Background . To retain guarantees for the provision of quality medical services in oncology, optimal tools of the system for monitoring medical activities are required to be further introduced in real practice. Analysis of the results of the selection of the most valid criteria for assessing the quality of medical activity is of significant scientific interest and contributes to the improvement of the organization of medical care. The work aimed to review the international literature on the identification of control criteria for the quality of cancer care. Materials and methods . The international experience is analyzed based on reliable sources of information obtained through the application of queries on the topic under study in the PubMed (Medline) database and Google search engine. Additional key phrases were used as and when required. About 45 of the most relevant information sources were selected. Results . Various criteria for the quality and safety of medical activity in oncology are presented. Some general (universal) criteria for assessing the quality of medical activity, specific to individual nosologies, have been identified. The advanced international experience in the classification and identification of key quality criteria used in oncology in patients with the most frequently diagnosed cancer types in Russia has been generalized. The standardization and validation of new quality assessment criteria are priorities for subsequent scientific development. Discussion and conclusions . During standardization, there has been a tendency to determine comprehensive parametric criteria for assessing quality and covering the entire scope of interdisciplinary medical care. To further improve the scientific and methodological support of control, it is advisable to develop medical methodologies for conducting clinical audits for various types of malignant neoplasms (ICD10: S00–96), considering specific indicators and requirements of regional healthcare system. The selection of the optimal, most valid, and informative indicators of the quality of medical activity and the establishment of digital standards for the quality of services are becoming an integral aspect of the general processes of improving clinical audit tools in oncological institutions.

The paper presents the first experience in treating 5 patients with stage II-III non-small cell lung cancer using combined modality treatment including 40 Gy preoperative hyperfractionated radiotherapy with concurrent 2 cycles of paclitaxel/carboplatin chemotherapy and local hyperthermia (10 sessions) followed by radical surgery. The overal response rate to preoperative treatment was 80 %. Chemotherapy was well tolerated and hyperthermia resulted no in adverse effects. All patients underwent surgery (4 lobectomies and 1 pneumonectomy). No complications were observed in the postoperative period. The follow-up period ranged from 6 to 20 months. No evidence of disease progression and radiation-induced damages were observed.

This review presents the structure of the proteasome system, discusses its involvement in the pathogenesis of many cancers, including the process of metastasis. It describes the distinctive structural characteristics of intra- and extracellular pools of proteasomes, possible ways of their exit into the extracellular space and their forms of existence outside the cell. Also in the present review discusses the importance of circulating proteasomes for prognosis course of the cancer.

Treatment outcomes for a patient with solitary brain metastasis after long-term relapse-free follow-up of invasive lung carcinoma were presented. Brain metastasis without other signs of disease progression was diagnosed 10 years after combined modality treatment for stage II lung cancer. Removal of intracerebral metastasis with intraoperative photodynamic therapy was performed. Histology microspecimens of the primary tumor and metastasis were similar. No signs of disease progression in the brain 9 months after surgery were found. This case demonstrates that it is important to increase cancer suspicion for patients with long-term relapse-free follow-up. The use of intraoperative photodynamic therapy with photoditazine as a sensitizer in the treatment of cerebral metastases results in a favorable anti-tumor effect, thus improving life quality of patients

RARβ2 and RASSF1A methylation index has been measured in extracellular DNA circulating in blood plasma and being bound with surface of blood cells of non-small-lung cancer (NSCLC) patients before treatment. Concentration of protein markers (CEA and CYFRA 21.1) has been quantified in the blood plasma of the same lung cancer patients. The RASSF1A and RARβ2 methylation index which calculated as the ratio of concentration of methylated gene copies by sum of the concentrations of methylated and unmethylated gene copies in blood provides the discrimination of NSCLC patients from healthy subjects with sensitivity and specificity of 90 % and 82 %. Immunochemical detection of CEA and CYFRA 21.1 protein markers provides the discrimination of NSCLC patients from healthy subjects with sensitivity of 43 % and 56 % and specificity of 88 % and 97 %. The association between concentration of epigenetic (RARβ2, RASSF1A, RARβ2 + RASSF1A) and protein markers (CEA, CEA + CYFRA 21.1) has been shown in blood of NSCLC patients, but not for the CYFRA 21.1 separately. The data obtained demonstrate that the analysis of RARβ2 and RASSF1A methylation index in combination with the protein markers concentration CEA and CYFRA 21.1 measuring is thought to be more effective than the detection of individual markers for lung cancer diagnostics.

Immediate response to preoperative chemotherapy with paclitaxel/carboplatin regimen was studied in 134 patients with stage III non-small cell lung cancer using spiral computed tomography (SCT) and fibrobronchoscopy (FBS). SCT and FBS were found to have a high diagnostic efficacy. Sensitivity, specificity and accuracy of SCT were 87,5 %, 96,7 % and 93,4 %. Concerning FBS, sensitivity, specificity and accuracy were 93,3 %, 96,7 %, 95,5 %. The data obtained show that endoscopic examination together with X-ray should be recommended for the assessment of the extent of tumor involvement after chemotherapy.