиническое наблюдение демонстрирует низкую эффективность вакцинации против ВПЧ больных с установленной ВПЧ инфекцией. У данной пациентки отсутствие адекватного лечения на протяжении около 1,5 лет привело к развитию ВПЧ ассоциированной CIN I шейки матки. В Центре лазерной и фотодинамической диагностики и терапии опухолей и МР МНИОИ им. П.А. Герцена пациентке проведен курс противовирусной ФДТ с достижением полной регрессии дисплазии и полной эрадикации вирусов ВПЧ. Лечение пациентка перенесла хорошо, без осложнений. Срок безрецидивного наблюдения – 19 мес

ВОЗМОЖНОСТИ ПРИМЕНЕНИЯ МЕТОДОВ ЛУЧЕВОЙ ДИАГНОСТИКИ В СТАДИРОВАНИИ И ОПРЕДЕЛЕНИИ ТАКТИКИ ЛЕЧЕНИЯ РАКА МОЧЕВОГО ПУЗЫРЯ

The urgency of the study was determined by the unsolved problems in the radiation evaluation of the local extent (stage) of a tumor and related surgical treatment policy. The results of a preoperative complex radiation study of 217 patients with urinary bladder cancer, including 134 men and 83 women, are presented. Based on the data of comprehensive preoperative examination, the authors define clear criteria for choosing a surgical treatment. A functional procedure for ultrasonography in varying urinary bladder filling is proposed to evaluate the degree of tumor invasion.The urgency of the study was determined by the unsolved problems in the radiation evaluation of the local extent (stage) of a tumor and related surgical treatment policy. The results of a preoperative complex radiation study of 217 patients with urinary bladder cancer, including 134 men and 83 women, are presented. Based on the data of comprehensive preoperative examination, the authors define clear criteria for choosing a surgical treatment. A functional procedure for ultrasonography in varying urinary bladder filling is proposed to evaluate the degree of tumor invasion

OFFICIAL MEDICATIONS FOR ANTI-TUMOR GENE THERAPY

This is a review of modern literature data of official medications for anti-tumor gene therapy as well as of medications that finished clinical trials.The article discusses the concept of gene therapy, the statistical analysis results of initiated clinical trials of gene products, the most actively developing directions of anticancer gene therapy, and the characteristics of anti-tumor gene medications.Various delivery systems for gene material are being examined, including viruses that are defective in  replication (Gendicine™ and Advexin) and oncolytic (tumor specific conditionally replicating) viruses (Oncorine™, ONYX-015, Imlygic®).By now three preparations for intra-tumor injection have been introduced into oncology clinical practice: two of them – Gendicine™ and Oncorine™ have been registered in China, and one of them – Imlygic® has been registered in the USA. Gendicine™ and Oncorine™ are based on the wild type p53 gene and are designed for treatment of patients with head and neck malignancies. Replicating adenovirus is the delivery system in Gendicine™, whereas oncolytic adenovirus is the vector for gene material in Oncorine™. Imlygic® is based on the  recombinant replicating HSV1 virus with an introduced GM–CSF gene and is designed for treatment of  melanoma patients. These medications are well tolerated and do not cause any serious adverse events. Gendicine™ and Oncorine™ are not effective in monotherapy but demonstrate pronounced synergism with chemoand radiation therapy. Imlygic® has just started the post marketing trials

ФЛУОРЕСЦЕНТНАЯ ДИАГНОСТИКА ПРИ РЕЦИДИВЕ РАКА МОЧЕВОГО ПУЗЫРЯ

The clinical case of successful use of local fluorescence spectroscopy combined with fluorescence imaging during cystoscopy for diagnosis of recurrent bladder cancer is represented in the article. Histological study of fluorescent foci confirmed tumor growth (urothelial carcinoma) in all areas with high levels of diagnostic parameter. In the fluorescent focus with low diagnostic parameter inflammation was detected.В статье описано клиническое наблюдение успешного применения локальной флуоресцентной спектроскопии в комбинации с методикой флуоресцентной визуализации с препаратом на основе 5-аминолевулиновой кислоты при цистоскопии в диагностике рецидива рака мочевого пузыря. Результаты гистологического исследования флуоресцирующих очагов подтвердили наличие опухолевого процесса (уротелиальная карцинома G1) во всех очагах с высокими значениями диагностического параметра. Во флуоресцирующем очаге с низкими значениями диагностического параметра выявлен очаг воспаления

PREVENTION OF ONCOLOGICAL DISEASES AS THE BASIS OF INTERACTION OF ONCOLOGICAL SERVICE WITH PRIMARY LINK OF HEALTH CARE

Malignant neoplasms (MN) are the second cause of death for the population of Russia, resulted in 15.5% of all deaths in 2015. Their share in the structure of the male population mortality rate was 16.4%, female — 14.4%. Among both sexes, deaths of working age, the proportion of deaths from MN was 16.0%, among women of reproductive age — 16.3%. More than half of the working age population of deaths in Russia falls on the disease from the group of preventable death, and a third — to preventable causes, depending on the primary and secondary prevention, quality of care, along with a high prevalence of behavioral risk factors (RF), demographic characteristics, marked medical and social reasons for the high mortality rate of the MN: late uptake of the population for health care, lack of alertness in oncology healthcare professionals, patients defects in routing.The leading factor in increasing life expectancy is prevention. Today, prevention is regarded as active method of strengthening and preservation of health, and the currently existing approaches in promoting healthy life mostly only directed at the prevention of behavioral risk factors: tobacco use, poor diet, physical inactivity and harmful use of alcohol. Experts estimate the impact on them will prevent, at least 40% of the cases of MN.In Russia we have a 3-step system of health care. In general preventive health orientation is implemented on the 1st level: in the provision of primary health care. In this regard, particular attention should be paid to the implementation of measures for specific clinical examination of the adult population, which plays an important role in the early detection of both the disease and the risk factors for their development. Properly organized conduct of the clinical examination can provide a substantial, up to 30%, the contribution to the reduction of total mortality, including mortality from MN. The necessity of increasing the role of the oncology service in the organizational and methodological support of the preventive measures implemented by primary health care is performed

Ductal prostate cancer

Prostate cancer (PC) preserves its leading position among male tumors. Ductal carcinoma is the second common type of prostate adenocarcinoma. The paper describes different types of ductal carcinoma, which have their morphological pattern. Ductal adenocarcinoma is a relatively rare morphological type of prostate adenocarcinoma traditionally regarded as a more aggressive type of PC, which is represented by the common forms with high Gleason scores (9, 10) and no well-defined treatment regimen. This paper describes 3 cases of ductal PC diagnosed at our center