UJR 2014, vol XXII, # 2
THE CONTENTS
2014, vol XXII, # 2, page 7
M. V. Sokolovska
The role and place of radiation therapy in early treatment of breast cancer in patients with endoprosthesis
Radiotherapy reconstructed breast cancer surgery will not different from the traditional methods of irradiation is not operated breast cancer, so do not cause difficulties when conducting pre-radiation prepare patients, dose calculation and technique of procedures. At the same time chemoradiotherapy/radiotherapy of breast cancer patients Stages I-II after radical surgical intervention with the primary reconstruction improves performance a ten-year total survival rate and improved far remote oncological outcomes (local recurrence-free survival and remote recurrence-free survival) in comparison with the independent operational intervention. But in the complex and combined treatment simultaneously postoperative surgical complications have had increased that require prevention and related additional therapy.
Keywords: breast cancer, primary breast reconstruction, breast endoprosthesis, postoperative chemoradiotherapy, postoperative radiation therapy.
2014, vol XXII, # 2, page 11
V. A. Pylypenko, O. O. Tereshchenko
Social and ecological factors in the formation of population health in surveillance zone of nuclear power plants
The purpose of work. Determination of main factors in formation of social and psychological component of population health in surveillance zone of Rivne Nuclear Power Plant.
Materials and Methods. Psychodiagnostic, social and hygienic methods were applied during the research. Proposed standard questionnaire includes in itself the questions about assessment of ecological situation, about factors that are forming the ecological situation and the impact of nuclear power plant, about social factors, health state self-appraisal, psychodiagnostic testing. 220people with the 6,7% error were observed as respondents of radiation-control area. Received data were coded and processed by statistics program.
Results. Most people of radiation-control area estimated ecological state as safe. Respondents pointed to such ecological factors as radionuclide pollutions, irresponsible ecological behavior of people, Rivne Nuclear Power Plant functioning consequences. The last one affects changes of water sanitation and ecological parameters.There is no significant difference between mental state of people of radiation-control area and control group of people by GHQ-28 indices, by somatization scale, anxiety, social disfunction and reactive anxiety.
Conclusions. The living life peculiarities are grounded by double risk: life in conditions of radioactive polluted territory and life in radiation-control area. Authors defined the correlation between mental state and factors that characterize ecological living conditions.
Keywords: radiation-control area, ecological situation,public mind, health.
2014, vol XXII, # 2, page 16
Yu. P. Lytvyn, V. V. Lohvynenko
Clinical radiation diagnostics of shoulder joint impingement syndrome
Objective. On the basis of clinical and radial inspection and the given surgical interventions to define direct and indirect radial signs an impingement of a syndrome of a humeral joint. To compare radiological, ultrasonographical, magnetic resonance imaging, symptoms an impingement of a syndrome of a humeral joint and to define their diagnostic value.
Materials and methods. 46 patients about an impingement are investigated by a syndrome of a humeral joint. Among them men was 28 (60,9 %) the person, women 18 (39,1 %). Middle age of the surveyed has made 52,6 ± 2,0 year. The traditional roentgenography is executed to all patients, a spiral computer tomography — 5 (10,9 %), an ultrasonography — 44 (95,7 %), a magnetic resonance imaging — 11 (23,9 %). Operative treatment is spent 16 (34,8 %) by the patient.
Results. The pain and disturbance of function of a humeral joint were the basic complaints of patients. It is established that the reasons the syndrome impingement was the conflict in subacromial space, a thickening acromioclavicular ligaments, tears of tendons of a rotator cuff of a shoulder, development of adherent process between an acromion, a greater tubercle and a tendon of a supraspinal muscle. We allocate direct and indirect radial symptoms a syndrome impingement. In group of straight lines the symptoms specifying in the reasons an impingement of a syndrome have been carried, in group of the indirect symptoms which are not the reasons a syndrome impingement have been carried, and is accompanying or consequences. It is established that methods of radial diagnostics possess unequal possibilities in revealing of changes of osteal, soft tissues structures, impellent disorders, blood flow disturbances. Signs of damages of osteal structures were defined on roentgenograms, computed tomograms, ultrasonograms and magnetic resonance tomograms, soft tissues — on ultrasonograms and magnetic resonance tomograms, impellent disturbances — on ultrasonograms. High diagnostic value of methods of radial diagnostics in revealing of an arthrosis of a acromioclavicular joint and tears of a rotator cuff of a shoulder is proved. At full and partial tears of a rotator cuff of a shoulder sensitivity of a magnetic resonance imaging has made 100 % and 83,3 %, specificity of 95,8 % and 95,5 %, accuracy of 97,1 % and 91,2 %, sensitivity of an ultrasonography has made 97,6 % and 84 %, specificity of 96,7% and 95,6 %, accuracy of 97,2 % and 91,4 %.
Conclusions. Direct radial symptoms are what specify an impingement of a syndrome of a humeral joint in the reasons, indirect — symptoms of an inflammation both degenerate and dystrophic changes of structures of area of a humeral joint which are involved in pathological process. The best results are given by complex radial research at which it is possible to find out direct and indirect symptoms a syndrome impingement..
Keywords: impingement, a humeral joint, ultrasonography, a magnetic resonance imaging.
