Objective of the study is to carry out an analysis of the data available in current literature on the factors affecting tumor growth and approaches to non-cytotoxic methods of its treatment.
Materials and Methods. The review comprises the data of foreign and Russian academic articles on the subject.
Results. We start to believe in the reality of tumor growth acceleration after the removal of primary tumor node, when we observe the development of recurrence and tumor metastasis. It seems incredible that a factor capable to specifi cally accelerate the division of millions of tumor cells, not only can’t be measured quantitatively, but it’s not even possible to detect its presence in blood serum. The article provides the evidence that tumor-specifi c proteins are antiproteases (serpins) and it is they which protect tumor cells from cathepsins of immunocompetent cells. So specifi c antiprotease-protease activity of blood serum is a necessary condition of tumor growth in the body. A fraction of human and animal blood serum which is capable of shifting the equilibrium towards tumor regression, has been discovered. Regression of at least two tumors was achieved: Ehrlich ascites carcinoma and solid ovarian adenocarcinoma of the mouse CaO1. Mice that had been treated lived without any signs of tumor for at least a year. No cellular immune response was observed in histological tumor regression. The author suggests that this approach can be used for the treatment of oncologic diseases.
Conclusion. The data presented in the article underscore the need for further investigation of the factors affecting tumor growth and development of the approaches to non-cytotoxic method of its treatment.
Keywords: cure of the tumor, blood serum proteins, protease-antiprotease equilibrium.
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Objective of the study is to carry out a systematic analysis of the data available in current literature on cardiovascular risks and disorders in patients with receptor-positive breast cancer who undergo hormone therapy.
Materials and Methods. The review comprises the data from foreign and Russian scholarly articles found in PubMed on the subject published over the past 10 years.
Results. Cardiovascular and oncologic diseases are the leading causes of death worldwide. Breast cancer is the most common oncologic disease in women. Hormonal methods, which are used for the treatment of this pathology, improve survival in one respect, in another respect can increase the risk of cardiovascular disorders and mortality among survivors after breast cancer treatment. An emphasis on multi-disciplinary approach to the management of healthcare of women during and after an active antitumor treatment, as well as optimization of pharmacologic strategies allow to reduce any associated risks.
Conclusion. The data presented in this paper underscore the need for further development of algorithms for the assessment of the risks of cardiovascular diseases based on evidence that can serve as guidelines for clinicians who consult breast cancer patients undergoing hormone therapy.
Keywords: breast cancer, cardiovascular disease, hormone therapy, selective estrogen receptor modulators, aromatase inhibitors.
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Objective of the study is to investigate the incidence and clinical features of hyperplastic processes of the endometrium (HPE) in women of different age groups based on WHO binary classifi cation of 2020.
Materials and Methods. A retrospective analysis of clinical and morphological data of 143 patients who had undergone hysteroscopy with histological examination of the endometrium was carried out.
Results. Hyperplasia of the endometrium without signs of atypia was confi rmed in 27 women in the whole cohort of patients that constituted 19% of cases, endometrioid intraepithelial neoplasia (EIN) — in 6 women (4% of cases). In the group of reproductive age (62 patients — 43%) a proportion of women with hyperplastic processes of the endometrium was 26%. In the group of transitional period (35 women — 25%) hyperplastic processes of the endometrium were identifi ed in 40% of cases. In postmenopause (46 patients — 32%) endometrial hyperplasia occurred considerably less frequently — in 6% of cases.
Conclusion. The incidence of endometrial hyperplasia varies from 6 to 40% in different age groups, prevailing in women in transitional period. Endometrioid intraepithelial neoplasia is identifi ed in 4% of cases that is consistent with literature data on the incidence of atypical hyperplasia (according to the classifi cation of 1994).
Keywords: hyperplastic processes of the endometrium, endometrial hyperplasia, endometrioid intraepithelial neoplasia.
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Objective of the study is to carry out a laboratory screening of the markers for differential minimally invasive diagnosis of various molecular subtypes of serous ovarian adenocarcinoma.
Materials and Methods. A comprehensive clinical, molecular and genetic examination of 100 patients with serous ovarian carcinoma and of 30 donors without oncologic diseases was conducted. Blood samples collected in venipuncture procedure were used to obtain extracellular DNA (exDNA). DNA extraction was performed using phenol-chloroform method. Determination of relative gene copy number was carried out using real-time quantitative polymerase-chain reaction (RT-qPCR). Non-parametric Mann-Whitney U-test was used for the evaluation of differences in quantitative indicators, and Bonferroni correction — to counteract the problem of multiple comparisons. Identifi cation of common signaling pathways of genes under study was performed using “multiple association network integration” algorithm. LASSO — penalized logistic regression was used for the choice of minimal gene set and for the creation of predictive models.
Results. Statistically signifi cant (p < 0,005) increase of SULT1-E1, CYP1-B1 and ESR1 gene copy numbers in extracellular DNA (exDNA) in patients with high-grade serous ovarian carcinoma relative to blood serum extracellular DNA (exDNA) of conditionally healthy donors was found. Statistically signifi cant increase (p < 0,05) in PTEN and BCL2 gene loci copy numbers and a decrease in BAX and CASP-3 gene copy numbers in extracellular DNA (exDNA) in patients with low-grade serous ovarian adenocarcinoma relative to blood serum extracellular DNA (exDNA) of conditionally healthy donors was revealed. A fi nal panel of genes PTEN/SULT1E1, ESR1/BCL2, PTEN/BCL2, BAX/BCL2, ESR1/BAX, PTEN/BAX, CYP1B1/ ESR1 was obtained based on bootstrap models.
