URJ 2/2017

2017, vol XXV, # 2, page 77

S. A. LUTSYK

Regional Municipal Institution Sumy Regional Clinical Oncology Dispensary

RATIONALE FOR CHOOSING ANESTHESIA FOR ELDERLY PATIENTS WITH INITIAL CARDIAC FAILURE

Objective. Providing anesthesia care for elderly patients with initial cardiac failure is still a complex clinical problem. The article deals with the outcomes of the study which enrolled two groups of patients requiring surgical intervention associated with cancer of the intestine. The patients had initial cardiac failure. The average age of the patients was 66.2 ± 2.1 years.

Materials and methods. The patients of both groups underwent a planned surgery with radical intervention. The patients of Group 1 were provided with total intravenous anesthesia; the patients of Group 2 were additionally administered L-arginine 4.2% 100 ml along with prolonged epidural anesthesia.

Results. The study outcomes show improved myocardium contractility and positive effect on the inhibition of stress factors in the form of decreased cortisol level by 17.1 % and reduced content of catecholamines in erythrocytes by 31.4% in patients of Group 2.

Conclusions. Therefore, the study makes it possible to consider a new solution of the scientific problem, i.e. improvement of the outcomes of treatment of patients with initial chronic cardiac failure who underwent surgical intervention concerned with GI tract cancer.

Keywords: heart failure, advanced age, anesthesia.

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2017, vol XXV, # 2, page 83

O. V. BILETSKІY, S. V. KURSOV

Kharkiv Medical Academy of Postgraduate Education

PREVENTION OF MITOCHONDRIAL DYSFUNCTION IN MULTIORGAN SURGICAL INTERVENTIONS

Abstract. The study was focused on the endogenous production of carbon monoxide (CO) and enrolled 23 patients with shock in polytrauma. A significant increase in the content of carboxyhemoglobin in the blood during reperfusion has been revealed. The use of a solution containing succinic acid, niacin, inosine, methionine in combination with thiamine has been found out to contribute to decreased production of endogenous CO, which leads to development of mitochondrial dysfunction.

Keywords: multiple trauma, shock, mitochondrial dysfunction, carbon monoxide, carboxyhemoglobin.

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2017, vol XXV, # 2, page 86

K. I. LIZOGUB1, S. V. KURSOV2

1 SE Sytenko Institute of Spine and Joint Pathology, NAMS of Ukraine, Kharkiv 2 Kharkiv Medical Academy of Postgraduate Education

FLUID INFUSION SUPPORT FOR PERFORMING TRAUMATIC SURGICAL INTERVENTIONS IN ORTHOPEDIC ONCOLOGY IN ACCORDANCE WITH GOAL-DIRECTED FLUID THERAPY PRINCIPLES

Abstract. Fluid infusion support was applied during the operation targeting the value of the stroke index of 35 ml/m2 and mean arterial pressure of 90 mm Hg In 24 for patients with malignant neoplasms of tubular bones. The volume of infusion was less than under the liberal regime of resuscitation. The complications due to anesthesiological management has not been observed.

Keywords: Goal-Directed Fluid Therapy, orthopedic oncology, anesthesiological management.

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2017, vol XXV, # 2, page 89

YU. I. KARACHENTSEV, M. YE. SAZONOV, V. V. KHAZIEV, V. N. DUBOVIK, YE. P. KORCHAGIN, L. V. НERASIMENKO, A. KORKELIIA

SI V. Ya. Danilevsky Institute for Endocrine Disorder Research of the National Academy of Medical Sciences of Ukraine, Kharkiv

DETERMINATION OF SODIUM-IODIDE SYMPORTER EXPRESSION IN WELL-DIFFERENTIATED PAPILLARY CARCINOMAS AND FOLLICULAR NEOPLASMS OF THE THYROID GLAND

Abstract. The main method for treating well-differentiated thyroid cancer (TC) is radical surgical treatment followed by radioiodine therapy (RIT), which efficacy depends on the ability of the cell to accumulate the radiopharmaceutical agent. Ability to trap iodine is determined by presence of the sodium-iodide symporter protein (NIS) on the cell membrane, which may be lost during carcinogenesis. The level of NIS expression in welldifferentiated papillary TC and follicular neoplasms, including both benign and malignant tumors, was studied. Up to 12 % of all papillary carcinomas and 56 % of follicular carcinomas demonstrate absence of NIS expression, which suggests possible insensitivity to RIT and increased risk of disease relapse.

