Accurate determination of the tumor with the use of modern diagnostic methods which make the maximum exposure to the tumor and the identified affected lymph nodes possible lead to careful attitude to healthy tissues and critical structures. During the period 2000-2015 301 patients with squamous cell carcinoma of the anal canal stage T1-4N0-3M0-1 completed complex treatment which consisted of radiation therapy in a conventional or conformal mode, including the use of modern technologies - radiation therapy with intensity modulation - IMRT and arch volume-modulated radiation therapy - VMAT. The use of IMRT andVMAT in comparison with conformal radiation therapy allowed to reduce the frequency of unplanned interruptions up to 48 % (p = 0.005), which led to increase in 5-year rates of local regional control - 83.7 % compared with the group where the interruption was applied - 74.2 % (p = 0.049); also increased the frequency of complete responses in the range of the total dose of 50-54 Gy to 28.5 %, 56-58 Gy to 44.3 % and 60-64 Gy to 26.1 %. The achievement of a complete response led to a significant increase in the 92.1 % 5-year locoregional control compared to the group with the absence of a complete response - 76.5 % (p = 0.001). Modern conservative treatment is based on continuous radiation exposure with the absence of intervals between courses, which is the radiobiologically considered the most effective treatment regimen.

Purpose: To demonstrate the diagnostic capabilities to control effects of radiotherapy and HIFU treatment in patient with osteosarcoma bone metastases by SPECT/CT method. Material and methods . It was conducted SPECT/CT treatment monitoring of the patient with bone metastases of osteosarcoma after external radiotherapy, ultrasound ablation and cyber knife. Results. It were detected changes in the SPECT/CT-images of treated bones osteosarcoma metastases in short time. The treatment effect induced by ultrasound ablation was manifested after 1 month observation. The SPECT/CT has proven as a reliable method of dynamic control at radiotherapy. The treatment effect all of these methods is to reduce or absence of accumulation bone-tropic radiopharmaceutical labeled with 99mTc. Conclusion . SPECT/CT study is demonstrative method for early determination of pathological metabolism degree at bone metastases of osteosarcoma after radiotherapy and HIFU. SPECT/CT is an effective method of treatment monitoring of bone metastases after radiotherapy and HIFU therapies.

Low-energy laser radiation has a good anti-inflammatory and stimulating effect on the damaged tissues; therefore, it can be used for the prevention and treatment of both early and late radiation-induced skin injuries in patients receiving radiotherapy. So far, the effect of low-energy laser radiation in the prevention of radiation-induced skin damage remains poorly understood. This article presents a brief overview of the results obtained in the latest foreign studies as well as own experience of laser therapy for the prevention and treatment of both early and late radiation-induced skin injuries in patients with breast cancer after simultaneous reconstructive plastic surgery.

Purpose: to estimate the rate of locoregional recurrence and distant metastases, and the grade of chemoradiotherapy toxicity when in combination with local hyperthermia for treating squamous cell anal canal cancer T1-4N0,1-3M0-1. Materials and methods. 112 patients with squamous cell anal canal cancer were treated between 2011 and 2015 with chemotherapy, radiation therapy based on 3D CRT, intensity-modulated radiation therapy (IMRT) and volumetric intensity modulated arc therapy (VMAT), and local hypothermia. Staging was based on TNM (7th edition): I - 4 (3.6%) patients, II - 39 (34.8%) patients; IIIA - 33 (29.5%) patients, IIIB - 34 (30.3%) patients and IV - 2 (1.8%) patients. The median of mean follow-up was 32 months (range, 3-63 months). Local hyperthermia was performed in 81 (72.3%) patients. Results. 2-year local control was 73.2%. All recurrences, no matter which chemotherapy was performed, were in patients with advanced disease (IIIA/IIIB stages), from which 22.2% relapses were in group without local hyperthermia vs. 4.7% in group with radiomodification, p=0.038. Distant metastases were found in 9.4% patients with hyperthermia and in 11.1% patients without radiomodification, p=1. Usage of local hyperthermia is associated with increase II grade of dermatological toxicity (p=0.056). Conclusion. The combination of local hyperthermia and modern technologies of conformal radiation therapy has influenced the decrease of locoregional recurrences, but it is associated with lack of influence on distant metastases appearance regardless on chemotherapy regimen.

