Malignant neoplasms are one of the main causes of death and disability in the population of developed, and in recent years, developing countries. A significant loss of working capacity of a part of the population associated with this morbidity takes it beyond the scope of a purely medical problem. The annual steady increase in the absolute number of patients with a diagnosis of a malignant neoplasm established for the first time in their life is due to an improvement in diagnosis and registration, an increase in the number of older people, and a true increase in the incidence of a number of nosological groups.

Злокачественные новообразования (ЗНО) являются второй причиной глобальной смертности населения. Доминирующую роль в этиологии ЗНО играют факторы окружающей среды и образ жизни человека. Согласно результатам популяционных эпидемиологических исследований, до 70% случаев онкологической заболеваемости ассоциированы с четырьмя потенциально модифицируемыми факторами риска (ФР): табакокурением, избыточным потреблением алкоголя, избыточной массой тела, недостаточным уровнем физической активности. Осуществлен анализ данных литературных источников, посвященных изучению связи поведенческих факторов с риском развития ЗНО. Результаты исследования свидетельствуют, что значительная доля всех случаев заболеваемости и смертности от ЗНО ассоциирована с модифицируемыми ФР, из которых наиболее изучено табакокурение. Необходимо дальнейшее изучение связи характера питания, ожирения и физической активности с риском развития ЗНО. Популяционная профилактика ФР позволяет снизить заболеваемость и смертность населения от ЗНО. Для более глубокого понимания роли потенциально предотвратимых ФР в заболеваемости ЗНО необходимо проведение многоцентровых эпидемиологических исследований с последующим анализом обобщенной базы результатов.

This article presents the results of a clinical study that examined the diagnostic efficacy of fluorescent diagnostics (FD) of non-muscularinvasive bladder cancer using a photosensitizer of FD of malignant neoplasms – 5-aminolevulinic acid hexyl ester (5-ALA HE) compared with standard cystoscopy. The study involved 110 patients. The study began with intravesical administration of 50 ml of 0.2% solution of 5-ALA HE, the exposure time was 1 hour, after which the drug was removed from the organ. During the next hour, the mucous membranes were examined in two cystoscopy modes, followed by a standard transurethral resection of all urothelium sites with suspicion for tumor lesion based on white light and visible red fluorescence, and a control blind biopsy from the visually unchanged and non-fluorescent mucous tissue in each patient. The results of the study indicate the high effectiveness of the developed FD methodology with 5-ALA HE in detecting non-muscularinvasive bladder cancer during intravesical administration of the drug, due to selective accumulation of hexasens-induced PPIX in the tumor tissue compared with healthy mucosa. Compared with the results of standard cystoscopy, fluorescence diagnostics significantly increased diagnostic sensitivity by 24.4% (from 75.1% to 99.5%), diagnostic accuracy – by 15.8% (from 82.4% to 98.2%) and a negative predictive value – by 33.2% (from 65.8% to 99%) (p≤0.05). Additionally, a total of 37 (33.6%) patients was found to have 63 foci of fluorescence with a diameter of 2.5 to 3.0 mm. 59 of these were morphologically confirmed to contain cancer cells.

The article presents a clinical observation of the patient of 38 y.o. with cancer of the left breast stage IIIC урТ4bN3М0L1V1. On the 1st step of the treatment the patient had 2 courses of CAF neoadjuvant chemotherapy, on the 2nd step – extended radical mastectomy on the left with intraoperative photodynamic therapy and closure of the defect with ТRАМ-flap, on the 3rd step – continuation of the chemotherapy (8 courses), on the 4th step – radiation therapy to the chest wall on the left and zones of regional lymph drainage, targeted therapy with herceptin a (1 year). Four years later a silicone implant was inserted into the left breast. Corrective surgery (reduction mammoplasty on the right side) was performed in april, 2017. Currently, the patient has remission of the disease of the left breast, the period of remission accounts for 8 years.

