ЭПИДЕМИОЛОГИЧЕСКИЕ АСПЕКТЫ ОСНОВНЫХ ЛОКАЛИЗАЦИЙ ГИНЕКОЛОГИЧЕСКОГО РАКА В ТОМСКОЙ ОБЛАСТИ

The purpose of the study was to evaluate the epidemiological aspects of the three major gynecologic cancers (cervical, endometrial and ovarian cancers) in Tomsk region. Material and methods. The data collected by the population-based cancer registry and the territorial body of the Federal State Statistics were analyzed. The epidemiological situation in Tomsk region between 2007 and 2015 was studied. Results. Gynecologic cancer is one of the most common cancers affecting women in Tomsk region. Cervical cancer is the 4-th most frequent cancer in Siberian Federal District. The incidence of gynecologic cancer has been steadily rising over time. Early diagnosis of endometrial and ovarian cancers remains a significant clinical challenge. The one-year mortality rate is still high. We recognize that unlike cervical cancer, screening benefits have not been shown for endometrial and ovarian cancer. To improve the specialized care for gynecological cancer patients, the screening programs in the region were approved.Статья посвящена анализу эпидемиологической ситуации по таким локализациям, как рак шейки матки, рак тела матки, рак яичников, на территории Томской области. Цель работы – изучить эпидемиологическую ситуацию по гинекологическому раку (рак шейки матки, рак тела матки, рак яичников) в Томской области. Материал и методы. Проанализированы данные официальных отчетных форм, базы популяционного областного ракового регистра и территориального органа государственной статистики. Изучена ситуация с 2007 по 2015 г. Результаты. Гинекологический рак занимает одно из лидирующих мест в структуре онкопатологии женского населения области. По заболеваемости раком шейки матки Томская область занимает 4-е место среди территорий Сибирского федерального округа. В динамике наблюдается рост показателей заболеваемости раком шейки и тела матки. Ряд показателей, характеризующих онкологическую помощь при гинекологическом раке, хуже, чем в среднем по региону (ранняя диагностика тела матки и яичника, низкий уровень активной выявляемости рака шейки, тела матки и яичника, высокий показатель одногодичной летальности). Для улучшения специализированной помощи больным гинекологическим раком в онкологическом диспансере утвержден план мероприятий по реализации скрининга рака шейки матки в женской популяции области

ELECTROPHORETIC DEPOSITION OF CeO2-BASED THIN-FILM ELECTROLYTE, MODIFIED SrTiO3, FOR ANODE-SUPPORTED SOFC

The aim of this work was to determine the possibility of creation the dense CeO2-based electrolyte membranes on anode substrates by the electrophoretic deposition. The SDC suspensions were modified by the SrTiO3 addition. The microstructure studies of deposited and sintered films were carried.Исследование выполнено за счет гранта Российского научного фонда № 22-23-00066, https://rscf.ru/project/22-23-00066/

ОСОБЕННОСТИ И ХАРАКТЕРИСТИКА ПОКАЗАТЕЛЕЙ ЗАБОЛЕВАЕМОСТИ РАКОМ ЩИТОВИДНОЙ ЖЕЛЕЗЫ У ЖИТЕЛЕЙ Г. ТОМСКА И ТОМСКОЙ ОБЛАСТИ

The analysis of thyroid cancer incidence and its structure among different populations of Tomsk region is presented. We studied the report documents, the database of the Tomsk regional oncologic dispensary for the period 2008 to 2012. The clinical characteristics of patients with thyroid cancer were summarizes according to sex, age and place of residence. The papillary cancer was the most often diagnosed. It was found that in young patients, thyroid cancer was diagnosed more often in the stage 1 and 2. On the other hand, in elderly patients (above 60 years), thyroid cancer diagnosed at stage 3 and 4. In the Tomsk region, as elsewhere in the world, thyroid cancer is detected more often in women.Представлены результаты анализа заболеваемости раком щитовидной железы среди жителей Томской области, особенности ее структуры среди различных контингентов населения. Были изучены база данных и отчетные документы Томского областного онкологического диспансера за период 2008–2012 гг. Обобщена клиническая характеристика больных раком щитовидной железы в зависимости от пола, возраста и места проживания. В результате анализа установлено, что лидирующее место в морфологической структуре рака щитовидной железы принадлежит папиллярному раку. Выявлено увеличение количества вновь выявленных больных, установлено, что рак щитовидной железы в молодом возрасте чаще диагностируется на ранних стадиях, стадии 3 и 4 при первичной диагностике встречаются преимущественно у лиц старше 60 лет. В Томской области, как и во всем мире, среди больных раком щитовидной железы превалируют женщины

Персонализированная адъювантная химиотерапия немелкоклеточного рака легкого II–III стадий

