The BCIRG 001 study has shown that a combination of Taxotere, doxorubicin, and cyclophosphomide (TAC regimen) is more effec- tive than the standard FAC (5-fluorouracil, doxorubicin, cyclophosphomide) regimen in adjuvant chemotherapy of operable breast cancer (BC) with mestastases to regional lymph nodes. With higher efficacy, TAC regimen was more toxic: the incidence of febrile neu- tropenia was 24.7%. According to the current EORTC and ASCO guidelines, the use of granulocyte colony-stimulating factors (G-CSF) for primary prophylaxis is indicated when the risk of febrile neutropenia is ≥20%. This study was designed to evaluate the safety of TAC regimen with G-CSF primary prophylaxis in adjuvant chemotherapy (CT) of BC .
Patients with operable BC (T1—3N1M0) and Karnofsky performance status 80% received adjuvant TAC regimen after radical surgery: Taxotere 75 mg/m2, doxorubicin 50 mg/m2, and cyclophosphomide 500 mg/m2. G-CSFs were administered in the standard doses for 5—7 days starting from cycle 1 of CT, for primary prophylaxis of febrile neutropenia.
One hundred and one patients have been treated since 2006. Mean age was 47.5 years (range 25—67 years). Almost half (48.5%) of the patients had Stage IIIa disease, Stages IIa and IIb had 18.8 and 27.7% of patients, respectively.
The tumor was estrogen receptor-positive in 57.4% of the patients and progesterone receptor-positive in 62.4%. Overexpression of Her- 2/neu receptor was documented in 49.5% of cases. The mean number of cycles per patient was 5.8. Ninety-one (90.1%) patients have received a complete course of 6 TAC cycles. The duration of prophylactic use of lenograstim or filgrastim during one CT cycle was 5.9 and 5.6 days, respectively.
Episodes of febrile neutropenia were observed at 19 (3.2%) CT cycles in 9 (8.9%) patients. Neutropenic infections were recorded at 4 (0.78%) cycles in 3 (3%) patients.
Thus, the use of GCSF substantially reduces the incidence of TAC-associated febrile neutropenia and infectious complications and ensures a safe and complete course of effective adjuvant CT for the vast majority (90.1%) of patients. The data presented suggest that there is a need for primary prophylaxis with G-CSF in all BC patients receiving adjuvant TAC.

Advances made in oncogynecology and improvements of surgical, radiation, and drug treatment provided relatively good sur- vival rates in patients with female genital organ lesions. However, this treatment often leads to postcastration syndrome mani- festations in most young women. New rehabilitation modalities for such female patients are important and urgent. It was inves- tigated whether Cimicifuga racemosa extract may be used for alleviation of postcastration syndrome symptoms and the results are encouraging.

The paper presents the results of a follow-up of 861 patients who have undergone organ-saving treatment (OST) for early breast can- cer. The relapse rate was 7.3% (63/861). The main task was to study an association of survival rates with the predictors characteriz- ing a local relapse. Five-year overall survival after the start of treatment for a local relapse was 65.7% (standard error 8.3). A Cox multivariance regression analysis led to the conclusion that the local relapse is a statistically significant factor of worsening survival without distant metastases when it develops within 3 years after primary OST.

The purpose of the study was to define the factors influencing the development of a recurrence depending on the volume of surgical intervention and to investigate the possibility of performing organ-saving surgery (OSS) for centric breast cancer.
The study used the clinical findings of 200 patients treated at the Department of Radiosurgery, N.N. Blokhin Russian Cancer Research Center in 1996 to 2006. According to the volume of surgical intervention, the patients were divided into 2 groups: 1) 106 patients who had undergone radical mastectomy; 2) 94 patients who had undergone radical resection. According to our data, the disease progressed in 32 (16%) cases. There were 12 local recurrences: in 8 (7.5%) and 4 (4.2%) cases after radical mastectomy and radical resection, respec- tively. The findings suggest that OSS may be performed after carefully patient selection, with all contraindications being kept in mind.

Breast cancer (BC) that is the most common malignancy in women presents an indubitable threat to their life and health. The basis for this investigation was magnetic resonance imaging (MRI) data of 203 women with histologically verified malignan- cies. The patients' mean age was 53±10.2 years. The paper describes the magnetic resonance semiotics of BC; the authors have developed criteria for dynamic contrast-enhanced magnetic resonance mammography used in the differential diagnosis of nodules.
Due to high soft-tissue contrast, the use of thin sections, and the possibility of examining in any projection, MRI allows one not only to accurately visualize a pathological mass as compared with X-ray mammography or ultrasound study, but also to characterize its vascularization, which is a major criteria for the differential diagnosis of benign and malignant breast nodules.