According to worldwide statistics breast cancer is the most common cancer in women. Despite the success in current methods of treatment post-operative period in major of patients is characterized by post-mastectomy syndrome which leads to impairment in daily activities, difficulties in social adaptation and consequently to dicrease of the quality of life. The specific causes, risk factors, characteristics of clinical and pathogenetic manifestations of post-mastectomy syndrome are described in detail in this review. Different approaches to post-mastectomy syndrome classification, its clinical and instrumental diagnosis are defined. Based on more than 40 publications of Russian and foreign authors, the issue of selection of appropriate treatment tactics for the syndrome is investigated and discussed in detail. A considerable part of the review is focused on the use of physical methods of treating the post-mastectomy syndrome. It is observed that an increasing number of specialists gives preference to methods of conservative treatment special of which are medical gymnastics, complex decongestive therapy and compression therapy. On the other hand, the absence of the unified treatment algorithms is challenging for clinicians. Therefore, its development with the focus on patient-specific approach is a crucial task for modern rehabilitology in breast cancer surgery.

1Московский научно-исследовательский онкологический институт им. П.А. Герцена — филиал ФГБУ «Национальный медицинский исследовательский радиологический центр» (дир. — акад. РАН А.Д. Каприн) Минздрава России, Москва, Россия; 2кафедра онкологии и радиотерапии Первого Московского государственного медицинского университета им. И.М. Сеченова (зав. — акад. РАН В.И. Чиссов), Москва, Россия; 3Морозовская детская городская клиническая больница (главный врач — д.м.н., проф. И.Е. Колтунов), Москва, Россия

Clinical observation of a patient with an orphan disease (mucinous peritoneal carcinomatosis) after 2 courses of intraoperative photodynamic therapy with photogem photosensitizer is presented. During the first course of photodynamic therapy, photogem was administered at a dose of 2.5 mg/kg, the energy density of the laser radiation was 10 J/cm2. The duration of stabilization after the first course of treatment was 2 years, after which the progression of the disease was registered. The second course of photodynamic therapy was carried out in the same way. The duration of stabilization after the first course of treatment was 2.5 years. The patient died as a result of an accident unrelated to the disease.

Clinical observation of a patient with an orphan disease (mucinous peritoneal carcinomatosis) after 2 courses of intraoperative photodynamic therapy with photogem photosensitizer is presented. During the first course of photodynamic therapy, photogem was administered at a dose of 2.5 mg/kg, the energy density of the laser radiation was 10 J/cm2. The duration of stabilization after the first course of treatment was 2 years, after which the progression of the disease was registered. The second course of photodynamic therapy was carried out in the same way. The duration of stabilization after the first course of treatment was 2.5 years. The patient died as a result of an accident unrelated to the disease.

Цель исследования -сравнение эффективности фотодинамического действия триметилового эфира хлорина е6 (3МеChl) и его производного с остатком галактозы в пирроле А (3MeChl_gal_NoAc), а также сравнительная характеристика накопления этих соединений в опухоли и их биораспределения в нормальных органах и тканях животных.Материалы и методы .Исследования в системе in vitro проводили на опухолевых клетках мышиной карциномы легкого Льюиса (LLC) в мультипараметрической системе.Фотоиндуцированную противоопухолевую активность и биораспределение 3МеChl и 3MeChl_gal_NoAc изучали на мышах BDF 1 с LLC.Биораспределение и фармакокинетику оценивали методом локальной флуоресцентной спектроскопии.Облучение проводили на 7-й день роста опухоли светодиодным источником с длиной волны 661 ± 16 нм при варьировании дозы фотосенсибилизаторов от 0,5 до 7,5 мг/кг и интервале времени между введением и облучением от 5 до 120 мин и при плотности энергии 90 Дж/см 2 .Результаты .В экспериментах на культивируемых клетках мышиной LLC установлено, что 3MeChl_gal_NoAc обладает более высокой фотоиндуцированной цитотоксичностью, чем его незамещенный предшественник: концентрация ФС, при которой наблюдается 50 % ингибирование клеток (ИК 50 ), составила 25 ± 1,5 нмоль и 171 ± 4,0 нмоль соответственно.При внутривенном введении мышам с подкожной LLC уровень нормированной флуоресценции в опухоли достигал максимальных значений для 3МеChl (18,4 ± 0,7 отн.ед.) в течение 60 мин, для MeChl_gal_NoAc (34,1 ± 6,9 отн.ед.) в течение 15 мин.Введение 3MeChl обеспечивало более высокий флуоресцентный контраст опухоли относительно нормальной кожи и мышечной ткани (до 7,4 и 4,1 соответственно), чем введение 3MeChl_gal_NoAc (до 5,0 и 2,5 соответственно).При сходном профиле биораспределения конъюгат 3MeChl_gal_NoAc быстрее, чем 3MeChl, элиминировался из организма мышей-опухоленосителей.На модели подкожной LLC у мышей при внутривенном введении 3MeChl_gal_NoAc в дозе 5,0 мг/кг и интервале между введением фотосенсибилизатора и началом светового воздействия 5 мин (длительность облучения 15 мин, доза света 90 Дж/см 2 ) получен высокий противоопухолевый эффект фотодинамической терапии -100 % излеченных животных.Однако стремительное выведение галактозильного производного из ткани опухоли, низкая избирательность ее фотодинамического повреждения, а также узкий интервал высокоэффективных терапевтических доз значительно ограничивают перспективность применения данной модификации триметилового эфира хлорина е 6 для фотодинамической терапии зло качественных опухолей.