Keywords: expression of sodium-iodide symporter, thyroid cancer.

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2017, том XXV, випуск 1, сторінка 94

O. I. SOLODIANNIKOVA, H. H. SUKACH, D. L. SAHAN, V. V. TRATSEVSKYI

National Cancer Institute, Kyiv

EFFICIENCY OF RADIOACTIVE IODINE THERAPY OF DIFFERENTIATED THYROID CARCINOMA DEPENDING ON PERFORMANCE PERIOD

Summary. Retrospective analysis of the effectiveness of radioiodine therapy in patients with DTC showed relatively high positive efficacy rates of the first course of 131I in 88.6–76.0 % of patients, irrespective of the time that has elapsed since surgery or diagnostic scintigraphy. However, the timing of radioiodine therapy have to be considered in each case on the basis of risk factors.

Keywords: differentiated thyroid cancer, radioiodine therapy, effectiveness of treatment.

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2017, vol XXV, # 2, page 98

V. V. SINAIKA

N. N. Alexandrov National Cancer Centre of Belarus, a/g Lesnoy, Minsk region, Belarus

COMBINATION AND MULTIMODALITY TREATMENT OF ELDERLY PATIENTS WITH GLIOBLASTOMA

Objective. Assessment of the outcomes of combination and multimodality treatment of elderly patients with primary grade IV glioblastoma.

Materials and methods. The study enrolled 74 glioblastoma patients aged ≥ 65 with Karnofsky performance scale ≥ 50%, who were treated by means of radiotherapy (RT) or chemoradiotherapy (ChRT) with temozolomide.

Outcomes. Postoperative ChRT vs RT made it possible to improve the median progression-free survival from 6 ± 0.67 months to 9 ± 1.71 months (Р = 0,005) and the median overall survival from 7 ± 1.11 months to 15 ± 1.33 months (Р = 0,001). The increase in the total target dose (TTD) from 50–52.2 Gy to 54–60 Gy raised the median progression-free survival from 4 ± 1.31 months to 8 ± 0.67 months (Р = 0,018), and the median overall survival from 5 ± 1.31 months to 11 ± 1.58 months (P < 0,001). The increase in the TTD from 54–57.6 Gy to 58–60 Gy did not result in survival improvement.

Conclusions. The inclusion of temozolomide in the postoperative therapy regimen for glioblastoma patients aged ≥ 65 improves the results of treatment. No relationship between the treatment outcomes and the alteration of RT TTD within 54–60 Gy range has been revealed.

Keywords: grade IV glioblastoma, elderly age, postoperative therapy.

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2017, vol XXV, # 2, page 105

L. M. BARANOVSKAYA, V. S. IVANKOVА, T. V. KHRULENKO,  T. V. SKOMOROKHOVA, G. L. GORELINA

National Cancer Institute, Kyiv

RESULTS OF DIFFERENT MODES CONFORMAL RADIOTHERAPY IN TREATMENT OF CERVICAL CANCER

Summary. Development of techniques for cytotoxic treatment applying different modes of conformal radiotherapy, brachytherapy and high-energy (high dose rate — HDR) is one of the promising areas of optimization and efficiency of conservative treatment of patients with regional forms of cervical cancer.

Materials and methods. At Radiation Oncology Department, National Cancer Institute, 89 patients with stage 2b–3b cervical cancer, aged 29 to 70, underwent examination and combined radiotherapy course. The patients were divided into 2 main groups (56 patients) depending on the mode of developed conformal radiation therapy, and a control group made up by 33 patients (classic, default conformal radiotherapy).

