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Breast cancer (BC) is a heterogeneous disease characterized by the presence or absence of membrane receptor overexpression on tumor cells that correlates with the disease prognosis. Understanding of the patterns and mechanisms of tumor progression gained through clinical experience of managing BC patients is important. The treatment strategy depends on the hormone receptor status of the tumor, the HER2 / neu expression, and the proliferative activity level. A clinical case of advanced luminal A breast cancer is reported, and the rationale for sequential treatment strategy is provided taking into account the clinical situation and clinical course of the disease. Adequate endocrine therapy for hormone-positive metastatic BC provides long-term tumor control like in this case, as well as a high quality of life over the entire course of sequential treatment with anticancer drugs.

Background. The implementation of tyrosine kinase inhibitors into clinical practice improved treatment outcomes in patients with radioiodine-refractory differentiated thyroid cancer (RR-DTC). Lenvatinib is recommended as a first-line drug for these patients. The study objective is to analyze clinical experience with lenvatinib in patients with RR-DTC in the Russian Federation. Materials and methods. The data from 18 clinical sites in Russia was analyzed for the period December 2015 and September 2019. Seventyseven patients with histologically verified DTC, proven resistance to radioactive iodine therapy, and tumor progression (according to the Response Evaluation Criteria In Solid Tumors 1.1 criteria) were included in the study. Results.Median progression-free survival in patients included into analysis (n = 72) was 26.1 months. In patients who responded to therapy (including those with partial and complete response), median progression-free survival reached 36.2 months, which is higher than that reported in the updated results of the SELECT study (33.1 months). Lenvatinib-associated adverse events (AEs) were observed in 87 % of patients. Severe AEs were registered in 18.2 % of participants. In 6.5 % of cases, AEs lead to lenvatinib cessation; in 74 % of cases, AEs required dose reduction.Conclusion. Our findings suggest high efficacy and good tolerability of lenvatinib in patients with RR-DTC in routine clinical practice in the Russian Federation.

Adhesive intestinal obstruction is one of the most common and potentially fatal complications after abdominal surgery. Among gynecological operations, leading to the development of adhesive intestinal obstruction, abdominal hysterectomy is the most common cause of emergency intervention. At the same time, in the recent past, mortality was observed from 40% to 60%. Currently ,due to the development of endovideosurgery, it was possible to reduce the postoperative mortality rate however, the mortality rate remains between 10% and 20% in all patients with adhesive small bowel obstruction. The cornerstone in the improvement of treatment results is the timely diagnosis of this complication. We have developed criteria for early computer tomographic diagnosis of adhesive intestinal obstruction in patients after gynecological surgery (patent No. 2669729). These include: free fluid in the lumen of the small intestine more than 200.0 ml, in two or more areas, pneumatized intestinal loops, expansion of the intestinal wall by 2.1 mm or more. The study was conducted in two groups of patients with adhesive peritoneal disease with intestinal obstruction, which included computed tomography (104 patients) and examined according to the traditional method (60 people). The validity of the diagnostic computer tomographic criteria of the study leaves no doubt about the need for their use in the preoperative prediction of access and the volume of surgery.

In the paper there is presented a review of foreign and literature data, documented in electronic search system PubMed regarding epidemiology, early and prenosological diagnosis, carcinogenic factors for development of malignant respiratory neoplasms, lung cancer.

The most important problem determining the indications for surgical treatment of peritoneal adhesion is associated with the uncertainty of the criteria for early diagnosis of intestinal obstruction. Of all the most common acute surgical diseases of the abdominal cavity, acute intestinal obstruction gives the highest lethality. The main reason for this is untimely diagnosis. In two groups of patients, we performed a study of chronic peritoneal peritoneal disease using X-ray computed tomography (RCT), with obstruction (58 patients) and absence of this pathology (56 patients). Analyzing nonparametric statistics with the calculation of the Pearson criterion, with the Yates correction. We presented the criteria for the RCT study, differential diagnosis of adhesive intestinal obstruction from exacerbation of peritoneal adhesion. The main indicators of this disease: the fluid content in the lumen of the small intestine is more than 200.0 ml, in two or more regions, the inflated intestinal loops, an extension of 2.1 mm and more of the intestinal wall. The validity of the diagnostic criteria for RCT research leaves no doubt about the need for their use in preoperative access prognosis and the scope of surgical intervention.

