Background. Salvage radiation therapy is the “gold standard” of treatment for patients with recurrent prostate cancer after radical prostatectomy. However, the results of the effectiveness of salvage radiation therapy in patients with regional recurrences are significantly lower than in patients with local one of prostate cancer, and, as a rule, the progression of the disease more often continues lymphogenic, affecting the next barrier of lymph outflow – retroperitoneal lymph nodes. Aim. To develop a new more effective radical method of salvage radiation therapy in patients with regional relapses of prostate cancer after radical prostatectomy. Materials and methods. The radiotherapy department of the N. N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russia has developed a new method of hypofractionation salvage radiation therapy of patients with regional recurrences of prostate cancer after radical prostatectomy, which includes treatment not only to regional recurrences, the bed of prostate and regional lymph nodes of the pelvis, but also and prophylactic radiation treatment to retroperitoneal lymph nodes. Results. 25 patients were treated with prophylactic radiation treatment to retroperitoneal lymph nodes from 2018 to 2021. The median follow-up of patients was 19 (7–22) months. In all patients, radiotherapy was performed in combination with hormone therapy with analogues of luteinizing hormone releasing hormone with a median duration of administration of 8 (6–10) months. All patients were treated without interruption according to the previously planned dosimetric treatment plans. At the end of the course of radiation therapy, none of the patients had any pronounced negative effects of the III–IV degree (according to the RTOG /EORTC scale). The 1-year local and biochemical control of the disease were 100 and 88 %, respectively. Conclusions. Initial data assessing the safety of the newly developed salvage radiation therapy technique in hypofractionation mode with additional prophylactic of retroperitoneal lymph nodes demonstrate good tolerability. However, further study and randomized phase III clinical trial are required to determine clinical efficacy.

Objective: to evaluate the effectiveness of salvage radiotherapy in patients with recurrent prostate cancer after radical prostatectomy.Materials and methods. In the period from March 2009 to January 2015, 92 patients with prostate cancer and biochemical recurrences after radical prostatectomy underwent salvage radiotherapy with classic fractionation and hypofractionation of the radiation dose.Results and conclusion. Median follow-up duration was 40 months (12–78 months). Overall survival was 100 %. Local control was 100 %. One (1), 2, and 3-year disease-free survival in the whole patient group was 96, 91, and 86 %; in the hypofractionation group it was 98, 95, and 89 %; in the classical fractionation group it was 95, 87, and 84 %, respectively. We have determined that the period of doubling of prostate-specific antigen level of ≤6 months (p = 0.035) after surgical treatment and prostate-specific antigen level >0.5 ng/ml (p = 0.037) at the time of salvage radiotherapy are significantly associated with worse prognosis for treatment effectiveness. There weren’t any differences in late toxicity between the 2 patient groups.

The problem of timely diagnosis and malignancy grade evaluation of prostate cancer is especially urgent considering continuous and progredient increase in morbidity and mortality caused by this nosology, as well as difficulty of diagnostics. The conducted literature review shows that currently magnetic resonance imaging (MRI) is the leading method for diagnostics and grading of primary prostate cancer, as well as evaluation of local metastases, diagnostics of distant metastases, and identification of recurrences in the prostatic fossa after radical prostatectomy. Sensitivity and specificity of MRI are higher than in any of the other safe methods of diagnostic radiology. Active and wide-scale introduction of MRI into routine urological practice provided an impetus for development of complementary modalities and methods including fusion biopsy, targeted prostate biopsy under control of MRI, active observation, focal therapy, and other methods, significance and effectiveness of which will be determined in the future.

This literature review provides information on the main radiation diagnostic methods and approaches for prostate cancer, which are used in current medical practice both by ultrasound (routine transrectal ultrasound (TRUS), sonoelastography, etc.) and most promising diagnostic techniques (multiparametric magnetic resonance imaging (mpMRI), hybrid fluorocholine and GaPSMA positron emission tomography/computed tomography and Ga-PSMA, etc.), the widespread clinical introduction of which has been recently observed. The paper discusses their sensitivity and specificity and the role and relationship in the diagnostic process. It also gives current unified mpMRI reporting and data system version 2 (RADSv.2). The advantages and disadvantages of standard ultrasound-guided biopsy (including its extended variant) are discussed. There are data on the experience with new procedures for prostate biopsy under guidance of up-to-date radiology techniques (mpMRI/TRUS fusion-guided biopsy and MRI-guided prostate biopsy) that are yet to take their place in routine clinical practice.

Cervical cancer (CC) is the third most common malignancy in women. The treatment depends on the extent of disease, i. e. on the stage of cancer. Staging of CC is based on the FIGO classification (2009) which has challenges in the evaluation of tumor invasion in parametrium and pelvic walls, involvement of regional lymphnodes and establishment of the real dimensions of the tumor by routine diagnostics approaches. Magnetic resonance imaging (MRI) looks like the method of choice in the staging of invasive CC. MRI is helpful in the evaluation of CC starting from stage IB FIGO (2009), to plan surgery or chemo-radiotherapy, to evaluate efficacy of treatment and to detect local tumor recurrence.

Cervical cancer (CC) is the third most common malignancy in women. The treatment depends on the extent of disease, i. e. on the stage of cancer. Staging of CC is based on the FIGO classification (2009) which has challenges in the evaluation of tumor invasion in parametrium and pelvic walls, involvement of regional lymphnodes and establishment of the real dimensions of the tumor by routine diagnostics approaches.Magnetic resonance imaging (MRI) looks like the method of choice in the staging of invasive CC. MRI is helpful in the evaluation of CC starting from stage IB FIGO (2009), to plan surgery or chemo-radiotherapy, to evaluate efficacy of treatment and to detect local tumor recurrence.

The efficiency of prostate cancer (PC) diagnosis using multipatametric magnetic resonance imaging (MRI) was evaluated. Unlike most of investigations of the similar problem, this trial provides an objective assessment applying the method of statistical analysis - binary logistic regression. It used data on 166 patients, including primary patients (with suspected PC), as well as patients with the established diagnosis of PC, those with a history of negative biopsy, and those with suspected recurrent PC. Some patients underwent target biopsy, the results of which were then employed for statistical processing. The data of the analysis showed that the sensitivity, specificity, and total accuracy of the method using the created model of binary logistic regression at the separation value of 0.625 were 75.0, 85.2, and 79.7%, respectively. The efficiency of diffusion-weighted images (DWI) with varying weighing degree by water molecule diffusion (b factor) on MRI systems with different magnetic field strength (1.5 and 3 Tesla) was also evaluated. There were no statistically significant differences in normalized absolute signal intensity as to the contralateral gland portion) in DWI with b factors of 1000 and 2000 between the MRI systems with a magnetic field strength of 1.5 and 3.0 Tesla.