A total of 115 children (median age 10.5 years, range 2-17) with Ewing sarcoma family tumors (ESFT) received therapy in N.N. Petrov Institute of Oncology pediatric department from April 1985 till August 2013. These patients were divided into two groups depending on treatment tactics used: patients treated according to modified T9 protocol (n = 64) and patients treated according to EICESS-92 or Euro-Ewing 99 regimens (n = 51). Twenty four patients from the second group with adverse prognostic factors received high-dose chemotherapy with autologous stem cell transplantation. All patients received surgical treatment and/or irradiation for primary tumor local control. Five-year overall and disease-free survival was 39% and 37,9% in the first group. In the second group these values were significantly higher; 55% and 39.5%, accordingly (p = 0.03 and 0.25). All patients from the first group with primary metastatic ESFT died of disease progression, while in the second group OS and DFS reached 45.8% and 28.9%, accordingly. There was a statistically significant correlation between local relapse rate and irradiation dose biological equivalent (in TDF units). The local relapse cumulative rate was minimal (12,6%) in patients receiving 80 TDF.

The paper presents the results of a study of the ovarian reserve in young women who received treatment for malignant tumors in childhood and adolescence and are in complete clinical remission. The function of the reproductive system was evaluated by serum concentrations of gonadotropins, estradiol, anti-Müllerian hormone (AMH) and inhibin B. The results were compared to the treatment, patients' age at the beginning of therapy and at the time of the examination. AMH level in serum was the most informative indicator of ovarian reserve in patients treated for malignant tumors.

The data on scintigraphic examinations of the bone marrow (BM) carried out in 76 patients, aged 2-16, are evaluated. Focal, multi-focal and diffuse lesions were identified. Metastases to BM were detected in 6 out of 28 (21%) patients with Hodgkin's disease. Scintigraphic evidence played a role in working out treatment modalities in 4 cases. Metastatic foci located outside primary tumor were detected in 3 out of 26 (11.5%) patients with Ewing's sarcoma and scintigraphic findings were considered in all 3 cases when scope of radiotherapy and chemotherapy intensity were elaborated. Also, lesions to BM were found in 9 out of 22 (41%) patients with neuroblastoma. Radiotherapy was ruled out in 4 cases of multi-focal and diffuse lesions while all 5 patients with focal ones received it.

A retrospective analysis of treatment of 67 children suffering localized osteogenic sarcoma received at the Institute's Clinic (1977-1995) has been carried out. The best 5-year survival results were obtained with the COSS-91 and PECOSS programs and those for pre- and post-operative COMBAP chemotherapy (77.8 and 70.0%, respectively). Another randomized comparative study of the effectiveness of different polychemotherapy and pre-operative radiation schedules are being planned.

High rates of overall and recurrence-free 5- and 10-year survival were recorded in 561 patients with Hodgkin's disease (stage IIIA-IIIAE and IIIB-IIIBE) after combination therapy using 2-4 cycles of MOPP, MOPP/ABV, COPP, DOPP or DOPP/ABV polychemotherapy, with radiation treatment being reduced to subtotal irradiation of lymph collectors. Total 5- and 10-year survival for stage IIIA was 96.8 and 91.5 and recurrence-free survival-81.2 and 81.2%, respectively: for stage IIIB-90.7; 83.2 and 68.6; 56.6%, respectively.

The results of combined treatment were analysed retrospectively in 85 children with nonlymphoblastic non-Hodgkin's lymphomas (NHL) of I-II-III stages (Ann Arbor). The importance of involved-field radiation therapy (IFRT) combined with ACOP, MEV, COP chemotherapy was assessed. All patients experienced high grade nonlymphoblastic subtypes of NHL as follows: follicular center cells, undifferentiated, immunoblastic (Lukes-Collins classification). Adjuvant IFRT resulted in significantly increased rate of 5-year overall and disease-free survival and diminished relapse frequency.

A retrospective analysis of the results of treatment of 467 cases of primary Hodgkin's disease (aged under 15) (1968-1992) has been undertaken. As such invasive diagnostic procedures as lower direct lymphography and laparotomy with splenectomy were being abandoned, polychemotherapy plus irradiation of zones of involvement alone at all stages were introduced. Although generalized forms of tumor (stage III-IV tumors in 69% of cases) were in evidence and risk-adapted therapy procedures were used, the 5-year survival for 1988-1992 was 88%, the recurrence-free survival rate in the treated cases being 67%.

The analysis included 187 cases of infantile non-Hodgkin's disease. It has identified Ann Arbor System stage and histological pattern of tumor (Lukes-Collins and Kiel) as a reliable and significant factor of prognosis.

Seventy percent of cases of Hodgkin's disease and 65% of those with kidney malignancies can be cured due to application of modern procedures of oncopediatrics. More intensive modalities have to be used for treatment of generalized forms of non-Hodgkin's lymphoma and sarcoma of Ewing. The rates of 3-year survival have risen to 70% in patients suffering acute leukemia following introduction of the new Protocol procedures. Infantile mortality from malignancies has been halved for the past 5 years (from 8.2/100,000 to 4.2/100,000) thanks to the taking of said measures and restructuring the oncopediatric service.

The retrospective analysis included the results of the treatment of 67 children suffering from localized sarcomas of bone (Ewing's sarcoma, lymphosarcoma). The advantage was demonstrated in patients, received combination of chemotherapy and radiotherapy on the involved bone. The resection of the primary tumor in combination with radio-chemotherapy improves the 10-year survival.

The postradiation changes in carcinoma of the proximal part of the stomach were studied in 32 patients: the parenchymal volume (PV), the damage index (DI), and the mitotic index (MI). The controls were 15 cases in which radiotherapy was not applied. Radiotherapy with large fractions (5 Gy 4 times daily) reduced the PV to 27 +/- 0.8 u on average as compared to the controls (77 +/- 1 u) and lowered the MI to 2.3 +/- 0.5% as compared to the controls (8% +/- 1), the DI ranged widely (3-67%). The methods of quantitative morphological study of tumors may be useful in objective evaluation of the efficacy of various schemes of preoperative concentrated irradiation.

The postradiation changes in carcinoma of the proximal part of the stomach were studied in 32 patients: the parenchymal volume (PV), the damage index (DI), and the mitotic index (MI). The controls were 15 cases in which radiotherapy was not applied. Radiotherapy with large fractions (5 Gy 4 times daily) reduced the PV to 27 +/- 0.8 u on average as compared to the controls (77 +/- 1 u) and lowered the MI to 2.3 +/- 0.5 % as compared to the controls (8 % +/- 1), the DI ranged widely (3-67 %). The methods of quantitative morphological study of tumors may be useful in objective evaluation of the efficacy of various schemes of preoperative concentrated irradiation.

The results of treatment of 53 cases of pediatric localized Ewing's sarcoma and bone reticulosarcoma were analysed. Chemoradiotherapy is a procedure of choice in bone marrow sarcoma treatment: while overall five-year survival was 28.4 +/- 6.2%, it was as high as 64.9% in cases of combined treatment (total focal dose of at least 50 Gy + polychemotherapy). Two cases of osteo- and chondrosarcoma development in exposed bone are described.