Russian Journal of Oncology

ISSN: 1028-9984 (Print) 2412-9119 (Online)
Russian Journal of Oncology
Rossiiskii Onkologicheskii Zhurnal
Launch Year: 1996
Frequency: 6 issues per year

The journal publishes original articles and reviews that cover current achievements in the fields of clinical and experimental oncology as well as practical aspects of diagnosis and comprehensive treatment of malignant tumors. The journal offers insights into actual experience of cancer centers, discusses the current state of oncology research and practice outside Russia, and facilitates experience exchange. The journal also publishes medical news and material on the implementation of scientific discoveries, the most essential theoretical and practical issues, and the history of oncology.

The journal is aimed at a wide range of medical professionals: oncologists, surgeons, general practitioners, and public health officials focusing on the diagnosis and treatment of cancers.

 

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Current Issue

Vol 25, No 1 (2020)

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Original articles
Ripretinib (DCC-2618): a new tyrosine kinase inhibitor for the treatment of metastatic gastrointestinal stromal tumors
Filonenko D.A., Tikhomirova T.E., Meshcheryakov A.A.
Abstract

Ripretinib (DCC-2618) is a novel tyrosine kinase inhibitor designed to broadly inhibit primary and secondary mutations in KIT (exons 9,11, 13, 14,17,18) and PDGFRA (exon 18). Here in our article we describe clinical trials of ripretinib for patient with advanced gastrointestinal stromal tumors (GIST).

The clinical trial INVICTUS-randomized phase III study of ripretinib for patient with advanced GIST in ≥4 lines therapy; it is the most important results, because there are currently no approved drugs for such patients. Median PFS was significantly improved with ripretinib compared with placebo 6,3 и 1 months (p<0,0001) and median OS was significantly improved with ripretinib compared with placebo 15,1 и 6,6 months (p<0,004).

High efficacy of ripretinib was accompanied with favorable profile of toxicity, only 8,2% patients experienced treatment discontinuations due to adverse events.

Russian Journal of Oncology. 2020;25(1):4-8
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Clinical investigations
Treatment of relapses of gestational trophoblastic neoplasias
Meshcheryakova L.A., Zharova A.S., Maslennikov A.F., Kuznetsov V.V., Chekalova M.A., Komarov I.G., Davydova I.Y., Molchanov G.V., Gigolaeva N.M., Meshcheryakov A.A.
Abstract

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 1–5, 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)

Russian Journal of Oncology. 2020;25(1):9-16
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Survival in patients with malignant neoplasms of pancreatoduododenobiliary zone complicated by obstruction of bile duct
Tseimakh A.Е., Lazarev А.F., Sekerzhinskaya E.L., Bedian N.К., Kurtukov V.А., Teplukhin V.N., Shoykhet Y.N.
Abstract

There were analyzed the survival and mortality of 227 patients with malignant neoplasms of pancreatoduodenobiliary zone complicated by obstruction of bile duct syndrome for the period from 01.01.2014 to 01.05.2018 divided into 4 groups. The first group consisted of 20 patients who underwent radical operative treatment of malignant neoplasms of the pancreatoduodenobiliary zone without the use of minimally invasive biliary decompression as preoperative preparation; the second group included 34 patients who had minimally invasive biliary decompressionas preoperative preparationfor radical surgery; the third group included 121 patients who had palliative operative treatment of malignant neoplasms of the pancreatoduodenobiliary zone without the use of minimally invasive biliary decompression; the fourth group consisted of 54 patients who underwent palliative operations with the use of mini-invasive biliary decompression. After paired comparative analysis of postoperative survival and lethality, it was revealed a statistically significant increase in the average life expectancy and a decrease in postoperative mortality in patients who underwent radical surgery with the use of minimally invasive decompression technologies for bile ducts compared with all the other groups; a statistically significant increase in life expectancy and a reduction in postoperative mortality in patients who underwent palliative surgery with the use of mini-invasive biliary decompression compared to the group of patients who underwent open palliative surgeries. In patients who underwent radical surgical treatment without prior application of minimally invasive procedures for decompression of the biliary tree, there was no statistically significant increase in mean life expectancy and a decrease in postoperative mortality in comparison with the group of patients who underwent palliative operations with the use of mini-invasive bile decompressiontechnologies.

Russian Journal of Oncology. 2020;25(1):17-26
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The influence of plastic techniques in surgery of primary skin melanoma on patient survival
Yargunin S.A., Shoyhet Y.N., Lazarev A.F.
Abstract

Objective. To analyze the feasibility of performing plastic surgery in patients with primary skin melanoma (SM).