2014, vol XXII, # 2, page 22
V. S. Ivankova, T. M. Nesterenko, N. M. Khranovska, L. M. Baranovska, T. V. Khrulenko, H. M. Shevchenko
Efficiency estimation methods of chemical radiation treatment of patients with disseminated cervicalcancer
The Department of Radiation Oncology, National Cancer Institute developed methods chemoradiotherapy (CRT) patients with locally advanced cancers of the cervix (cervical cancer MR). Before treatment patients underwent complex examination, including DNA index determination by laser DNA flow cytometry based on biopsies of the cervix. During concomitant radiotherapy were used cytotoxic drugs in radiomodifying doses. Conducted to investigate the possibility of monitoring the effectiveness of treatment at the subcellular level. The treatment and analysis of the clinical and instrumental monitoring data in 79 patients with MR of cervical cancer (63 patients studied and 16 — control group). Effectiveness of CRT was evaluated by the degree of tumor regression, the dynamics of indicators DNA status of cervical cells and severity of toxic effects.
Analysis of the direct method results CRT showed that the dynamics of DNA clones of tumor status correlates with clinical data obtained in response to cytotoxic therapy MR cervical cancer. Positive response of tumors in patients with cervical cancer MR after a full course chemoradiation increased by 25,0 % in comparison with standard methods. Toxic effects of treatment on the number and severity of patients in the study group did not differ from the control group, did not exceed the second degree.
Key words: cervical cancer, chemoradiation therapy, cytotoxic therapy.
2014, vol XXII, # 2, page 27
Yu. T. Kynoshenko
The X-ray morphological classification of the modern stomach cancer and the general X-ray semiotics of its separate classification forms
(published in the order of discussion)
During the first year after the stomach cancer has been diagnosed, 61-62% of patients die in Ukraine. These data are very alarming, being evidence of existence of timely diagnostics problem. Author thinks that the one of causes lies in the changes of stomach cancer pathomorphology. Now the endophytic forms of cancer dominate where fibrogastroscopy has no effect. The roentgenologic method, as the most available, must be applied as a key method in stomach cancer diagnosis. Fibrogastroscopy is a valuable method but it must be used at the next stage after roentgenologic examination.
Author has studied evolution, general X-ray semiotics of small and developed forms of cancer and proposed the new roentgenomorphological classification of stomach cancer.
Keywords: stomach cancer, pathomorphism, clinical picture of endophytic stomach cancer, general X-ray semiotics, classification.
2014, vol XXII, # 2, page 38
I. O. Krasnyy, S. V. Limaryev, I. O. Voronzhev
Possibilities of radial methods of research in differential diagnostics of pulmonary involvement at opportunistic infections at patients with AIDS
In this article describes the comparative characteristic of clinical manifestations of changes in patients with pneumocystics pneumonia, cytomegalovirus and Chlamydia pneumonia. Describes the possibility of some radiology methods (radiography and CT), and semiotic changes of each pneumonia. Also are shown differential criteria of X-ray diagnostics of each type of pneumonia. Given literature data of possibility of using CT in diagnostic pneumonia and its complications.
Keywords: AIDS, opportunistic infections, radial differential diagnostics.
2014, vol XXII, # 2, page 44
I. O. Kramnyy, I. O. Voronzhev, S. V. Limaryev, O. P. Sorochan, O. O. Kiprushev
Revisiting features of radiological changes of coral-like concrements in children and adolescents
At the work presents the literature data on the incidence of urolithiasis at a young age, features of the clinical manifestations of staghorn calculi and possibilities of radiological methods in their diagnostics. Represented own observation of a patient 17 years old with systemic lupus erythematosus, with fragmentation of staghorn calculi in the right kidney under the influence of phytotherapy, with a complete outlet of fragments.
Keywords: children and adolescents, x-ray diagnostics, staghorn calculi, fragmentation and expectoration.
2014, vol XXII, # 2, page 48
H. V. Hatskevych, Y. H. Borodyn, S. A. Khoruzhyk
Legal aspects of radiation therapy in Republic of Belarus
The reasons that lead to harm to patients during radiotherapy considered. Some examples of radiation damage presented.
The types of liability for harm to the patient used in the Republic of Belarus described. The recommendations to ensure legal protection for medical and technical personnel suggested.
Keywords: radiation therapy, harm to the patient, legal liability, legal protection.
2014, vol XXII, # 2, page 51
Y. H. Tarutyn, E. V. Tytova, H. V. Hatskevych
Dosimetric accompaniment of high technology radiation therapy. Instruction for use.
The contents of prepared guide on high technological radiation dosimetric accompaniment is discussed in scope of application of modern linear electron accelerator. The main attention is paid on dose measurements types for evaluation quality work of separate systems and devices used for patients irradiation.
Key words: radiation therapy, high technology, dosimetric accompaniment.
2014, vol XXII, # 2, page 54
E. V. Tytova, Y. H. Tarutyn, H. V. Hatskevych
Verification measures for exposure patients to radiation using IMRT method at RSPC OMR of N.N. Alexandrov
The contents of the prepared instruction on dosimetric maintenance of new methods radiation therapy on modern linear accelerators of electrons are discussed. Types of dosimetry for performance evaluation of separate systems and devices used at patients beaming are briefly described.
Key words: radiation therapy, high technologies, dosimetric maintenance.
2014, vol XXII, # 2, page 57
N. H. Semykoz, R. YE. Horovenko, I. O. Kaminskyy, YU. M. Selivra, O. O. Hrabovskyy
Planning methodology of the treatment of tissue tumors with the usage of contact applicators in brachytherapy
Donetsk Regional Antitumoral Center was re-equiped with unit of contact radiation therapy through intermediary of charitablefund of Rinat Ahmetov “Ukraine development” in June, 2013.
Modern planning of contact radiation therapy could be divided into several stages: primary examination, location of rentgenocontrast markers, imaging, planning.
The tumor can be removed without incisions and stitches by brachytherapy that is very important for evaluation of cosmetological consequences after treatment.
