The aim of this study is compare the early (within 24 hours) blood vessels reaction to photodynamic therapy (PDT) by optical coherence angiography (OCA) in case of tumor (basal cell carcinoma) and inflammation lesions (vulvar lichen sclerosus). It was shown that the microvascular damages was the primary reaction to PDT whereas tumor cells necrosis was the secondary response. The blood vessels reaction and its dynamic was universal for both tumor and inflammation lesions.

ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить влияние пандемии COVID-19 на течение онкологических заболеваний и достижение целевых показателей онкологической службы на примере Нижегородской области. МАТЕРИАЛ И МЕТОДЫ В Нижегородской области анализ данных по выявлению и учету COVID-19 у пациентов со злокачественными новообразованиями (ЗНО) проводится на основании данных информационно-аналитической системы «Канцер-регистр 6S» (ИАС «Канцер-регистр 6S»). РЕЗУЛЬТАТЫ На 31.12.20 на учете всего состояло 99 477 пациентов с ЗНО, из них с подтвержденным случаем COVID-19 1470 пациентов, что составило 1,5% от всех состоящих на учете пациентов с ЗНО. Среди заболевших COVID-19 онкологических пациентов в 1,6 раза больше заболело пациентов женского пола, чем мужского. Анализируя возрастную структуру онкологических пациентов с COVID-19, выявлено, что чаще заболевали лица старшего трудоспособного возраста (61,6%), чем трудоспособного (38%). В 15,9% случаев сочетание онкологического заболевания и COVID-19 приводило к тяжелому течению COVID-19 и в 17,8% случаев к смерти. Чаще умирали пациенты старшего трудоспособного возраста, что составило 89,3% от общего количества умерших онкологических пациентов с COVID-19. В структуре причин смерти онкологических больных с COVID-19 1-е место занял COVID-19 (51,3%), 2-е — ЗНО (33%), 3-е — болезни системы органов кровообращения (13%), 4-е место — прочие причины (2,7%). По итогам 2020 г. в Нижегородской области в условиях пандемии COVID-19 наблюдался рост на 0,4% показателя смертности от новообразований, в том числе от злокачественных, на 5% снизился показатель доли ЗНО, выявленных на I—II стадии, и на 22% — активной выявляемости, произошел рост показателя запущенности на 21%. ЗАКЛЮЧЕНИЕ Таким образом, пандемия COVID-19 отрицательно влияет на течение онкологических заболеваний, утяжеляя состояние пациентов, что в 17,8% случаев приводило к летальному исходу.

Vulvar intraepithelial neoplasia (VIN) is the proliferation of atypical basal cells in the vulvar epithelium. The global VIN incidence has recently doubled; its incidence among white women under 35 years of age has almost tripled with a tendency for further growth. Such an increase in the number of usual-type VIN cases in young women is primarily attributed to infection with highly oncogenic human papillomavirus. The second type of dysplasia, namely differentiated VIN, is usually found in older women and is associated with chronic dystrophic diseases of the vulva, most frequently with lichen sclerosus of the vulva. VIN diagnosis is quite challenging; no screening programs for this disorder have been developed so far. Patients with VIN practice self-treatment for a long time, which aggravates their condition and might trigger the development of vulvar cancer. Several treatment options are currently available; however, their efficacy worldwide is not high.

The aim of the investigation was evaluating the possibilities of cross-polarization optical coherence tomography (CP OCT) to monitor the effectiveness of photodynamic therapy (PDT) and radiation therapy (RT) of the oral cancer and of the cervical cancer. Materials and Methods. The CP OCT investigation was performed by an OCT-1300U tomograph (Institute of Applied Physics of the Russian Academy of Sciences, LLC “Biomedtech”, Russia). The monitoring of the two types of treatment was performed after different periods of exposure: for RT of the oral cancer — once for every 2–3 days throughout the whole course of the treatment, starting from the first day of radiation; for the PDT of the cancers of the skin and cervix uteri — before the exposure, immediately after the exposure, and then at 1 day, 7 day and 1 month after the exposure. Fourteen patients were examined in total. Results. The results of the study of the medical pathomorphism of different kinds of tumors performed on the 14 patients showed that visual evaluation of CP OCT images of a tumor does not reveal any visible changes in response to RT, however it does register the reaction of the normal mucosa in the area exposed to the radiation. During the PDT of tumors of the skin and cervix mucosa CP OCT was capable of detecting the key morphological changes (edema, necrosis, and structural recovery). It can be applied most effectively at later stages of the follow-up observation (at 30–35 days after PDT) to evaluate the completeness of the recovery of the stromal component of the tissues. Conclusion. The use of CP OCT contributes to realization of non-invasive monitoring of the responses of tumors and the adjacent normal tissues to PDT and to RT that can be useful for evaluation of the effectiveness of therapy and to help in choosing optimal tactics for the treatment.