Results. Along with external beam radiotherapy, the patients of Group 2 were provided with conformal radiotherapy carried out by means of the linear accelerator of electrons in the mode of enhanced multifractionation of irradiation dose applied to the small pelvis area (tumor and lymph efflux channels) with the single tumor dose 1.3 Gy twice per day once 4–6 hours up to the total radiation dose of 45 Gy applied to the small pelvis lymph nodes. The patients of Group 1 and the ones of the control group underwent conformal radiotherapy in the mode of standard fractionation applied to the small pelvis area with the single tumor dose of 1.8 Gy up to the total radiation dose of 45 Gy. Conformal radiotherapy was carried out for the patients of Group 1 associated with chemoradiomodifiers (tegafur, cisplatin). At the stage 2 of combined radiotherapy course, all patients underwent HDR brachytherapy via Co60 source in the mode of the single tumor dose of 5 Gy at point A up to the total radiation dose of 35–400 Gy. The direct outcomes of combined radiotherapy provided for the patients with regional cervical cancer are indicative of increased positive response of the tumor to irradiation when conformal radiotherapy in the mode of accelerated multifractionation (patients of Group 2) is applied. Thus, a positive response of the tumor nidus (the total gross and partial regression) was observed in 75% of patients of Group 1, 78.6% of patients of Group 2 and 54.6% of patients of the control group. Statistically significant total toxic and early radioreactions of second degree involving key organs in patients of the main group and the control one were not observed.

Conclusions. Therefore, employing accelerated mode of multifractiation in conformal radiotherapy of patients with regional cervical cancer makes it possible to enhance canrcinocidal irradiation doses applied to a tumor, and an interval between radiotherapy fractions provides conditions for initiation of additional processes of reparation and elimination of sublethal injuries in healthy tissues as well contributes to reduction of radioreactions, shortening of treatment period and improvement of life quality.

Keywords: cervical cancer, conformal radiation therapy, high-energy brachytherapy.

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2017, vol XXV, # 2, page 111

V. S. IVANKOVА, T. N. NESTERENKO, N. N. KHRANOWSKAYA,  L. M. BARANOVSKAYA, T. V. KHRULENKO

National Cancer Institute, Kyiv

MONITORING THE EFFECTIVENESS OF CHEMORADIOTHERAPY FOR CERVICAL CANCER AT THE MOLECULAR-GENETIC LEVEL

Summary. The study of the unbalanced composition of DNA (aneuploidy) in tumor cells and their proliferative activity in order to assess disease prognosis in comparison with other clinical and morphological characteristics is of a particular concern.

At Radiation Oncology Department of National Cancer Institute, the patients with regional cervical cancer underwent a complete examination before chemoradiotherapy. It included assessment of DNA index by means of laser DNA-flow cytofluorometry method applying biopsy cervix material. The cytotoxic medical agents in radiomodifying doses were applied in the process of combined radiotherapy. The study concerned with the possibility of monitoring of treatment efficacy at subcellular level was carried out. Treatment and analysis of obtained clinical and instrumental monitoring data in 149 patients with regional cervical cancer (114 patients under the study and 35 patients of the control group) were provided. The effectiveness of chemoradiotherapy was assessed based on tumor regression degree, indices of cervix cells DNA-status and severity of toxic manifestations.

The analysis of direct outcomes of chemoradiotherapy method showed that alterations of DNA-status of tumor clones correlates with clinical data obtained as a response to cytotoxic therapy of regional cervical cancer. The positive response of the tumor in patients with regional cervical cancer was 22.0% higher after chemoradiotherapy full course in comparison with the standard method. Manifestations of early and late toxicity of the developed methods did not exceed I–II degree according to RTOG/EORTC toxicity scale.

Keywords: cervical cancer, chemoradiation therapy, cytotoxic therapy.

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2017, vol XXV, # 2, page 117

V. S. IVANKOVA, T. V. SKOMOROKHOVA, A. Y. STOLYAROVA, G. V. GALYAS

National Cancer Institute, Kiev

IMPACT OF TOPOMETRIC PREPARATON QUALITY ON EFFICACY OF TREATMENT OF PATIENTS WITH UPPER RESPIRATORY TRACT MALIGNANCY

Topicality. The main task of radiotherapy is to bring tumorocidal dosage to the tumor with the minimal possible load on the surrounding healthy tissues. Taking availability of high-tech equipment into account, today this is an individualized approach to implementation of all links of the technological chain: the choice of the method of remote radiation therapy, the quality pre-irradiation topometric preparation of the patient, the calculation of the radiation plan, the maximum dose in the target.

Purpose. To estimate effectiveness of radiotherapy in patients with locally advanced malignant neoplasms of the upper respiratory tract using modern technologies by means of high-tech equipment in comparison with standard treatment.

