Oncological Coloproctology (E-Journal) / Онкологическая колопроктология
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    КОМПЛЕКСНОЕ ЛЕЧЕНИЕ БОЛЬНЫХ РАКОМ ПРЯМОЙ КИШКИ С ИСПОЛЬЗОВАНИЕМ НЕОАДЪЮВАНТНОЙ ТЕРМОХИМИОЛУЧЕВОЙ ТЕРАПИИ

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    A new combined treatment scheme with short-course chemoradiotherapy and 2 selective radiosensitizers (metronidazole in a polymeric composition and local hyperthermia) is investigated in this article.Material and methods. 77 T1–3N0–2M0 rectal cancer patients treatment data was analyzed. All patients received 5 Ч 5 Gy radiotherapy with capecitabine 1300 mg/m2 days 1–5 per os and radiosensitization with local hyperthermia and metronidazole.Results. Investigated treatment scheme has acceptable toxicity and leads to high local control rate (none of the patients experienced local recurrence). 7 (9.1 %) patients developed distant metastases. 59 (76.6 %) patients had sphincter-sparing surgery. Median followup was 65.6 months. 5-year survival rate was 81.7 %.Conclusion. Developed treatment scheme is safe and leads to high local control rate

    ВОЗМОЖНОСТИ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ БОЛЬНЫХ МЕСТНО-РАСПРОСТРАНЕННЫМ РАКОМ ПРЯМОЙ КИШКИ С ВОВЛЕЧЕНИЕМ ЗАДНЕЙ СТЕНКИ МОЧЕВОГО ПУЗЫРЯ

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    The aim of investigation is the optimization of surgical treatment of patients with locally advanced rectal cancer with the involvement of posterior wall of urinary bladder.Materials and methods. The basis of investigation is the analysis of results of combined treatment of 67 patients with locally advanced rectal cancer involving triangle and cervix of urinary bladder. Radical operations of different volume were carried out in the department of common surgery during a period from 2000 till 2010. All patients had Т3–4N0–2M0 rectal cancer. Following types of surgery have been performed:1. Ultra-low anterior resection with coloanal anastomosis or abdomino-perineal excision combined with resection of 2/3 of urinary bladder — main group (44 patients);2. Pelvic exenteration — control group (23 patients).Results. The application of combined surgical intervention with the resection of posterior wall of urinary bladder didn’t lead to the increased post operative complications rate, which were diagnosed in 1 (2.27 %) of 44 patients in the main group. The patients, which had the operativetreatment in the volume of pelvic exenteration (control group), had a complication rate of 4.34 % (1 patient). In both cases, pelvic abscess of with a favorable outcome took place.Three-year disease-free survival rate in main investigated group was 55.3 %, in control group (23 patients) — 74 %.Conclusion. The investigation showed that pelvic exenteration for locally advanced rectal cancer involving posterior wall of the bladder is not always justified. We consider, that it’s more reasonable to save even small part of urinary bladder for the better patients rehabilitation

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    Первый конгресс Общества специалистов по онкологической колопроктологии

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    Первый конгресс Общества специалистов по онкологической колопроктологи

    ОПЫТ ПРИМЕНЕНИЯ АВАСТИНА В КОМБИНИРОВАННОМ ЛЕЧЕНИИ ПАЦИЕНТА С ДИССЕМИНИРОВАННЫМ РАКОМ ТОЛСТОЙ КИШКИ

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    Treatment of patients with metastatic colorectal cancer (mCRC)  is one of the priority questions in oncology. Despite the significant progress in chemotherapy treatment, development of target agents is the only way of further improvement of the results. Bevacizumab (Avastin) is the first biologic demonstrated it’s efficacy in 1st and 2nd therapy lines in mCRC patients and what’s more important – in continuation with first two serial chemotherapy lines.Author presents his own experience of prolonged bevacizumab (Avastin) therapy in several serial therapy lines in mCRC patient.Лечение больных метастатическим колоректальным раком (мКРР) относится к числу приоритетных вопросов онкологии. Несмотря на значительный прогресс в химиотерапии, дальнейшее улучшение результатов лечения связано с развитием таргетных препаратов. Первым препаратом, продемонстрировавшим свою эффективность в 1-й и 2-й линиях терапии, а также на протяжении последовательных первых двух линий терапии, является бевацизумаб (Авастин).Автор приводит собственный опыт эффективного длительного применения бевацизумаба (Авастина) в нескольких последовательных линиях терапии у больного мКРР

