Vol 25, No 4 (2023)

CLINICAL ONCOLOGY

Resolution on the experts' discussion of the TRIANGLE study results

Abstract

On September 30, 2023, a discussion of the results of the European Community study on mantle cell lymphoma – TRIANGLE study was held in Moscow. The TRIANGLE phase III international randomized trial enrolled nearly 900 young subjects (up to 65 years of age) with histologically confirmed untreated mantle cell lymphoma in advanced stages II–IV. Study centers from 14 European countries participated in the study. According to the TRIANGLE study results, adding ibrutinib to autologous hematopoietic stem cell transplantation allows achieving a 3-year disease-free survival rate of 88%, which is significantly better than in the standard chemotherapy group.

Journal of Modern Oncology. 2023;25(4):415-416
pages 415-416 views

Can bispecific antibodies change the paradigm and goals of therapy for patients with relapsed non-Hodgkin lymphomas?

Poddubnaya I.V.

Abstract

Non-Hodgkin lymphomas are a heterogeneous group of hematological malignancies, the vast majority of which are B-cell tumors. Standard immunochemotherapy with anti-CD20 monoclonal antibodies is effective as the first-line therapy in treating these lymphoproliferative diseases. However, many patients develop a relapse or refractory disease. Recent therapeutic advances with new targeted agents and cell-based therapies have improved treatment outcomes. However, most of the new strategies cannot cure the disease or achieve long-term remissions, leaving a part of patients with an unmet need for effective and well-tolerated treatment options. One of the most promising therapeutic options is bispecific antibodies, which are expected to provide an unprecedentedly high level of deep responses with an improved safety profile. The available data open up prospects for extrapolating these results to the overall survival of patients.

Journal of Modern Oncology. 2023;25(4):417-420
pages 417-420 views

Effectiveness and safety of empegfilgrastim (Extimia®, BIOCAD) in patients with lymphoproliferative diseases receiving cytotoxic therapy: results of LEGERITY, a multicenter retrospective-and-prospective observational post-marketing study

Nesterova E.S., Saydullaeva A.F., Sherstnev D.G., Shelekhova T.V., Klitochenko T.Y., Khusainova G.N., Lysenko I.B., Lyalina I.S., Demchenkova M.V., Orlova S.A., Proydakov A.V., Betrozova М.V., Fadeeva N.V., Gofman A.A., Marchenko Y.M., Voloshin S.V., Pashneva E.A., Sarzhevskiy V.O., Babicheva A.R., Bondareva I.B., Glonina N.N., Ishchanov D.G., Poddubnaya I.V.

Abstract

Aim. To evaluate the effectiveness and safety of Extimia® BIOCAD (international non-proprietary name: empegfilgrastim) to reduce the incidence and duration of neutropenia, the incidence of febrile neutropenia (FN) and infections associated with FN in patients with lymphoproliferative diseases receiving myelosuppressive therapy.

Materials and methods. The paper presents the results of a multicenter retrospective-and-prospective observational post-marketing study of the safety and effectiveness of Extimia® BIOCAD (international non-proprietary name: empegfilgrastim) in patients with lymphoproliferative diseases receiving cytotoxic therapy. Initially, the study was defined as retrospective-and-prospective. However, only 2 of 671 (0.3%) patients were included retrospectively. Thus, the study is based on the evaluation of prospectively collected data. The analysis describes the characteristics and treatment of 671 patients diagnosed with lymphoma who received one or more cycles of chemotherapy in the LEGERITY study. The endpoints of interest included the incidence of grade 3–4 neutropenia, FN, and grade 3–4 infectious complications, the frequency of antibiotic therapy, and the incidence of all adverse reactions in patients who received at least one dose of the study medication.