Materials and methods. The study enrolled 121 patients with malignant neoplasms of the upper respiratory tract who underwent treatment at National Cancer Institute at Radiation Oncology Department. The patients were divided into three groups: Group I patients were treated by means of the device with a linear electron accelerator Mevatron KD2 — 32 patients, Group 2 patients — LET Clinac 2100 — 41 patients and Group 3 patients — Rokus AM and Teratron cobalt devices — 48 patients. All patients were exposed to remote radiation therapy with the previous pre-irradiation topometric preparation. As a result, the patients of Group 1 and 3 experienced radiation reactions of II–III degree during treatment, which led to forced treatment interruption.

Outcomes. Due to the radiation therapy provided, most patients with upper respiratory tract malignancy managed to achieve regression of the tumor and a significant improvement in life quality. The best result was noted in patients who underwent topometric preparation applying 3D planning. Positive feedback from patients who received treatment via advanced technology, was increased for more than 13%. The recurrence-free three-year survival rate of patients with upper respiratory tract tumors was 2 times higher than in the control group.

Keywords: pre-irradiation topometric preparation, irradiation target, tumor center, external beam radiation therapy, tumorocidal dose.

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2017, vol XXV, # 2, page 123

FEATURES OF BRACHYTHERAPY OF SECONDARY VAGINAL CANCER WITH DUE REGARD FOR RADIOBIOLOGICAL ASPECTS

Introduction. Technologies of high-energy modern brachytherapy with high-dose rate (HDR) sources of 192Ir and 60Co of higher than 12 Gy make it possible within a short time interval to concentrate high doses of energy of ionizing radiation in a limited volume of tissues with minimal risks of severe radiation reactions or damage. Purpose. The search for optimal models of contact radiation therapy aimed to increase the effectiveness of chemoradiotherapy of secondary vaginal cancer (metastatic forms) continues to be the subject of extensive discussion.

Materials and methods. The National Cancer Institute, Radiation Oncology Department, conducted complex conservative treatment of 87 patients with metastatic cancer of the vagina II–III stages, T2-3 N0-1 M0 aged from 28 to 72. Depending on the method of HDR brachytherapy, 3 groups were formed on the background of chemosensitizing agents (oral fluoropyrimidines, platinum preparations): 2 study groups (25 patients who underwent HDR brachytherapy using 192Ir source and 29 patients with 60Co HDR source) and 33 patients of the control group, who underwent brachytherapy by Co sources with an average medium dose rate (MDR — from 2 Gy/h to 12 Gy/h). The total focal dose from combined radiotherapy was up to 80–90 Gy on the tumor focus and 45–50 Gy on the regions of regional metastasis. Brachytherapy was carried out via 5 Gy regimen twice a week.

Outcomes. The analysis of the direct outcomes of the effectiveness of the use of 60Co or 192Ir sources with HDR brachytherapy and dynamic observation data for 3 months showed that the positive tumor response (complete + partial regression) in patients with metastatic vaginal cancer after the course of chemoradiotherapy increased by 19.7 % and 14.5 % compared to 60Со МDR in brachytherapy. Toxic effects of treatment concerned with the number and extent of their manifestations in the study groups of patients did not differ from the control group and did not exceed the second degree.

Conclusions. The use of 192Ir HDR and 60Co HDR in combined radiotherapy in patients with secondary (metastatic) vaginal cancer makes it possible to enhance the therapeutic effect of radiotherapy, substantially improve the immediate outcomes of treatment of patients with secondary (metastatic) vaginal cancer without increasing toxicity (general and local), quantity and extent of possible early and late local radiation complications involving the key organs, which is due to the high accuracy of pre-irradiation preparation and adequate planning. The clinical effect of chemoradiotherapy is delayed. The use of radio modifiers in the process of combined radiotherapy in patients with metastatic vaginal cancer does not lead to toxic complications that adversely affect the quality of life of patients.

Keywords: brachytherapy, secondary vaginal cancer (metastatic form).

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2017, vol XXV, # 2, page 128

O. REMINNIK2, D. MECHEV1, V. IVCHUK1, L. ROMANENKO2, S. ROMANENKO2, S. RAZYUMEIKO2, O. VASKEVITCH2, Z. SHEPEL2

1 Shupik National Medical Academy of Postgraduate Education 2 Kiev City Clinical Oncological Centre

BRACHYTHERAPY CANCER OF VISUALIZED LOCALIZATIONS

This work presents a treatment report about 22 patients with malignant tumors of visalzated localizations II–IV stage with the aid of 192Ir «Microselectron».

