Introduction. The diagnosis of breast cancer in pregnant patients is challenging due to physiological changes in breast tissue and limitations in the use of standard imaging modalities, which may lead to delayed detection, inaccurate staging, suboptimal treatment selection, and consequently poorer outcomes.
Objective. To evaluate the diagnostic value of computed tomography (CT) as a surrogate staging method for breast cancer in pregnant patients in comparison with breast ultrasound (US).
Materials and Methods. A retrospective study was conducted at the V. A. Almazov National Medical Research Centre and the N. N. Petrov National Medical Research Center of Oncology (Russia) from 2024 to 2026, including 24 patients with pregnancy-associated breast cancer. Eight patients who underwent chest CT for staging purposes were included in the analysis. A comparative evaluation of CT and ultrasound in assessing the extent of locoregional disease was performed. The following parameters were assessed: tumor location, size, and structure, signs of local invasion, regional lymph node involvement, and the presence of distant metastases. Staging was performed according to the TNM classifi cation. Statistical analysis was descriptive.
Results. Ultrasound visualized the primary tumor in all cases (100 %) and allowed assessment of its structural characteris tics. However, in several cases, tumor size and extent were underestimated. CT demonstrated higher diagnostic value in assessing regional and distant disease spread: metastatic lymph node involvement was detected in the majority of cases, and distant metastases were identifi ed in some patients, including bone and pulmonary lesions. In certain cases, CT revealed a more extensive disease burden compared to ultrasound, leading to stage adjustment. At the same time, non-contrast CT failed to visualize the primary tumor in some cases. Perinatal outcomes in the study group did not show evidence of deterioration.
Conclusions. Computed tomography provides high diagnostic value in assessing the extent of breast cancer in pregnant patients and may be considered an additional surrogate staging method. Optimal diagnostic strategy requires a combined use of ultrasound and CT, taking into account their complementary roles.
Keywords: breast cancer; pregnancy; ultrasound; computed tomography; tumor staging
 Full text (in Russian)

Relevance. External beam radiation therapy (EBRT) is an integral part of a combined treatment for breast cancer (BC). The advent of accelerated partial breast irradiation (APBI) has enabled the use of high dose-rate brachytherapy (HDR-BT) in the treatment of patients with early breast cancer (BC). The objective of this study was to compare long-term outcomes, toxicity and cosmetic outcomes of two techniques of postoperative radiation therapy in patients with early breast cancer (BC) after organ-conserving surgeries: standard external beam radiation therapy (EBRT) for the whole breast and accelerated partial breast irradiation (APBI) with high dose-rate brachytherapy (HDR-BT).
Materials and Methods. The prospective non-randomized study included 83 patients with stages pT1-2N0M0. Group I (n = 48) received external beam radiation therapy (EBRT) for the whole breast in the 40-50 Gy regimen. Group II (n = 35), which met strict low-risk criteria (ASTRO/GEC-ESTRO), underwent the accelerated partial breast irradiation (APBI) using high dose-rate brachytherapy (HDR-BT) with the placement of fl exible applicators, employing a template-based tech nique (total dose 32 Gy, in 8 fractions of 4 Gy each). Overall survival (OS), relapse-free survival (RFS), and cancer-specific survival (CSS), as well as acute and late toxicity (CTCAE v5.0) were assessed.
Results. With a median follow-up of 53 and 95 months for the groups of external beam radiation therapy (EBRT) and of high dose-rate brachytherapy (HDR-BT), respectively, oncologic effectiveness rates were consistent or higher in the group of brachytherapy: relapse-free survival (RFS) — 91,67 % vs 100 % (p = 0,090), cancer-specifi c survival (CSS) — 93,75 % vs 100 %, overall survival (OS) – 89,58 % vs 94,29 %. In the group of external beam radiation therapy (EBRT), cases of acute skin erythema (14 %) and a signifi cant rate of late complications (lipogranuloma — 39 %) were reported. In the group of high dose-rate brachytherapy (HDR-BT), no cases of grade 2-3 toxicity were observed, and the cosmetic outcome was excellent in 97 % of patients.
Conclusion. High dose-rate brachytherapy (HDR-BT) demonstrates high effectiveness and a signifi cantly improved safety profi le compared to standard external beam radiation therapy in strictly selected patients with low-risk early breast cancer. This method minimizes radiation exposure to critical organs, reduces treatment time, and achieves excellent cosmetic results, making it a preferred option for personalized treatment approach.
Keywords: high dose-rate brachytherapy, HDR – brachytherapy, breast cancer, accelerated partial breast irradiation (APBI).
 Full text (in Russian)

