Efficacy of combined treatment (203 patients) and surgical treatment (200 patients) alone was analyzed. In combined treatment either radiation therapy (RT) in the dose 20 Gy over 5 days (group 1) or hypoxyradiotherapy (HRT) in the same doses but in combination with hypoxia (10% oxygen and 90% nitrogen--hypoxic gas mixture HGM-10--group 2) were used in preoperative period. In group 3 HGM-9 (9% oxygen and 91% nitrogen) was used as radioprotector in preoperative period but in increased by 25% radiation doses: total 25 Gy, 5 Gy for 5 days. In the control group only radical surgical treatment was performed. Preoperative irradiation didn't increase the rate of postoperative complications. At the same time the 5-year survival rate was higher in all the groups of patients on combined treatment than in the group of patients on surgical radical treatment. In the group with HGM-9 and increased by 25% radiation doses postoperative complications rate was lower, recurrences and distant metastases occurred less frequently.

Morphological study has confirmed the advantage of using doses of single radiation doses 5 Gy (total dose 25 Gy) and inhalation of a hypoxic gas mixture vs other methods of treatment. The study of radiation pathomorphosis showed significants devitalization of the tumor cells realized clinically with a fall in the number of postoperative recurrences and metastases.

The data on surgical treatment of 455 patients operated on for primary and recurrent non-organ retroperitoneal tumors (NRT) are discussed. 64.2% of tumors were resected; postoperative lethality was 8.2%. Particular emphasis is placed on the complex nature of diagnosis and an algorithm of examination is suggested. The sequence of main procedures and stages are described; 43% of radical procedures were performed in combination with one another. NRTs tended to relapse and malignant tumors recurred most frequently within the first 18 months. In the course of 182 operations, 54.4% of NRTs were resected: postoperative lethality was 11.1%. The end results were determined by a number of factors, primarily, nature of tumor (benign or malignant), tumor process (primary or recurrent), tumor size and histological pattern. Because of the poor end results, surgical procedures should be improved and their range should be extended.

A retrospective analysis of the end results of surgical treatment of 1.417 patients with T1-2N0-1M0 breast tumors is presented: local recurrence after radical surgery (1.151)-2.4% after radical resection (165)-5.5%, and after lumpectomy combined with axillary lymphadenectomy (101)-4.0%. In the T1N0M0 group, the end results of radical resection and radical mastectomy were identical. In the T1N0M0 and T2N0M0 groups, in which lumpectomy combined with axillary lymphadenectomy was performed, the end results were inferior to those radical mastectomy. There was a correlation between tumor cell detection in the blood and lymph vessels and extent of intervention: radical mastectomy-6%; radical resection-13% and lumpectomy combined with axillary lymphadenectomy-17%. The latter index tended to rise in cases of recurrence after breast-conserving surgery.

The results of the randomized treatment of 1,280 cancer patients (hypooxyradiotherapy (HRT)--923, radiotherapy as a control procedure--357) are discussed. HRT was administered pre-operatively to cases of stomach cancer, colonic carcinoma and breast cancer. Owing to reduced radiation injury caused by HRT, pre-operative dosage was increased by 50% (single dose--6 Gy; total dose--30 Gy; 54 isoGy) in stomach cancer patients, and by 25% (single dose--5; total dose--25 Gy; 40 isoGy) in colonic cancer patients. The time of pre-operative irradiation with a single HRT dose of 10 Gy (28 isoGy) for breast tumors was reduced 4 times. As a result of HRT application, dosage rose by 25-42% in treating pancreatic carcinoma and non-organ retroperitoneal tumors.

The paper analyzes the results of surgical and multimodality therapies for 237 patients with Stage III colonic cancer, which were divided into 3 groups. Group 1 included 119 patients undergone only surgical management, Group 2 comprised 43 who were additionally treated with intensive radiation (4 Gy daily for 5 days) and Group 3 consisted of 75 patients who were irradiated in the presence of overall hypoxia evoked by breathing a gaseous mixture containing 9% oxygen. A five-year follow-up has indicated that there are significantly higher survival rates among those who have received a multimodality therapy rather than those merely operated on (82 +/- 5 and 53 +/- 9%, respectively). A short-term gaseous hypoxia has been found to reduce the incidence of systemic radiation reactions in patients during preoperative radiation and to fail to lower the efficiency of multimodality therapy.

Hypoxic mixtures, delivered during hypoxic radiotherapy, must contain different values of the volume portion of oxygen depending on atmospheric pressure variations. The authors give a formula of calculation of a necessary volume portion of oxygen and tables of atmospheric pressure variations in Moscow as well as rated values of the volume portion of oxygen, applied to possible atmospheric pressure variations.

The authors presented the results of pathomorphological investigations of surgical specimens of 110 stomach cancer patients following preoperative radiotherapy or hypoxyradiotherapy and radical operation. Single and total focal doses depended on oxygen percentage in the inhaled mixture and were 4-5 and 20-25 Gy, respectively. Radiation pathomorphosis was established in 62.8% of the patients (in 19.1% it was marked, in 13.5% it was absent, unclassified changes were noted in 23.6%). Short-term hypoxia resulted in no tumor "protection". Radiation changes in the stomach mucose in hypoxyradiotherapy were noted 2-3-fold less frequently than in radiotherapy, suggesting predominant "protection" of healthy tissues by hypoxia.