Contact “nozzles” don’t traumatize the surface, they are adjusted exactly to relief of the area of the skin. Exposure to radiation is strictly localized, adjacent tissues are not affected.
Keywords: brachytherapy, contact radiation therapy, planning, applicators, exposure to radiation.
2014, vol XXII, # 2, page 59
L. L. Vasylyev
Potentials of roentgenoscopy for estimation of tumor movement amplitude during respiratory act during planning radioactive therapy
It is very important to take into account the tumor movement connected with respiration during topometricpreparation of patients with lung cancer in order to decrease additional dosimetric cost. Roentgenoscopy methods proposed for movement detection because of the absence of specialized equipment. This methods allows to register movement amplitude exactly and to compose adequate plan of radiation exposure.
Key words: radiation therapy, lung tumor, topometric preparations, planning of radiation dose.
2014, vol XXII, # 2, page 61
T. O. Zhukova, A. V. Chornobay
Possibilities of helix CT machine in diagnostics and planning of treatment of patients with advanced cancer of larynx and laryngopharynx
The results of research of spiral computer tomography with intravenous bolus stainingfor diagnosis and planning of treatment of disseminated larynx and laryngopharynx cancer are performed in article. The high method informativity allows to estimate the structure of organ and adjacent tissues, the affection degree, the process prevalence and metastatic changes of regional lymph nodes. Method allows so much as to step aside from traditional less informative X-ray tests and to save patient's money and time.
Keywords: larynx, laryngopharynx, tumor, helix CT machine.
2014, vol XXII, # 2, page 63
N. V. Tuyeva, O. V. Lukʺyanchuk, V. I. Stoyan, L. P. Antonova
Examined approach to planning of combined radiation therapy for patients with locally advanced cervical cancer
High dose brachytherapy is done under control of computer tomography for 72 patients in order to diagnose locally advanced cervical cancer. Personalized protocol of combination of both the distance and the contact radiation therapy is developed and implemented that makes it possible to take into account the peculiarities of tumor extension in certain patient.
Keywords: locally advanced cervical cancer, combined radiation therapy, high dose brachytherapy.
2014, vol XXII, # 2, page 66
A. V. Trofymov
Assessment of shifting of planned radiation dose by radiation therapy of prostate gland tumor
There can be increased radiation exposure on surrounding critical organs and tissues when undergoing radiation therapy sessions of patients with prostate cancer due to movement of prostate gland which at the same time is caused by changes in bladder volume. In order to improve treatment quality its proposed to define displacement with ultrasound before each radiation therapy session with further correction of target volume location.
Key words: radiation therapy, prostate cancer, target volume, prostate displacement, bladder volume.
2014, vol XXII, # 2, page 69
A. V. Trofymov
The role of IAEA and WHO in formation of support and quality maintenance system for radiation therapy in Ukraine
The IAEA and WHO’s general response to a creation and implementation of quality maintenance system for radiation therapy was considered in article.
The IAEA's role in technical assistance to Ukraine was shown in scope of creation of national center of TLD-audit of quality estimation of pencil of rays calibration, of cancer care facility retooling with modern equipment for clinical dosimetry, of improvement of experience level of medical physicists:
Keywords: radiation therapy, quality maintenance, quality control.
2014, vol XXII, # 2, page 72
R. Ya. Abdullaev, S. A. Ponomarenko, D. Yu. Hulchenko, A. Y. Mukhomor
The role of color flexography in the differential diagnosis of focal changes in the mammary glands
Authors studied the peculiarities of color fl exography in the differential diagnosis of focal changes in the mammary glands in
11 women with a demarcatedfat slice of glandular tissue, in 21 women with a fi broadenosis, in 17 women with a fi broadenoma and in 9 women with a cancer. Th e color mapping of tissue stiffness is executed on ultrasonic equipment with the qualitative assessment of the resulting staining. Red and yellow colors correspond to soft tissues, blue and light blue ones correspond to stiff areas of more hard tissue. The frequency of staining of those entities or a different color is determined. Red colors stained fi broadenosis (61.9 % of cases), aft erwards — delimited fat slice (in 54.5 % of cases), yellow color — fi broadenoma (in 52.9 % of cases). Delimited fat lobules and fi broadenosis yellow stained in a 23.8 % and 22.2 % of cases. Blue tones stained only breast cancer.
Color elastography being integrated additional mode ultrasound improves the e ffi ciency of the diff erential diagnosis of focal changes of mammary glands aft er the preliminary selection of cases on the basis of gray-scale and color Doppler study.
Keywords: color flexography, mammary gland, diagnostics.
2014, vol XXII, # 2, page 74
R. Ya. Abdullaev, Y. V. Kryzhanovskaya
Echographic characteristics of structural and functional changes in the antrum cancer
The character of structural andfunctional changes in the antrum was studied in 18 patients with cancer using transabdominal ultrasound. Wall layers of a stomach were not differentiated in all the patients with stomach cancer. The thickness of the involved segment was 9,8 ± 2,7 mm, diameter of the pylorus — 8,2 ± 0,9 mm, speed of evacuation — 31 ± 3 cm/s, fasting stomach volume — 39 ± 6 ml in patients with compensated pyloricstenosis. Stomach wall thickness was 19,2 ± 3,8 mm, diameter of the pylorus — 4,5 ± 1,2 mm, speed of evacuation — 34 ± 5 cm/s, the amount of content on an empty stomach 137 ± 31 ml among the patients with subcompensated pyloricstenosis. The thickness of the affected area of the output of the stomach was 31,2 ± 4,8 mm, diameter of the pylorus — 2,4 ± 0,9 mm, the residual volume of the stomach on an empty stomach — 335 ± 32 ml in patients with decompensated pyloricstenosis.
