Rossiiskii Onkologicheskii Zhurnal

1406-004
THERAPY WITH ALK-POSITIVE NON-SMALL CELL LUNG CANCER: REALITY AND PROSPECTS
Breder V.V., Laktionov K.K., Yudin Denis I., Hamrina N.E.

N.N. Blokhin Russian Cancer Research Center, 115478, Moscow, Russian Federation; A.I. Evdokimov Moscow State University of Medicine and Dentistry, 127473, Moscow, Russian Federation
Abstract: There is highlighted special small subgroup of patients with non-small cell lung cancer who has translocation of gene ALK in tumor. The modified gene encodes a fusion of pathological protein, leading to activation of ALK receptor on the membrane of tumor cells and then malignant transformation. Clinical studies of crizotinib noted a high frequency (> 60%) of complete and partial responses in chemoresistant metastatic ALK-positive lung cancer; median of progression-free survival reached more than 9 months. Crizotinib is the ATP competitive inhibitor of tyrosine kinase receptor like ALK, MET and ROS1, is one of the most effective drugs for the treatment ofALK-positive lung cancer. However, it is almost inevitable that almost all patients, even in the most pronounced immediate effect to 24 months of treatment crizotinib marked progression of the disease, which is associated with the development of tumor resistance. Currently, clinical studies of the second generation inhibitors of tyrosine kinases, such as ceritinib, alectinib, AP26113 etc, are continuing. Their application is possible in case of the development of resistance to crizotinib.
Keywords: немелкоклеточный рак легкого, транслокация гена ALK, ALK-позитивный рак легкого, кризотиниб, церитиниб, алектиниб, резистентность, non-small cell lung cancer, translocation of gene ALK , ALK-positive lung cancer, crizotinib, ceritinib, alectinib, resistance

1406-014
LUMINAL BREAST CANCER HETEROGENEITY AMONG WOMEN OF DIFFERENT REPRODUCTIVE STATE
Kit O.I., Shatova Yuliana S., Todorov S.S., Lisutin A.Je., Gudtskova T.N., Kechedzhieva Je.Je.

Rostov Scientific Research Institute of Oncology, 344037, Rostov-on-Don, Russian Federation
Abstract: The conducted research included 850 patients with breast cancer, treated in the FSBD «RNIOI» Ministry of Health RF in the period 2010-2013. Among them 649 had luminal tumors. According to our results their nature depend on menstrual state. The proprtion of the hormone-positive tumors prevails in all groups (p<0,05). In general, 76,4% against 23,6%. This is particularly evident in the group of menstruating women (79,8% against 20,2%). Luminal B subtype is the most common regardless menstrual state (59,9%). It’s also most expressed in the group of menstruating women, too (67,5%). However, the high level incidence of luminal B subtype in this group, unlike in perimenopausal women, is supported by higher level of Her2-neu overexpression or amplification associated with positive receptors (48,6% against 35,7%). In perimenopause, the level of luminal B is slightly lower than luminal A (55,9%). And in postmenopause it becomes higher again (58,1%), but due to the higher proliferative activity of tumors.
Keywords: рак молочной железы, молекулярно-биологические подтипы, люминальные опухоли, репродуктивный статус, breast cancer, biomolecular subtypes, luminal tumors, reproductive state

1406-018
ANALYSIS OF THE USE ULTRASOUND IN THE COMPLEX DIAGNOSIS OF CHOLANGIOCARCINOMA
Danzanova Tat’yana Yu., Sinyukova G.T., Lepedatu P.I., Kudashkin N.E.