Introduction. Ovarian cancer remains the leading cause of mortality from gynecological malignancies. Approximately 80 % of patients are diagnosed at advanced stages (III-IV FIGO), when 5-year survival rate doesn’t exceed 40 %. Hyperthermic intraperitoneal chemotherapy (HIPEC) is considered to be a promising method for enhancing local control during interval cytoreductive surgery.
Objective: To evaluate the effectiveness and safety of adding hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin to the interval cytoreduction in patients with primary advanced ovarian cancer.
Materials and Methods. A single-center, prospective comparative cohort study was conducted at State Autonomous Healthcare Institution “Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine” for the period from January 2012 to January 2026. A total of 110 patients with verifi ed diagnosis of III IV stage ovarian cancer were enrolled in the study, ECOG 0-1, divided into HIPEC group (n = 75) and the control group (n = 35). All patients received 3 cycles of neoadjuvant polychemotherapy (NAPCT) followed by interval cytoreductive surgery (ICS) hyperthermic intraperitoneal chemotherapy (HIPEC) and 3 cycles of adjuvant polychemotherapy (APCT). Hyperthermic intraperitoneal chemotherapy (HIPEC) was administered using closed technique, cisplatin 100 mg/m2. Survival was estimated using Kaplan – Meier method.
Results. Complete cytoreduction was achieved in 64 % and 65,7 % of patients, respectively. Median progression-free survival (PFS) made up 34,8 vs 27,3 months (HR 0,75; 95 % confi dence interval (CI) 0,45 – 1,23; p = 0,243). Median overall survival (OS) was not achieved in either group (HR 0,86; 95 % confi dence interval (CI) 0,46 – 1,61; p = 0,629). Thirty-day mortality – 0 %. Major complications in the hyperthermic intraperitoneal chemotherapy group (HIPEC) were: hematologic toxicity (36 %), nausea/vomiting (28 %), nephrotoxicity/hepatotoxicity (12 %).
Conclusions. The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) was associated with a clinically significant trend toward increased progression-free survival (PFS) with an acceptable safety profi le. The results are consistent with the data of large–scale randomized controlled trials and meta-analyses. Prospective randomized trials are required to determine the role of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of ovarian cancer.
Keywords: hyperthermic intraperitoneal chemotherapy (HIPEC); ovarian cancer; interval cytoreduction; cisplatin; peritoneal carcinomatosis; survival.
 Full text (in Russian)

Objective of the study: Systematization of clinical and morphological criteria of sex cord stromal tumors (SCST) and the evaluation of their prognostic significance.
Materials and Methods. A retrospective analysis was conducted on the data of 456 patients with histologically verified sex cord stromal tumors (SCST) who underwent examination and treatment at Federal State Budgetary Institution “N. N. Blokhin National Medical Research Center of Oncology” (Russian Federation) and at National Center of Oncology and Hematology (Kyrgyz Republic).
Results. The study examined the correlation between tumor stage, grade of malignancy, the presence of necrotic foci in tumor tissue and survival rates. Tumor necrosis was statistically signifi cantly associated with a poorer prognosis: the 10 year survival rate was 17,2 % for patients with necrosis compared to 78,1 % in the necrosis-free group.
Conclusion. The key indicators of an unfavorable clinical prognosis in sex cord stromal tumors (SCST) are the extent of the process (FIGO stage) and histologically verifi ed necrobiotic changes in the tumor substrate.
Keywords: stromal cell ovarian tumors, granulosa cell tumors of the ovary, sex cord stromal tumors (SCST), ovarian cancer
 Full text (in Russian)

Introduction. Endometrial cancer is one of the most common malignant diseases in women. Assessment of the status of regional lymph nodes is a crucial prognostic factor, that guides the planning of adjuvant treatment. Currently, sentinel lymph node detection with subsequent ultrastaging procedure is increasingly being used as an acceptable alternative to lymphadenectomy in a surgical staging of endometrial cancer.
Materials and Methods. 566 patients with early endometrial cancer underwent surgical interventions in the form of laparoscopic hysterectomy and sentinel lymph node biopsy using ultrastaging protocols at the Department of Gynecologic Oncology of the State Budgetary Healthcare Institution of Kaluga Region “Kaluga Regional Clinical Oncological Dispensary” for the period from 2022 to 2025.
Results. The rate of bilateral sentinel lymph node detection was 87,6 % (496 patients). Sentinel lymph nodes were not identifi ed in 3 patients (0,53 %). Morphological examination revealed lymph node metastases in 64 patients, accounting for 11,3 % of the cohort. This included 6,25 % of low-risk cases, 18,52 % of intermediate-risk cases, and 23,33 % of high risk cases. The use of ultrastaging protocols increased the detection rate of lymphogenous metastasis by 38 % compared to the traditional technique.
Conclusions. Sentinel lymph node mapping can potentially become a standard technique for assessing the zones of regional lymphatic drainage in early endometrial cancer in the routine activity of the departments of gynecologic oncology. Ultrastaging protocols made it possible to increase the detection rate of metastases and to signifi cantly enhance the diagnostic accuracy of the technique.
Keywords: endometrial cancer, sentinel lymph nodes, ultrastaging
 Full text (in Russian)