Objective: to analyze the results of early-stage breast cancer patients’ treatment using accelerated partial breast irradiation technique after breast-conserving surgery.Materials and methods. The study enrolled 100 patients with histologically proven breast cancer pT1–2N0–micM0 who were treated in N.N. Blokhin National Medical Research Center of Oncology in 2008–2017. Median age – 65 years, median of follow-up – 36 months. All patients underwent breast-conserving surgical treatment (radical resection), radiation therapy and hormonal therapy if needed. Radiation therapy was performed in accelerated partial breast irradiation technique. All patients corresponded strict selection bias. For proper visualization and accurate delineation of tumor bed 94 % underwent clipping with radiopaque metal clips. All patients were treated with 3D-conformal radiation therapy in 2.5 Gy per fraction twice a day, overall dose 40 Gy (in 16 fractions).Results. Median follow-up was 36 months. No locoregional recurrences or distant metastases were observed. Excellent and good cosmetic results were observed in 96 % patients.Conclusions. Accelerated partial breast irradiation in very selected patients after breast-conserving surgery gives excellent clinical results, quite similar with those after whole breast irradiation.

The problem of primary multiple tumors is relevant to current clinical oncology because of increasing of number of patients with multiple malignant tumors and unsolved issues of treatment. Primary multiple malignant lung tumors is a common oncological situation requires an individualized, differentiated approach to treatment. The results of treatment are associated with the prevalence of the process, stages of tumor development, spare capacity of patients. There is presented clinical example of a patient with metachronous primary multiple malignant tumors of one lung.

The paper gives the long-term results of organ-saving surgery in 141 patients with stage Ia–IIIc breast cancer. Emergent histological examina- tion of a breast tissue sector was made during the surgery. Due to intraoperative morphological findings, the surgical volume was extended to gland reresection or mastectomy in 34 % of cases. There were low rates of local recurrences (0.6 % per year) and delayed operations.

The improvement of early diagnostics of breast cancer has resulted in the increased proportion of early forms of the disease in women with newly diagnosed breast cancer. Enhancement of the existing and development of new breast conserving therapeutic techniques, as well as recurrence-free and total survival rate indices is of current concern. The obligatory radiotherapy for the remaining breast part has been shown to be the gold standard of such treatment.The authors have analyzed the main current radiation techniques: boost to the tumor bed, radiation of regional metastasis areas. Particular attention is paid to a new technique, which is under study now - accelerated partial breast irradiation (APBI) in some patients. The advantages and disadvantages of these methods using the data of original studies have been presented.There have been discussed the problems of clipping of a removed tumor bed using titanium wire clips, and the main criteria for selecting patients for accelerated partial breast irradiation.

Our investigation was aimed at establishing a relationship between single metastases in the brain and a set of prognostic factors. It involved 278 patients treated at the Center in 1983-2003. The whole brain was irradiated in 273 while 159 of them (58.2%) received additional local irradiation of the brain. Single dosage of 2-2.5 Gy was administered to 158 (57.9%), 115--3Gy and more (42.1%). Mean total dosage was 36 Gy per metastasis for the whole brain and 46 Gy--for total plus local exposure. Among patients with favorable prognosis (RPA) were those aged up to 65, Karnofsky's index > or = 70%, with cured or controllable tumor and without extracranial metastases; poor prognosis--Karnofsky's index < or = 70%, irrespective of any other prognosticators, and intermediate prognosis--the remaining cases. The following four treatment modalities were used: 1) surgery --> radio- or radiochemotherapy (40); 2) chemotherapy > or = radiotherapy --> chemotherapy successively (56); (3) radiotherapy alone (110) and (4) simultaneous radiochemotherapy (72).

The reports deals with the data on repeat large-scale dissection of soft-tissue sarcoma following non-radical removal in 23 patients (13 males and 10 females , aged 14-75; mean age 42+/-30.2 yrs). Repeat surgery was carried out 3-6 weeks after primary one. Tumor progression was registered in 8 (34.8%): local recurrences which required radical intervention 4 (17.4%), distant metastases - 6 (26.1%) (lung - 3; liver - 1; lung and mediastinal lymph nodes - 1; lung and lumbar vertebra - 1). During the study, 5 patients died of tumor progression; all of them revealed distant metastases while 2 had local recurrences. Overall 5-year survival in 23 patients was 78%; whereas disease-free one - 65%.

