BACKGROUND: Diagnosis and treatment of patients with colorectal cancer is a multidisciplinary task. The transition to a new edition of clinical guidelines for the treatment of colorectal cancer in 2024, while maintaining the routine approach to MR staging of malignant neoplasms of this localization, reduces the level of continuity between medical specialists. AIM: To improve the quality and completeness of MR diagnostics of malignant neoplasms of the rectum to ensure continuity and improve the multidisciplinary approach. MATERIALS AND METHODS: A retrospective analysis of the completeness of compliance with the parameters of TNM 8 (2017) and the MRI subclassification T3 of rectal cancer was carried out on 137 MRI scans of the pelvic organs and protocols with conclusions to them. Based on the results of the analysis, educational training and a conclusion template for radiologists were developed and conducted, after which the MR images were re-evaluated. Before and after the training, the most fully evaluated MRI scans by radiologists were provided to medical experts to form a “second opinion”. The results obtained made it possible to calculate the absolute and relative number of consensuses (coinciding in all parameters of the conclusions) and to identify cases of rectal cancer restaging that require changes in treatment tactics. RESULTS: Before the educational training, only 11% of MRI scans and their reports met the requirements of the modern protocol. After the training, 78% of the images were completed in compliance with all requirements. Particular difficulties and the majority of “discrepancies” in conclusions arose when determining the depth of tumor invasion into the mesorectal tissue; measuring the distance from the tumor and/or affected lymph node to the mesorectal fascia or edge of the levator ani muscle and identifying signs of extramural vascular invasion. It was not possible to achieve complete consensus in all cases on these parameters. CONCLUSION: The analysis of MRI scans of the pelvic organs, the development and implementation of educational training to improve the interpretation of medical images, made it possible to significantly improve the staging of rectal cancer and ensure proper continuity in the implementation of a multidisciplinary approach.

Introduction. Recent decades indicate a significant increase in the incidence of skin cancer. Aim. To upgrade the specialized device and to improve the quality of skin neoplasm diagnostics. Materials and methods. The study mainly involved the method of non-invasive differential diagnostics of skin neoplasms. The method relies upon optical research methods, including Raman spectroscopy, a spectroscopic technique. A 10-year study, conducted by the Department of Oncology, the Samara Regional Clinical Oncology Dispensary (SOKOD), included more than 500 observations. The study used samples of various skin neoplasms obtained during surgical treatment of patients. Experimental tests provided a certain spectrum of various benign and malignant human skin neoplasms, including melanoma. Results. A series of experimental tests resulted in an experimental setup that is absolutely safe to use. Discussion. The study involved comparison of individual characteristics of the Raman spectra, obtained in the examination of neoplasm and healthy skin for each patient, thereby individualizing the method. The study revealed a high accuracy rate of 92% (with sensitivity of 89%, specificity of 93%), thus minimizing risks of false negative results, which is essential for mass examination. Conclusion. Since the proposed device setup does not require consumable products and different reagents, the method is marked with lower time costs and maintenance burden. Raman spectroscopy obtains a significant potential, thus, can be widely used for skin neoplasms in various medical and preventive institutions.

Aim – assessment of the effectiveness of complex therapy to reduce the development of early cardiovascular complications. Materials and methods. Information from medical histories and outpatient follow-up cards of 139 patients with invasive breast cancer was analyzed: in the G.V. Bondar Republican Cancer Center 64 patients (main and control groups); as an additional comparison group, the study included 75 patients of the Samara Regional Clinical Oncology Dispensary. Patients in the control group (33 people) and the Samara Regional Clinical Oncology Dispensary group (75 people) received standard therapy (RUSSCO, recommendations, 2023): doxorubicin 60 mg/m2 IV on day 1 + cyclophosphamide 600 mg/m2 IV on day 1 Day 4 – 4 courses. In 31 patients of the main observation group, in addition to similar drug treatment, in order to prevent the development of early cardiovascular complications, the method was used, which included 7 courses before the start of 1 cycle of chemotherapy + 3 courses of interval normobaric hypoxic therapy (INHT) before the start of each subsequent cycle of chemotherapy. Results. When analyzing the total effectiveness of treatment between the groups of patients, statistically significant differences were obtained: the control and main groups were compared (χ2=5.4, p=0.03), the group of the Samara Regional Clinical Oncology Dispensary group and the main group (χ2=3.45, p=0.076). Conclusions. Hypoxic therapy significantly affects the quality of life of patients. For all indicators reflecting quality of life, traditional treatment was inferior to combination drug therapy with INHT.