Introduction. A diversity of axillary pathologies was a prerequisite for the development of a new differential approach to diagnosing such conditions. There are new technologies (pre- and intraoperative radionuclide studies, molecular genetic techniques), that have shown themselves, along with classical methods (physical examination, mammography, X-ray and ultrasound studies).
Materials and methods. The subject of the analysis is the results of a comprehensive examination of 502 women aged 22 to 84 years. Different groups were comprehensively examined using both X-ray, ultrasound, radionuclide, and molecular genetic (polymerase chain reaction) studies.
Results. The molecular genetic and cytological studies could provide the actual results in 95 and 84% of cases, respectively; but a com- prehensive clinical study and X-ray ultrasound computed tomography could yield them in marginal metastases in only 65.3%.
Conclusion. The authors have proposed the optimal diagnostic algorithm for examination in the ambulatory-outpatient network and specialized institutions.

GENERAL PRINCIPLES OF DRUG TREATMENT FOR PRIMARY OPERABLE AND LOCALLY ADVANCED BREAST CANCER

Intrapleural immunotherapy for metastatic pleurisies demonstrates a high efficiency in the treatment of patients with breast cancer (BC). This immunotherapy modality is regarded as one of the stages of complex treatment in patients with disseminated BC and allows its capabilities to be extended for their further management.

The paper describes a role of the nuclear transcription factor NF-κB in oncogenesis and presents studies of this factor in breast can- cer (BC). It also shows it promising to use the values of the transcription factor NF-κB activity to identify a hormone-resistant sub- group among the patients with receptor-positive BC, in its early stages in particular.

Affine chromatography was used to isolate Lec antibodies from the sera of a healthy female donor with the high titers of these anti- bodies, which were labeled with biotin. The study enrolled 51 patients with primary breast cancer (BC). Antigen expression was found by immunohistochemistry and flow cytometry. With these two techniques being used, the detection rate of Lec expression in BC cells was 65% (33/51); the antigen was most frequently found by flow cytometry as compared with immunohistochemistry: 72 and 58% of cases, respectively.

The diagnostic value of the serum levels of proinflammatory (TNF-α, IL-1β, IL-6, and IFN-γ) and anti-inflammatory (IL-4 and IL-10) cytokines of the immune system was studied in 54 patients with breast cancer (BC). Analysis identified the increased concen- trations of proinflammatory cytokines, such as IL-1β, TNF-α, and IL-6, in the peripheral sera of BC patients.
Analysis of anti-inflammatory cytokines in the peripheral sera of patients with BC also revealed a significant increase in the values of IL-4 and IL-10. The findings suggest that there is imbalance between cellular and humoral immunity factors, the study of which will be an important diagnostic criterion for BC.

The investigation enrolled 31 patients with inflammatory breast cancer (IBC) treated at the N. N. Blokhin Cancer Research Center from 2006 to 2008. IBC is diagnosed on the basis of signs of rapid progression, such as localized or generalized breast induration, red- ness and edema. IBC accounts for less than 5% of all diagnosed breast cancers and is the most lethal form of primary breast cancer. We studied tumor markers of the immunophenotype of IBC and levels and subpopulations of immunocompetent tumor-infiltrating cells. We found that expression of HLA-DR is in negative correlation with MUC-1 expression and lymphoid cells tumor infiltration is asso- ciated with the increase in T-cell subpopulations.

Positron emission tomography (PET) is one of the current techniques of molecular radionuclide imaging, which provides a qualitative and quantitative assessment of biochemical processes occurring in a living organism. The paper contains information on how to per- form 18F-fluorodeoxyglucose PET for whole-body examination. It analyzes factors that influence the accuracy of obtained results, methods for PET image analysis, and reasons for possible diagnostic errors.

More than 500,000 cases of cervix uteri cancer are annually registered in the world. Almost half die within the first year due to its late diagnosis. In this connection, the early diagnosis of cancer is a challenge today.

Researches of the capabilities of radionuclide diagnosis are one of the most important trends in modern medical science and practice, especially in the area of dynamic renal scintigraphy. This technique proved to be safe and highly informative when used in oncogyne- cology to evaluate defects of renal drainage. However, failure to make an objective evaluation of ureteral patency reduces significant- ly the capabilities of the technique in patients after small pelvis surgery and radiotherapy. The study issues presented in this article are devoted to this particular problem. The authors have developed an original procedure for evaluating renal drainage disorders during dynamic renal scintigraphy. The specific visual and digital parameters which characterize both normal and obstructed urine outflow in the supravesical segment are given. Criteria for serious disorders in urine derivation from the kidneys through the ureters are defined. Risk factors for urine outflow disorders are identified in cervical cancer patients who receive various treatments.

Based on the results of preoperative examination in 180 patients, the investigators studied and analyzed the specific features of ultra- sonic images of endometrial cancer in detail. The comprehensive study comprising color Doppler and energy mapping, three-dimen- sional echography with standard and variable-frequency transducers was conducted using the expert-class ultrasound equipment. A close analysis revealed the high informative value of complex ultrasonic tomography in the preoperative staging of cancer of the cor- pus uteri, in its early stages in particular.

