Efficiency of radiotherapy during local hyperthermia in the treatment of laryngeal and laryngopharyngeal cancer

Cancer of the larynx and laryngopharynx, which is accessible to visual and instrumental examination, remains the most relevant and complicated problem among head and neck malignances as before. Investigations show that the incidence of cancer at these sites in Russia in the last decade has risen from 4.5 to 9.67 %. This is a severe and poor prognostic form of cancer, which is characterized by its nonspecific early clinical manifestations, complex anatomic and topographic structure, and a high rate of regional metastases. The mainstay of treatment for head and neck cancer involves 3 components: surgery, chemotherapy, and radiotherapy (RT), which are performed alone or in combination. The most commonly used technique is combined, frequently crippling due to organ-removing operations. The clinical introduction of current radio modifiers, local and deep hyperthermia systems, is a promising approach to improving the results of treatment, to enhancing the radiation damage of RT, and to achieving the tumor regression sufficient for surgical intervention without augmenting the early and late toxicity inherent in chemoradiation treatment. The results of the performed study of 35 patients with T2–3N0–2M0 laryngeal and laryngopharyngeal cancer proved the high efficiency of local hyperthermia in treating malignancies in this region during both preoperative (grades III– IV therapeutic pathomorphism) and radical beam RT

ЭПИДЕМИОЛОГИЯ КОЛОРЕКТАЛЬНОГО РАКА В ТОМСКОЙ ОБЛАСТИ

Background. Colorectal cancer is the third most common cancer worldwide. The tendency towards increased incidence of colorectal cancer in Tomsk region correlates with World and Russian tendencies. The purpose of the study was to analyze the incidence rate of colorectal cancer in Tomsk region. Material and methods. The study was based on cancer register data collected at the Cancer Research Institute and Regional Cancer Center (Tomsk) and covered the period 2005 по 2015. Demographic data were obtained from local authorities and government statistics. Results. In Tomsk region, colorectal cancer is the second most common cancer. During the study period (2005–15), the incidence rate of colorectal cancer increased by 39.9 %. The highest incidence rates were observed in patients aged 55 years and older. The median age of patients diagnosed with colorectal cancer in 2015 was 56.3 years. The female and male median age showed a decreasing tendency. In 2015, the colorectal cancer incidence rate in both females and males was the highest among the territories included into the Siberian Federal Region, being 30.9 per 100,000. The rate then stabilized in females, but tended to increase in males. The cumulative risk of developing cancer among the population of Tomsk region had increased, being 7.9 in 2015 compared to 6.5 % in 2005. The cumulative risk of developing cancer was higher in males than in females (10.1 % versus 6.9 %). A specialized care to patients with colorectal cancer over a 10-year period has improved, however one-year mortality rate remains high. The study has shown that screening programs based on the detection of occult blood in the stool are not specific enough. Colonoscopy using high-resolution endoscopy and narrow beam imaging (NBI) are recommended to use as a screening method for the detection of precancerous diseases of the colon.Введение. Колоректальный рак (КРР) является одним из самых распространенных злокачественных новообразований. В России наблюдается рост заболеваемости при неудовлетворительной ранней диагностике. Актуальна проблема колоректального рака и для Томской области, входящей в состав Сибирского федерального округа. Цель исследования – оценить эпидемиологическую ситуацию по колоректальному раку в Томской области, предложить мероприятия по ее улучшению. Материал и методы. Показатели заболеваемости и состояния онкологической помощи рассчитывались за период с 2005 по 2015 г. с использованием официально-отчетной документации областного онкологического диспансера, данных государственной статистики о годовой численности населения и программы «ОНКОСТАТ». Проанализированы результаты обследования 170 пациентов неорганизованного населения, направленных на видеоколоноскопию за 2013–2016 гг. Результаты. В течение исследуемого периода число больных колоректальным раком в Томской области увеличилось на 39,9 %. В структуре заболеваемости злокачественными новообразованиями населения области (без учета рака кожи) колоректальный рак занимает второе место. Наибольшие показатели заболеваемости регистрируются в возрасте старше 55 лет. Средний возраст заболевших в 2015 г. составил 56,3 года. Различие среднего возраста между заболевшими мужчинами и женщинами – 2,6 года. В динамике наблюдается уменьшение среднего возраста заболевших как у мужчин, так и у женщин. В 2015 г. Заболеваемость колоректальным раком (оба пола 30,9 на 100 тыс. населения) была одной из самых высоких среди административных территорий, входящих в состав Сибирского федерального округа. В течение времени показатель варьировался с тенденцией к росту у мужчин и стабилизацией у женщин. Кумулятивный риск развития КРР у жителей области составил 7,9 %, этот показатель увеличился по сравнению с 2005 г. (6,5 %). У мужчин (10,1 %) он выше, чем у женщин (6,9 %). Показатели специализированной помощи больным колоректальным раком за 10-летний период улучшились. Но осталась низкой выявляемость заболевания на профилактических осмотрах, запущенность снизилась незначительно, высока одногодичная летальность, менее половины заболевших находятся на учете 5 лет и более. Исследование показало, что скрининговые программы, основанные на определении скрытой крови в кале, недостаточно специфичны. Предлагается использовать как метод скрининга для выявления предопухолевых заболеваний толстой кишки колоноскопию с применением видеоэндоскопов высокого разрешения и узкоспектральной эндоскопии (NBI)