Results. A total of 671 patients were enrolled in the study, the majority having B-cell non-Hodgkin lymphoma (428/671, 64%) and Hodgkin lymphoma (211/671, 31%). The mean age was 54 years (18–84); 35% (236/671) of patients were elderly (over 60). The number of injections of empegfilgrastim for the entire observation period was 3093 (n=671). Adverse events were reported in 57/3093 (1.8%) cases. The most common adverse events were mild to moderate ossalgia and myalgia (27/671, 4%), back pain, and arthralgia (12/671, 1.8%), which did not require drug therapy. Two patients developed serious adverse reactions – CTCAE v.5 grade 4 hypotension events. 529 (78.8%) patients received at least 4 courses of chemotherapy. FN was reported in 14 (2.6%) patients and did not require antimicrobial therapy.

Conclusion. The final analysis results confirm the high clinical efficacy and safety of the Russian original pegylated granulocyte colony-stimulating factor empegfilgrastim (Extimia®) in patients with indolent and aggressive lymphomas. The data obtained from real-world clinical practice demonstrate a favorable safety and tolerability profile of empegfilgrastim in all age groups, including the elderly population.

Journal of Modern Oncology. 2023;25(4):422-431
pages 422-431 views

Ribociclib + adjuvant hormone therapy in early breast cancer: prevention of recurrence. New opportunities. A review

Ognerubov N.A.

Abstract

Breast cancer (BC) occupies a leading position among all malignant neoplasms in women worldwide and is the 4th deadliest. Most cases are diagnosed in stages I–III. Among the molecular biological variants, luminal HER2 negative (HER2-) prevails, accounting for 70–75%. Currently, therapies combining surgery with chemotherapy and, more rarely, radiation therapy, followed by adjuvant hormone therapy for up to 10 years, are a standard of care in BC. The goal of these regimens is the prevention of early recurrence in patients in the high-risk group with a primary hormone-resistant tumor. However, at the end of treatment, it occurs in 27–57% of patients with stage II–III breast cancer. For its prevention in early HR-positive (HR+) HER2- BC, an innovative class of drugs, cyclin-dependent kinase 4/6 inhibitors, is used combined with hormone therapy (aromatase inhibitors, anti-estrogens, gonadotropin-releasing hormone agonists), which is the subject of a randomized phase III NATALEE study evaluating the efficacy and safety of ribociclib in combination with endocrine therapy in early non-metastatic BC. The study enrolled patients with stage II–III breast cancer, including those with N0. Patients of the study group received ribociclib at a dose of 400 mg/day for 21 days in combination with aromatase inhibitors, and in the control group, only aromatase inhibitors. The median follow-up was 34 months. Three-year survival without invasive disease was 90.7% in the ribociclib group and 87.6% in controls. The risk of distant metastasis and invasive diseases was reduced by 25.1% in the ribociclib group. Therefore, ribociclib tended to improve overall survival. The initial dose of 400 mg/day reduced the incidence of adverse events; the most common were neutropenia (62.5%), arthralgia (37.3%) and hepatic toxicity (26.4%). The most common reasons for discontinuing ribociclib were hepatic toxicity (8.9%) and arthralgia (1.3%). The results demonstrate a statistical and clinical superiority of ribociclib in combination with hormone therapy in the treatment of early HR+ HER2- breast cancer with a high risk of recurrence.

Journal of Modern Oncology. 2023;25(4):432-439
pages 432-439 views

The use of hydroxyethyldimethyldihydropyrimidine to improve regeneration processes in a postoperative wound after sectoral resection of the breast

Shabaev R.M., Khodyrev S.A., Kolyadina I.V., Blagovestnov D.A., Starokon P.M.

Abstract

Background. Partial mastectomy is the method of choice for the surgical treatment of benign neoplasms (BN) of the breast. The drawback of this technique is the occurrence of residual cavities with the accumulation of serous and hemorrhagic exudate, promoting inflammation. Hydroxyethyl dimethyldihydropyrimidine (Ximedon) in the postoperative treatment improves the healing and overall treatment outcomes.

Materials and methods. The study included 101 patients. All of them had a partial mastectomy for the BN. The study patients received different pharmacotherapy in the postoperative period. They were divided into two groups depending on the use of hydroxyethyl dimethyldihydropyrimidine. Group 1 included 52 (51.5%) patients who received hydroxyethyl dimethyldihydropyrimidine 2 hours before surgery and 0.5 g on days 1 to 7 in the postoperative period. Group 2 included 49 (48.5%) patients who had not received hydroxyethyl dimethyldihydropyrimidine.