Conclusion. The study allowed to identify subtypes of low-grade and high-grade serous ovarian adenocarcinoma on molecular genetic level. Simultaneous determination of indicators of PTEN, SULT1E1, ESR1, BAX, BCL2 and CYP1B1 gene copy numbers in extracellular DNA (exDNA) of blood serum permits to identify patients with serous ovarian adenocarcinoma of two types — low-grade and high-grade of malignancy. The results of the study provide great opportunities for personalized approach to the treatment of these tumors.
Keywords: serous ovarian carcinoma, molecular subtype, gene copy number, extracellular DNA.
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Objective of the study is to carry out an analysis of literature data on the current principles of performing brachytherapy for locally advanced cervical cancer based on CT scan images.
Materials and Methods. The review comprises the analysis of the articles submitted in PubMed database.
Results. Brachytherapy (BT) plays a key role in a course of combined chemoradiation therapy in patients with locally advanced cervical cancer. Brachytherapy based on MRI visualization is advanced, popular, most common and has gained wide acceptance in the USA and European countries. Determining of target volume and critical organs based on MRI data, leads to improving of clinical outcomes of the treatment and to reduced toxicity. An extensive use of this visualization technique in brachytherapy is limited in Russia due to challenging logistics and insuffi cient logistical and procurement support of the clinics. Therefore, brachytherapy for cervical cancer is performed generally based on CT scan images. The paper introduces the principles of performing brachytherapy based on CT scan images.
Keywords: cervical cancer, conformal radiation therapy, interstitial radiation therapy, brachytherapy.
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Objective of the study is to evaluate the quality of life of patients with locally advanced cervical cancer in the process of combination treatment with neoadjuvant chemotherapy and in the follow-up care.
Materials and Methods. The evaluation of the quality of life of patients with locally advanced cervical cancer was conducted under the International Clinical Protocol of the European Organization for Research and Treatment of Cancer (EORTC). The most sensitive for oncologic diseases Quality of Life Questionnaire — Core 30 of the European Organization for Research and Treatment of Cancer version 3.0 and cervical cancer specifi c module — EORTC QLQ-CX24 were used to assess the quality of life of cancer patients . The study comprised 107 patients with stage IIb-IIIb locally advanced cervical cancer.
Results. It was revealed that the use of neoadjuvant chemotherapy in the combination treatment of patients with locally advanced cervical cancer (LACC) contributes to the enhancement of quality of life of patients by reducing clinical manifestations of the disease and improving long-term outcomes of the treatment. It was concluded that the indicators of functional assessment scale and of general health status were statistically signifi cantly higher in comparison with patients who had undergone chemoradiation treatment and combination of external beam radiotherapy and internal irradiation. The maximum level of restoration of functional scale and the reduction of indicators of symptom severity scale is observed 12–24 months after the completion of anti-tumor treatment.
Keywords: locally advanced cervical cancer, quality of life, chemoradiation treatment.
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Objective of the study is to carry out an analysis of the data available in current literature on sexual dysfunctions in women who underwent radical treatment for breast cancer.
Materials and Methods. The literature review comprises the data of Russian and foreign researchers on the subject.
Results. The paper focuses on the relevance of the problem of sexual disorders in women who underwent radical treatment for breast cancer and also it introduces the current data on the possibilities of rehabilitation.
Conclusion. Among sexual disorders in patients with breast cancer anorgasmia (inability to reach an intense release of accumulated sexual excitement during sexual response cycle) and dyspareunia (painful sensations during intercourse), decreased sexual arousal while preserving sexual desire occur most commonly. For the recovery of mental health and sexual function in women various psychological approaches including cognitive-behavioral psychotherapy proved to be effective.
Keywords: rehabilitation, breast cancer, sexual dysfunction, anorgasmia, dyspareunia, cognitive-behavioral psychotherapy.
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Objective of the study is to carry out an analysis of the results of research on local methods of treatment of oligometastatic disease in gynecologic cancers.
Materials and Methods. The review includes the data of foreign and Russian academic articles found in PubMed on the topic area published over the past 10 years.
Results. Drug therapy is a standard of treatment of patients with gynecologic cancers who have distant metastases. However, despite the advancements in chemo- and targeted therapy, a median overall survival of such patients is low. The concept of “oligometastatic” process, which implies that tumor biology in a number of patients with single (not exceeding 5) tumor foci may be quite favorable for the use of local methods of drug delivery and radiation exposure, has been developing in recent years. It was observed that the combination of drug therapy and surgical intervention or stereotactic radiation therapy may enhance the survival rates in a group of patients with such a course of disseminated tumor process as “oligometastatic disease”.
Conclusion. International oligometastasis classifi cation must become a base for prospective research and clarifi cation of indications for the use of local methods of treatment in patients with gynecologic cancers who have single distant metastases.
Keywords: oligometastases, oligometastasis classifi cation, stereotactic radiation therapy, surgical treatment of metastases.
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