MULTIMODAL APPROACH TO THE TREATMENT OF ESOPHAGEAL CANCER

Objective: To study the effectiveness and tolerability of preoperative chemotherapy (CHT) in combination with radical surgery in patients with esophageal squamous cell carcinoma (ESCC) II-III stages Methods: The results of the combined and surgical treatment of 43 patients with ESCC II-III stages are presented. The main group consisted of 22 patients who were assigned two courses of CHT before surgery (gemcitabine/cisplatin), followed by a radical surgery. The control group included 21 patients who received only surgical treatment. Results: Preoperative CHT in one (4.5±4.6%) patient gave a complete regression of the tumor, incomplete regression was in ten (45.5±11.1%) and stabilization is established in nine (40.9±10.9%) patients. The therapy had satisfactory tolerability and low toxicity, most patients observed the restoration of a full enteral nutrition. Postoperative complications in both groups of observations developed in 18.2±8.6% and 23.8±9.5% respectively (p>0.05). Preoperative CHT in the combined treatment of ESCC II-III stages has significantly improved two-year relapse-free and overall survival (80,9±8,7% and 85,7±7,8%) compared to the control group (35.0±10.6% and 55.0±11.1%) (p<0.05). Conclusion: The multimodal approach in the treatment of patients in II-III stages ESCC has pronounced damaging effect on the tumor and allows to significantly increase two-year relapse-free and overall survival rate compared to patients who have undergone only surgical treatment

COMBINED TREATMENT OF PATIENTS WITH NON-SMALL CELL LUNG CANCER WITH PERSONALIZED PRESCRIPTION OF ADJUVANT CHEMOTHERAPY

Objective: To study the long-term results of the combined treatment of non-small cell lung cancer (NSCLC) using pre-surgery chemotherapy, radical surgery and personalized adjuvant chemotherapy based on the level of monoresistance genes. Methods: Four-year results of treatment of 72 patients of NSCLC II-III stage were analyzed. All patients underwent 2 courses of neoadjuvant chemotherapy (vinorelbine/carboplatin) and surgical treatment. Personalized adjuvant chemotherapy based on the levels of expression of monoresistance genes АВСС5, RRM1, TYMS, TOP1, TOP2α, TUBB3, BRCA1, and ERCC1 was performed in the main group (n=35). Three courses of adjuvant chemotherapy (vinorelbine/carboplatin) were performed in the control group (n=37). Results: In the main group the progression of the disease was observed in 14 out of 35, and in the control group – in 21 out of 37 patients. Relapsefree survival (RFS) in the main group was 60.0% (95% CI: 43.6-74.5), in the control group – 43.2% (95% CI: 28.7-59.1); Log-Rank test χ2 =3,071, р=0,080; RR=1,808 (95% CI: 0.918-3.561). The median RFS in the control group was 27 months (95% CI: 5.7-48.3). The overall survival rate in the main group was 77.1% (95% CI: 61.0-87.9), in the control group – 54.1% (95% CI: 38.4-69.0); Log-Rank test χ2 =2,813, p=0.094; RR=2,024 (95% CI: 0,870-4,709). Conclusion: The developed method of personalized prescribing adjuvant chemotherapy to patients with NSCLC based on the molecular genetic characteristics of the tumor improves relapse-free and overall survival