N.N. Blokhin Russian Cancer Research Center, 115478, Moscow, Russian Federation
Abstract: Objective - to determine the role of ultrasound in the diagnosis of cholangiocarcinoma. Material and methods. Ultrasound examination conducted in 120 cholangiocarcinoma patients. The results were confirmed by data from other research methods, biopsy, surgical palpation and histopathological examination of the resected material. Results. The most difficult is to diagnose tumors of the distal portions of common bile duct. Sensitivity of ultrasound, X-ray CT, MRI, surgical evaluation in the diagnosis of cholangiocarcinoma was: in intrahepatic type - 100%, 100%, 100%, 100%; hilus type - 69%, 75%, 86%, 92%; distal type - 37%, 42%, 69%, 80%. Ultrasound found no evidence of intrahepatic CCA semiotic signs that would distinguish it from other liver cancers. The features of infiltrative tumor growth bile ducts - hyperechoic structure infiltration along the outer contour of the ducts, or hypoechoic structure infiltration at the thickening of the walls of the ducts. The ultrasonic semiotics of modified metastatic lymph nodes has been developed. Conclusion. Ultrasound showed highly informative diagnostic ultrasound in determining the expansion of the bile ducts; the tumor has spread to the liver and lymph nodes. Recommended to extend indications for intraoperative ultrasonography with extrahepatic cholangiocarcinoma to delineate tumor lesions ducts.
Keywords: холангиоцеллюлярный рак, ультразвук, диагностика, рентгеновская компьютерная томография, магнитно-резонансная томография, холангиография, cholangiocarcinoma, ultrasound, x-ray computed tomography, magnetic resonance tomography, cholangiography, diagnosis

1406-026
EXPERIENCE OF USING COMPRESSION SONOELASTOGRAPHY FOR DIAGNOSIS OF METASTATIC LESIONS OF THE LYMPH NODES IN PATIENTS WIT BREAST CANCER
Safronova Mariya A., Solovyev V.I., Borsukov A.V.

Smolensk State Medical Academy, 214019 , Smolensk, Russian Federation
Abstract: In this article we consider the experience of compression sonoelastography lymph nodes in the axillary region preoperative diagnostic algorithm of examination ofpatients with malignant tumors of the mammary glands.
Keywords: рак молочной железы, лимфатические узлы, компрессионная соноэластография, breast cancer, lymph nodes, compression sonoelastography

1406-030
SIGNIFICANCE OF REGULAR SOMATOSTATIN ANALOGUES AND INTERFERON-ALFA APPLICATION IN PATIENTS WITH HIGHLY DIFFERENTIATED NEUROENDOCRINE TUMORS (CLINICAL CASE)
Emelianov Galina S., Gorbunova V.A., Orel N.F., Markovich A.A., Kuzmiovn A.E., Selchuk V.Yu.

N.N. Blokhin Russian Cancer Research Center, 115478, Moscow, Russian Federation
Abstract: Presented clinical case demonstrates the importance of regular use of somatostatin analogues and interferon-alpha in patients with well differentiated NETs.
Keywords: нейроэндокринные опухоли, биохимические маркеры, аналоги соматостатина, neuroendocrine tumor, biochemical markers, somatostatin analogs

1406-032
RETROPERITONEAL NEUROFIBROMAS AND INFLAMMATORY PSEUDOTUMORS, RESULTS OF RESECTIONS, INVOLVING MAJOR VESSELS
Tereshin Oleg S., Zotov S.P., Vazhenin A.V.

Chelyabinsk regional oncologic dispensary, 454087, Chelyabinsk, Russian Federation; City clinic №8, 454071, Chelyabinsk, Russian Federation
Abstract: Long-term results of 5 patients treatment, operated for non-malignant formations of the retroperitoneal space, with signs of locally aggressive growth involving large vessels are presented. In all cases, the separation of the tumor from the surrounding structures proved impossible and its forced removal was performed en block with a segment of the vessel - the inferior vena cava and (or) common iliac artery. Resected and a prosthetic artery in two cases. Inferior vena cava in one case is substituted with prosthesis in 1 - resected for without recovery and double lateral resection was performed with a patch of polytetrafluoroethylene (PTFE) in one case. The final diagnosis in 3 cases - neurofibroma, a 2 - inflammatory pseudotumor. Results were evaluated in terms from 19 to 280 months. Remission in all cases, there are two signs of compensated venous insufficiency.
Keywords: нейрофиброма, воспалительная псевдоопухоль забрюшинной локализации, резекция нижней полой вены, резекция общей подвздошной артерии, neurofibroma, inflammatory retroperitoneal pseudotumor, vena cava resection, common iliac artery resection

1406-036
MATHEMATICAL JUSTIFICATION OF ADVANTAGE OF HODGKIN'S LYMPHOMA RISK-ADAPTED THERAPY IN CHILDREN AND ADOLESCENTS
Kulyova Svetlana A., Karitsky A.P., Filatova L.V.