Current technologies of plasma electrolytic oxidation (PEO) for modifying the surfaces of dental implants made of the Grade IV titan alloy provide predictable long-term results in implant dentistry. The aim of the study is to evaluate the efficacy of PEO technology comparing two types of surface modification of dental implants made of VT1-0 medical titanium alloy. Materials and Methods:50 IRIS dental implants (Scientific Production Company LICOSTOM, Russia), 10-mm long and 4 mm in diameter, were manufactured from the VT1-0 alloy. The implant surface was treated by two PEO methods: 1) in the aqueous solution of alkaline electrolyte without any additional modifiers (PEO-Ti); 2) in the aqueous solution of orthophosphoric acid-based electrolyte containing calcium carbonate (PEO-Ca). Implants made of VT1-0 alloy after milling and without additional treatment served as control samples. The implant surfaces were studied by electron microscopy and energy dispersive X-ray spectrometry. Some of the implants were installed in sheep, samples were obtained at 2, 4, and 8 weeks and studied by microcomputer tomography. Results:Regardless of the electrolyte composition, a highly developed porous surface was formed in the samples with PEO-modified surfaces. The surface of the PEO-Ti samples in a simple unmodified electrolyte was characterized by a large number of open pores with a wide range of size distribution from 200 nm to 3 μm. The pore size distribution was of a monomodal character, with a maximum near 0.23 μm. The PEO samples in the Ca-containing electrolyte had pores also in a wide range from ~80 nm to ~7 μm. The pore distribution, in contrast to PEO-Ti, was bimodal in nature, with the main maximum in the region of 1.05 μm and the concomitant maximum near 2.45 μm.The obtained surfaces of both types (PEO with Ca and Ti) possessed high purity and optimal microroughness for osseointegration. Both types of PEO treatment (PEO with Ca and Ti) have demonstrated a similar osseointegrative potential, nevertheless, the surface of the PEO-Ca showed a better contact with the implant surface (49.8%) than PEO-Ti (42.4%) obviously due to the presence of calcium in its composition. Conclusion:The PEO-formed implant surfaces demonstrate high osseointegrative properties after any variants of treatment and show the potential for application in osteoporosis.

We present here the results of studies of a photocatalytic method for hydrolysis of urea in model solutions of treated dialysate. This work used a photocatalytic flow cell with a working range of 340-390 nm. The experiments showed that use of photocatalytic titanium metal plates alloyed with impurity atoms TixCayOz, TixCeyOz, and TixZnyOz led to removal of urea from dialysate by 1.7, 1.9, and 2.3 mM in 5 h respectively. Photocatalytic titanium plates were found to hydrolyze easily decomposing compounds in model solution without significantly altering its ionic composition.

In Samara region colorectal cancer has taken a leading position in the structure of the incidence of oncological diseases in recent years. The aim of the study is to optimize preventive work in the region aimed at preventing the development of colorectal cancer and improving the detection of this disease at early stages. Material and methods. In addition to the activities provided by the program of dispanserisation of the adult population, the oncological service of the region proposed a number of organizational solutions: the program «Men’s health» was introduced, the target audience of which was men 40-60 years old; the programs of examinations at manufactures and offices of the region, carried out by the regional center of pathology associated with the profession, have been optimized; active educational activities are carried out by the department of medical prevention of the regional oncological center. Results. The introduced approaches allowed increasing the coverage of the population with preventive examinations and increasing the number of patients with diagnosed colon polyps. Extremely important is the work aimed at shaping the ideology and motivation of the population to actively maintain health.

В статье рассматриваются современные стратегии вторичной профилактики онко-ассоциированных тромбозов. Представлены материалы исследований и собственного клинического опыта. Оценена возможность применения пероральных антикоагулянтов для длительной антикоагулянтной терапии The article discusses current strategies for secondary prophylaxis of cancer-associated thrombosis. Research materials and own clinical experience are presented. The possibility of oral anticoagulants use for long-term anticoagulant therapy has been evaluated.

Aim to study the dynamics of morbidity and mortality from cervical cancer, the age characteristics of the patients for the period 2010-2019 in the Samara region. Material and methods. We used the statistical data on morbidity and mortality in women with cervical cancer in the period from 2010 to 2019, registered in the statistical reporting forms of the Samara region. Results. In 2010, 12,329 patients were diagnosed with malignant neoplasms (MN) for the first time, of which 281 patient (2.3%) was diagnosed with cervical cancer. In 2019, 14,456 patients were diagnosed with MN for the first time, of which 422 patients (3%) had cervical cancer. At the same time, the peak incidence of cervical cancer was registered in 2017 627 patients (4.5%). Between 2010 and 2019 there was an increase in patients with a confirmed diagnosis of cancer by 30.2%, and with a diagnosis of cervical cancer by 18.3%. Conclusion. The analysis indicates a trend towards an increase in the incidence of cervical cancer. This result may demonstrate both a real increase in the frequency of this pathology, where an unfavorable environmental situation in the Samara region may be a risk factor, and an improvement in the quality of diagnosis and statistical records.