Results. Analysis of treatment outcomes showed that in group 1 patients receiving hydroxyethyl dimethyldihydropyrimidine, the overall treatment results were better. Therefore, hydroxyethyldimethyldihydropyrimidine improved overall treatment outcomes and increased patients' quality of life in the postoperative period.

Conclusion. The use of hydroxyethyldimethyldihydropyrimidine in the postoperative period, which has a protective effect at the cellular level due to membrane-stabilizing, antioxidant, adaptogenic, and antibacterial properties, is promising and improves wound healing, thus improving the overall results of surgical treatment of breast BNs.

Journal of Modern Oncology. 2023;25(4):440-446
pages 440-446 views

Genotyping of UGT1A1 and DPYD polymorphisms in patients with colorectal cancer. A review

Timoshkina N.N., Petrusenko N.A., Gabrichidze P.N., Cherkess M.A., Pushkareva T.F., Savchenko D.A.

Abstract

The main treatment regimen for patients with metastatic colorectal cancer is still cycle-based chemotherapy with fluoropyridines combined with oxaliplatin and/or irinotecan. The activity of these chemotherapeutic agents depends on a predominant specific metabolism pathway. Therefore, the genetic features of the patient become important as a prognostic factor for the occurrence and severity of adverse events during therapy. The review addresses current views about the mechanisms of toxic activity of irinotecan and fluoropyrimidines, analyzes the results of pharmacogenotyping of UGT1A1 and DPYD polymorphisms, and published studies assessing the relationship between genetic variants of these genes and the safety of chemotherapy. A significant role of the population component is noted both in the distribution of gene allele frequencies and in their phenotypic expression. For some polymorphisms of the DPYD gene, dose-dependent associations with the toxicity of 5-fluorouracil have been established. Nevertheless, they determine only 1–8% of cases out of 40–60% of patients with adverse events and DPD protein deficiency associated with other enzyme activity reduction mechanisms. The pharmacological significance of UGT1A1 genetic variations is associated with toxicity prediction and helps allocate patients for more effective high-dose irinotecan therapy. Data is presented on the pharmacogenotyping of these markers to establish the dose of drugs in various national guidelines. Currently, the heterogeneity of the available pharmacogenetic data leaves open the question of determining the most appropriate dosing strategies for irinotecan and fluoropyrimidines. The widespread introduction of UGT1A1 and DPYD genotyping into clinical practice balances the economic feasibility and predictive value of biomarkers. As pharmacogenomics evolves rapidly, more robust research would overcome existing hurdles and facilitate personalized drug dosage decisions.

Journal of Modern Oncology. 2023;25(4):447-453
pages 447-453 views

Personalized treatment options of refractory and relapsed medulloblastoma in children: literature review

Dinikina Y.V., Zheludkova O.G., Belogurova M.B., Spelnikov D.M., Osipov N.N., Nikitina I.L.

Abstract

Medulloblastoma (MB) is the most common malignant tumor of the central nervous system in pediatric patients. Despite the complex anticancer therapy approach, refractory and relapsing forms of the disease remain fatal in most cases and account for approximately 30%. To date, repeated surgery, radiation, and chemotherapy can be used as life-prolonging treatment options; nevertheless, it should be emphasized that there are no standardized approaches based on existing data of molecular variants of MB. It is obvious that only a deep understanding of the biological mechanisms in association with clinical aspects in refractory and relapsing forms of MB would make it possible to personalize second- and subsequent-line therapy in order to achieve maximum efficiency and minimize early and long-term toxicity. The article presents the current understanding of prognostic factors in relapsed/refractory forms of MB, methods of modern diagnostics, as well as existing and perspective treatment options based on the biological and clinical aspects of the disease.

Journal of Modern Oncology. 2023;25(4):454-465
pages 454-465 views

Patient resource to improve the effectiveness of oncological care for the population

Kozlov V.A., Samsonov I.V., Mushnikov D.L.