N.N. Petrov Research Institute of Oncology; Saint-Petersburg State Pediatric Medical University, 197758, Saint-Petersburg, Russian Federation; N.N. Petrov Research Institute of Oncology, 197758, Saint-Petersburg, Russian Federation
Abstract: The aim of the study was confirmation of advantage risk-adapted therapy by creation of mathematical models of the individual forecast of Hodgkin’s lymphoma in children and adolescents. Material and methods. Data of 138 patients with Hodgkin’s lymphoma aged from 4 to 18 years old (median 14 years old) treated on risk-adapted programs are included in the investigation. Results. Two factors significant increased recurrence risk at criteria selection and assessment: disease IV stage (correlation coefficient of 0,1904, p=0,024) and B symptoms (correlation coefficient of 0,1876, p=0,026). It wasn’t revealed collinear signs. The regression equation looked as follows: y =-0,156702+0,056748Х + 0,092922Х ; the determination coefficient was 0,05241494. Separate elements and the whole equation stopped being significant in multiple regression analysis that doesn’t allow to use them for forecasting of lymphoma recurrence. Conclusion. Thus, inclusion in the correlation analysis of the parameter «treatment program» levels influence of adverse factors on the recurrence, and proves adequacy of selection of therapy burden and advantage of risk-adapted protocols before the unified programs. It is once again proved that it is necessary to consider the principles of «response-adapted therapy» when effective treatment partially compensate negative influence of some adverse signs, minimizing their weight in prognostic models.
Keywords: дети, подростки, лимфома Ходжкина, риск-адаптированная терапия, прогностические факторы, children, Hodgkin’s lymphoma, risk-adapted therapy, prognostic factors, adolescents

1406-040
THE EPIDEMIOLOGY OF PROSTATE CANCER IN ALTAI REGION
Ganov Dmitry I., Fedoskina A.V., Varlamov S.A., Averyanova M.V., Lazarev A.F.

Altai State Medical University, 656038, Barnaul, Russia Federation; N.N. Blokhin Russian Cancer Research Center, 656049, Barnaul, Russia Federation
Abstract: The article deals with the main issues of the epidemiology of cancer of the prostate in the Altai region in the last 20 years. The incidence of prostate cancer in the Altai Krai had increased almost 4 times for the period from 1994 to 2013. More than 9% of men with newly diagnosed prostate cancer are of working age. The death rate from prostate cancer, and the percentage of patients in the fourth stage in recent years decreases. Morphological verification, identification at an early stage has increased significantly over the years.
Keywords: рак предстательной железы, эпидемиология, prostate cancer, epidemiology

1406-044
THE PROBLEM OF ADRENOCORTICAL CANCER THERAPY
Kolomeytseva Alina A., Gorbunova V.A., Perevodchikova N.I.

N.N. Blokhin Russian Cancer Research Center, 115478, Moscow, Russian Federation
Abstract: Adrenocortical carcinoma (ACC) - a rare and very aggressive malignant tumor originating from the adrenal cortex. About 60% of tumors are hormone producing. Surgical treatment is the only method that can heal the sick ACC. Adjuvant therapy may be recommended for patients with a high risk of relapse. Treatment of advanced ACC includes systemic therapy in combination with local methods of exposure, such as surgery, radiofrequency ablation, and chemoembolization. For the treatment of ACC uses a combination of steroidogenesis mitotane inhibitor with cytotoxic drugs. The most effective chemotherapy regimen in metastatic ACC is a combination of etoposide, doxorubicin and cisplatin against the background of continuous use mitotane (Scheme EPD-M). In the second-line treatment is possible to use a combination of gemcitabine and fluoropyrimidines. The results from the use ACC drugs, which have direct action on the receptor of insulin-like growth factor (IGF-1R) and insulin receptor (IR) as a monotherapy and in combination with inhibitors ofserine-threonine kinase mTOR. The clinical introduction of new effective drugs will improve the results of patients with ACC treatment.
Keywords: адренокортикальный рак, митотан, рецептор IGF-1, adrenocortical carcinoma, mitotane, IGF-1 receptors