2019.27 (3)

2019, VOL. XXVII, PUB. 3, PAGE 165

O. SUKHINA1, К. NEMALTSOVA1, O. NEMALTSOVA2

1 SI «Grigoriev Institute for medical Radiology NAMS of Ukraine», Kharkiv

2 Communal noncommercial organization «Regional center of oncology», Kharkiv

THE EXPERIENCE OF APPLICATION OF CHRONOMODULATED RADIOCHEMOTHERAPY FOR INOPERABLE FORMS OF CERVICAL CANCER

Radiation therapy is a priority direction in special treatment for locally advanced cervical cancer (LACC).

Materials and methods. The data were analyzed for 526 patients with IIB–IIIB stage CC, who received treatment from 2006 to 2018 by the developed (389 patients) and standard (137 patients) techniques.

The purpose of thispaper is to analyze the effectiveness of the application of the developed method of conducting chemoradiotherapytreatment of patients with LACC.

Results. In the majority of patients in group 1, there was a complete regression of the tumor, and in group 2 the incidence of complete regression of the tumor was statistically significantly lower. One-year non-recurring survival in group 1 was 94.3 %, in group 2 — 88.3 %. The 10-year survival rate was 75.3 and 35.8 % in the respective observation groups.

Conclusion.. The unconventional technique for treating patients with LACC, usingsimultaneous chemoradiotherapy with 5-fluorouracil, leads to improvements in both immediate and long-term results of antitumor treatment.

Keywords: cervical cancer, radiotherapy, concurrent chemotherapy, 5-fluorouracil.

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2019, VOL. XXVII, PUB. 3, PAGE 172

Y. YEVSTAKHEVICH, I. YEVSTAKHEVICH, M. SEMERAK, V. LOGINSKY

SI «Institute of Blood Pathology and Transfusion Medicine of NAMS of Ukraine», Lviv

SPLENECTOMY IN THE TREATMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA

Splenectomy was performed in 41 patients with chronic lymphocytic leukemia (CLL). Indications for splenectomy in the presented group of patients were significant splenomegaly with abdominal discomfort, concomitant immune hemocytopenia in the absence of the effect of cytostatic therapy, the phenomenon of hypersplenism, spontaneous rupture of the spleen with intra-abdominal bleeding. Splenectomy was effective in 38 (93 %) patients with CLL: a large volume of tumor mass was removed, abdominal discomfort was eliminated, hemolysis with concomitant autoimmune hemorrhage ceased, and in case of immune thrombocytopenia — increase the level of trombocytes. Postoperative mortality was 2.4 %. The worst long-term results of splenectomy were observed in CLL patients with concomitant Evens–Fisher syndrome. The median overall survival in these patients was only 49.5 months.

Keywords: chronic lymphocytic leukemia, splenectomy, autoimmune hemolytic anemia, immune thrombocytopenia.

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2019, VOL. XXVII, PUB. 3, PAGE 176

I. MOTUZIUK, O. SYDORCHUK, P. PONIATOVSKYI, Y. KOSTIUCHENKO, H. SLAVUTA

Bogomolets National Medical University, Kyiv

ECONOMIC EXPEDIENCY OF ONE-STAGE RECONSTRUCTION IN BREAST CANCER PATIENTS

Aim. To prove the economic expediencyof performing one-stage reconstruction in breast cancer (BC) patients.

Materials and methods. Mastectomy with one-stage reconstruction with implant or own tissues and modified radical mastectomy were chosen to compare the methods of surgical treatment in BC patients.

Results. Mastectomy with one-stage reconstruction with TRAM-flap is characterized by the best ratio of «cost minimization» for BC patients. The cost of using this method for a 5-year period is 58 241 UAH against 71 055 UAH / 5 years after performing mastectomy with one-stage reconstruction with implant, against 73 436 UAH / 5 years in case of modified radical mastectomy. Modified radical mastectomy is more expensive than mastectomy with one-stage reconstruction with implant by 3 % (2381 UAH) or TRAM-flap by 21 % (15 195 UAH) after 5 years behind breast surgery.

Conclusion.. The study results indicate the economic expediencyof performing mastectomy withone-stage reconstruction in BC patients.

Кeywords: economic expediency, breast cancer, reconstructive surgery.

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2019, VOL. XXVII, PUB. 3, PAGE 183

M. KRASNOSELSKIY, O. MOVCHAN

SI «Grigoriev Institute for Medical Radiology of NAMS of Ukraine», Kharkiv

CORRELATION BETWEEN CHANGES OF PERIPHERAL BLOOD INDICES IN PATIENTS WITH GASTRIC CANCER DEPENDING ON THE VOLUME OF SURGICAL INTERVENTION

Purpose of the work: determination of changes in the immunological status of patients with gastric cancer after surgical treatment and the relationship with the development of inflammatory changes depending on the choice of method for performing the reconstructive stage of the operation.

