ВTo maintain the normal status of the osseous system in cancer patients is an important task of practical oncology as the complications associated with skeletal pathology substantially worsen quality of life in the patients, increase the cost of treatment, and can affect their lifespan. Osseous complications must be prevented not only in patients with skeletal metastatic lesion, but also in healthy individuals cured from cancer, who may have a significant reduction in bone density (osteoporosis) as a complication due to antitumor therapy. Along with bisphosphonates that are well-known and traditionally used in this situation, there have today been target drugs (denosumab) that can be effective in monitoring the osseous system and preventing the complications of osteoporosis and skeletal metastatic lesion.

The practical introduction of new effective drugs for the prevention and treatment of nausea and vomiting is one of the important constitu- ents of maintenance therapy in cancer patients, which helps maintain a good quality of life during drug treatment. This paper considers the main mechanisms of occurrence of nausea and vomiting and current recommendations for their prevention and gives the results of the authors’ studies evaluating the use of ganaton, a D2-receptor antagonist, alone and in combination with 5-HT3-receptor antagonists for the prevention and treatment of acute and delayed nausea and vomiting. The drug has shown a high efficacy and it is recommended for clinical application.

Objective: to study the urinary levels of estrogen metabolites as a diagnostic criterion in patients with cancer of the cervix uteri (CCU) associated with human papillomavirus (HPV) infection to provide a rationale for the use of pathogenetic therapy in the combination treatment of CCU.
Subjects and methods. The study enrolled 26 patients with Stages I-IV CCU who were treated at the Department of Gynecology, Tomsk Research Institute of Oncology. The patients’ mean age was 45.6±1.3 years (range 24 to 72 years), the patients of reproductive age ac- counted for 50%. Tumor was staged in accordance with the FIGO classification. Genotyping was carried out on 12 oncotropic types, by estimating the viral load by polymerase chain reaction. Urinary estrogen metabolite levels were measured in all patients.
Results. In the female patients, the urinary level of the metabolite 2-OHE1 responsible for normal cell growth was 8.95±2.9 ng/mg, which was significantly below the values in healthy women (19.7±1.2 ng/mg). The level of the metabolite 16

The paper considers the use of poly(ADP-ribose)-polymerase inhibitors in therapy for breast and ovarian cancer. Particular attention is given to drugs, such as olaparib and BSI-201. It is noted that the emergence of drugs of this class, of course, holds great promise for using remedial measures and gives certain hopes for their optimization.

The paper considers the urgent problems of improving a breast cancer (BC) screening program, which are concerned with the motivation to be formed in a female population for actively seeking medical advice and for being regularly examined by specialists. The priorities of specialists’ popularizing work on female orientation in the problem of BC are formulated. The role and place of procedures for doing breast self-examina- tion are described. A screening has been in a large population sample in two Moscow companies.

The analysis of the long-term results of treatment in patients with Stages I-IIa breast cancer in relation to major prognostic factors re- vealed poor morphological factors that greatly influenced the lifespan of female patients, such as tumor invasion along the neural fibers, tumor necrosis, cancer emboli in the lymph gaps and vessels, vascular tumor invasion.

This is the first description of upper rib block occurring as a complication due to surgical and radiation therapy in 64% of 136 patients with verified breast cancer. Procedures for manual diagnosis and treatment of costal block are outlined. The mechanisms responsible for the pathogenesis of costal pathology are considered in the context of protective myofixation of the humeroscapular region and thoracic outlet syndrome.

Taxanes (paclitaxel and docetaxel) are currently considered to be basic cytostatics in the treatment of all breast cancer (BC) stages. The results of conducted and ongoing clinical trials suggest that incorporation of taxanes into adjuvant and neoadjuvant chemotherapy regimens enhances the efficiency of treatment for operable BC and show it necessary to apply an individual approach depending on prognostic and predictive factors.

Objective: to study hormone balance changes caused by various options of neoadjuvant chemotherapy (CT) in patients with breast cancer (BC).
Materials and methods. Data on 200 patients aged 30 to 65 years with primary BC (Stages IIB-IIIA), who had been treated at the Rostov Cancer Research Institute in 2006 to 2009, served as a material for the study. The levels of steroid hormones of the estrogenic, androgenic, and glucocorticoid series were studied before and after neoadjuvant CT.
Results. When neoadjuvant poly-CT (PCT) was performed on automedia, the levels of total estrogens were almost unchanged; the frac- tions of estrone and estriol also remained stable. Only estradiol levels were recorded to show a certain declining tendency.
There were considerable changes in the expression of all steroid hormones during preoperative systemic PCT.
According o the drug therapy option, significant differences were found in the time course of changes in blood cortisol levels.
Conclusion. Neoadjuvant CT on automedia results in diminished estrogenization irrespective of age and the phase of the menstrual cycle.

The paper gives the results of studying the genes of epidermal growth factor receptor (EGFR) and topoisomerase IIα (TOP IIα) in patients with triple-negative breast cancer (BC). It is suggested that the lack of EGFR gene amplification might serve as a factor of good prognosis. TOP IIα gene amplification usually occurs in the tumors responsive to chemotherapy including anthracycline drugs. The altered status of the above genes should be interpreted in the context of aneusomy of chromosomes 7 and 17, on which they are located. No association was found between the pattern of EGFR and TOP IIα gene abnormalities and the basaloid phenotype of BC.

