The purpose of the study was to analyze surgical treatment outcomes for renal cell carcinoma (RCC) with inferior vena cava tumor thrombosis (IVC-TT) on the basis of one cancer center.Material and Methods. A retrospective analysis of treatment outcomes of 25 patients with locally advanced and metastatic RCC with IVC-TT, who underwent surgery from 01.2021 to 12.2022, was carried out. The median follow-up was 21 months (95 % CI 14.3–33 months). The patients were divided into groups according to the Mayo IVC-TT classifcation: Type I: 8 patients, type II: 8 patients, and type III: 9 patients.Results. Tangential IVC resection was done in 20 (80 %) cases, circular-in 3 (12 %) cases, and IVC extirpation was done in 2 (8 %) cases. The median intraoperative blood loss was 600 ml (from 250 to 1700 ml). The incidence of postoperative complications was 28 %, distribution by Clavien–Dindo classes was: III – 4, IV – 2, V – 1, an increase in the incidence of complications of class III–IV was revealed in patients with Mayo type III, however, no statistically signifcant differences were found (p=0.153). The most common complication was acute kidney injury. Two (8 %) patients required repeated surgical intervention. One patient died due to sepsis. Statistically signifcant differences were obtained in blood loss (p=0.003), the number of erythrocyte suspension blood transfusions (p=0.006), and the time of surgery (p=0.014) and prevailed in the group with the Mayo III level. However, the median length of hospital stay did not differ in the subgroups (p=0.978) and amounted to 6 bed days in the range from 4 to 20 days in the general group. The 30-day postoperative mortality rate was 4 %.Conclusion. Our experience has shown that surgical treatment of RCC with IVC-TT is feasible and provides acceptable surgical and oncological outcomes. However, the complication rate and postoperative mortality are higher in patients with Mayo III thrombus levels, requiring careful patient selection.

The purpose of the study was to immediate results of neoadjuvant chemoradiotherapy in patients with locally advanced gastric cancer were analyzed in a multicenter randomized trial. Material and Methods. The comparative analysis of neoadjuvant chemotherapy regimens, toxicity and postoperative complications was carried out. Patients of the study group received conformal radiation therapy (46 Gy in 2 Gy daily fractions) concurrently with chemotherapy with Capecitabine at a dose of 1850 mg/m2 divided in two equal doses during the course of radiation therapy, and Oxaliplatin at a dose of 85 mg/m2 on days 1 and 21. After an interval of 4–6 weeks and a control examination, in the absence of evident disease progression, patients were scheduled for surgery (gastrectomy or subtotal gastrectomy with D2 lymph node dissection) and 4 cycles of adjuvant chemotherapy according to the FOLFOX4 or CAPOX regimen. The treatment program for patients in the control group included surgery (gastrectomy or subtotal gastrectomy with D2 lymph node dissection) after randomization, and 6 cycles of adjuvant chemotherapy using the same regimens. The study included 70 patients with an equal distribution between groups. Results. Among the patients of the study group, grade 1 and 2 toxicity was the most common; grade 3 toxicity occurred in 9 cases; grade 4 and 5 toxicity was not observed. Among the manifestations of hematological toxicity, thrombocytopenia and leukopenia were the most common (57–60 % of patients), and grade 3 hematological toxicity was observed in 6 (17.1 %) cases. Among the manifestations of gastrointestinal toxicity, nausea, vomiting and decreased appetite prevailed; grade 3 toxicity was observed only in 3 (8.6 %) cases. The radiation component of neoadjuvant therapy was completed in 32 (91 %) patients. Both protocol-prescribed oxaliplatin infusions were performed in 34 (97 %) patients. Changes in capecitabine administration were required in 8 patients. Immediately before surgery, some patients had grade 1–2 toxicity, which did not prevent performing surgery. There were no statistically significant differences in the frequency and severity of complications in the early postoperative period between the comparison groups. Grade 1–2 postoperative complications were the most common.

The aim of the investigation was to assess the fluorescent imaging capabilities to monitor photodynamic therapy (PDT) of non-melanoma skin cancer, and study the correlation of PS (photosensitizer) fluorescence value (accumulation and photobleaching rate) and efficacy of the treatment provided.Materials and Methods. The study was conducted in the Nizhny Novgorod Regional Oncologic Hospital. We analyzed fluorescent images and PDT outcomes in 226 patients with non-melanoma skin carcinomas.Results. The assessment of short-term treatment results revealed the relationship between PS photobleaching and tumor complete response rate: a complete response was found in 89% cases in complete photobleaching, in 87% cases -in partial photobleaching, and in 81% - in no photobleaching (p>0.05). However, we found no effect of PS accumulation rate on complete response rate. The analysis of long-term results with significant difference (p=0.044) showed tumor recurrence rate in low PS concentration (tumor/norm) to be 9.5%, while in moderate and high concentrations the recurrence rate appeared to be 4.1%. There was revealed the tendency for recurrence rate increase - 10.4% with no PS photobleaching versus 4.4% in PS complete and partial photobleaching (p=0.051). The patients with high accumulation rate and complete PS photobleaching had the best clinical findings, the observation period being from 4 to 40 months.Conclusion. Fluorescent monitoring enables to maintain noninvasive control of PS accumulation and photobleaching that can contribute to the selection of individual laser exposure parameters. It is reasonable to develop multimodal bioimaging for follow-up real-time monitoring of basic photodynamic reactions and treatment results.

Photodynamic therapy is a promising method for the treatment of tumors with a broad potential of clinical and research applications. The possibility to combine the diagnostic and therapeutic options is of particular note that can significantly improve treatment efficiency. However, it is important to consider carefully the issues of service organization for the photodynamic therapy. Specialists’ inadequate education, incomplete service ensuring with medical and diagnostic equipment and non-compliance of treatment protocols can lead to a significant deterioration in the results and discredit the method.