Cutaneous squamous cell carcinoma accounts for 20 % of all malignant non-melanoma skin tumors, which is one of the most common cancers worldwide. Antitumor treatment is usually very effective: cure rate reaches 90 %, while local recurrence rate is 25 %. The main treatment option for primary skin cancers is surgery. The most significant risk factors for locoregional recurrence include tumor location (head and neck), size (>2 cm), depth of invasion (>4 mm), tumor differentiation grade, perineural invasion, immune system disorders (immunosuppression), severe concomitant diseases, and previous treatment. In patients with advanced cutaneous squamous cell carcinoma, 1-year, 2-year, and 3-year survival rates are 50–80, 30–35 and 15–16 %, respectively. Radiotherapy is a radical treatment option that increases the 5-year survival rate to 90 % and ensures good cosmetic results in 80 % of cases. There are 3 main variants of radiotherapy for cutaneous squamous cell carcinoma: sole radiotherapy according to a radical program, adjuvant radiotherapy in combination with surgery, and palliative radiotherapy. most frequently, radiotherapy is used as part of adjuvant postoperative treatment and is not initially considered as a sole conservative treatment for cutaneous squamous cell carcinoma patients below 45 years of age with resectable tumors, especially high-risk tumors. palliative radiotherapy is an affordable and effective method for combating painful symptoms; moreover, it often provides long-term local control.

The original methods of the radical and palliative endobronchial and combined radiation treatment of patients with primary and relapsing cancer of trachea and bronchi and the approaches to the calculation of dosimetric radiation plans are developed and suggested. The possibility of combining endobronchial radiation therapy, distance radiation therapy and laser destructionof the tumor, is studied. The indications to endobronchial radiation therapy are formulated. The suggested method of the endobronchial and combined radiation treatment significantly extended the possibilities of organsaving treatment of patients with primarily multiple metachronous and synchronous cancer and made it possible to formulate the new approaches to the radical treatment of patients with locally spread cancer of trachea.

Introduction. One of the effective and minimally invasive methods prostate cancer treatment is interstitial radiation therapy, the essence of which is the implantation of radioactive microsources into the tumor tissue. Brachytherapy of prostate cancer is performed in more than 20 clinics in the Russian Federation using mainly foreign microsources, but their high cost does not allow increasing the number of operations and opening new brachytherapy departments in the Russian Federation. Based on the model of foreign microsources such as seed No. 6711 (Nicomed Amersham), a technology for the manufacture of microsources with iodine-125 (IPPE SEED) has been developed at the State Research Center of the Russian Federation - IPPE, as well as a pilot production facility with a capacity of up to 50 thousand items per year. Materials and methods. In order to assess the safety of microsources for medical personnel during brachytherapy, local dosimetric control was carried out. As part of a clinical study in 2015, 36 patients with stage T1 – T2 prostate cancer underwent low-power brachytherapy using domestic microsources. Results. The obtained values of absorbed doses do not differ within the limits of measurement errors from the values of doses determined during the operation with foreign microsources under similar conditions. It follows from the data obtained that even the maximum values of the measured local absorbed doses do not pose a radiation hazard when using IPPE SEED microsources for brachytherapy. Among the treated patients, adverse reactions were in the expected manifestations of grade 1 dysuria according to the RTOG / EORTC classification. No gastrointestinal toxicity has been reported. Patient monitoring was continued in order to obtain long-term results of treatment. PSA disease-free survival at 5-year follow-up was 94.4%. Discussion. Clinical trials of Russian medical devices have demonstrated their safety for patients and medical personnel, which was proved by conducting dosimetry control during the procedure itself, as well as during examination of patients after brachytherapy. The effectiveness of Russian microsources I-125 during low-power brachytherapy is demonstrated by a decrease in PSA level from baseline by 87% at a follow-up period of 6 months. The disease-free survival rate for 5 years was 94.4%. The absence of significant radiation reactions both in the early and in the late postoperative period is important. The low cost of microsources produced by JSC «SSC RF – IPPE» relative to foreign analogs makes it possible to increase the number of operations performed annually, and also gives prospects for opening new divisions performing interstitial radiation therapy operations. Conclusions. Russian microsources «IPPE SEED» have successfully passed clinical trials, during which their effectiveness and safety were proved. The study also demonstrated high rates of relapse-free survival and a low level of adverse reactions in treated patients.