Cervical cancer (CC) morbidity is analyzed on the basis of the data of the Karelian cancer register over the period 1998-2007. During this period, 816 cases of CC were registered and 126 were found at an antenatal clinic (AC). Its early detection rate was ascertained to be 96% during screening at the AC. A comprehensive examination was made in 1742 women with various cervical diseases, of them 37.5% were infected with human papillomavirus (HPV). High-grade dysplasia and carcinoma in situ were diagnosed in 6.6% of the HPV-infected patients. Large-scale screening for HPV infection and pretumor disorders with their further treatment will aid in reduc- ing CC morbidity and mortality rates.

The paper presents the results of treatment for locally advanced cervix uteri cancer, by applying a 192Ir radioactive source for contact radiation. Three- and five-year overall and relapse-free survival rates have been obtained for stages: 82.5 and 82.5%; 78.4 and 78.4% for Stage IIb; 57 and 52.3%; 41.6 and 41.6 for IIIb; 53.3 and 47.3%; 42.4 and 37.7% for IVb, respectively.

The appropriate management of early-stage ovarian carcinoma is controversial. The literature has been analyzed to find answers to the following questions: how to make an early diagnosis of ovarian cancer and to minimize the treatment in order to avoid complica- tions and toxicity without any harm to health and to increase therapeutic effectiveness. The use of the current noninvasive techniques (positron emission tomography, magnetic resonance imaging) is shown to considerably improve the diagnostic estimation of the extent of a tumor. This fact and deeper knowledge of prognostic factors will allow us to optimize and individualize treatment.

Multmodal programs are the perspective trend in different malignant tumors treatment but increasing risk of combined complications may influence negatively on the results. Ozone therapy and low-intense laser therapy are perspective methods for complication treatment and prevention as they show their own antibacterial, analgesia and detoxing activity in experiment.
To form the algorhythm and to evaluate the results of intravenous and local ozone applications plus low-intense laser (LILT) therapeutic complex used in treatment and prevention of malignant tumors multimodal treatment complications.

Recurrent ovarian granulose cell tumors (OGCT) occur in 20-40% of cases. The low incidence of OGCT and the specific features of their clinical course highly hamper the study of the mechanisms of development of recurrences and the possibilities of timely detection of disease progression and the determination of their optimal treatment policy. Thus, the problem of OGCT needs early diagnosis, monitoring, and treatment to be developed for patients with this type of tumors.

Intratumoral T-lymphocyte subpopulations were studied in 27 patients with ovarian serous adenocarcinoma, by using immunohisto- chemical techniques (n = 27) and three-color flow cytometry (n = 11).
The subpopulations of intratumoral lymphocytes infiltrating the tumor parenchyma and stroma differed. The intraepithelial cells were mainly CD8+ T cells (30.7%) and CD56+ lymphocytes (25%), which were indicative of the predominance of NK cells. Stromal infil- tration was primarily presented by mature CD3+ T lymphocytes (33%). This was supported by flow cytometric studies; CD3+ constitut- ed 62—92.6% among the CD45+ intratumoral leukocytes. The CD3+CD8+/CD3+CD4+ ratio was > 2 only in 3 cases. CD25+ cells made up the bulk among the CD3+CD4+ lymphocytes - 30—60% in 6 patients

Due to the poor outcomes of treatment for locally advanced cervix uteri cancer (CUC), new multimodality treatment modes have been recently sought for this patient population, by using neoadjuvant multidrug chemotherapy (MDCT) prior to surgical intervention. Many investigators are inclined to consider this approach to be an alternative to the standard treatment, although a number of issues, among them optimal combination of chemical drugs, are not settled yet.
This study has evaluated the short-term results of MDCT with selective chemoembolization of uterine arteries with gemcitabine in 22 CUC patients treated at the N.N. Alexandrov Republican Research-and-Practical Center of Oncology and Medical Radiology in 2007-2009. MDCT courses have been noted to be satisfactorily tolerated, without causing severe adverse reactions. Neoadjuvant treat- ments have provided tumor resectability in 90.9% of the patients, the radicability index being 85%.

The paper gives recent data on the use of target agents, such as erlotinib, gefitinib, cetuximab, bevacizumab, and sorafinib in advanced cancer of the cervix uteri (CCI). Approaches using target drugs in combination with chemotherapy are of the greatest interest. A spec- trum of molecular biomarkers (epidermal and vascular growth factors) in CCI and its correlation with prognosis and treatment response are shown. A number of adverse relations caused by target agents are considered.

Gynecological malignancies (cervix and corpus uteri cancer, ovarian tumors) are characterized by high comorbidity rates (35—55%) with mental disorders of mainly depression and anxiety sphere, as well as disorders considered within adjustment disorders.