    КОМПЛЕКСНОЕ ПРИМЕНЕНИЕ ЭНДОСКОПИЧЕСКИХ МЕТОДОВ В ДИАГНОСТИКЕ РАННИХ ФОРМ РАКА ТОЛСТОЙ КИШКИ

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    The aim of the research: explore the possibilities of modern visual differential diagnostics of early colon cancer and bening colon tumors.Methods.Results of endoscopic examination of 174 patients with unclear endoscopic data were analyzed. These patients underwent complex diagnostics, which revealed 293 tumors. Following groups were distinguished (according to the results of morphological study of biomaterial and visual endoscopic evaluation): early colon cancer – 28, lobular hyperplasia of the mucous shell – 38, polyps (adenomas with dysplasia varying degrees) – 184, limited infiltrative cancer – 37, neuroendocrine tumors – 6.Results.Visual and morphological data coincided in 89.3 % patients, sensitivity 93.9 %, specificity of 88.6 %, positive predictive value 90.4 %, negative predictive value 82.4 %, accuracy of 89.6 %.Conclusions. Use of the complex endoscopic diagnostics allows to identify the neoplastic changes of the mucous membrane in the early stages of development, and make a high-precision biopsy

    СОВРЕМЕННАЯ ТЕХНОЛОГИЯ ПОДГОТОВКИ И ПРОВЕДЕНИЯ ЛУЧЕВОЙ ТЕРАПИИ БОЛЬНЫХ ПЛОСКОКЛЕТОЧНЫМ РАКОМ АНАЛЬНОГО КАНАЛА

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    Squamous-cell anal cancer is a rare disease that requires a comprehensive approach in treatment and skilled professionals. Modern diagnostics is important for rational choice of treatment tactics. Radiotherapy is the cornerstone of sphincter-sparing anal cancer treatment. Radiotherapy dose, volume and duration are the key factors affecting treatment efficacy and toxicity.3D-conformal radiotherapy is a priority treatment allowing exact reproduction of treatment conditions, controlled by OBI (on-board imager) and kV X-Ray and cone-beam CT analysis. Intensity-modulated radiation therapy (IMRT) is a next-generation treatment with improved technologies, allowing better protection of normal tissues.Our experience with 21 squamous-cell anal cancer patients treated with IMRT during Nov 2011 – March 2013 is presented in this article

    НЕОАДЪЮВАНТНАЯ ТЕРМОХИМИОЛУЧЕВАЯ ТЕРАПИЯ С ВНУТРИРЕКТАЛЬНЫМ ВВЕДЕНИЕМ 5-ФТОРУРАЦИЛА В КОМПЛЕКСНОМ ЛЕЧЕНИИ БОЛЬНЫХ РАКОМ ПРЯМОЙ КИШКИ

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    Safety and efficacy of intrarectal 5-fluoruracil in combined treatment of localized rectal cancer was investigated in this article. Our data supports safety, economical efficacy and simplicity of use of this method. It improves sphincter preservation rate in patients with distal rectal cancer, does not increase surgical mortality and morbidity, leads to high tumor regression rate, improves local control and decreases distant failure rate.В статье представлены результаты изучения эффективности и переносимости созданного нового варианта комплексного лечения больных первично-операбельным раком прямой кишки (РПК) с использованием интраректального введения 5-фторурацила. Полученные данные позволяют говорить о том, что новый созданный способ дешев и прост в использовании, обладает приемлемым профилем токсичности, большинству больных РПК дистальной локализации позволяет провести сфинктеросохраняющие операции, не приводит к повышению числа осложнений, связанных с оперативным вмешательством, способствует развитию высоких показателей  лечебного патоморфоза, обеспечивает адекватный локальный контроль заболевания и позволяет достоверно снизить частоту возникновения отдаленных метастазов

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    Oncological Coloproctology (E-Journal) / Онкологическая колопроктология
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