Brachytherapy is one of the methods of radiotherapy allowing to deliver a highly effective radiation dose to a tumor through a minimally invasive intervention. Depending on the source, brachytherapy can be low- and high-energy. The article describes the main stages of development of prostate cancer brachytherapy both in Russia and abroad. The main methods of brachytherapy used in modern medicine are described. References to recommendations of the leading radiological organizations on low-energy brachytherapy are provided. The main indications and counterindications for brachytherapy for treatment of prostate cancer using low-energy sources are described. Summary data on the effectiveness of the method depending on prostate cancer prognosis are presented. The results of using low-energy brachytherapy at the branches of the National Medical Research Center of Radiology of the Ministry of Health of Russia are described.

INTRODUCTIONIn 2014, the incidence of prostate cancer in the Russian Federation was 116.4 per 100,000 population. It is noteworthy that from 2004 to 2014, the proportion of patients with stage I-II prostate cancer increased from 35.5% to 52.5%, while that of patients with stages III and IV disease decreased from 38.4% to 29% and from 22.7% to 16.5%, respectively. All of this allows an increasing number of prostate cancer patients to be treated with radical treatment - low dose-rate brachytherapy. For the first time in this country, we report a clinical trial of low dose-rate brachytherapy for prostate cancer using domestically manufactured I-125 seeds. The successful results of this clinical trial are presented in this article. The aim of this work was to show the clinical efficacy and safety of domestically manufactured I-125 seeds for low dose-rate prostate cancer brachytherapy.MATERIALS AND METHODSThe clinical trial comprised 36 patients with stage T1-T2 prostate cancer. Patients were randomly assigned according to the risk of cancer progression. Low and intermediate risk groups comprised 30 (83.3%) and 6 (16.7%) patients, respectively. Patients of low risk group underwent brachytherapy alone with the minimum therapeutic dose of 145 Gy. I-125 seeds of two activities, 0.55 and 0.35 mCi per seed were used for implantation. Depending on the prostate volume, from 40 to 80 seeds, 57 on average were implanted. Mean implantation time was 85 minutes. In patients of the intermediate risk group brachytherapy was performed in combination with laparoscopic pelvic lymphadenectomy which was carried out 4-5 weeks prior to brachytherapy.RESULTSFollow-up examination at 6 months after implantation showed that PSA decreased in all patients on average by 87% from the baseline. No adverse events were reported.CONCLUSIONThe findings of the clinical trials of domestically manufactured I-125 seeds showed they are effective, safe and comply with international standards.

65 По данным ВОЗ, злокачественные новообразования являются причиной смерти 20% населения, занимая 2-е место по частоте после сердечно-сосудистых заболеваний [1]. В Российской Федерации в 2012 г. было выявлено 52 5931 новых случаев злокачественных новообразований (ЗНО). «Грубый» показатель заболеваемости на 100 000 населения России составил 367,3, прирост за 10-летний период — 17,9% [2]. По данным международных экспертов, 50% онкологических больных в процессе лечения хотя бы раз нуждаются в проведении радиотерапии, а более 20% должны получать радиотерапию повторно [3]. Число онкологических пациентов, подлежащих облучению, рассчитывается индивидуально и зависит от эпидемиологии ЗНО. На потребности в том или ином специализированном лечении влияет структура онкологической заболеваемости и показатели запущенности в конкретном регионе [4]. К одному из основных критериев качества медицинской помощи относится ее доступность. Под доступностью понимают свободный доступ к службам здравоохранения независимо от географических, экономических, социальных, культурных, организационных или языкоdoi: 10.17116/onkolog20165665-70