Surgery is the standard of care for non-small cell lung cancer (NSCLC). The overall survival rates especially in patients with locally advanced lung cancer are low. The resistance of cancer cells to chemotherapeutic drugs reduces the efficacy of treatment. Special attention is paid to the feasibility of assessing the tumor sensitivity to certain chemotherapy drugs. Currently, the most studied predictors are monoresistance and multidrug resistance genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS.The aim of the study was to analyze the outcomes of combined modality treatment using radical surgery and personalized adjuvant chemotherapy for stage II–III NSCLC.Material and Methods. The study included 120 patients with stage II–III NSCLC, who underwent radical lung resection with mediastinal ipsilateral lymph node dissection. The patients were then divided into two groups. The main group consisted of 60 patients who received personalized platinum-based adjuvant chemotherapy based on the expression levels of the genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS. The control group consisted of 60 patients who received postoperative chemotherapy empirically.Results. In the main group, disease progression occurred in 14 out of 60 patients, three-year disease-free survival (DFS) was 76.7 % (the median was not reached). In the control group, DFS was 53.3 % (28 out of 60 patients), the median was 31.0 (4–36 months); the differences were statistically significant: Logrank test χ2 =4.382 p=0.036. The overall three–year survival rate was 90.0 % in the main group (6/60 patients died) and 61.7 % in the control group (23/60 patients died), the differences were statistically signifcant: Logrank test χ2 =6.915, p=0.009.Conclusion. The personalized adjuvant chemotherapy resulted in the improved three-year relapse-free and overall survival rates in NSCLC patients.Основным методом лечения немелкоклеточного рака легкого (НМРЛ) является хирургический, при этом показатели общей выживаемости, особенно при местнораспространенном процессе, низкие. Химиорезистентность опухоли определяет низкую эффективность проводимого адъювантного лекарственного лечения. Особое внимание исследователей привлекает возможность оценки чувствительности опухоли к определенным химиопрепаратам. Наиболее изученными предикторами в настоящее время являются такие гены монорезистентности и множественной лекарственной устойчивости, как АВСС5, RRM1, ERCC1, BRCA1, TOP1, TOP2α, TUBB3 и TYMS. Цель исследования – изучить результаты комбинированного лечения немелкоклеточного рака легкого II–III стадии с использованием радикального хирургического вмешательства и персонализированной адъювантной химиотерапии.Материал и методы. В исследование включены 120 больных с немелкоклеточным раком легкого II–III стадии, которым на первом этапе комбинированного лечения проводилось хирургическое лечение, включающее радикальную резекцию легкого в объеме лоб-, билоб- или пульмонэктомии с медиастинальной ипсилатеральной лимфодиссекцией. Далее больные были распределены на две группы. Основную группу составили 60 пациентов, которым после операции проведены курсы персонализированной адъювантной химиотерапии, назначенной на основании уровней экспрессии генов АВСС5, RRM1, ERCC1, BRCA1, TOP1, TOP2α, TUBB3 и TYMS в виде платиносодержащих дублетов. Контрольную группу составили 60 пациентов, которым послеоперационная химиотерапия назначалась эмпирически.Результаты. В основной группе прогрессирование заболевания зафиксировано у 14 из 60 пациентов, трехлетняя безрецидивная выживаемость (БРВ) – 76,7 % (медиана не достигнута). В группе контроля БРВ составила 53,3 % (28 из 60 пациентов), медиана составила 31,0 мес (от 4 до 36 мес); различия статистически значимы: Logrank test χ2 =4,382 р=0,036. Общая 3-летняя выживаемость в основной группе составила 90,0 % (умерло 6/60 пациентов), в группе контроля – 61,7 % (умерло 23/60 пациентов), различия статистически значимы: Logrank test χ2 =6,915, р=0,009.Заключение. Разработанная программа комбинированного лечения НМРЛ с персонализированным назначением послеоперационной химиотерапии позволяет добиться улучшения показателей 3-летней безрецидивной и общей выживаемости

Lancet

BACKGROUND: In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014. METHODS: CONCORD-3 includes individual records for 37.5 million patients diagnosed with cancer during the 15-year period 2000-14. Data were provided by 322 population-based cancer registries in 71 countries and territories, 47 of which provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate, and melanoma of the skin in adults, and brain tumours, leukaemias, and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated 5-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: For most cancers, 5-year net survival remains among the highest in the world in the USA and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway, and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas, and lung. For women diagnosed during 2010-14, 5-year survival for breast cancer is now 89.5% in Australia and 90.2% in the USA, but international differences remain very wide, with levels as low as 66.1% in India. For gastrointestinal cancers, the highest levels of 5-year survival are seen in southeast Asia: in South Korea for cancers of the stomach (68.9%), colon (71.8%), and rectum (71.1%); in Japan for oesophageal cancer (36.0%); and in Taiwan for liver cancer (27.9%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (59.9% in South Korea, 52.1% in Taiwan, and 49.6% in China), and for both lymphoid malignancies (52.5%, 50.5%, and 38.3%) and myeloid malignancies (45.9%, 33.4%, and 24.8%). For children diagnosed during 2010-14, 5-year survival for acute lymphoblastic leukaemia ranged from 49.8% in Ecuador to 95.2% in Finland. 5-year survival from brain tumours in children is higher than for adults but the global range is very wide (from 28.9% in Brazil to nearly 80% in Sweden and Denmark). INTERPRETATION: The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed worldwide every year. It contributes to the evidence base for global policy on cancer control. Since 2017, the Organisation for Economic Co-operation and Development has used findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries worldwide. Governments must recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer. FUNDING: American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3) : analysis of individual data from 258 cancer registries in 61 countries

Background Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years). Methods We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0–14 years), adolescents (15–19 years), and young adults (20–24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings 164563 young people were included in this analysis: 121328 (73·7%) children, 22963 (14·0%) adolescents, and 20272 (12·3%) young adults. In 2010–14, the most common subtypes were lymphoid leukaemia (28205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010–14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000–14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group.peer-reviewe

Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000–2014 (CONCORD-3)

Background: Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. Methods: We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000–2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. Results: The study included 556,237 adults. In 2010–2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%–38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000–2004 and 2005–2009. These improvements were more noticeable among adults diagnosed aged 40–70 years than among younger adults. Conclusions: To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines