2018, vol XXVI, # 1, page 7
H. V. LAVRYK
National Cancer Institute, Kyiv
STRATEGY OF DIAGNOSTIC RADIOLOGIC STUDIES IN ASSESSING EFFECTIVENESS OF CHEMOTHERAPY OF METASTATIC COLORECTAL CANCER
Purpose. To identify visual features, which characterize activity of metastatic process in the liver. To estimate polychemotherapy effectiveness criteria in patients with metastatic colorectal cancer (mCRC).
Materials and methods. The study enrolled 196 patients with colorectal cancer liver metastases who were provided with CT and MRI. The analysis of baseline diagnostic images as well as control studies were carried out; treatment outcomes were assessed.
Outcomes. The diagnostic images of liver metastasis are signifcantly altered after chemotherapy and differ from the baseline images. Due to CT/MRI, visual and the most important features, which characterize activity of liver metastatic disease, dynamic morphologic changes during treatment period were assessed. Polychemotherapy effectiveness criteria were defned. The assessment of diagnostic methods (CT, MRI) signifcance was made as well as the outcomes of treatment provided for patients with mCRC were analyzed in accordance with RECIST criteria.
Conclusions. Diagnostic monitoring along with radiologic methods have made it possible to assess treatment effectiveness and carry out correction measurements.
Keywords: metastatic colorectal cancer, radiologic diagnostic methods, treatment effectiveness criteria, RECIST criteria.
2018, vol XXVI, # 1, page 15
M. V. KRASNOSELSKYI, E. M. KRUTKO, L. V. CHERKASKO, S. O. PYLYPENKO
SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Science of Ukraine»
EARLY DIAGNOSIS OF CHRONIC BRAIN ISCHEMIA IN SUPERIOR VENA CAVA SYNDROME IN ONCOLOGY PATIENTS
Superior vena cava syndrome is a disorder consisting in impaired venous blood outfow from the upper part of the trunk (circulatory disturbance). This condition is caused by vein compression or thrombus formation mainly resulting in impaired outfow from the head, shoulders and upper body. It can lead to severe complications that can threaten life of a human and cause brain disorders.
There are a lot of different ways to diagnose brain damage starting with morphological methods of assessing pathological state of the brain, determining certain bioelements and their ratios, assessing the state of the blood-brain barrier by comparing molar concentrations of various substances in the blood serum and CSF, CT, ultrasound, etc. However, the above mentioned methods have a signifcant disadvantage, i.e. they do not provide an early diagnosis of chronic cerebral ischemia, some of them experience diffculties and need much time to be carried out.
The most modern way of this complication is the use of markers, one of which is the neuron-specifc enolase (NPE).
Therefore, applying method of early diagnosis of chronic cerebral ischemia in superior vena cava syndrome in cancer patients makes it possible to diagnose ischemic brain damage in 95% of cases. To assign a program of intensive treatment of patients in order to prevent progressing ischemic brain damage. To identify the risk groups of developing chronic cerebral ischemia in the short term and to assign necessary intensive therapy in due time.
Keywords: superior vena cava syndrome, chronic cerebral ischemia, neuron-specifc enolase, glycolysis enzymes, oncopathology, diagnosis.
2018, vol XXVI, # 1, page 19
N. A. MITRYAEVA, L. V. GREBENIK, O. P. LUKASHOVA
SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv
INFLUENCE OF IONIZING RADIATION ON VEGF CONTENT IN THE BLOOD SERUM OF TUMOR-BEARING RATS
Purpose. To study VEGF level in the blood serum of rats with a transplanted Heren tumor under X-ray irradiation.
Materials and methods. Twenty tumor-bearing rats of Wistar population weighing 160–180 g, with transplanted Heren carcinoma, were exposed to fractionated irradiation (5 Gy + 5 Gy) along with (0.5 Gy + 0.5 Gy) the tumor growth zone by means of RUM-17 device, with 24 hours intersession interval. Blood sampling was performed via life-time decapitation method 24 hours after the last irradiation fraction. VEGF content in the blood serum was assessed by means of enzyme immunoassay method applying standard Vector-Best kits (Russia). Heren tumor metastructure study was carried out in accordance with electron microscopy standard methods. The mitotic index and the index of cells with granules were counted in semifne sections under light microscope, the apoptosis index — in ultrathin sections under electron microscope.