Aim. To study the qualitative indicators for radiotherapy of patients with malignancies and the level of technical equipment of radiotherapy service in the Republic of Tatarstan. Methods. The incidence of malignant tumors, the number of patients treated with radiotherapy at the Tatarstan Regional Clinical Cancer Center since 2002 to 2012 were assessed. The comparative analysis of relative parameters characterizing the radiotherapy service and the level of technical equipment of radiotherapy service in the Republic of Tatarstan compared to Turkey and Japan. Results. The increase in number of patients treated with radiotherapy over time was noted. Nevertheless, compared to data from Turkey and Japan, the share of patients who offered radiotherapy as a method of complex treatment of patients with malignancies in the Republic of Tatarstan stays below the recommended levels compared to Turkey and Japan. Only 18.4% of patients receive radiotherapy during the first year of the disease. The remote radiotherapy equipment rate in the Republic of Tatarstan is twice lower compared to Turkey and Japan. Only 50% of the minimal recommended technical equipment units quantity for remote radiotherapy are available in the Republic of Tatarstan, with over than a half of this number out-of-date. Conclusion. Healthcare optimization and wide use of out-patient service along with modernizing the radiotherapy service allowed to increase the coverage of patients with malignancies with radiotherapy during the last years, hence the use of radiotherapy as a method of complex treatment of patients with malignancies in the Republic of Tatarstan stays below the recommended levels, to increase in further, the re-equipment of the radiotherapy service with the modern equipment for remote radiotherapy is necessary.

In recent years, human papillomavirus (HPV)-related oropharyngeal tumors have been more frequently detected in the world. Their proportion is 20 to 90% depending on the spread of smoking and the rate of alcohol consumption in the country conducting a study. On the other hand, the proportion of HPV-related squamous cell carcinoma of the oral and pharyngeal mucosae is higher in the countries loyal to sexual norms. According to recent data, HPV-related oropharyngeal cancer should be considered as an individual nosological entity characterized by a tendency to regional metastases generally in relatively small primary tumors and by a high sensitivity to chemotherapy and radiotherapy. The paper describes the experience in successfully treating a 56-year-old patient with locally advanced oropharyngeal cancer and HPV infection.

Herzen Moscow Oncology Research Institute, Ministry of Health and Social Development of Russia The role of radiotherapy in treating head and neck tumors is on the increase, which is associated with a tendency for organ-saving treatment and with a need for a combination and comprehensive approach in case of locally advanced cancer. At the same time, only group prediction is already insufficient in clinical practice to define adequate treatment for these patients; and an individual approach to defining indications for radiotherapy is increasingly greater importance. Despite the fact that the generally accepted clinical and morphological parameters are rather informative in choosing an adequate local and systemic treatment; however, they are insufficiently individual. There is a need for putting into practice the new predictors of the efficiency of radiotherapy, which make it possible to optimize treatment policy, thus improving its results.

In recent years, human papillomavirus (HPV)-related oropharyngeal tumors have been more frequently detected in the world. Their proportion is 20 to 90% depending on the spread of smoking and the rate of alcohol consumption in the country conducting a study. On the other hand, the proportion of HPV-related squamous cell carcinoma of the oral and pharyngeal mucosae is higher in the countries loyal to sexual norms. According to recent data, HPV-related oropharyngeal cancer should be considered as an individual nosological entity characterized by a tendency to regional metastases generally in relatively small primary tumors and by a high sensitivity to chemotherapy and radiotherapy. The paper describes the experience in successfully treating a 56-year-old patient with locally advanced oropharyngeal cancer and HPV infection.

Herzen Moscow Oncology Research Institute, Ministry of Health and Social Development of Russia The role of radiotherapy in treating head and neck tumors is on the increase, which is associated with a tendency for organ-saving treatment and with a need for a combination and comprehensive approach in case of locally advanced cancer. At the same time, only group prediction is already insufficient in clinical practice to define adequate treatment for these patients; and an individual approach to defining indications for radiotherapy is increasingly greater importance. Despite the fact that the generally accepted clinical and morphological parameters are rather informative in choosing an adequate local and systemic treatment; however, they are insufficiently individual. There is a need for putting into practice the new predictors of the efficiency of radiotherapy, which make it possible to optimize treatment policy, thus improving its results.