Background. Breast cancer (BC) is distinguished with its biological tumour subtypes as luminal A, B, HER2-positive and triple-negative. The current clinical guidelines of the Russian Ministry of Health prescribe neoadjuvant targeted chemotherapy as combined treatment in the HER2-positive cancer subtype. An adequate model for treatment efficacy prediction in such patients had been missing to date.Aim. Development of a mathematical model and its computer realisation for complete morphological regression estimation in patients with primary operable HER2-positive breast cancer.Materials and methods. Statistically significant predictors were estimated with the treatment outcome data on 103 HER2- positive breast cancer cases with neoadjuvant targeted chemotherapy. A binary logistic regression model was developed to account for a dichotomous variable dependency on certain predictors.Results and discussion. Multivariate analysis laid out a mathematical model and software “Complete morphological regression estimation in primary operable EGFR-expressing breast cancer under neoadjuvant chemotherapy”. Our results attest that the program correctly automates a systematic estimation of complete morphological regression achieved prior to neoadjuvant targeted chemotherapy and is clinically justified for optimising treatment regimens in primary operable HER2-positive BC.Conclusion. The mathematical model and computer program developed estimate the rate of complete morphological regression achieved prior to neoadjuvant targeted chemotherapy with a high 92 % sensitivity, 97.33 % specificity and 93.21% accuracy.

Objective to refine the method of incisional biopsy in the diagnosis of oral mucosa cancer using the auto-fluorescent stomatoscopy. Materials and method.The study was conducted on the base of the Samara Regional Clinical Oncology Center. The inclusion criterion for patients was the diagnose of the oral mucosa cancer of various localization. Patients were divided into 2 groups. The main group included patients (n=43), who were being diagnosed for cancer with the help of optimized incisional biopsy of the oral mucosa formations, using the "AFS-400" autofluorescence complex and glasses with a green light filter for identification. The patients of the control group (n=46) received the standard biopsy procedure under direct vision. Results.The first incisional biopsies revealed cancer in 25 (54%) patients of the control group and in 36 (84%) patients of the main group. A histological verification of the diagnosis was necessary in 7 (16%) patients of the main group and required the second biopsy. In the control group, for the same purpose, 17 (37%) patients underwent the second biopsy and 4 (9%) patients required the third biopsy procedure. Exophytic-papillary forms of cancer were the most complex for histological verification. The primary biopsy of these cases was effective in 16 (37%) patients in the main group and in 8 (17%) patients in the control group (p = 0.036). In patients with initial stages of cancer (I-II), with the first incision biopsy, the histological verification of cancer was achieved in 16 (37%) cases in the main group and in 8 (17%) cases in the control group (p = 0.036). Conclusion.The use of the "AFS-400" autofluorescent complex and glasses with a green light filter for incisional biopsy of oral mucosal formations allows histological verification of cancer with the first biopsy in 84% of cases, including in stages I - II in 16 (37%) cases and in exophytic papillary forms in 16 (37%) cases. The significant difference was registered for the similar indicators of the control group (p = 0.036).

Цель – оптимизировать методику инцизионной биопсии с применением аутофлуоресцентной стоматоскопии при диагностике рака слизистой оболочки полости рта. Материал и методы. Работа выполнена на базе ГБУЗ «Самарский областной клинический онкологический диспансер». В исследование вошли больные с установленным диагнозом «рак слизистой оболочки полости рта» различных локализаций. Пациенты были разделены на 2 группы. В основной группе (n=43) для диагностики рака применена оптимизированная методика инцизионной биопсии образований слизистой полости рта с использованием в качестве идентификации аутофлуоресцентного комплекса «АФС-400» и очков с зеленым светофильтром. В контрольной группе (n=46) применялась стандартная методика под контролем глаза. Результаты. После выполненных однократных инцизионных биопсий в контрольной группе рак выявлен у 25 (54%), а в основной группе – у 36 (84%) пациентов. В контрольной группе для получения гистологической верификации (ГВ) диагноза проводились дву- и трехкратные биопсии – 17 (37%) и 4 (9%) соответственно, в основной – только двукратно у 7 (16%) пациентов. Наиболее сложной группой пациентов были больные с экзофитно-папиллярными формами. В основной группе ГВ при первичной биопсии была получена у 16 (37%) больных, в контрольной у 8 (17%) больных (р=0,036). У пациентов с начальными стадиями (I-II) при однократной инцизионной биопсии ГВ рака достигнута в основной группе в 16 (37%) случаях, в контрольной в 8 (17%) случаях (р=0,036). Заключение. Применение аутофлуоресцентного комплекса «АФС-400» и очков с зеленым светофильтром для инцизионной биопсии образований слизистой полости рта позволяет уже при первой биопсии в 84% случаев получить ГВ, с учетом наличия I-II стадий – в 16 (37%) случаях и экзофитно-папиллярной формы – в 16 (37%) случаях. Это значимо отличается от аналогичных показателей контрольной группы (р=0,036).