Abstract

Background. Improving oncological care for the population is defined as one of the main priorities for the development of domestic health care, which is determined by the high medical and social significance of malignant neoplasms. The problem of improving cancer care is multidimensional. However, there are not enough scientific papers that consider the patient's resource as a factor in achieving a greater level of effectiveness of cancer care.

Aim. To assess the state and possibilities for improving the patient's resource of cancer care.

Materials and methods. The study was conducted at the Ivanovo Regional Oncology Center, Ivanovo in the period 2020-2022 on the basis of a comprehensive program using traditional methods: sociological, expert assessment, analytical, documentary. The assessment of the patient's resource of oncological care was carried out according to the original methodology, which included 10 parameters. A survey of 1000 oncological patients at different stages of diagnosis and treatment of malignant neoplasms was carried out and its results were analyzed, taking into account the factors of the staging of the oncological process, medical and demographic characteristics of patients. The assessment of the quality of life of patients was carried out using the SF12 (12Item ShortForm Health Survey) questionnaire. Based on the examination data of 410 cases of the provision of oncological medical services by experts of medical insurance companies, according to regulatory medical, economic and clinical criteria, as well as an assessment of patient satisfaction with the care provided, all cases are divided into 2 groups with an optimal and non-optimal level of care effectiveness. Statistical data processing was carried out on the basis of electronic databases using applied computer programs and provided for the calculation of relative values, the reliability of the difference in indicators, and the Spearman correlation coefficient.

Results. Data were obtained on the decrease in the patient resource of oncological care for all its selected components and its established relationship with the effectiveness of care, which requires the improvement of medical and organizational technology for working with oncological patients. A medical and organizational technology for providing assistance to oncological patients in the conditions of passing through the stages of the treatment and diagnostic process is proposed.

Conclusion. An integral assessment of the 10 components of the patient resource at the stages of clinical observation of patients in an oncological dispensary makes it possible to monitor the main factors on the part of the patient that determine the effectiveness of care, as well as to carry out planned measures to correct adverse and strengthen favorable factors. The proposed approach is the basis for making management decisions.

Journal of Modern Oncology. 2023;25(4):466-471
pages 466-471 views

How a significant increase in survival in pancreatic cancer is achieved. The role of nutritional status and supportive care: A review

Zhukova L.G., Bordin D.S., Dubtsova E.A., Ilin M.A., Kiriukova M.A., Feoktistova P.S., Egorov V.I.

Abstract

Pancreatic cancer (PC) is a serious public health problem. The mortality rate of patients with PC remains one of the highest among cancers. Early diagnosis of PC is challenging, so it is often diagnosed in the later stages. Current treatment approaches, including surgery, neoadjuvant and adjuvant chemotherapy, chemoradiotherapy, and supportive care, have demonstrated improved outcomes. A significant problem remains exocrine pancreatic insufficiency (EPI) in patients with PC, which requires enzyme replacement therapy. However, this is not given due attention in the Russian literature. This review addresses the survival trends of patients with PC, current therapies, and enzyme replacement therapy as an integral part of supportive care and improvement of nutritional status; also, the issues of routing patients with PC are addressed. It is emphasized that the diagnosis and treatment of EPI are mandatory to improve and maintain the nutritional status and quality of life; failure to treat EPI renders antitumor treatment ineffective.

Journal of Modern Oncology. 2023;25(4):472–483
pages 472–483 views

Results of pelvic exenteration in patients with cervical cancer: clinical experience

Khakimov G.A., Khakimova G.G.

Abstract

Background. Despite the progress in pelvic exenteration (PE) technique in international oncological practice, it is still debatable for cancer surgeons. The main reasons for its unpopularity are technical complexity, high rate of intra- and postoperative complications (60%), high postoperative mortality (30%), and challenging postoperative rehabilitation of patients.

Aim. To evaluate long-term outcomes after pelvic exenteration in patients with locally advanced recurrent cervical cancer.