Key words: stomach cancer, ultrasound diagnostics, structural andfunctional changes.
2014, vol XXII, # 2, page 77
R. Ya. Abdullaev, A. Y. Mukhomor
Importance of color flow mapping of tissue stiffness in the diagnosis of prostate cancer
Authors have studied the potentials of color flow mapping of tissue stiffness in the diagnosis of prostate cancer in 124 men aged 49-87years. Ultrasonic flexography with mapping tissue stiffness held on the scanner Hitachi Hi Vision 900. The red and yellow colors correspond to the soft tissues, blue and light blue — harsher areas of more hard tissue. The frequency of staining of those entities or a different color is determined.
When the color flexography red-yellow color detected in 29 (23.4 %) cases of prostate cancer and in 43 (64.2 %) cases of benign prostatic hyperplasia, a blue-green color in 95 (76.6 %) and 24 (35.8 %) cases, respectively. Among 95 patients with prostate cancer dark blue color detected in 58 (61.1 %) cases of 24patients with benign prostatic hyperplasia — 7 (29.2 %) cases..
Key words: color flow mapping, tissue stiffness, prostate cancer, diagnostics.
2014, vol XXII, # 2, page 80
V. S. Ivankova, E. A. Domina, L. M. Baranovska, T. V. Khrulenko, T. V. Skomorokhova, O. P. Pylypchuk, I. I. Muzalov, O. V. Halyas
The use of conformal radiotherapy in locally common forms of cervical cancer with radiobiological maintenance
The Department of Radiation Oncology, National Cancer Institute of the Ministry of Health in collaboration with the Institute of Experimental Pathology, Oncology and Radiobiology R. E. Kavetsky NAS conducted research on optimization of combined radiotherapy of patients with locally common forms of cervical cancer by conducting conformal radiotherapy. Remote conformal radiotherapy received 84patients with cervical cancer stage III (T3N0-1M0) compared with the group of patients (control group — 72 patients) who underwent Conventional external beam radiotherapy. The methods of complex conservative therapy patients locally common forms of cervical cancer. System used: Play isosurface therapeutic dose in accordance with the contour of the target irradiation; even distribution of absorbed energy over the entire volume of the irradiated target; clear display of the planned program of radiation through the use of three-dimensional volumetric planning (3D) in the process of preparation and holding topometricheskoy course conformal radiotherapy with modern equipment. This makes it possible to create an optimal dose distribution for the entire target volume with a maximum in the region of the tumor and to minimize the radiation dose to surrounding healthy tissue area. Carried out experimental studies biodosimetric T — lymphocytes in peripheral blood of patients with the aim of modeling radiobiological reactions facilitate the evaluation of the biological effectiveness of ionizing radiation. The immediate results of conformal radiation therapy of patients with locally common forms of cervical cancer indicate greater its efficiency and reduce toxicity of treatment compared with the control. There is a clear trend towards increasing regression in patients in group I with relatively radioresistant forms of locally advanced cervical cancer who underwent remote conformal radiation therapy, which is a consequence of enhanced destructive effect of ionizing radiation on tumor high power target. Toxic effects of treatment on their number and degree of manifestations of patients in the study group did not exceed II degree. Research data obtained biodosimetric peripheral blood lymphocytes indicate the uniformity of the spatial distribution of the absorbed dose of X-rays within the given parameters of the irradiation field.
Key words: cervical cancer, conformal radiotherapy, research biodosimetric T-peripheral blood lymphocytes.
2014, vol XXII, # 2, page 84
N. H. Semykoz, O. O. Hrabovskyy, L. V. Karpushyna, I. O. Kaminskyy
Optimization of vagina tumors brachytherapy by the usage of multichannel vaginal applicator
Data about treatment of 46 patients with primary and metastatic cancer of vagina were represented in article. It was shown that multichannel vaginal applicator has much more benefits then single-channel one in combination with radiation therapy of vagina tumors.
Keywords: vagina tumor, brachytherapy, multichannel vaginal applicator.
2014, vol XXII, # 2, page 86
D. S. Mechev, N. I. Polyakova, O. I. Avramenko, A. D. Mechev
The treatment of metastasises of mammary gland cancer in the skeleton with the use of Samarium-153 Oxabiphor
This paper presents the first results of clinical testing of patients who received palliative treatment of bone metastases by local radiopharmaceitical Sm-153 oxabifore. Refise from analgetics, decreasing of pains and stabilization of metastatic process during 4-5-monthes after treatment were determined. This preparate is very prospective for further investigations.
Keywords: breast cancer, bone metastases, radionuclide therapy, 153Sm, bone-seeking radionuclide’s.
2014, vol XXII, # 2, page 89
A.V. Svynarenko, O.M. Zasukhina, V.P. Starenkyy, T. P. Hryshchenko, A.M. Nasonova, I.V. Belozorov
Chronoradiosensitization of radiation therapy of rectal cancer
The results of inoperable rectal cancer treatment with irradiation in chronomodulated mode (during 7:00-10:00,12:0014:00 and 18:00-20:00) and sensibilisation of tumor by previous 8-hour infusion of 5-fluorouracil are presented. The interval from 7:00 to 10:00 was proved to be the best time for a session of irradiation. Radiotherapy group 7:00-10:00 determined development of enterocolitis in 8,5 % of cases. In the group 18:00-20:00 frequency of this adverse event was 26,3 %, respectively (p <0,01). Group 12:00-14:00 occupies intermediate position — 19 % of enterocolitis.:
Keywords: chronomodulated radiochemotherapy, rectal cancer, 5-fluorouracil, toxic property.