EPIDEMIOLOGY OF COLORECTAL CANCER IN TOMSK REGION

Background. Colorectal cancer is the third most common cancer worldwide. The tendency towards increased incidence of colorectal cancer in Tomsk region correlates with World and Russian tendencies. The purpose of the study was to analyze the incidence rate of colorectal cancer in Tomsk region. Material and methods. The study was based on cancer register data collected at the Cancer Research Institute and Regional Cancer Center (Tomsk) and covered the period 2005 по 2015. Demographic data were obtained from local authorities and government statistics. Results. In Tomsk region, colorectal cancer is the second most common cancer. During the study period (2005–15), the incidence rate of colorectal cancer increased by 39.9 %. The highest incidence rates were observed in patients aged 55 years and older. The median age of patients diagnosed with colorectal cancer in 2015 was 56.3 years. The female and male median age showed a decreasing tendency. In 2015, the colorectal cancer incidence rate in both females and males was the highest among the territories included into the Siberian Federal Region, being 30.9 per 100,000. The rate then stabilized in females, but tended to increase in males. The cumulative risk of developing cancer among the population of Tomsk region had increased, being 7.9 in 2015 compared to 6.5 % in 2005. The cumulative risk of developing cancer was higher in males than in females (10.1 % versus 6.9 %). A specialized care to patients with colorectal cancer over a 10-year period has improved, however one-year mortality rate remains high. The study has shown that screening programs based on the detection of occult blood in the stool are not specific enough. Colonoscopy using high-resolution endoscopy and narrow beam imaging (NBI) are recommended to use as a screening method for the detection of precancerous diseases of the colon

MEDICAL CARE FOR BREAST CANCER PATIENTS IN THE AMUR REGION FOR THE PERIOD 1999–2014

The purpose of the study was to estimate the medical care for cancer patients in the Amur region from 1999 to 2014. Material and methods. The study was based on cancer register data collected at the Oncology Dispensary of Amur region and covered the period 1999 to 2014. Results. Breast cancer is the most common cancer in women of the Amur region, accounting for 20.8 % of all cancer cases. In 2013, the breast cancer incidence rate was 52.8 per 100,000. The incidence rate for breast cancer increased by 36.4 % from 2003 to 2013, the overall rise being 2.2 %. The mortality rate decreased from 20.3 % in 2003 to 17.3 % in 2014. Cancer care in rural areas of the Amur region is worse than in Blagoveshchensk, which is the regional administrative center. The one-year mortality rate in rural areas is 1.3 times higher than that in the city. The one-year mortality rate is 1.3 times higher in rural areas than in the city, and is 1.2 times higher in the Amur region than in the Russian Federation. Conclusion. Appropriate treatment and prevention measures are recommended for further improvement of medical care for breast cancer patients in the Amur region

COMBINED MODALITY TREATMENT INCLUDING LOCAL HYPERTHERMIA IN PATIENTS WITH LOCALLY-ADVANCED LARYNGEAL AND LARYNGOPHARYNGEAL CANCER

The paper presents two-year results of combined modality treatment of patients with stage III–IV (T3N0–1M0) locally advanced laryngeal and laryngopharyngeal cancer. In the first phase of the treatment, all 24 patients included into the study, received preoperative RT with local hyperthermia. Preventive tracheostoma was not an obstacle for the treatment. Patients who achieved partial response or stable disease underwent surgery. In case of complete tumor regression (n=5), radiotherapy was continued up to the total dose of 66 Gy. Histological examination of surgical specimens revealed complete pathological response in all patients who received combined modality treatment. Regional metastases were revealed in 2 patients, and they subsequently underwent lymph node dissection. The overall 2-year survival rate was 100 % and 2-year metastasis-free survival was 91.7 %