Photodynamic therapy and fluorescence diagnosis of malignant tumors have been actively developed over the last 15 years by the scientists participating in the Moscow Government-funded "Fight against Cancer" program. New effective photosensitizers absorbing in the long-wave spectral region were revealed. Unique agents Alasens-lio, Alasens-gel, Hexasens-lio, Phthalosens-lio, Holosens-lio, and Holosensgel were produced and preclinically studied both in vitro and in vivo. New methods using low-intensity and pulse modes of irradiation and also combined methods of treatment by photodynamic therapy and well-known chemotherapy or laser hyperthermia were developed. Methodological recommendations for experimental studies of agents with photoinduced antitumor properties were published.

Renal cell carcinoma (RCC) is one of the most urgent topics in modern oncourology. This is attributable to the high morbidity and mortality rates associated with this pathology. Renal dystopia is a rather rare developmental anomaly. The literature data describing cases of the diagnosis and treatment in patients with dystopic kidney malignancies are scarce. Moreover, if a tumor is present in the solitary dystopic kidney, it is often extremely difficult to perform an organ-saving operation for a number of features of the anatomic structure of the dystopic kidney and its vascular architectonics. The paper describes a clinical case of S-shaped crossed dystopic kidney resection in a patient with RCC.

We compared the composition and biological activity of fetal calf serum and platelet lysate from donor platelet concentrate. In platelet lysate, the concentrations of alkaline phosphatase, lactate dehydrogenase, creatinine, and mineral metabolism parameters were lower, while parameters of lipid and protein metabolism were higher than in fetal calf serum. The concentrations of growth factors (platelet-derived (AA, AB, BB), vascular endothelial, insulin-like, and transforming growth factor β) in platelet lysate 1.7-148.7-fold surpassed the corresponding parameters in fetal calf serum. After replacement of fetal calf serum with platelet lysate in the culture medium (0, 25, 50, 75, and 100%), the count of multipotent mesenchymal stromal cells on day 7 (in comparison with day 1) increased by 154.8, 206.6, 228.2, 367.7, and 396.5%, respectively. Thus, platelet lysate can be an adequate non-xenogenic alternative for fetal calf serum.

The concurrence of gastric cancer and primary hepatic neoplasm ranks third in the structure of polyneoplasia associated with gastric cancer and accounts for 14.3%. Gastric tubular adenocarcinoma and hepatocellular carcinoma are predominant histological forms. In practice, the hepatic focal mass detected is generally interpreted as metastatic lesion, which frequently leads to unfounded refusal of radical treatment. At the same time, adequate preoperative examination with the obligatory histological verification of both a gastric tumor and a hepatic mass and the comparison of their morphological patterns permits one to make a correct diagnosis and to plan a potentially radical intervention for both nosological entities.

The concurrence of gastric cancer and primary hepatic neoplasm ranks third in the structure of polyneoplasia associated with gastric cancer and accounts for 14.3%. Gastric tubular adenocarcinoma and hepatocellular carcinoma are predominant histological forms. In practice, the hepatic focal mass detected is generally interpreted as metastatic lesion, which frequently leads to unfounded refusal of radical treatment. At the same time, adequate preoperative examination with the obligatory histological verification of both a gastric tumor and a hepatic mass and the comparison of their morphological patterns permits one to make a correct diagnosis and to plan a potentially radical intervention for both nosological entities.