Three groups of patients with inoperable soft-tissue sarcoma received preoperative radiotherapy (57), thermoradiotherapy (102) and thermoradiochemotherapy (16) (n=175). Five year recurrence-free survival in group 1 was 37+/-7%, group 2 48+/-6%, and group 3 - 56+/-1,7%. Patients survived 5 years and more in group 3 (60+/-2%), group 2 - 50+/-7%, and group I 44+/-8% (p>0.05). Local hyperthermia used in conjunction with radio- and chemoradiotherapy was followed by a significant rise in the rate of complete and partial tumor regression.

The main stages of development of such conservative modalities as radio- and chemoradiotherapy for localized Ewing's sarcoma are discussed. Factors affecting five-year overall and recurrence-free survival of patients treated with chemoradiotherapy are presented.

Data on radio- and thermoradiotherapy of 83 patients with extra-abdominal desmoid tumors are discussed. In a group of 57 patients followed up for 10 years or less, the relapse-free survival rates, in thermoradiotherapy-treated cases, were significantly higher (74.4% and 28.6%) than in those receiving radiotherapy (9.3% and 57.1%). Monitoring tumor temperature during local hyperthermia is a factor of relapse-free survival of vital importance.

The purpose of this study was to improve treatment outcomes in inoperable soft-tissue sarcomas using preoperative thermoradiotherapy and thermoradiochemotherapy. 175 patients with inoperable soft-tissue sarcomas were divided into 3 groups: Group 1 (57 patients) received preoperative radiotherapy, Group 2 (102 patients) received thermoradiotherapy and Group 3 (16 patients) received thermoradiochemotherapy. Radiotherapy was given by split doses. Irradiation was given at 4 or 5 Gy 2 or 3 times a week to a total tumor dose 30-32 Gy. Local electromagnetic hyperthermia was performed using «Yakhta» apparatus at 915; 460 and 40 MHz. Heating was given 2 times weekly for 60 min. Tumor temperature was maintained at 41-45°C. Group 3 patients (thermoradiochemotherapy) received intra-arterial adriamycin and cisplatin chemotherapy at 3-4 days before thermoradiotherapy. Complete tumor response or a more than 50% tumor regression were achieved in 76 (74,5%) patients from Group 2 and in 13 (81,3%) patients from Group 3, cf. with only 14 (24,6%) patients from Group 1 (p0,05). Local hyperthermia in combination with preoperative radioand radiochemotherapy increases significantly complete and partial response in soft-tissue sarcomas.

Main method of treating the epidermoid lung carcinoma patients is a surgery which gives a 5-year survival of 53–70% of patients with 1 and 2 stage of disease. However, if metastases in lymphatic nodes of mediastinum are present then number of patients surviving this period considerably decreases. To increase surgery effectiveness one seeks the combined therapy methods using, in particular, neoadjuvant radiotherapy. We have studied such a therapy method which is to be applied during the pre-operative period of hypoxiradiotherapy. Date of 237 epidermoid lung carcinoma patients has been analyzed, mainly for the 3-d stage of disease: 1-st group of 123 patients was given a surgery treatment, the second one, of 114 patients, received an additional intensive pre-surgery radiation (5 Gy daily, 20 Gy) under condition of a short term hypoxya of a short term hypoxya caused by a gas mixture of 10% of oxygen and 90% of nitrogen. Surgeries were carried out during the first 3 days after the completing the radiation treatment. Mechanical conditions of the surgery procedure, blood losses and after surgery complications were similar in both cases. The number of cases of general radiation reactions decreased 3 times, all the cases being limited to the 1 and 2 degrees on the RTOG scale. After analysis of deferent factors, which define the result of treatment, significance the most reliable were the size of primary lesion and presence of mediastinum lymphatic nodes metastasis. Was shown rising of 3-year survival rate after combined treatment vs. operative treatment only.