Material and methods. We studied patients with primary MK treated in our institution in 2013 (n = 333), who were randomized to a group of 2 blind selection methods to the main one (n = 168), in which the tumor removal operation in patients ended with a tissue defect repair and a comparison group ( n = 165) (after removal of the tumor, simple linear suturing of the wound was performed). A statistically significant difference was found in the comparison groups in the occurrence of negative dynamics (ND), progression-free survival (PFS) and overall survival (OS) in patients with MK 0-IIA st during the follow-up period up to 36 months.

Results. It was found that patients with 0-IIA st who underwent plastic surgery to close the defect when removing primary SM have a statistically proven advantage in ND, PFS, and OS compared with patients without plastic surgery for up to 36 months. In general, the use of plastics has a statistical tendency towards the dynamics of an increase in PFS and OS in the early stages of SM.

Discussion. In the early stages (0-IIA) up to 36 months, cases of negative dynamics (4.2%) were observed 2.3 times less frequently than in the comparison group (9.7%) (p = 0.048), and fatal outcomes in the main group (1.8%) were observed 3.7 times less than in the comparison group (6.7%) (p = 0.028). The analysis also shows that in patients who underwent surgery using plastic surgery statistically significantly reduces the risk of distant metastasis by 3 times (p = 0.05), but significantly more often (in every third patient) (p = 0.022) than in the control group (without plastic surgery) met transient metastases. The appearance of ND, as well as an increase in PFS, OS depended on the plastic replacement of the defect after excision of the primary SM in patients with SM 0-IIA st during the observation period up to 36 months.

Conclusion. The use of plastic methods for closing a wound defect reduces the risk of distant metastasis by 3 times compared with linear suturing, provides a reduction in mortality in patients with SM 0 – IIA st for 60 months, prolongs the patient’s life by an average of 10 months and is the operation of choice in this category.

Russian Journal of Oncology. 2020;25(1):27-36
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A method for reducing lymphorrhea in the postoperative period after axillary lymphadenectomy for metastatic lesion in patients with skin melanoma
Yargunin S.A., Shoyhet Y.N., Lazarev A.F.
Abstract

Objective. Prevention of prolonged lymphorrhea, postoperative lymphocysts in patients with melanoma metastases after axillary lymph node dissection.

Material and methods. Patients with metastases of melanoma in axillary lymph nodes (n = 67) who underwent axillary lymph node dissection were studied. Patients were divided into two groups – comparisons (n = 35), which, after surgical intervention in the armpit, installed an active aspiration system according to Redon and the main (n = 32), patients of which, in addition to the draining system, installed an elastic rubber ball with water, which provided additional pressure on the skin. A significant difference (p<0.001) was established between the main and comparison groups in the number of hospital days spent by patients in the hospital. For a statistical comparison, the Mann-Whitney test was used, the distribution form was checked using the Kolmogorov-Smirnov test. The median and interquartile range (Me [Q25%–Q75%]) were determined as measures of the average tendency and spread.

Results. In the main group, patients with lymphorrhea stopped faster, drainage was removed earlier and the average hospital stay was 3 days shorter than in patients in the comparison group, and lymphocyst formation was not observed in comparison with the comparison group in which this complication was observed 11.4%.

Discussion. The duration of patients’ stay in the hospital directly depended on the date of drainage removal, the time of tissue adhesion and the end of lymphorrhea, the formation of a lymphocyst in the postoperative period, which directly depended on the application of a new technique of additional pressure on the tissues besides vacuum drainage.

Conclusion. the installation of hydraulics immediately after the operation leads to a faster gluing of the separated tissues, a reduction in lymphorrhea, and, accordingly, a shorter use of drainage, early removal and discharge of the patient from the hospital, and prevention of the formation of lymphocytes with the corresponding medical and economic effect. Priority certificate No. 2019109858 dated 04/03/2019 was received for the method used.

Russian Journal of Oncology. 2020;25(1):37-41
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Clinical case
Successful treatment of a chemo-resistant gestational trophoblastic neoplasia using GEMOX. Clinical case
Meshcheryakov A.A., Tikhomirova T.E., Meshcheryakova L.A.
Abstract

Gestational trophoblastic neoplasia is a rare malignancy. The main treatment approach is chemotherapy. Almost all patients can be cured if the diagnosis is established timely and adequate treatment is provided in specialized centers.

In a small part of patients, the tumor progresses despite the use of all standard chemotherapy regimens. Treatment of such patients is difficult for all oncologists, including ones working in specialized centers for the treatment of gestational trophoblastic neoplasia.

This article presents a clinical case of the successful treatment of a patient with multidrug resistant gestational trophoblastic neoplasia using GEMOX regimen.

 

Russian Journal of Oncology. 2020;25(1):42-46
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