Aim. Eribulin is an active cytostatic, associated with a wide range of mechanisms of antitumor effects, but eribulin efficiency and safety in patients with breast cancer (BC), associated with cerebral metastases are still poorly understood. Materials and methods. We analyzed the combined Russian experience of eribulin application in BC patients associated with brain metastases; the analysis included 459 Russian women with advanced BC who had received at least 2 course of eribulin during the period from 2014 to 2018; 35 of 459 patients had brain metastases (40.0% - luminal HER2-negative subtype, 31.4% - triple negative subtype and 28.6%h - HER2-positive BC). The median age was 52 years (39 - 80 years of age). In most cases, the patient had two or more metastatic brain lesions (68.6%; the median was - 3); brain radiotherapy was used in 62.8% of patients before eribulin treatment and in 5.8% of patients was held stereotactic radiation therapy during eribulin chemotherapy. We analyzed the efficiency of eribulin application (the therapy continued until disease progression, the development of unacceptable toxicity, or impossibility to apply the drug for any other reason). Results. The results showed that clinical efficacy (objective response rate + stabilization of disease lasting for more than 6 months) was 48.6%: partial response - in 20% of patients and stabilization of disease - 62.9%; tumor growth control was in 82.9%. Median PFS in all group of patients with brain metastases was 4.1 months and was similar to median PFS in patients who received radiotherapy before eribulin treatment or without eribulin - 4.1 vs 3.47 months; p=0.798. Conclusions. The application of eribulin in BC patients with brain metastasis are absolutely justified, the drug demonstrates the efficiency in a retrospective analysis in a Russian population. The determination of the optimal algorithm for the treatment of patients with metastatic BC associated with brain metastasis requires a multidisciplinary approach and further research.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Aim - to improve the long-term results of cytoreductive treatment of patients with simultaneous multiple bilobar liver metastases of colorectal cancer by the use of RFTA. Materials and methods. The study presents the results of treatment of 168 patients diagnosed with colorectal cancer of stage IV with simultaneous bilobar metastases in the liver. In the main group, cytoreductive tumor removal was accompanied by radiofrequency thermal ablation (RFTA) of metastatic formations. In the control group only the primary tumor was removed. Results. The use of RFTA during cytoreductive surgery does not worsen the immediate results of surgical treatment, in comparison with patients, where the effect on liver metastases has not been performed, but allows to increase medians of uneventful and overall survival from 9 and 22 months to 17 and 29 months, respectively. Conclusions. The use of RFTA for simultaneous multiple bilobar metastases in the liver during cytoreductive surgery makes it possible to achieve 22.7% of the three-year uneventfulness and 4.3% of the five-year overall survival.

A device for mobilization of the greater pectoral muscle during endoprosthetic surgery was developed at the Samara Regional Clinical Oncology Center (Utility model patent No. 175229; November 28, 2017). The device makes the surgery less traumatic, reduces the volume of blood loss and the duration of surgery, and improves the quality of visualization of the surgical area. It allows the rate of injuries to the greater pectoral muscle to be reduced.

В работе описан принцип создания математической модели и программы для ЭВМ по расчету эффективности неоадъювантной химиотерапии с включением антракциклинов у больных с диагнозом трижды негативный рак молочной железы. Данное исследование проведено в Самарском областном клиническом онкологическом диспансере на основе статистической обработки результатов лечения 98 пациентов. Предложенная математическая модель и программа для ЭВМ (Свидетельство о государственной регистрации программ для ЭВМ № 2017660720 от 25.09.2017) позволяет с высокими показателями точности, чувствительности и специфичности определить эффективность химиотерапии, что возможно использовать для выработки схемы лечения больных с диагнозом трижды негативный рак молочной железы.

The study objective was to analyze the clinical signs of chemotherapy-induced neuropathy (CIPN) in cancer patients and explore pharmacotherapy correction options using vitamin B. Materials and design. During Part 1 lasting from May to September 2017, we screened and then enrolled 219 consecutive patients (mean age of 50.4 ± 6.9 years); 105 (46.7%) of them were women undergoing chemotherapy treatment cycles at Samara Regional Oncological Clinic. Through standard-of-care neurological examination and patient responses we defined the clinical signs of polyneuropathy: its localization, primary symptoms, including sensory impairments and/or pain, and then randomized the patients into two groups: group 1 received vitamin B agents, and group 2 received no vitamin B. The patients were observed for 60 days. Results. The incidence of polyneuropathy in oncology patients receiving chemotherapy turns out to be very high. The phenotype of clinical signs and their severity and localization is probably related to the type of the drug agent used. We have proved the efficacy of the step-down therapy with vitamin B agents used to improve clinical signs of polyneuropathy.