Materials and methods. The comparative results of the radical surgical treatment of patients with cancer of stomach are given. To the patients of the first group after the radical removal of stomach with the tumor, reducing-reconstructive stage was carried out with the formation of intestino-intestino reservoir employing the procedure proposed (20 patients), to the patients of the second group all stages of operation were carried out employing the standardized procedure (20 patients). All patients were definition cell and humoral immunity and it relationships with postoperative complications.

Results. In the patients of 1-st group are noted the best direct, distant and functional results of treatment, it is proven in studying of immune status.

Conclusion.. Check that when carried out with the formation of intestino-intestino reservoir in restoration stage after radical surgical intrusions about stomach cancer are provided earlier reduction of cell and humoral immuny, so are decreasing postoperаtive complications. Discovered something recovering stage of the patients of group one were shorter, accounted faster normalization of the physiological processes. Studied something direct, distant survival in essential group were better.

Keywords: stomach cancer, surgical treatment, immune status, inflamatory postoperation complications.

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2019, VOL. XXVII, PUB. 3, PAGE 188

P. TKACHENKO, I. YAKOVTSOVA, I. IVAKHNO, O. DOLGAYA, A. OLIYNIK

Kharkov Medical Academy of Postgraduate Education

IMMUNOHISTOCHEMICAL CRITERIA FOR PROGNOSIS OF PROSTATE CANCER

Among the diagnostic clinical and morphological features of prostate cancer (PCa), the most significant remain: the level of blood PSA, Gleason sum score, the stage of the disease according to the TNM system. The consideration of immunohistochemical (IHC) factors are necessary for the prognosis of the disease and the choice of therapeutic tactics. The aim of the study was to improve the morphological criteria for the prognosis of prostate cancer by examining IHC markers in the forming of aggressive tumor phenotype. PCa was divided into three groups of low, intermediate and high risk, according to EAU guidelines. The IHC study was performed using markers: TGF-β, Ki-67, E-cadherin, androgen receptors, VEGF, vimentin, CD34+, CD4+, CD8+, CD3+, CD20+, CD68+, GMA-α, cytokeratin 8/18, cytokeratin HMW. Of the 15 IHC markers, a statistically significant relationship was found between the expression levels of Ki-67, E-cadherin, vimentin, CD34+, CD68+ and the presence of prostate cancer in the study groups, which determines these markers significant for disease prognosis.

Keywords: prostate cancer, prognosis, immunohistochemistry.

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2019, VOL. XXVII, PUB. 3, PAGE 193

E. TITOV, I. YAKOVTSOVA, I. IVAKHNO, S. DANILYUK

Kharkov Medical Academy of Postgraduate Education

PROGNOSTIC MARKERS OF RECURRENCE AND PROGRESSION OF NON-INVASIVE UROTELIAL BLADDER CANCER

In the routine diagnosis of non-invasive urothelial cancers of the bladder (NIUCB) it`s important for search the objective prognostic criteria of the disease. The aim of the investigation was to study the prognostic value of immunohistochemical markers to determine risk of recurrence and progression of the disease.

Material and methods. The material was divided into 3 groups: NIUCB without recurrence, with recurrence without progression, with recurrence and progression. We studied the expression of p63, p53, E-cadherin, and cytokeratin 20 (ck 20), 7 (CC 7), N-cadherin, vimentin, CD34+, VEGF, CD3+, CD8+, CD20+, CD68+, collagen type IV, Ki-67, MMP-9.

Results. Criteria of recurrence-free NIUCB are the expression of Ki-67 less than 20 % (p < 0.005), weak reaction of MMP-9 (p < 0,03), a weak tumor infiltration of CD3+ lymphocytes (p < 0.05), CD8+ T-lymphocytes (p < 0.005) and CD68+ macrophages (p < 0.005). Stage 1 epithelial-mesenchymal transformation (EMT) in tumor cells is associated with recurrence without progression of NIUCB (p < 0,03); stage 2 EMT — with the recurrence and progression of the disease (p < 0.05).

Keywords: non-invasive urothelial bladder cancer, immunohistochemistry, recurrence, progression, prognosis.

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2019, VOL. XXVII, PUB. 3, PAGE 198

N. UZLENKOVA, N. SKOROBOGATOVA, A. KRIVKO, E. MASLENNIKOVA, I. LEONOVA

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

EXPERIMENTAL MODELING OF ACUTE RADIATION SKIN INJURIES IN RATS AFTER X-RAY RADIATION

Purpose. To develop an experimental model of acute radiation skin injuries in rats under various conditions of x-ray exposure to create protocols for the therapeutic use of mesenchymal stromal bone marrow cells (BM MSC) based on it.

