Vol 25, No 3 (2020)

The aim of the study is to estimate the potentiality of using immunocytochemical and molecular genetic techniques in diagnosis of patients with pleural effusion. Materials and methods. The results of a cytological study of 580 patients with pleural effusion examined in the Altai Regional Oncological Dispensary in 2019 were evaluated. Immunocytochemical and molecular genetic techniques were applied using cytological specimens prepared from pleural fluid. Epidermal growth factor receptor (EGFR) gene status was determined. Results. Non-tumor pleural effusion was diagnosed in 378 cases (65%). Tumorous cells of 181 (31%) patients were found in pleural effusion. It was very difficult to diagnose a pathological process by cell composition in 21 (4%) cases because of the inability to distinguish histiocytes and mesothelial cells from tumor cells using light microscopy. Immunocytochemical researches of 105 patients with pleural effusion were used for specification of metastases and in uncertain diagnostic cases. EGFR gene mutation for the diagnosed pulmonary adenocarcinoma had been determined in 31 cases for proper assignment of the target medicines. Dotty L858R mutation and deletions 19 exon were detected. Conclusions: Light microscopy allowed us to differentiate tumor and non-tumor plural effusion in 96% of cases. Immunocytochemical technique revealed the primary tumor site in 95% of cases of pleural effusions. Cytological specimens are full-advantaged material for molecular genetic technique. Mutations were found in 19% of cases.

Aim. This study reported clinical results of patients with locally advanced cervical cancer who were treated with conformal radiotherapy and three-dimensional (3D) image-guided adapted brachytherapy and combinations of cytotoxic drugs.

Material and methods. This study included 190 patients with cervical cancer stages IIb, IIIb, and IVb (metastases in para-aortic lymph nodes) during 2011–2015 treated with definitive conformal radiation or chemoradiotherapy, with total dose for D95 50 Gy for 25 fractions. 3D brachytherapy high dose rate planning and dose reporting followed the GEC-ESTRO recommendations. Prescribing dose per fraction for HR-CTV D90 was 7.5 Gy weekly 4 fractions. Total dose HR-CTV D90 40 Gy (EQD2). Average total dose for HR-CTV D90 from the course of radiation therapy was 95.0 ± 0.67 Gy (EQD2).

Following four groups of patient were evaluated: group 1 – radiation therapy (n = 72), group 2 – chemoradiation therapy with cisplatin (n = 40), group 3 – chemoradiation therapy with a combination of irinotecan + cisplatin, two courses of adjuvant chemotherapy (n = 39), group 4 – chemoradiation therapy with a combination of paclitaxel + cisplatin, two courses of adjuvant chemotherapy (n = 39). Clinical outcomes including local control (LC), cancer-specific survival (CSS), overall survival (OS), and toxicity were analyzed.

Results. Three-year OS and CSS in all these groups were as follows: group 1 – 88.4% ± 4.5% and 64.4% ± 7.3%, respectively; group 2 – 77.7% ± 7.6% and 77.5% ± 7.1%, respectively; group 3 – 69.8% ± 9.6% and 66.3% ± 8.9%, respectively; group 4 – 81.3% ± 6.4% and 62.1% ± 8.0%, respectively (p > 0.05). The use of chemoradiotherapy in the groups did not increase the 3-year OS in cervical cancer stage IIIb: in group 1 – 84.0% ± 7.5%, group 2 – 76.2% ± 9.4%; group 3 – 77.2% ± 9.1%, and group 4 – 84.9% ± 7.0% (p > 0.05). However, CSS was higher on the first year of observation in group 3 – 96.3% ± 3.6% compared with group 1 – 74.2% ± 7.5% (p = 0.049), with a 3-year observation – 75.7% ± 9.6% and 59.0% ± 11.4%, respectively (p = 0.31). Combined chemoradiation therapy in patients with cervical cancer increases the time of progression from 9.5 months (in groups 1 and 2) up to 19.4 months and 16.4 months (in groups 3 and 4), respectively (p = 0.05). A decrease in the number of local relapses during 3 years was obtained in groups 2 and 4 compared with group 1 (100% vs. 90.3%, p = 0.05). LC within 3 years among 190 patients was 94.7% ± 1.6%. Gastrointestinal early toxicity was noted higher in group 3 compared to groups 1, 2, and 4 (recites G2–3 – 25.7% vs. 5.6%, 5.0%, and 2.6%, respectively, p = 0.05). Late cystitis G2–3 is higher in groups 2, 3, 4 compared with group 1 (15.4% vs. 4.2%, p = 0.07).

Conclusion. The study showed high efficiency of treatment of patients with cervical cancer with the introduction in the clinic of modern technologies in radiation therapy with 3D visualization, as well as chemoradiotherapy programs with acceptable toxicity.

The article deals with the epidemiology of prostate cancer in the Altai region in the last 26 years. The incidence of prostate cancer in the Altai Krai from 1994 to 2019 had increased almost 4.7 times. More than 10.7% of men diagnosed with prostate cancer were of working age. Stable from year to year increases the 5-year survival of men after treatment of prostate cancer. Morphological verification, identifying at an early stage has increased significantly over the years.