The paper deals with the results of a study assessing the specific data of laser DNA-flow cytofluorometry and the level of mutant p53 in different histogenetic subtypes.

The experience with serial renal scintigraphy demonstrated its high informative value and safety in evaluating the severity of intrarenal urine outflow disorders; however, failure to make an objective assessment of ureteral patency considerably limits its study. The set of studies, which is given in this paper, is devoted to precisely this, highly urgent, problem. The authors describe an original procedure for diagnosing impaired urine outflow along the ureters, which has been used during serial renal scintigraphy, define the visual and digital characteristics of normal and impaired urine outflow in the supravesical segment, and denote the criteria characterizing severe impair- ments of renal urine derivation along the ureters. Risk factors for urine outflow disorders have been identified in patients with cancer of the cervix uteri, who receive various treatment modalities.

The morbidity rates and pathogenetic types of vulvar cancer (VC) and reasons for its advance were studied in the Novgorod Region. The condylomatous type of VC (that has developed in the presence of vulvar intraepithelial neoplasia) was stated in 18% of patients; 48 (75%) had a classical pathogenetic type 2 of VC (caused by significant vulvar dystrophy and lichen sclerosus). The tumor process had an intermediate variant in 9.4% of patients with VC. The reason for untimely diagnosis is that obstetricians and gynecologists have no current knowledge of vulvar carcinogenesis, the standards for the diagnosis and treatment of vulvar dystrophies. Tumor cryodevitalization and the application of a radio-wave knife create optimal conditions for implementing the basic principles of ablastics and antiblastics. Reparative surgery using skin and fascial flaps from the posterior surface of the hip to close the organ-tissue defect resulting from vulvectomy, to reduce the risk for postoperative complications, and to form the appearance of the organ is the method of choice in treating VC.

Ovarian Sertoli-Leydig cell tumors are rare, unusual neoplasms that generally occur in young women. There is currently no unified tactic for managing patients with this pathology. The paper presents a review of literature on clinical and morphological characteristics, prognostic factors, diagnosis, and specific features of treatment in patients with Sertoli-Leydig cell tumors.

Vulvar sarcomas are extremely rare tumors. They account for less than 1

The tolerability and efficiency of peritonectomy in combination with hyperthermic intraperitoneal chemoperfusion were studied in patients with pseudomyxoma peritonei. Data from 10 patients were analyzed. The pattern of complications classified as surgical and chemotherapy- associated ones is presented. The long-term results of treatment are demonstrated.

This article is review of literature on role of surgery in the initial management of advanced stage ovarian cancer, focusing on the definition of optimum surgical cytoreduction, assessment of resectability, estimation of the risk of postoperative complications. Analyze of published scien- tific data suggest that removal of all evidence of macroscopic disease should be the goal of primary or interval cytoreductive surgery.

The N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, has developed and used new polychemotherapy regimens including platinum preparations for the treatment of patients with trophoblastic tumors. A cysplatin + ethoposide or carboplatin + ethoposide (CyE/CaE) combination was used as second-line chemotherapy in methotrexate-resistant locally advanced form (Stages I-II) of the disease. A cysplatin or carboplatin + methotrexate + dactinomycin + vincristine) (CyMDV/CaMDV) regimen was used as first-line therapy in patients with disseminated (Stage III-IV) disease and as second-line therapy in patients with its resistant form (Stages III-IV). The CyE/CaE regimen could cure 21 patients with Stages I-II without surgical intervention. When the CyMDV/CaMDV regimen was used as first-line therapy in 24 patients with Stages III-IV disease, of them 21 (87.5%) patients achieved a complete therapeutic effect, they all have been survivors to the present time. The CyMDV/CaMDV regimen used as second-line chemotherapy in patients with the resistant form turned out to be effective in 5 (83.3%) of 6 cases. The follow-up lasted > 3 years.
The benefit of the developed regimens including platinum preparations is that they are effective, less toxic, require long hospitalization and are technically simpler, which allows them to be used in the outpatient setting of the wide oncological network.

Social rehabilitation in patients who have been treated for malignancies of different sites and stages becomes a particularly urgent problem today and its solution is one of the promising areas of oncology. The important stage of this rehabilitation that seems to us is to maintain or recover their reproductive and sexual function, which becomes possible due to the use of current reproductive technologies in different cancer situations.

Cancer of the cervix uteri. Causes and prevention

Cervical intraepithelial neoplasias (CIN), the stages of development in cancer of the cervix uteri (CCU) during persisting infections caused by human papillomavirus (HPV), are a disease frequently occurring in young women. The carcinogenic process lasts 3-5 to 10-30 years during which timely detection and organ-saving treatment for the lesion are possible. The development of markers for the persis- tence of HPV infection and the transition of a productive to transforming phase of infection (from mild to severe CIN) is a basis for the current approach to screening for CIN and BC and to a patient follow-up. The review paper presents the main areas of studies developing markers that are directly associated with HPV infection (HC2 viral load), virus typing, viral physical status, E6 and E7 mRNA, E2/E6 ratio) and its mediated action on host cells (p16INK4a, hTERT). The pathogenetic effect of HPV early genes and their association with the expression of basic surrogate markers are considered in detail. The majority of the presented markers are being actively put into clinical practice in foreign countries.