There is no official data on malignant glioma morbidity in Russian Federation. The data absence became the main reason for Russianmulticenter project conduction to research malignant gliomas’ epidemiology. The epidemiology data and glioblastoma treatment approac-hes are presented in the article. Significant variability of 1st line treatment choice both for radiotherapy and combined therapy was confir-med. The current treatment standard (chemoradiotherapy + temozolomid) is received only by one of every four patients with new diagno-sed glioblastoma. Less than half of patients receive 2nd line therapy, which apparently influences on patient’s life duration. More than thirdof patients with recurrent glioblastoma received bevacizumab.

Efficacy of radiochemotherapy of malignantly-converted brain gliomas using teniposide was evaluated in a randomized prospective study. Combined use of cytostatics and irradiation appeared safe, tolerable and significantly more effective than radiotherapy alone as assessed by local control of tumor and survival.

The integrative diagnosis is based on a simultaneous analysis of the data obtained by various methods of examination. Nine direct and 14 indirect symptoms of central pulmonary carcinoma were distinguished. Three introscopic complexes, that helped a correct diagnosis, were used in examinations of 147 patients with this condition. The presence of direct symptoms and combinations of 3 or more indirect signs were regarded as a manifestation of cancer. Metastases to the lymph nodes of the root of the lung were detected in 57.1% of patients, metastases to the mediastinum in 32.7% of cases. The results of biopsy were positive in 93.9% of the patients. The suggested method extends the diagnostic potentialities of the routine methods of investigation and helps optimize the algorithm of examinations and detect the tumors that are difficult to recognize.

The authors compare the incidence of bladder carcinoma recurrences and dissemination after long-distance gamma-beam therapy, carried out according to a traditional method, and in an accelerated hyperfractionation mode combined with metronidazole therapy. The recurrences were most frequently detected at the site of the primary tumor (62-67% of cases) in 6 to 18 months after the treatment. They come to a conclusion that accelerated hyperfractionation and local metronidazole radio-modification were conducive to a reduction of the incidence of recurrences from 45 to 28% as against the traditional split radiotherapy course in the classical fractionation mode.

The paper is devoted to analysis of the potentialities of radionuclide renography as a method for assessment of the effectiveness of radiotherapy of bladder cancer. The results obtained suggested close correlation between change of renal function and the results of irradiation. Normal renal function was observed in 3 patients, improvement--in 16 patients, and deterioration--in 8 patients whereas a complete effect of radiotherapy brought about the following figures: 5, 11 and 3, respectively. A conclusion was made of a high significance of renography parameters in objective assessment of the results of radiotherapy of bladder cancer in conjunction with other therapeutic modalities.

The paper is devoted to analysis of the potentialities of radionuclide renography as a method for assessment of the effectiveness of radiotherapy of bladder cancer. The results obtained suggested close correlation between change of renal function and the results of irradiation. Normal renal function was observed in 3 patients, improvement--in 16 patients, and deterioration--in 8 patients whereas a complete effect of radiotherapy brought about the following figures: 5, 11 and 3, respectively. A conclusion was made of a high significance of renography parameters in objective assessment of the results of radiotherapy of bladder cancer in conjunction with other therapeutic modalities.

The authors presented short-term and immediate results of radiation therapy of bladder cancer by a conventional method and optimized program, combining accelerated hyperfractionation and local radiomodification with metronidazole. A variant, proposed by the authors, included the use of a single focal dose of 1.4 Gy twice a day with a 4-hour interruption up to a total dose of 39.2 Gy. It was followed by a dose of 6 Gy once a week with preliminary administration of 2 g of metronidazole in 30-40 ml of 50 per cent dimexide solution in the bladder. A total of 2 large fractions of irradiation combined with metronidazole were used. This method was used for the treatment of 89 cancer patients. Better local control and survival in anemic patients with poorly differentiated cancer were observed.

The paper is devoted to the description of the combined methods of radiotherapy of urinary bladder cancer and the local use of metronidazole. At the 1st stage of therapy a dose of 140 cGy twice a day with 5-6 h interruption was delivered up to a summary dose of 43 Gy on conversion to small fractionation by the TDF factor. Then two fractions at a single dose of 6 Gy once a week were given. Altogether 36 patients were treated by this method. The control group of patients was given radiation therapy in a split course in the regimen of routine fractionation. Short-term therapeutic results were analyzed for both groups. The total positive effect was higher in the study group (81.25% versus 66.7%). A conclusion is that this method holds promise.