Methods. The experiments were carried out on 57 white female rats 160–180 g body weight, which were kept under standard conditions on a normal diet of vivarium. Local irradiation of rast thighs at doses of 35 and 50 Gy was performed on X-ray irradiation system Faxitron MultiRad 225 under selected technical conditions (without filters, 0.5 mm Al filter, 0.3 mm Cu filter). The severity of radiation skin injuries was evaluated according to the scoring scale for dynamic observations within 180 days after exposure.

Results. The experimental modeling of acute radiation skin injuries in rats under local irradiation at a dose of 35 and 50 Gy depending on the different penetrating powers of x-ray radiation was carried out. It was established that local irradiation at a dose of 50 Gy with filter 0.3 mm Cu is the optimal x-ray radiation exposure regime for the occurrence of acute reactions and chronic ulcerative processes in rat skin.

Conclusion. The developed experimental model of acute radiation skin injuries can be used to create and improve protocols for BM MSC therapy.

Keywords: experimental model, acute radiation injuries of skin, x-ray radiation.

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2019, VOL. XXVII, PUB. 3, PAGE 202

I. GROMAKOVA, Р. SOROCHAN, N. PROKHACH, I. PONOMARYOV, I. GROMAKOVA

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

PERIOPERATIVE THERAPY OF CANCER PATIENTS

Surgical interventions in oncology are accompanied by a significant number of cancer recurrences. Perioperative therapy serves to eliminate the factors affecting postoperative relapse. This review summarizes the results of perioperative use of β-blockers, nonsteroidal anti-inflammatory drugs, statins, ω-3-polyunsaturated fatty acids, antithrombotic drugs, which are considered as potential means to improve postoperative disease-free survival.

Keywords: oncology, perioperative therapy, β-blockers, nonsteroidal anti-inflammatory drugs, statins, ω-3-polyunsaturated fatty acids, antithrombotic drugs.

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2019, VOL. XXVII, PUB. 3, PAGE 210

УДК 615.849.1

VALENTYNA SEVASTIANOVA

V. N. Karazin Kharkiv National University

RADIATION MEDICINE

The materials are intended for medical students studying radiation medicine.

Keywords: ionizing radiation, radiation medicine, background radiation, penetrating power.

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2019, VOL. XXVII, PUB. 3, PAGE 214

V. STARIKOV, I. SENNIKOV, K. MAYBORODA

Kharkov National Medical University

CLINICAL CASES OF LONG SURVIVAL IN PATIENTS WITH METASTATIC AND RECURRENT LUNG CANCER

The paper presents a clinical case of 12-year survival of a patient, with metastatic cancer of the left lung who underwent trial thoracotomy and receiwed polychemotherapy, as well as a case of local recurrence of lung cancer 14 years after surgical treatment.

Keywords: lung cancer, polychemotherapy, recurrence, survival.

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2019, VOL. XXVII, PUB. 3, PAGE 218

O. URSUL1, A. VESELY2, V. MOSHCHENKO2, I. KALINOVSKAYA3

1 University Clinic of the KHNMU

2 Zaitsev institute of General and Emergency Surgery of the NAMS of Ukraine

3 Kharkiv Regional Clinical Hospital

CASE OF TUBERCULOUS PERITONITIS IN A PATIENT WITH HIV

This article describes a rare clinical observation of tuberculous peritonitis in an HIV-infected man 36 years old, and also discusses the causes, clinical picture and diagnostic methods for this rare complication of HIV infection.

Keywords: HIV infection, tuberculosis, tuberculous peritonitis, computed tomography of the abdominal cavity and small pelvis.

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2019, VOL. XXVII, PUB. 3, PAGE 222

O. PANOV1, R. SPUZYAK2, O. RADCHENKO1, A. SKORYK3

1 SI «Grigoriev Institute for Medical Radiology of NAMS of Ukraine», Kharkiv

2 Kharkiv National Medical University

3 Regional Children’s Clinical Hospital No 1, Kharkiv

CASE OF GASTROINTESTINAL MELANOMA (PRIMARY MULTIPLE OR SECONDARY LESION?)

Malignant melanoma of gastrointestinal tract is rare non-cutaneous neoplasm, that occurs with frequency of 0,0036 cases per 1 million people in year. Thus, etiology of this pathology is not studied well yet. This type of melanoma may be metastatic from the primary skin tumor or truly primary, arising from mucosal epithelium of gastrointestinal tract. Esophageal melanomas comprise about 0,1–0,2 % of all esophageal cancers and about 0,5 % of all non-cutaneous melanomas. In 90 % cases tumor is located in middle and lower thirds of esophagus. Often melanoma is presented as single solid tumor, but in 12 % cases multiple lesions are observed. Differential diagnosis of primary and metastatic melanomas is quite complicated. Diagnosis of gastrointestinal melanomas is based on visualization of pathological zone and biopsy with histological examination.

Keywords: melanoma, gastrointestinal tract, diagnosis.

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