2014, vol XXII, # 2, page 93
V. P. Ilchuk, N. A. Yefremova, A. M. Synyushkina, A. V. Vintsevych, O. O. Yudko
The treatment of patients with rectal cancer at II-III stage by the usage of linear accelerator
The experience of radiation therapy of 61 patients with rectal cancer at II-III stage with the usage of linear accelerator by individual program is represented in article. It is shown that conformal exposure substantially decreases radiation dose for adjacent critical organs, improves efficiency of the treatment, decrease amount and degree of radioreactions and involvements.
Key words: rectal cancer, a linear accelerator, the effectiveness of treatment.
2014, vol XXII, # 2, page 95
V. S. Ivanova, T. V. Skomorokhova, O. YU. Stolyarova, V. T. Perepechkina, A. A. Makarenko
Radiation therapy of patients with locally advanced forms of upper airway cancer
Since 2001 year there are scientific researches that are carried out on the basis of National Cancer Institute in the Distance Radiation Therapy department. These researches devoted to the planning and radiation therapy problems and intended for patients with malignant neoplasms of upper airways. 183 patients were divided into three groups have been cured after all this time. Devices «Rocus AM» and «Teratron-95» were applied towards the patients of 1st group in amount of 95 persons. Linear accelerator «Mevatron KD-2» was applied towards the patients of 2nd group in amount of 57 persons. Linear accelerator « Clinac 2100» was applied towards the patients of 3rd group in amount of 31 persons. The 3rd group of patients had exact topometric preparation with further 3D planning of radiation fields.
Analysis of the results showed radioreactions percentage much lower and clinical effect much higher than before for the 3rd group patients. Such accuracy and quality of treatment is grounded on 3D planning, low doses for critical organs and tissues, the usage of laser, multiblade collimators and wedge filters.
Keywords: upper airway cancer, topometric preparations, 3D planning, radioactive therapy.
2014, vol XXII, # 2, page 98
N. V. Bilozor, V. P. Starenkyy, N. A. Mitryayeva, O. M. Sukhina, L. V. Hrebinyk, T. S. Bakay
Chemoradiation treatment of non-small-cell lung cancer oriented to apoptosis' induction
A comparative analysis of the radiotherapy results in different modes of fractionation with etoposide modification on gamma-therapeutic apparatus and linear accelerator in patients with non-small cell lung cancer. Objective effect and one year survival rates were significantly higher in the cases of accelerated fractionation regimes, while the frequency of radiation pneumonitis and esophagitis was reduced in cases of the treatment on a linear accelerator compared to gamma radiation. Modes of accelerated hyperfractionated combined with etoposide modification are aimed at the induction of ceramide apoptosispathway, as evidenced by the dynamics of sphingomyelinase activity in serum of patients with NSCLC.
Keywords: non-small cell lung cancer, radiation therapy, accelerated fractionation regimes, objective effect, overall survival, sphingomyelinase activity.
2014, vol XXII, # 2, page 102
V. PP. Starenkyy, O. M. Sukhina, A. V. Svynarenko, T. P. Hryshchenko, V. V. Karvasarska, S. V. Artyukh
Possibilities of the conformal radiotherapy combined with Temodal during reirradiation concerning metastatic lesion of the brain
Objective: The aim of the study is to explore the possibilities of conformal radiotherapy in combination with Temodal (temozolamyd) when re-irradiation brain’s metastasis.
Materials and Methods: The study involved 65 patients divided into 2 groups, which consist of 43 patients with non-small cell lung cancer (NSCLC) and 22 patients with breast cancer. Planningfor re-irradiation was carried out at TPS Eclipse with obligatory 3D-reconstruction of focus or foci of lesion as a pathological area covered 90% isodose. The total dose was depending on the initial irradiation (28-46 Gy). Irradiation was conducted 6 MeV photon radiation on a linear accelerator Clinac 600C. The classical mode of fractionation with chemosensitization by Temodal in a dose of 75 mg/m2 was daily used.
Results: In the process of re-irradiation 75.4% of patients showed improvement in neurological status in a decrease the intensity of headache, nausea and vomiting, dizziness on total doses not less than 20 Gy, and the restoration function of vision and movement (doses 25-30 Gy). Direct analysis of the results showed that the regressionfocus (or foci) more than 50% registred only in 46.1% of cases. As in the study group and as in the control group clinical and instrumental confirmation of progression of metastatic process in the brain manifested in terms of 4 to 6 months.
Conclusions: Combination of conformal radiotherapy with Temodal when repeated irradiation on metastatic brain’s damage does not influence on the time to progression of metastatic process, but also greatly improves the quality of life by reducing the neurological manifestations of the disease.
Key words: Conformal radiotherapy, linear accelerator of electrons, Temodal, re-irradiation of the brain.
2014, vol XXII, # 2, page 105
V. Y. Lysak, V. V. Karpenko, E. V. Hordeeva, Y. V. Myroshnychenko, Y. N. Repetskaya, A. YU. Chornay, H. B. Bernshteyn, A. B. Vynnytskaya
The experience of patients managment under prophylactic gastrostomy when using chemical-radiation therapy of malignant swelling of head and neck at LISSOD clinic
Percutaneous endoscopic gastrostomy - low-invasive medical method of enteral feeding maintenance in patients with dysphagia of different origin.
Two groups of patients with larynx and pharynx tumors were considered in article. These are 46 patients which had placed percutaneous endoscopic gastrostomy and 31 patients which had radiation therapy without previous gastrostomy.
Key words: percutaneous endoscopic gastrostomy, nutritious insufficiency, continuous radiation therapy course, split-course of radiation therapy.