Single local dose was 5,2 Gy, total irradiation dose — from 41,6 Gy to 46,8 Gy in dependence of hystostructure, growth form and tumors size. After this kind of radiotherapy, all patients are a lived during 3 years observation without any recurrences or relapses.

Keywords: brachytherapy, malignant tumors, «Microselectron», 192Ir.

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2017, vol XXV, # 2, page 131

М. V. SOKOLOVSKA1, T. M. GOVORUKHA2, N. A. EFREMOVA2, L. V. VINZEVICH2, O. S. CHURIKOVA2, M. D. PLESHKOV2, O. V. OVSIENKO2

1 Shupik National Medical Academy of Postgraduate Education, Kiev 2 Kiev City Clinical Oncological Centre

THE CHOICE OF TARGET VOLUME DELINEATION OF LARYNGEAL CANCER RADIOTHERAPHY DEPENDING ON LOCALIZATION AND STAGE OF THE PRIMARY TUMOR

Purpose. To justify selection of the necessary irradiation volumes, depending on localization and stage of laryngeal cancer.

Materials and methods. At Kiev oncological centre, patients with laryngeal cancer undergo conformal radiotherapy by means of ONCOR Impression Plus (Siemens) linear accelerator. Before treatment, the patients were prepared for external beam therapy including immobilization, SCT, receiving the series of CT and processing them to choose necessary volumes of irradiation.

Results. We developed detailed algorithm of target volume delineation and conduct of external beam therapy of laryngeal cancer depending on localization of a primary tumour. The comparison of dosimetry plans in order to show importance of adequate topometric planning was carried out.

Conclusions. The differentiated approach to the target volume delineation depends on localization and stage of the process. It makes it possible to provide treatment of laryngeal cancer at necessary total dose without serious radiotherapy affects. Adequate pre-irradiation preparation aids in decreasing probable radiation changes in key organs that influences the life quality.

Keywords: cancer, larynx, radiation therapy, target volume delineation.

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2017, vol XXV, # 2, page 135

 G.V. GRUSHKA

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

RADIOIODINE THERAPY ОF DISTANT METASTASES OF DIFFERENTIATED THYROID CARCINOMA

The lecture deals with topical issues concerning radioiodine therapy of distant metastases of differentiated thyroid cancer. The achievements of 131I-therapy, as well as those clinical cases where it is impractical, have been presented with due regard for clinical experience or retrospective studies. It was shown that metastatic lesions, which have high avidity for 18 F-FDG in PET, appear to be resistant to high-dose radioiodine therapy. The issue of repeated high doses for patients without signs of a positive response to radionuclide therapy is considered. The approaches to management of patients with thyroid cancer, who have increased level of serum thyroglobulin in the absence of identifiable lesions, are provided.

Keywords: radioiodine therapy, thyroid cancer, thyroglobulin.

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2017, vol XXV, # 2, page 139

E. V. TITOVICH, I. G. TARUTIN, H. V. HATSKEVICH, M. M. PETKEVICH

N. N. Alexandrov National Cancer Center of Belarus, a/g Lesnoy, Minsk region, Belarus

OPENING OF THE TRAINING CENTER IN THE N. N. ALEXANDROV NATIONAL CANCER CENTER OF BELARUS

Purpose. Development of training programs for medical physicists of radiotherapy departments at the training center of N. N. Alexandrov National Cancer Center of Belarus.

Materials and methods. Curricula and training programs for specialists working in the field of radiation therapy.

Outcomes. Training programs for two training courses have been developed.

Conclusions. It is planned to conduct one training course for medical physicists in 2017 and two courses in 2018. The center provides training for citizens of other countries.

Keywords: training center, radiotherapy, course for medical physicists.

