The 15th author’s name should read I. A. Gulidov. The caption for Fig. 3 on page 336 should read

Radiological methods of treatment of malignant tumors are widespread in medical practice. In addition to the type of radiation and dose and fractionation of the radiation regime, the dose rate is one of the factors that affects the effectiveness of treatment. The therapeutic dose rate lies in the range of tens of mGy/s. At modern high-current accelerators of relativistic electron beams, a significant increase in the dose rate to hundreds of MGy/s is achievable, which is more than 10 8 times greater than the therapeutic dose rate. It is difficult to predict the nature of processes in tissues and its cells at such radiation intensities. To determine the effect of extreme dose rate on the radiosensitivity of tissues at the Angara-5-1 facility, experiments were conducted to determine the lethal dose (LD50/30) for laboratory mice. Our result on the study of the LD50/30 dose (~100 MGy/s) allows us to make a conclusion about a possible higher lethal dose than the power range of the doses used for medical purposes.

The aim was to evaluate the effectiveness of various fractionation proton boost in the proton-photon radiation therapy of locally advanced prostate cancer. The study included 272 patients with prostate cancer and intermediate-to-high risk of progression. 114 patients received 3-D conformal local irradiation of the prostate by proton beam 220Mev. The focal dose of 28-28,8 SoGy-eq was fed to the prostate for 8, 5 or 3 fractions for 3, 4 or 5.5 Gy-eq, respectively. Given the photon component (44 Gy in 22 fractions to the whole volume of the pelvis), the dose to the prostate was 72.8., 72 and 72SoGr-eq, respectively. In 158 patients in the control group the similar doses to the pelvis were supplemented by local 4-dipole photon irradiation of the prostate to 68-72 Gy in 12-14 fractions of 2 Gy. Acute gastro-intestinal (GI) toxicity maximum, 2 St expression, were found significantly less frequently after the proton-photon therapy: in 54.4% of cases, versus 69.2% in the controls (p <0,01). Differences between acute genito-urinary (GU) toxicity were not observed. The frequency of late GI damage of 2 St. was 3 times less frequently observed in the study group: 10.2% versus 34,8 +/-% in controls. Damages of 3-4 St. were found in 1 patient of the main group and in 2 patients in the control group. GU damages of 2 St. were equally common after the proton-photon or just photon irradiation in 8.3% and 9.1% of patients respectively. Damages of 3-4 St. were diagnosed in 2.8% and 3.8%, respectively (p> 0.05). A 5-year survival without biochemical recurrence was in the study and control groups 60,0 +/- 5,4% and 61,9 +/- 4,4%, and a 9-year survival--45,5 +/- 8,5% and 42,8 +/- 7 1%, respectively (p > 0.05). Thus, precise local irradiation by a proton beam with ROD 3-5.5 Gy-eq. and SOD 28-28,8 Gy-eq supplementing photon irradiation of total small pelvis significantly reduces the severity of early and late post-radiation proctitis but does not reduce the risk of damage to the lower urinary tract and does not influence the anti-tumor treatment effectiveness compared to conventional conformal photon radiotherapy. In this case, the proton boost modes: 8 fractions for 3 Gy, 5 fractions for 4 Gy and 3 fractions for 5.5 Gy does not significantly differ in the level of toxicity.

The aim of the current study was to improve the bone metastases irradiation parameters in patients with life expectancy more than 3 months. The current randomized study included a total of 333 patients with bone metastases (breast cancer metastases in 71% of cases) receiving 488 courses of photon irradiation. Irradiation effect was observed in 95.8-100% of cases regardless of fraction number and irradiation regimen. The rate of complete effect was the same for all irradiation regimens, but raised gradually from 33.3% to 50.4% and 65.9% respectively when irradiation was given by 2, 3 and 4 fractions, 6,5 Gy each (p < 0.03); 78.4% (p < 0.01) cases of complete effect were observed in patients receiving irradiation by multiple small fraction compared to the groups receiving irradiation by 2 or 3 fractions of 6.5 Gy. The complete effect was more often observed in breast cancer (67%) and prostate cancer (63%) patients in comparison to lung cancer (47%) and renal cancer (30%) patients (p < 0,05) independent of metastases localization. The mean frequency of pain recurrence in irradiated area was 8.2% in all primary tumor and metastases localizations, irrespective of irradiation dose and regimen. Based on above results we recommend for breast cancer and prostate cancer patients with bone metastases and life expectancy more than 3 months the irradiation with 19.5 Gy given by 3 fractions. The patients with metastasizing lung and renal cancer should receive 26 Gy irradiation by 4 fractions 6.5 Gy each given once every 5.

Sixty-six patients with biliary ducts carcinoma were treated: 41 with primary tumors of bile ducts and 25 with metastatic lesions of hepatic portal lymph nodes. The main method of radiological diagnostics was sonographic tomography. Morphological diagnostics was made after cytological examination of bile and transcutaneous puncture biopsy. Hepatic insufficiency was detected in all patients with biliary ducts carcinoma with the syndrome of jaundice. In those cases transcutaneous, trashepatic endobiliarty decompressive interventions effectively liquidated cholestasis with minimal risk of complications and of death, caused by hepatic insufficiency and intervention itself. 3 patients with primary cancer of bile ducts received combined treatment, 30 such patients got radiation therapy; 20 patients with metastatic tumors underwent chemotherapy and radiation therapy. Mean survival, 3-year survival after radiation therapy or chemoradiotharapy were 22,7 ± 4,2 months and 8,3 ± 3,8 %, respectively. The mean survival of patients with metastatic lesions of hepatic portal lymph nodes was 24,5 ± 4,3 months

The authors analyze the histories of cases of 89 patients with cancers of the major duodenal papilla, which got treatment in Russian Scientific Center of Roentgenoradiology since 1990 till 2008. The various ways of early diagnostics and treatment of those cancers complicated by jaundice syndrome are compared.