2014, vol XXII, # 2, page 109
T. L. Berdova, V. V. Honchar, O. I. Hlushchenko
The case of effective usage of G. S. Kalendo's method when treating metastasizes of skin melanoma
It is shown that the usage of G. S. Kalendo’s method when treating metastasizes of skin melanoma has effect in patients which attended Dnepropetrovsk Oncologic Dispensary for three years.
Key words: radiation therapy, melanoma, metastasizes, surgical treatment.
2014, vol XXII, # 2, page 111
V. S. Ivankova, I.I. Smolanka, A. M. Baranovska, V. YU. Sklyar, O. M. Ivankova
Investigation of efficiency of chemical-radiation therapy of patients in order to diagnose mammary gland cancer using radio modificators
The article describes effective methods of chemoradiotherapy of patients with locally advancedforms of breast cancer using radiomodificated agents (ftorafur and microelements’ complex) during the radiotherapy. 106 breast cancer patients have been conducted the chemoradiotherapy. At the first treatment stage all patients received four courses of polychemotheraphy on the modified scheme FAC. Patients of the first main group (34 patients) was conducted radiotherapy on the background of cytostatic agent ftorafur at radiomodifying doses 1200 mg daily per os. Patients of the second main group (36 patients) were put on the complex of microelements — the drops «Beresh Plus’ before an irradiation session, in the dose of 1 drop for 1 kg bodyweight three times a day per os (on the average 20 drops triple a day) at 8,11 and 14 o’clockfollowed by radiotherapy from 15 till 19 o’clock. Patients of the control group (36 patients) received radiation therapy according to the standards of care. Obtained data indicate more efficacy of chemoradiotherapy of patients with locally advancedforms of breast cancer in the main groups, where radiotherapy was followed by using radiomodificated agents (ftorafur and microelements’ complex).
Key words: breast cancer, chemoradiotherapy, radiomodification, ftorafur, microelements’ complex.
2014, vol XXII, # 2, page 114
V. V. Synayko
Afterhistory of high grade (III-IV) cerebral glioma treatment using postoperative conformal radiotherapy and adjuvant chemotherapy with temozolomide
Postoperative radiotherapy at a total target dose of 54-60 Gy and adjuvant chemotherapy with temozolomide for high grade (III-IV) brain glioma patients improve median survival and 5-year survival vs radiotherapy alone from 12 to 15 months and from 7,0 ± 3,4 % до 24,1 ± 7,9 % (Р = 0,028).
Key words: high grade (III-IV) glioma, postoperative radiotherapy, temozolomide.
2014, vol XXII, # 2, page 116
L. M. Vasko, A. V. Chornobay
Potentials of transrectal ultrasound examination in assessment of efficiency of neoadjuvant chemical-radiological treatment of patients with advanced rectal cancer
The transrectal ultrasound examination (TRUE) is one of the most informative methods used for a detection of the invasion depth of a rectal tumor. It is shown that the TRUE can be applied for an assessment of efficiency of neoadjuvant chemical-radiological treatment of patients with extensive rectal cancer. The changes in ultrasound images of tumor were estimated before and after chemical-radiological treatment. It is detected that during the dynamic observation size tumor, size of perifocal inflammation component and pararectal component had been decreased. Received data confirm possibility of TRUE application for patients.
Keywords: rectal cancer, neoadjuvant chemical-radiological treatment, transrectal ultrasound examination.
2014, vol XXII, # 2, page 118
O. A. Mikhanovskyy, O. V. Slobodyanyuk, N. M. Shchyt
Afterhistory of combined treatment of patients with hysterocarcinoma using 5-Fu radiomodification in preoperative course of radioactive therapy
The purpose of research is to improve efficiency of combined treatment of patients with hysterocarcinoma using 5-fluorouracil radiomodification in preoperative course of radioactive therapy.
Authors assessed influence of such procedure on a rate of tumor cells detection in operative field and on vaginal scar during surgical operation. Authors made analysis of immediate and distant data of combined treatment of patients with hysterocarcinoma using 5-fluorouracil radiomodification in preoperative course of radioactive therapy.
Object of research is materials obtained from examination of 133patients with endometrium adenocarcinoma Т lЬ-2aNх-0M0 body of womb cancer in age of42-74.
It is defined that application of proposed method significantly improves ablastics of surgical operation and leads to increasing of recurrence-free period on 12.2 % in comparison with control group.
Keywords: hysterocarcinoma, radiomodification, 5-fluorouracil, radiation therapy.
2014, vol XXII, # 2, page 122
N. I. Lukhovytskaya, H. I. Tkachenko, YU. H. Tkachenko, H. V. Hrushka, O. M. Astapyeva, A. S. Savchenko
Outcome analysis of application of recombinant human thyrotropin alpha for exogenous stimulation TSH in patients with differential thyroid cancer based on literature and own experience
Differentiated thyroid cancer (DTC) is the mostfrequently occurring endocrine cancer. A necessary conditionfor radioiodine treatment and follow up patients (thyroglobulin determination) is hypothyroidism. Acute hypothyroidism may be induced by thyroid hormone withdrawal or introduction of recombinant human TSH (rhTSH). The results of treatment with recombinant human thyrotropin alfa was evaluated in the literature and our clinical experience (10patients). Using of «Tirogen» significantly improves the quality of life for patients with DTC, stimulates the uptake of radioiodine, which allows to achieve a complete cure of patients with fewer active 131I. Use of the drug «Tirogen» significantly improves the quality of life of patients with DTC, low-dose radioiodine plus thyrotropin alfa was as effective as high dose radioiodine. Using of «Tirogen» in cases of thyroid cancer Radioiodine resistance of patients with low levels of TSH and patients with bilateral vocal fold paresis (without imposing taheostomy) is the method of choice and the only way to complete recovery of patients with DTC:
Keywords: differential thyroid cancer, diagnostics, treatment, hypothyroidism.