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.

The objective of the investigation was to show the advisability of using optical coherence tomography (OCT) for noninvasive diagnostics and monitoring of treatments in gynecological practice for female patients of reproductive age.Materials and Methods. OCT studies were performed during standard gynecological procedures like laparoscopy and colposcopy, as well as in course of pelvic inflammatory diseases of cervical neoplasia, with the use of an OKT1300U (BioMedTech, Russia). 330 patients of reproductive age (aged 18-45) were examined. The methods used for numeric processing of the OCT images were based on an analysis of histograms and on calculation of the first derivative of the OCT signal over depth.Results. The use of OCT with numeric processing of the images increases the sensitivity of laparoscopy diagnosis of latent chronic salpingitis from 43.5 to 96.0%. In the case of minimal endometriosis, OCT can be used as a substitute for excisional biopsy for the visualization and verification of endometrioid heterotopias. The use of OCT in the case of cervical neoplasia in female patients of reproductive age enables a considerable decrease in surgical aggression during the diagnosis and treatment of cervical intraepithelial neoplasia and early forms of cancer.Conclusion. The use of OCT helps to maximize individualization and organ preservation during the diagnosis and treatment of gynecological pathology, and therefore to preserve the reproductive potential of young female patients.

The aim of the investigation was evaluating the possibilities of cross-polarization optical coherence tomography (CP OCT) to monitor the effectiveness of photodynamic therapy (PDT) and radiation therapy (RT) of the oral cancer and of the cervical cancer.Materials and Methods. The CP OCT investigation was performed by an OCT-1300U tomograph (Institute of Applied Physics of the Russian Academy of Sciences, LLC "Biomedtech", Russia). The monitoring of the two types of treatment was performed after different periods of exposure: for RT of the oral cancer - once for every 2-3 days throughout the whole course of the treatment, starting from the first day of radiation; for the PDT of the cancers of the skin and cervix uteri - before the exposure, immediately after the exposure, and then at 1 day, 7 day and 1 month after the exposure. Fourteen patients were examined in total.Results. The results of the study of the medical pathomorphism of different kinds of tumors performed on the 14 patients showed that visual evaluation of CP OCT images of a tumor does not reveal any visible changes in response to RT, however it does register the reaction of the normal mucosa in the area exposed to the radiation. During the PDT of tumors of the skin and cervix mucosa CP OCT was capable of detecting the key morphological changes (edema, necrosis, and structural recovery). It can be applied most effectively at later stages of the follow-up observation (at 30-35 days after PDT) to evaluate the completeness of the recovery of the stromal component of the tissues.Conclusion. The use of CP OCT contributes to realization of non-invasive monitoring of the responses of tumors and the adjacent normal tissues to PDT and to RT that can be useful for evaluation of the effectiveness of therapy and to help in choosing optimal tactics for the treatment.

The experience of treatment for precancer and early cervical cancer by photodynamic therapy in 12 patients with primary diagnosis H-SIL (CIN II–III) and cancer in situ is described. Chlo-rine photosensitizer Photolon was given intravenously at a dose of 0.75–1.15 mg/kg body weight. 2.5 h later the treatment with polyposition laser exposure (light dose – 150 J/cm2, light power density – 400–500 mW/cm2) was made. Thirty days later conization of the cervix with endocervical curettage assessing therapeutic response of cervical tumor tissue was per-formed. According to histological data complete response was in 4 patients, minute foci of CIN I were determined in 7 patients, 1 patient had foci of CIN II. 8 of 10 HPV-positive patients had complete eradication of HPV after treatment. There were no serious adverse events after light exposure. Marked therapeutic response, high anti-viral activity and good feasibility allow to consider photodynamic therapy as alternative organ-sparing treatment of early cancer and pre-cancer of cervix.

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.