Experimental cryodestruction of the pancreas performed in 40 dogs served as a basis for selecting the temperature regimen, exposure time and extent of treatment to be subsequently used in man. Cryodestruction and combined cryoradiotherapy were employed in 30 patients with locally advanced pancreatic cancer. The procedure proved effective as it assured alleviation of pain, improvement in performance status and an increase in survival. CA-19-9 level and T-lymphocyte count were followed. These markers may be used to predict progression of pancreatic cancer.

The results of the preoperative radiotherapy of 217 stomach cancer patients are discussed in this paper. Radiotherapy (irradiation) had been fulfilled in 58 patients and it was performed without inhalation of the hypohic mixtures of a single dose radiotherapy in 4 Gr and a summary dose in 20 Gr.51 patients received radiotherapy (IRRADIATION (ОН ТХ & 51 patients received; radiotherapy (irradiation) on the background of the hypoxic gaseous mixture inhalation, containing 10 % of oxygen (HGM-10) with doses in 4,5 and 22,5 Gr respectively; in 52 patients the doses were 5 and 25 Gr on the background of the mixture inhalation, containing 9 % of oxygen (HGM-9). It was noticed to have total radiation reaction in 60,3% of patients, irradiated without hypoxia; in 39,2% of patients, irradiated with HGM-10; and in 38,4 % with HGM-9; and there was marked radiation reaction in 8,6; 7,8 and 1,9% of patients respectively. The HGM-8 (hypoxic gaseous mixture-8) usage detected its intolerance in 27,5 % of patients. The usage of HGM-9 and inhibitory irradiation, in 15 MEv made it possible for 20 patients to bring single doses of radiotherapy to 6 Gr and summary doses to 30 Gr; the investigation is still going on. The operation had been performed in 1-24 hours after the irradiation completion, the course of the operation and the postoperative period were not complicated with hypoxiradiotherapy, the radical operation was performed in 75,6 % of patients. Hypoxic mixtures usage allows to reduce considerably (by 21-23 %) the total number of the radiation reactions, includiting marked ones to reduce 4-fold and gives the possibility to increase the radiation doses by 25-50%.

Conservative treatment was carried out in 119 cases of hepatic malignancy (primary cancer--36 and metastatic tumors--83). Radiation therapy using a Rokus-M installation or a Saturn linear accelerator was performed in 26 cases, chemoradiation treatment--14 and cytostatic therapy alone--in 79 patients. Single focal dose used was 2 Gy, while total dose was as high as 51-70 Gy in cases receiving radiation alone and 35-40 Gy in the combined therapy group. Various combinations of carminomycin, bleomycin, cisplatinum, adriamycin, 5-fluorouracil, allopurinol and cyclophosphamide were employed. Radiation and chemoradiation treatment proved effective in 67.5% of cases. Mean survival time for patients suffering primary cancer was 15.8 +/- 4.3 months, and for those with metastatic tumor--8.3 +/- 1.6 months. Remission was registered in 14, while stabilization--in 31 out of 79 patients who had received chemotherapy. The symptomatic effect was observed in 38%.

Chemoradiation treatment was given to 60 patients with locally-advanced cancers of the urinary bladder and their recurrences. Split-course radiotherapy was carried out using a rotation technique at 3-4 week intervals. Total focal dose for two courses was 65-70 Gy. Combined therapy used cyclophosphamide, dactinomycin and cisplatin. Chemotherapy was given immediately after each course of irradiation. Concomitant cardiovascular pathology was registered in 46.6% of patients and renal function derangement--in 36.6%. However, all the patients, except three, received treatment matched by symptomatic therapy. Myelosuppression was among major side effects. Response was assessed in 47 cases (75%). The immediate effect of combined treatment was observed in 57.4%.

The paper discusses the results of preoperative intensive irradiation used in combined treatment for cancer of the sigmoid colon. Diagnosis was verified morphologically. Patients were randomly assigned for irradiation+surgery (group 1-97 cases) or surgery alone (group 2-111). Those undergoing radical operations only (in both groups) were included into the analysis. No difference was found between the two groups in rate of postoperative complications development (frequency of intestinal anastomosis failure included). The frequency of recurrence and metastasis development was significantly higher in the surgery only group. In patients with metastasis into regional lymph nodes, five-year survival was significantly higher among those who had undergone irradiation.

The paper is devoted to the discussion of the results of combined therapy of 79 patients with malignant renal tumors. Eight patients underwent nephrectomy and postoperative irradiation at a mean dose of 28 Gy, a marked radiation reaction was noted in 3 of them, and irradiation had to be discontinued. All 8 patients died within 3 yrs. of a follow-up period. Thirty patients received preoperative irradiation at a single focal dose of 2-2.5 Gy and a summary dose of 30-50 Gy 3-4 weeks before nephrectomy. A dose of 30 Gy did not result in tumor reduction, a dose of 40 Gy led to an insignificant reduction of a tumor size by 1-2 cm, tumor resorption by 30-50% was noted at doses of 50-60 Gy. Thirty-eight patients were given preoperative irradiation at a daily single focal dose of 4 Gy and a summary dose of 20 Gy, followed by nephrectomy in 24-48 h. Radiation reactions in preoperative irradiation were less marked than in postoperative irradiation. The 3-year survival rate in preoperative irradiation and nephrectomy was 72.5%, the 5-year survival rate was 53.2%. A fractionation type did not influence the survival rates.