Outcomes. It was found that at low irradiation doses (0.5 Gy + 0.5 Gy), VEGF level was 5.6 times higher than when irradiated with high doses (5 Gy +5 Gy). Comparison of C control / C ratio at different doses showed that at low doses the coeffcient is 5.64 times less than when using high doses, i.e, there is a signifcant difference in VEGF content in the blood serum of rats depending on radiation doses. The obtained outcomes indicate a direct participation of VEGF in the response to irradiation. During the action of ionizing radiation at low doses (1 Gy), angiogenesis processes are stimulated, and at high doses (10 Gy) angiogenesis processes are slowed down. The relationship between VEGF level and the structural and functional state of the Guerin carcinoma was revealed. In a low level of the marker and total dose of 10 Gy, disturbance in tumor vessels and enhancement of apoptotic death of tumor cells are observed. When irradiated at low doses (total — 1 Gy), increased apoptosis in the tumor associated with increased VEGF level is not observed.
Conclusions. The peculiarities of x-ray irradiation impact on VEGF level in the blood serum of tumor-bearing rats depending on the dose of irradiation have been ascertained. Inhibition of apoptosis in Heren tumor with fractionated irradiation of 0.5 Gy + 0.5 Gy was established in the setting of hyperexpression of VEGF and intensifcation of apoptotic death of tumor cells with fractionated irradiation at a dose of 5 Gy +5 Gy and VEGF low level.
Keywords: X-ray irradiation, vascular endothelial growth factor (VEGF), angiogenesis, apoptosis.
2018, vol XXVI, # 1, page 25
M. V. KRASNOSELSKYI, O. V. MOVCHAN, E. M. KRUTKO, S. M. HRAMATYUK, O. M. BILYI
SI Grigoriev Institute for Medical Radiology of NAMS of Ukraine
IDENTIFICATION OF MICROBIOCENOSIS AS A FORECAST FACTOR OF POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH STOMACH CANCER
Purpose. To improve direct separate and functional outcomes of surgical treatment of patients with stomach cancer via development and implementation of new methods of reconstructive reparative surgery stage.
Materials and methods. The comparative outcomes of radical surgical treatment of patients with stomach cancer, divided into two groups, have been presented.The patients of Group 1, after radical removal of the stomach affected by tumor, were provided with reducing-reconstructive stage with the formation of ileoileal reservoir according to the suggested technique (20 patients). The patients of Group 2 underwent all operation stages in accordance with the standardized procedure (20 patients).
Outcomes. In the patients of Group 1, better direct, distant and functional treatment outcomes were observed.
It was proved when studying intestinal microbiocenosis.
Conclusions. It has been established that in case of formation of ileoileal reservoir at restoration stage after radical surgical intervention concerned with stomach cancer, partially evacuation of the nutritive masses is provided and it is considered as prevention of dumping-syndrome. The recovery stage in patients was revealed to be shorter after surgeries carried out in accordance with suggested technique due to faster normalization of physiological processes in the patient’s body. It has been studied that direct and distant survival rate in Group 1 is better. When studying intestine microbiocenosis it was established that in case of ileoileal reservoir formation, the pathogenic microfora percentage was lower that made it possible to decrease postoperative complications level.
Keywords: stomach cancer, surgical treatment, microbiocenosis, postoperative complications.
2018, vol XXVI, # 1, page 31
Y. RADZISHEVSKA1, 2
1 SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv
2 Kharkiv National Medical University
INTELLIGENCE ANALYSIS OUTCOMES OF REMOTE EFFECTS OF TREATMENT OF PATIENTS WITH THYROID CANCER
Purpose. To carry out an intelligence analysis of the database containing information about the course and posttreatment screening of patients with thyroid cancer (TC) in order to reveal statistically signifcant relationships between past medical history data, disease course and the fact of appearing remote oncological effects after treatment.