2014, vol XXII, # 2, page 125
V. S. Ivanova, L. M. Baranovska, T. V. Kharchenko, O. O. Bakay, N. P. Dotsenko
The usage of high-energy gamma-therapeutic equipment during chemical-radiation therapy for patients with uterine neck cancer
106 patients with uterine neck cancer on IIB-IIIB stages (T2b–3bN0–1M0) were examined at National Cancer Institute department of clinical radiooncology, brachytherapy block. These patients were subdivided into two main groups and one control group. Conventional brachytherapy was applied for 36 patients of 1-st main group using Gyne Source device with 60Со source of high activity of radiation: one-time local dose 5 Gy per point A x 2 times per week, total local dose 35-50 Gy during 7-8 fractions. For 31 patients of 2-nd main group: one-time local dose 7 Gy per point A x 1 time per week, total local dose 28-35 Gy during 4-5 fractions. Control group was studied by «Agat-VU» device with 60Со source of middle activity of radiation: local dose 8 Gy per point A х 1 time per 6-7 days, total local dose 40-48 Gy during 5-6 fractions. External beam radioactive therapy was applied for patients of all groups using «Teratrone» device with energy of 1,25 MeV to a pelvis minor region with standard method. Patients received chemical therapy — phthorafurum, radiomodificating dose was 800 mg per day peroral in two intakes. Proposed method increase the level of regression of tumors in comparison with standard method MDR brachytherapy without increasing of intensity of local toxicity of treatment for critical organs.
Keywords: uterine neck cancer, chemical-radiation therapy, high-energy brachytherapy.
2014, vol XXII, # 2, page 128
O. A. Mikhanovskyy, O. V. Slobodyanyuk
Analysis of 5-year treatment results for patients with vulva cancer
Objective: analysis of results of surgical, combined and complex treatment of patients with vulva cancer at I-IV stages.
Materials and methods: 34patients were examined. Surgical treatment applied as an advanced vulvectomy hy Bohman method.
Patients with vulva cancer (T1N0M0) were treated comhinationally started with surgical intervention with following postoperational external beam gamma-therapy (EBGT) for a vulva region using "Rokus-M” device: classic fractioning onetime local dose 2 Gy, total local dose 40 Gy. Patients with vulva cancer (T2-3N0-1M0-1) were treatedpostoperationally in next modetotal local dose 30 Gy with radiomodification of cisplatin 100 mg one time per week. Postoperational course was going on in 2-3 weeks after operation up to total local dose has reached 45-50 Gy. Patients with T1-3N1M0 additionally received EBGT to the region of inguinal lymph nodes, total local dose 40 Gy, as well as 4-6 cycles of adjuvant chemical therapy used “cisplatin, cyclophosphan, vyctristin”plan.
Keywords: vulva cancer, surgical, combined and complex treatment.
2014, vol XXII, # 2, page 131
E. Y. Abolmasov, N. M. Serehyna, V. Y. Kotylevskaya, D. A. Stryukov
Influence of neoadjuvant radiation therapy by large dose fractionation on distant results of multimodality therapy for breast cancer
The article presents a retrospective analysis of the impact of neoadjuvant radiotherapy in large fractions mode to remote results of treatment of patients with breast cancer. Long-term results of the effectiveness of the treatment were assessed in terms of the three-year disease-free survival. Found that the performance of patients included in the study lived longer without recurrence after preoperative radiotherapy in large fractions mode than after adjuvant radiotherapy by classic fractionation. It is proved that the survival of breast cancer patients stage II after preoperative radiotherapy in large fractions mode higher than after only adjuvant radiotherapy. Concluded that the method of choice for the treatment of patients with breast cancer is stage II is neoadjuvant radiotherapy mode large fractions followed by radical surgery.
Keywords: breast cancer, radiation, fractionation.
2014, vol XXII, # 2, page 134
M. I. Khvorostenko, YU. M. Kikhtenko, YU. M. Khvorostenko, S. I. Kikhtenko
Quantitative assessment of lungs' radiolesions
Authors have proposed the method of quantitative assessment of abundance and mass of beam fibrosis in lungs by data of CT that allows to estimate objectively treatment results and to expertize radiolesions excluding subjective human factor. Keywords: CT, beam fibrosis, quantitative assessment, lungs.
2014, vol XXII, # 2, page 137
T. V. Udatova, O. V. Safronova, YA. V. Kmetyuk, H. O. Kurylo, A. V. Ashykhmin
Assessment of acute and chronic manifestations of local toxicity using modern methods of external beam radiotherapy in the case of radical treatment of prostate cancer
Article evaluated strokes of acute and chronic toxicity in case of local treatment of radical prostatic cancer by modern methods of external beam radiotherapy - 3D-conformal radiation therapy, and intensity modulated dose radiotherapy (IMRT) using classical and medium fractionation modes. According to a study in the application of IMRT techniques with medium fractionation the frequency of acute and chronic local toxicity manifestations was not significantly increased.
Keywords: 3D-conformal radiation therapy, intensity modulated dose radiotherapy, prostate cancer, radiation response, the toxicity of radiation therapy.
2014, vol XXII, # 2, page 140
A. O. Haysenyuk, H. V. Kulinich, A. S. Savchenko, S. V. Artyukh, O. S. Zats
Features of separate links of homeostasis in patients with lung cancer under the radiation therapy using linear accelerator
Authors studied 35 patients with lung cancer in dynamics of radiation therapy using linear accelerator Clinac-600 and made monitoring of clinical and biochemical blood analysis, coagulography, lipid composition indices, cardiovascular risk markers, markers of nonspecific inflammation. Predictive criterias that point to a possibility of cardiopulmonary complications were defined.