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2017, vol XXV, # 2, page 142

E. V. TITOVICH, О. A. HERTSYK, P. O. PATSIAPALAU, I. G. TARUTIN, H. V. HATSKEVICH

N. N. Alexandrov National Cancer Center of Belarus, a/g Lesnoy, Minsk region, Belarus

ORGANIZATION OF MEDICAL LINEAR ACCELERATORS OPERATION PROCESS EDUCATION FOR MEDICAL PHYSICISTS AND ENGINEERS OF RADIOTHERAPY DEPARTMENTS AT N. N. ALEXANDROV NATIONAL CANCER CENTRE OF BELARUS

Purpose. To develop and implement a training program for medical physicists and engineers of radiotherapy departments that makes it possible to quickly integrate new employees into the working process of the oncological dispensary and organize continuous professional training of engineering specialists.

Materials and methods. The instruction on standard operations of the personnel of the Radiotherapy engineering and medical physics department in Russian and an educational program for the training of specialists that are operating radiotherapy equipment have been developed.

Outcomes. The training was provided for all employees of the Radiotherapy engineering and medical physics department of the N.N. Alexandrov NCCB in accordance with their job duties. The developed instruction describes the following procedures for the operation of equipment for radiation therapy: switching on/ off and rebooting the medical linear accelerator and the OBI system; daily quality control of the medical linear accelerator; treatment of patients; adjustment and calibration of linear accelerator parameters; obtaining 2D and 3D images using EPID and OBI; service mode operations; a procedure for the weekly quality control of the accelerator; calibration of the monitor unit; production of individual shielding blocks.

Conclusions. Introduction of the developed instruction in the clinical practice of the N.N. Alexandrov NCCB made it possible to streamline the process of training the staff of the Radiotherapy engineering and medical physics department and to competently approach the evaluation of the knowledge acquired by the personnel that is operating of the radiotherapy equipment.

Keywords: radiation therapy, linear accelerator, training program.

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2017, vol XXV, # 2, page 146

D. I. KAZLOUSKI, E. V. TITOVICH, I. G. TARUTIN, H. V. HATSKEVICH

N. N. Alexandrov National Cancer Center of Belarus, a/g Lesnoy, Minsk region, Belarus

ORGANIZATION OF BRACHYTHERAPY TREATMENT PLANNING AND AFTERLOADERS MAINTENANCE TRAINING PROCESS FOR MEDICAL PHYSICISTS AND ENGINEERS OF RADIOTHERAPY DEPARTMENTS IN THE N.N. ALEXANDROV NATIONAL CANCER CENTRE OF BELARUS

Purpose. To develop and implement a training program for medical physicists and engineers of radiotherapy departments that allows to quickly integrate new employees into the working process of the oncological dispensary and organize continuous professional training of engineering specialists.

Materials and methods. The instruction on standard operations of the personnel of the Radiotherapy engineering and medical physics department in Russian and an educational program for the training of specialists that are operating radiotherapy equipment have been developed.

Results. Training was conducted for all employees of the Radiotherapy engineering and medical physics department of the N. N. Alexandrov NCCB in accordance with their job duties.

Conclusions. Introduction of the developed instruction in the clinical practice of the N. N. Alexandrov NCCB allowed to streamline the process of training the staff of the the Radiotherapy engineering and medical physics department and to competently approach the evaluation of the knowledge acquired by the personnel that is operating of the radiotherapy equipment

Keywords: brachytherapy planning, training program.

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2017, vol XXV, # 2, page 151

M. М. PIATKEVICH, E. V. TITOVICH, I. G. TARUTIN, H. V. HATSKEVICH

N. N. Alexandrov National Cancer Center of Belarus, a/g Lesnoy, Minsk region, Belarus

ORGANIZATION OF TELETHERAPY TREATMENT PLANNING TRAINING PROCESS FOR MEDICAL PHYSICISTS AND ENGINEERS OF RADIOTHERAPY DEPARTMENTS AT N.N. ALEXANDROV NATIONAL CANCER CENTRE OF BELARUS

Purpose. To develop and implement a training program for medical physicists and engineers of radiotherapy departments that makes it possible to quickly integrate new employees into the working process of the oncological dispensary and organize continuous professional training of engineering specialists.

Materials and methods. The instruction on standard operations of the personnel of the Radiotherapy engineering and medical physics department in Russian and an educational program for the training of specialists that are operating radiotherapy equipment have been developed.