Materials and methods. The study was focused on the analysis of 215 paper medical records. The information concerning disease course of 68 patients, who were selected in accordance with the criteria or due to appearing of any kind of malignancy 3 and more years after provided treatment or in case of remote therapeutic complications, was added to the electronic database. At the time of data processing, oncological consequences were revealed in 33 patients, therapeutic ones in 35 patients. Statistical processing was carried out using nonparametric statistics by means of Statistica Basic Academic 13 for Windows software package.
Outcomes. The patients with TC, who have had remote oncological effects after the treatment, are characterized by a higher body mass index; in female patients, the overall lactation term in the reproductive period is 2.3 times higher than that one in women without remote oncological effects; prolongatio morbi is more typical for patients with stage 3 of the process, and the absence of oncological effects and appearing of second cancers – for patients with stage 2 of the process; the patients with the frst group of blood had worse fndings in remote terms after special treatment.
Conclusions. The intelligence analysis of catamnestic data have made it possible to reveal a lot of statistically signifcant dependencies that were not obvious without an adequate mathematical processing. Expanding the volume of the electronic array of data will allow us to obtain additional information of clinical and scientifc value.
Keywords: medical informatics, thyroid gland cancer, treatment remote effects, statistical analysis.
2018, vol XXVI, # 1, page 38
A. S. SIMBIRIOVA, O. M. SUKHINA, V. S. SUKHIN
SI «Grigoriev Institute for Medical Radiology of NAMS of Ukraine», Kharkiv
EARLY RADIOEPITHELIITIS OF THE VAGINA IN PATIENTS WITH ENDOMETRIAL CANCER
The leading method of treatment of endometrial cancer (EC) is radiotherapy (RT), which often leads to occurrence of radioepitheliitis.
Purpose. To study the frequency of development and severity of early radioepitheliitis of the vagina in EC patients of stage I–II receiving RT in the postoperative period.
Materials and methods. Sixty patients with endometrial cancer of stage I–II (T1a-2NхM0) received a postoperative radiotherapy on the ROCUS-AM or CLINAC 600 C devices, and 40 of them received intracavitary radiotherapy (ICRT) on the AGAT-B device.
Outcomes. The patients were divided depending on which device the remote treatment component was performed and whether additional irradiation of the vaginal scar was performed. In 21 (35.0%) patients out of 60, radioepithelitis of I–II degree was noted. When intracavitary gamma-therapy has been added to treatment in 40 patients, radioepitheliitis was noted in 27 (67.5%) cases. In 6 (10.0%) patients who had previously experienced periculitis or incomplete healing of the vaginal scar, there was II degree radioepitheliitis. In 12 (20.0%) patients the mucous membrane of the vagina was unchanged.
Conclusions. The occurrence and development frequency of radioepitheliitis depend on the dose. Infammatory changes in the vaginal mucosa before the start of RT contribute to increased radiation reactions. The type of distant irradiation does not affect the degree of severity of radiation reactions.
Keywords: endometrial cancer, radiation therapy, radiation reactions, radioepitheliitis of the vagina.
2018, vol XXVI, # 1, page 48
M. V. KRASNOSELSKYI1, 2, A. M. BELIY1, 2, Y. M. KRUTKO1, R. A. PODLESNIY1
1 State institution «Institute of Medical Radiology by S.P. Grigoriev of NAMS of Ukraine», Kharkiv
2 Kharkiv National Medical University
GIANT RELAPS OF FEMOUR SARCOMA
The article describes the case of a giant recurrence of soft tissue sarcoma in a patient of 78 years. In 2016 patient was undergone a combined treatment for soft tissue left femour sarcoma (surgical, radiotherapy 50 Gy). At july 2017 a recurrent sarcoma of the same area was diagnosed. She addressed with the help to the regional oncologic center, where, by the decision of the consilium: a tumor of gigantic size with major vessel invasion. She was denied in surgical treatment. The complexity of the case is also due to post-radiation fbrosis of the tissues. The patient is successfully operated, the vascular-nerve bundle of the femour is saved, only the deep femour artery, which was invased by the tumor, is ligated. Six months after the operation is without recurrence.
Keywords: sarcoma of soft tissues, relapse, radiotherapy, surgical treatment.