Keywords: radiation therapy, lung cancer, radiation complications, cardiopulmonary system, diagnostics markers.
2014, vol XXII, # 2, page 143
O. A. Chernenko, V. S. Sakalo, O. V. Shcherbyna, A. V. Sakalo
Bone mineral density in patients with prostate canser with metastatic involvement of lumbar spine
Objective: analysis of bone mineral density in patients with and without metastatic involvement of loin before the androgen-suppressant therapy.
Materials and methods: 30 patients with prostate cancer were examined by scintigraphy and CT. Metastasis was diagnosed in these patients (1-st group). The values of bone mineral density for patients of 1-st group were compared with 30 patients’ values (2-nd group of patients without metastasis) and 20 healthy patients’ values (contro; group). Density values were defined on level L1-L4 for all the patients using X-ray adsorptiometer ““Prodigy ” GE, Lunar company.
Keywords: prostate cancer, bone metastasis, densitometry, bone mineral density.
2014, vol XXII, # 2, page 145
V. V. Hrabar
Ultrasound screening of congenital defect of the fetus in induced pregnancy in I-st trimester
The aim of our retrospective study was to evaluate the differences, and hence the effectiveness of ultrasound screening markers in the I trimester in women with complicated reproductive history (after ART) and in physiological pregnancy. For this, we analyzed the results of ultrasound screening in I trimester in 1381 women with induced and 966 spontaneous pregnancies. Revealed that quantitative (nuchal translucency thickness, frontomaxillarangle, IVventricle thickness) and qualitative (single umbilical artery, megacystis, tricuspid regurgitation, choroid plexus cysts, hyperechoic focus in the ventricle of the heart) ultrasound markers of congenital abnormalities in I trimester are informativefor both spontaneous and induced pregnancies. Resistance of blood flow in the ductusvenosus in fetus and uterine arteries during induced pregnancy was higher, which may be associated with hemostasis and vascular disorders in women with infertility.
Keywords: ultrasound markers, I trimester, chromosomal defect.
2014, vol XXII, # 2, page 149
N. YE. Uzlenkova, O. A. Brazhko, M. M. Kornet, V. M. Pasyuha, N. H. Skorobohatova, I. O. Leonova, O. V. Nenyukova, O. L. Maslennikova
The experimental study of the potential radioprotectors - S-(azaheteryl) substituted cysteamine
Objective: To study experimentally the radioprotective activity of the compounds synthesized from a number of S-(azageteril) substituted cysteamine in acute radiation injury of the body.
Materials and Methods. Experiments were carried out on the nonlinear mature white male rats weighing 160-180 g, which were irradiated with X-ray machine RUM-17 under standard conditions in absorbed dose of 4.0; 5.5; 6.2 and 8.5 Gy.
Test compounds KM50 and KM51 from several S-(azageteril) substituted cysteamine administered at a dose of 25 mg (dry substance) intraperitoneally 30 min before irradiation.
Results. The high radioprotective activity of the compound by irradiation KM51 minimum absolutely lethal dose of 8.5 Gy in terms of increasing the 30-day survival rate - 3.6 times (rtmf = 0.028) and increase of avaraged survival time (DSA) of animals 1.3 times (rManna Whitney = 0.044) are defined during the initial selection set. Identified radioprotective activity of the compound at a dose of KM51 6.2 Gy appeared in the absence of an early « intestinal» death of animals (I peak), at a dose of 8.5 Gy - in its reducing to 7.4% compared with 25.9% under control, reducing of «marrowy destruction» (peaks II and III) to 22.2% and 33.3% in comparision with 40.7%, and the absence of the late radiation death (VI peak).
The introduction of the compound KM51 at a dose of 8.5 Gy reveals significant rate reduction for appearance of intestinal syndrome in survived animals - in 1.6 times (rx2 = 0.014) and marrowy syndrome - in 1.8 times (rx2 = 0.001). According to the results of the probit analysis radioprotective activity of the compound KM51 by FID was proportionally increasing depending on dose and reached the LD16-1.31; LC50-1.56 and LD84-1.82 values, and had a maximum value for the LD84.
Conclusions. High radioprotective activity of hydrochloride-S-(6-ethoxy-2-methyl-quinolin-4-yl)-cysteamine (compound KM51) in acute radiation injury of the body has revealed.
Keywords: S-(azageteril) substituted cysteamine, acute radiation injury, radioprotective activity.
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We are proud to announce the annual scientific conference of young scientists with the international participation, dedicated to the Day of Science in Ukraine. The conference will be held on 20th of May, 2016 and hosted by L.T. Malaya National Therapy Institute, NAMS of Ukraine together with Grigoriev Institute for medical Radiology, NAMS of Ukraine. The leading topic of conference is prophylaxis of the non-infectious disease in different branched of medicine.
of the scientific conference with the international participation, dedicated to the Science Day, «CONTRIBUTION OF YOUNG PROFESSIONALS TO THE DEVELOPMENT OF MEDICAL SCIENCE AND PRACTICE: NEW PERSPECTIVES»
We are proud to announce the scientific conference of young scientists with the international participation, dedicated to the Science Day in Ukraine that is scheduled to take place May 15, 2014 at the GI “L.T. Malaya National Therapy Institute of the National academy of medical sciences of Ukraine”. The conference program will include the symposium "From nutrition to healthy lifestyle: a view of young scientists" dedicated to the 169th anniversary of the I.I. Mechnikov.
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