Objective. Endometrial cancer (EC) — is a heterogenous disease that requires accurate preoperative staging to select the optimal surgical strategy. The TCGA molecular classifi cation and methods of diagnostic imaging (PET/CT) have significantly complemented standard approaches to risk stratifi cation.
Materials and Methods. A retrospective analysis of the data of 39 patients who had received treatment in 2022-2025 (mean age 63,4 9,9 years) was carried out. Diagnostic imaging data (ultrasound scan, MRI, PET/CT) were compared with the results of histological examination, specifi cally evaluating the depth of invasion, lymph node status and histotype. Spearman correlation analysis was used to assess the strength of association between variables. We evaluated the diagnostic accuracy of the methods and compared the two histological subgroups — endometrioid adenocarcinoma (n = 32) and non endometrioid (n = 7) — using the Mann-Whitney U-test.
Results. A correlation between a volume of tumor tissue based on MRI data and metabolic tumor volume (MTV) on PET/ CT (rho = 0,72; p < 0,01) was found. Non-endometrioid carcinomas were characterized by a statistically significantly higher SUVmax level (median 9,9) compared to low-grade endometrioid carcinomas (median 6,4; p < 0,01). The overall accuracy of MRI in determining deep myometrial invasion was 76,9 %, the sensitivity of PET/CT in the detection of lymph node metastases (75 %) signifi cantly exceeded that of an MRI (25 %).
Conclusion. PET/CT is an important tool in the preoperative staging of endometrial cancer, particularly for identifying aggressive non-endometrioid subtypes, that exhibit high metabolic activity. Combination of MRI and PET/CT enhances clinical staging accuracy.
Keywords: gynecologic oncology, endometrial cancer, diagnostics, staging, MRI, PET/CT
 Full text (in Russian)

Introduction. Recurrent endometrial cancer (EC) has an unfavourable prognosis, therefore, the treatment of such patients is a relevant and complex clinical challenge in gynecologic oncology. In cases of isolated recurrence of endometrial cancer (EC) in the lesser pelvis area or in regional lymph nodes, the treatment outcomes are signifi cantly better. The trend of expanding indications for cytoreductive surgery in multimodal treatment for locoregional recurrence of endometrial cancer (EC) has substantially increased patient survival rates. If prior radiation therapy has been administered as part of the primary treatment for endometrial cancer (EC), when the options for repeat irradiation are limited, and/or in the presence of positive resection margins after secondary cytoreductive surgery, the oncological outcomes of treatment are compromised. Local site-specifi c follow-up in the area of resected recurrent tumor is of the paramount importance for this cohort of patients. The combination of secondary cytoreductive surgery with intraoperative radiation therapy (IORT) enables targeted devitalization of the potential cancer microfoci in the bed of the resected recurrent tumor, using a single high dose of ionizing radiation.
Objective is to present clinical cases of the use of intraoperative radiation therapy (IORT) in locoregional recurrences of endometrial cancer (EC) and to analyze the latest literature data on the use of intraoperative radiation therapy (IORT) in recurrent endometrial cancer (EC).
Materials and Methods. The technique of using intraoperative radiation therapy (IORT) was demonstrated based on the clinical observations of endometrial cancer (EC) recurrence, which manifested as isolated metastases in the para-aortic and pelvic lymph nodes.
Results. All patients underwent intraoperative radiation therapy (IORT) using a mobile electron linear accelerator device Mobetron, which generates electron beams with the energy, ranging from 6 to 12 MeV. Following retroperitoneal lymphadenectomy and excision of metastatic lymph nodes, irradiation of the surgical fi eld was performed. The irradiation area was shaped using applicator tubes tailored to the size of the resected tumor bed and its anatomical geometry. The depth of irradiation did not exceed 3 cm with a radiation energy of 12 MeV and the total focal dose of 10 Gy was delivered to the resected tumor bed. No complications were reported following intraoperative radiation therapy (IORT). The patients are currently alive with no evidence of disease progression at 12 and 20 months of follow-up, respectively.
Conclusion. Among carefully selected patients with isolated locoregional recurrence of endometrial cancer (EC), cytoreductive surgery in combination with intraoperative radiation therapy (IORT) should be considered as a stage of combined treatment which can improve local control in the resected tumor area. Further research on this treatment method is highly important for developing clear criteria for patient selection and intraoperative radiation therapy (IORT) techniques, detailing potential complications and assessing the impact of intraoperative radiation therapy (IORT) on oncological treatment outcomes based on the status of tumor resection margins.
Keywords: endometrial cancer, locoregional recurrence, cytoreductive surgery, intraoperative radiation therapy
 Full text (in Russian)

Due to the vastness of the presented material, the article is divided into two parts. The fi rst section provides literature data summarizing the features of the pathogenesis, prevalence and mechanism of occurrence of various types of oncological pain, as well as the author’s classifi cation of pain syndromes in oncogynecology. The clinic and diagnosis of pelvic pain are described separately, the characteristics of domestic painkillers for its pharmacotherapy are given, indications for prescribing drugs, dosage forms, single and daily doses for the treatment of severe and moderate pain, as well as contra indications and possible limitations are indicated. The presented material is supplemented by a description of cases from clinical practice.
Keywords: oncogynecology, pelvic pain in oncology, pharmacotherapy of pelvic pain, interventional methods of pelvic pain therapy
 Full text (in Russian)