The purpose of the study was to investigate rare cases of concurrent incidence of esophageal squamous cell carcinoma and gastric adenocarcinoma to develop an effective treatment strategy. Material and Methods . Herein, we present a report of three cases of simultaneous occurrence of esophageal squamous cell carcinoma and gastric adenocarcinoma treated at the Regional Clinical Oncology Center in Ulyanovsk and Sverdlovsk Regional Oncology Center in Yekaterinburg. The patients underwent surgery, chemotherapy and radiation therapy. Results . Synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma pose significant treatment challenges, necessitating a multidisciplinary team of specialists. Chemoradiotherapy with the FOLFOX regimen demonstrated favorable tolerability and satisfactory clinical response. Conclusion. A multimodal approach, involving surgery and chemoradiotherapy with the FOLFOX scheme, may be a valuable option for the treatment of patients with synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma.
Background. Esophageal cancer (EC) is one of the most aggressive gastrointestinal malignancies with a poor prognosis. The standard treatment for thoracic EC involves chemoradiotherapy (CRT). For localized tumors, a multimodal approach, including neoadjuvant chemoradiotherapy followed by surgery, is considered optimal. This approach can improve long-term treatment outcomes and provide better local control. The CROSS regimen is a commonly used chemoradiotherapy regimen for EC in Europe and Russia. Objective: to evaluate the effectiveness of chemoradiotherapy with the CROSS regimen administered both preoperatively and alone, as well as to assess long-term overall and recurrence-free survival rates. Material and Methods . This retrospective study included patients with stage I–III thoracic esophageal cancer treated at the Ulyanovsk Regional Clinical Oncology Center from January 1, 2019, to December 31, 2023. A total of 94 patients began chemoradiotherapy in the CROSS regimen. The final analysis included 80 (85.1 %) patients who completed the entire treatment program. Data collection was performed according to a unified protocol. Results. The rate of complete pathological response (TRG 1) was 10/26 (38.5 %). The 1-year overall survival rates in patients undergoing surgery and in patients not undergoing surgery were 83.3 % and 71.7 %, respectively. The 3-year overall survival rates in patients undergoing surgery and in patients not undergoing surgery were 58.3 % and 50.9 %, respectively. The 1-year and 3-year recurrence-free survival rates were higher in patients who received CRT followed by surgery compared to those who received CRT alone (76.9 % versus 63.5 % and 53.9 % versus 44.2 %). Conclusion . Chemoradiotherapy with the CROSS regimen was shown to achieve a complete response in more than a third of EC patients. Survival rates were higher in patients undergoing a three-modality approach.
TPS4620 Background: For metastatic urothelial cancer (mUC) with multiple metastases, the standard treatment involves platinum-based chemotherapy followed by maintenance avelumab. Despite this, disease progression occurs in approximately half of patients at a median of 5.5 months, often requiring a switch to second-line therapy. The concept of oligoprogressive mUC and its optimal management remain poorly defined compared to other tumor types. The VOLGA 2 study aims to assess the preliminary efficacy and safety of SBRT in patients with mUC and oligoprogression during maintenance therapy with avelumab. Methods: VOLGA 2 is a randomized, prospective, multicenter phase 2 trial. Patients with histologically confirmed mUC and measurable lesions according to RECIST 1.1, undergoing avelumab maintenance therapy with extracranial oligoprogression, are randomized to receive SBRT targeting oligoprogressive lesions or to second-line therapy of the physician’s choice. Oligoprogression is defined as disease progression due to the appearance of up to five new metastases or a significant increase in up to five existing lesions, with other disease sites remaining stable under ongoing systemic or local therapy. For patients in the SBRT arm, repeat SBRT to previously non-irradiated lesions is allowed and recommended if the interval between progressions exceeds four months. Patients with brain metastases and cord compression are excluded from the study. The primary endpoint is 2-year overall survival (OS) rate. Secondary endpoints include median OS and progression-free survival, overall and irradiated lesion response rates, and safety. The study will enroll 58 patients (H0 = 45%, Ha = 80%, alpha = 0.05, power = 0.8). Clinical trial information: KCRB10122024 .
Introduction. Breast cancer (BC) has a leading position among oncological diseases in women. Early diagnosis and search for predictors of malignant neoplasms using radiation imaging methods allows timely diagnosis and treatment, which improves the prognosis for BC. Most of the data obtained by radiological imaging is largely non-specific at the molecular level. Radiomics is engaged in solving these issues, which performs a comprehensive quantitative assessment of tumor phenotypes by extracting a large number of quantitative signs from medical images.Purpose — systematization of modern scientific directions of radiomics in the radiation diagnosis of BC.Methods. Comprehensive analysis of PubMed and eLibrary.ru electronic databases over the past 5 years.Results. Based on the studied literature data, we identified the main promising scientific directions for the development of radiomics in the radiation diagnosis of BC: the study of the prevalence of BC, its risk factors, new screening approaches in the early diagnosis of BC; the search for specific markers and available visualization of signs of a certain molecular type of BC; the search for prognostic predictors and the study of the accuracy of the forecast based on the identified characteristics; identification of the possibilities of personalized therapy, assessment of the most effective treatment and modern management of cancer patients; expansion of the possibilities of radiomics in combination with other scientific fields.
Purpose: To evaluate the proportion of BRCA1 / 2 mutations in patients with serous and endometrioid cancer of the ovary, fallopian tube, and peritoneum in Russia, to evaluate the percentage of germinal and somatic mutations, to identify the spectrum of mutations in BRCA1 / 2 genes, to evaluate clinical and morphological features of the BRCA-associated ovarian cancer (OC).Patients and methods: The study enrolled patients of 18 years and older with newly diagnosed serous and endometrioid cancer of the ovary, fallopian tube, and peritoneum. Biological material (blood, tumor tissue) was collected, followed by molecular genetic analysis. The method of mutations detecting in the blood were: allele-specific PCR, high-resolution melting (HRM), Sanger sequencing method. Advanced genetic testing included the use of generation sequencing (NGS) and multiplex amplification of ligated probes (MLPA). The collection of clinical data, family history, clinical and morphological characteristics of the tumor was performed.Results: 500 patients were included in the study, the evaluation of BRCA1 / 2 mutations was performed in 496 patients (99,2 %). The frequency of BRCA1 / 2 mutations in the Russian patient population was 28,4 % (n = 141 / 496). The incidence of germinal mutations was 23,5 % (n = 117 / 141), and somatic — 4,8 % (n = 24 / 141). Frequent mutations in the Russian population were identified in 50 % of cases. When analyzing the ethnicity of patients in the Russian Federation BRCA-associated OC was most common in Russian (83,6 %, n = 118 / 141), Ukrainian (4,2 %, n = 6 / 141) and Tatar (3,5 %, n = 5 / 141) women. A family history of cancer was detected in 44 % of patients (n = 62 / 141) with BRCA1 / 2 mutations.Conclusions: Due to the high frequency of germinal and somatic BRCA1 / 2 mutations in the Russian patients it is recommended to conduct the advanced testing methods not only in blood samples but also in tumor tissue.
