The article presents data from a retrospective study of COVID-19 outcomes in cancer patients from 24 regions of the Russian Federation.The study included 1,055 patients who had a Coronavirus disease 2019, including 451 (42.7 %) men and 604 (57.3) women. The mean age was 58.7 years (29–90); 108 (10.2 %) patients were diagnosed with various comorbidities. 627 (59.4 %) were receiving antitumor drug therapy at the time of diagnosis of COVID-19, and 332 (31.5 %) received antitumor chemotherapy.Most patients had asymptomatic or mild COVID-19: asymptomatic in 205 (19.4 %) patients, and mild — in 517 (49.0 %) patients. Moderate / severe COVID-19 was observed in 268 (25.4 %) patients, while severe / critical COVID-19 was diagnosed in 65 (6.2 %). 1204601776 25 (2.4 %) patients died after COVID-19. The average age of cancer patients who died was 66.3 years (31–84). Among the deceased patients, 16 (64.0 %) were women and 9 (36.0 %) were men. To determine the factors increasing the risk of death in cancer patients we performed univariate and multivariate analyses. Conclusions: based on the presented data, the probability of death from COVID-19 was associated with the anti-tumor therapy administered during the disease. This conclusion obliges us to stop antitumor chemotherapy during the COVID-19 disease.
В данном разделе указаны критерии оценки клинической значимости применения дорогостоящей противоопухолевой лекарственной терапии в соответствии со шкалой, разработанной экспертной группой (см. стр. 7). В тексте они обозначены, как магнитуда клинической значимости (МКЗ).
Background. Transrectal (TR) prostate biopsy remains the ”gold standard” but is associated with infectious risks; transperineal (TP) biopsy is considered a safer alternative with comparable diagnostic accuracy. Objective. To compare the diagnostic performance, complication rates, pain levels, and short-term outcomes of TR- and TP-guided prostate biopsies. Materials and methods. A prospective randomized study included 68 men aged ≥40 years with suspected prostate cancer (PSA4 ng/mL, positive DRE, and/or PIRADS≥3). Patients were randomized into the TP group (n=53) and the TR group (n=15). A 12-core transrectal ultrasound-guided biopsy was performed with targeted sampling of PIRADS 3–5 lesions. Overall and clinically significant cancer detection rates (Gleason score ≥7), complications (Clavien–Dindo classification), pain using the Visual Analog Scale (VAS), and events within 30 days were analyzed; p0.05 was considered statistically significant. Results. Prostate cancer was detected in 72.1% of patients: 75.5% in the TP group and 60.0% in the TR group (p=0.62). Clinically significant cancer accounted for 59.2% of cases (45.3% in TP vs 33.3% in TR; p=0.59). No Clavien grade III or higher complications or cases of urosepsis were observed. Minor complications occurred in 32.1% of TP and 40.0% of TR patients (p=0.69); low-grade fever requiring oral antibiotics (Clavien grade II) was reported only in 3.8% of TP cases. The procedure duration was longer for TP (20.6±5.2 min vs 10.3±3.8 min; p0.001) but was associated with lower pain scores (2.6±1.1 points vs 4.7±1.5 points; p0.01); 81% of TP patients rated the pain as minimal. No delayed complications were reported at 30-day follow-up. Conclusion. Transperineal biopsy provides comparable detection of clinically significant prostate cancer, results in less procedural pain, and demonstrates an absence of severe complications, offering a safe alternative to the TR approach, particularly for patients with a higher risk of infection or difficult-to-access magnetic resonance imaging lesions.
INTRODUCTION: Identification of brain glioma recurrence and necrosis — is actual neurosurgical problem, due to an absence of particular radiological signs on MRI image. Especially in the early stages. Identification of brain glioma recurrence and necrosis on MRI images — is a problem of object`s classification on medical images. Depending on this, an issue of chemotherapy is decided. OBJECTIVE: Development and practical approbation of a method for differential diagnostic of a recurrent glial tumor from radiation necrosis on MRI images by using mathematical model of medical image`s processing.MATERIALS AND METHODS: Analysis of existing methods for differential diagnostic of a recurrent glial tumor from radiation necrosis and description of principal deficiencies’ description. Authors proposed an algorithm for differential diagnostic of a recurrent glial tumor from radiation necrosis. Development of algorithmic, structural and mathematical models for proposed solution: prototype of an app and an interface. Testing of proposed method on the practice: dynamic examination for 98 patients with brain glioma Grade III–IV — brain MRI with contrast enhancement 1, 3, 6, 9, 12 months after surgical intervention and a chemotherapy.RESULTS: As a result of practical approbation, authors’ noticed that this method has a high level of brain glioma recurrence and radial necrosis detection (97,4%).DISCUSSION: The variety of scientific papers describing ways to differentiate recurrence of glial brain tumors and radiation necrosis based on MRI diagnostics confirms the relevance of the topic of the article in the medical scientific community. We have developed a method of differential diagnosis using MRI of the brain with contrast enhancement, due to the fact that this is the most accessible method of diagnosis in the postoperative period and a course of chemoradiotherapy.CONCLUSION: A high-precision method for differential diagnosis of radial necrosis and brain glioma recurrence using a clinical decision support system allows the neurosurgeon to timely adjust treatment tactics, thereby improving the survival rates of patients with Grade III–IV glial tumors.
Differentiated thyroid cancer is one of the most common malignant diseases of the endocrine system. Usually, it responds well to the standard treatment (surgery + radioiodine therapy), especially at early stages. During both treatment and dynamic observation, distant metastases are detected in 10–15 % of patients. In these cases, the patients continue treatment with radioactive iodine. If tumor cells have insufficient ability to capture and retain 131I or completely lose this ability, the effect of radioiodine therapy becomes limited and the disease progresses during therapy which leads to 5–10 % decrease in 10-year survival. The main problem in treatment of differentiated thyroid cancer is communication between radiologists in centers performing radioiodine therapy and clinical oncologists performing surgeries and observation at patient’s place of residence. For both specialists, the main goal is to identify clinical situations where early and effective treatment intervention can be beneficial without the risk of overdiagnosis and excessive treatment.The article considers common questions arising during multidisciplinary interactions with radiologists of radioiodine centers and presents concise guidelines on the observation and treatment procedures for patients with differentiated thyroid cancer.