Outcomes. Training was provided for all employees of the Radiotherapy engineering and medical physics department of the N.N. Alexandrov NCCB in accordance with their job duties. The developed instruction describes the following procedures for the operation of equipment for radiation therapy: CT and PET images registration procedure, analysis of the treatment planning statistics, import of the patient data to the Eclipse TPS, patient data transfer from CT to the dedicated data server, CT and MRI images registration procedure, 3D treatment planning using MasterPlan TPS, 3D treatment planning using Eclipse TPS, IMRT and VMAT verification using EPID, IMRT and VMAT verification using Octavius 4D, EPID calibrations, IMRT treatment planning using Eclipse TPS, VMAT treatment planning using Eclipse TPS.

Conclusions. Introduction of the developed instruction in the clinical practice of N.N. Alexandrov NCCB made it possible to streamline the process of training the staff of the Radiotherapy engineering and medical physics department and to competently approach the evaluation of the knowledge acquired by the personnel that is operating of the radiotherapy equipment.

Keywords: radiation therapy, treatment planning, training program.

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2017, vol XXV, # 2, page 155

O. V. LUKYANCHUK, O. V. ANTONYUK, V. T. STOYAN, L. I. BOGDANOVICH, O. V. KULIСНKOVA

CU «Odessa Regional Oncology Center»

THE RESULTS OF TREATMENT OF PATIENTS WITH THYROD CANCER WITH METASTASES IN THE MEDIASTINAL LYMPH NODES AND LUNGS

Purpose of work: to show there sults of treatment of patients with metastases in lungs and mediastinal lymph nodes differentiated thyroid cancer by radio-active iodine as to one of constituents of the combined treatment.

Results: 9-years clinical looking showed after this group of patients (34): Died 10 patients over 45 years of age, 6 patients have generalisation cancer disease, 9 patients do not have effect of treatment, 1 patient died from comorbidity pathology.

Conclusions: metastases in lungs and mediastinal lymph nodes on the basis of generalisation of the malignant process often called poorly differentiated thyroid cancer, insensitive to therapy rado-active iodine.

Keywords: thyroid cancer, metastases in lungs, mediastinal lymph nodes, therapy radio-active iodine.

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2017, vol XXV, # 2, page 158

N. YU. SPIZHENKO, T. I. CHEBOTAROVA, O. G. YARMAK, L. V. MATVІEVSKA, R. M. ZELINSKY, YU. P. KOPANEVA

Spizhenko Onkologichna clinic

FEATURES AND BENEFITS ELEKTRONOTERAPIYI IN THE TREATMENT OF NON-MELANOMA SKIN CANCER

Summary. The study is base don the analys is of the experience of treatment of 54 patients (19 men and 35 women aged 20-95 years). All patients satisfactorilyunderwenttreatment. Thefullregressionoftheprimarytumorwa sachievedin 52 patients, reducingthetumorbymorethan 50% in 2 patients. Theobservationperiodwas 6-60 months.

Keywords: Non-melanoma skin cancer, electrontherapy, linAc.

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2017, vol XXV, # 2, page 162

M. I. KHVOROSTENKO1, I. N. KIKHTENKO1, Y. M. KHVOROSTENKO1, S. V. VOLOKITIN2, N. V. SKLYAR2

State Institution Dnipropetrovsk Medical Academy of Ministry of Health of Ukraine

Public Institution Clinical Oncological Dispensary Dnipropetrovsk Regional Council

WAYS OF IMPROVING THE QUALITY OF PLANNING RADIOTHERAPY WITH MODULATED INTENSITY

Introduction. 3D planning standards do not exclude the presence of sections of the tumor with absorbed dose less than planned, which is considered as a prerequisite for relapse.

Purpose. To improve radiation therapy outcomes in cancer patients through the enhancing IMRT radiation planning quality, identifying areas of the tumor with minimal optical density exposed to lower absorbed dose in comparison with the planned one and assessment of the ways to eliminate it.

Materials and methods. Due to identified locations with a minimum optical density and the absorbed dose lower than the planned one, the “resale” was carried out. It was aimed to achieve the values recorded in the plan.

Outcomes. The percentage of coverage isodose GTV and PTV was increased; on the area, where the total focal dose was lower than the planned, the dose absorbed was increased in comparison with the recorded one.

Conclusions. Assessment of the tumor areas with minimal optical density makes it possible to detect areas with likely lower value of the total focal dose in comparison with the target on; correction of the total focal dose in these areas will improve the quality of radiation therapy.

Keywords: 3D planning, IMRT radiation.

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