Materials and methods. From September 2021 to December 2022, 23 PEs were performed, including 12 total and 11 anterior. The mean age was 52.2±10.0 years (range 39–83 years). All patients were diagnosed with locally advanced recurrent cervical cancer: 7 (30%) with stage II, 8 (35%) with stage III, and 8 (35%) with stage IV according to the TNM classification. Histologically, cervical cancer was represented by moderately differentiated squamous cell carcinoma. PE was preceded by the following treatments: neoadjuvant chemotherapy in 17 (74%) patients, surgical treatment in 4 (17%) patients, and chemoradiotherapy in 2 (9%) patients. More than half (56%) of patients achieved grade 2 therapeutic pathomorphism. The advanced disease involved the following adjacent organs: bladder (16; 70%), intestines (13; 56%), uterine endometrium (7; 30%), myometrium and parametrium (4; 17%), fallopian tubes, vagina, and ovary (2; 9%).

Results. The average follow-up time for patients was 9.4±8.8 months. Median time to progression – 8.7 months [5.9; 10.8]. During the observation period, 78.3% (18/23) of patients died. Progression was recorded in 39.1% (9/23) of patients. The 1-year overall survival of patients was 38.7% (median 8.9 months). The 1-year tumor-specific survival rate was 60.6% (median 14.1 months). The 1- and 3-year progression-free survival (PFS) rates were 63.0 and 49.0% (median, 13.4 months), respectively.

Conclusion. During the observation period, death occurred in 54.6% (12/23) of cases in the anterior PE group, and in 25% (6/23) in the total group. The median overall survival with anterior PE is 2 times higher compared to total PE (9.6 months versus 4.1 months). Median PFS was 13.4 months. For patients after anterior and total pelvic exenteration, 1-year PFS was 51.9±17.6 and 72.9±13.5; 3-year – 25.9±15.7 and 72.9±13.5 (p=0.178), respectively. Thus, PE is justified and significantly expands the possibilities of surgical treatment.

Journal of Modern Oncology. 2023;25(4):484-489
pages 484-489 views

Comorbid pathology in SARS-CoV-2 infected in cancer practice as a predictor of severe outcomes in COVID-19. COVID-19 prognostic online risk assessment tool in oncology: A retrospective study

Sekacheva M.I., Rusanov A.S., Kokhanovskaia I.I.

Abstract

Aim. Evaluation of comorbid pathology in SARS-CoV-2 infected in cancer practice as a predictor of severe outcomes. Testing the COVID-19 risk assessment tool in oncology (CORONET), to predict the likely severity of COVID-19 course in cancer patients on inpatient treatment.

Materials and methods. A retrospective analysis of 173 cancer patient disease stories was conducted. The study was conducted as part of the program of the World-Class Research Center “Digital Biodesine and Personalized Health Care” of the University of Sechenov, with participation in the ESMO-CoCARE Register project. Based on the ESMO COVID-19 and CAncerREgistry (ESMO-CoCARE) registry, taking into account the entered our patient sample (n=173), a COVID-19 risk assessment tool in oncology (CORONET) was developed.

Results. Cancer patients with comorbid pathology have been shown to have an increased risk of COVID-19 course of the disease from this sample by CORONET (mean conclusion score CORONET 2.44 pointsseverity). Prognosis of probable severity of outcomes in cancer patients infected with SARS-CoV-2 depends on associated diseases. The presence of a history of ≥3 comorbid pathologies in COVID-19 patients was detected in 106 people (61.27%). 15 patients were included in the risk of severe course. Retrospective analysis obtained actual confirmation of the prognosis of severe course of the disease in this group followed by death in all these patients (71.42% of all deaths). Indicators such as low albumin levels, high levels of C-reactive protein and neutrophils showed high prognostic significance of the likely severity of coronavirus infection in cancer patients on inpatient treatment for COVID-19. The mortality rate of patients admitted with COVID-19 and cancer was 12.14%.

Conclusion. The most informative predictors of severe outcomes in COVID-19 in inpatient cancer patients to assess the prognosis of disease severity are: number of comorbidities, age, NEWS2 scale, ECOG patient activity status, albumin level, C-reactive protein level and absolute neutrophil level. The benefits gained in the use of the online decision support tool CORONET are considered convincing not only during the decision-making phase of hospitalization, but also in cancer patients on inpatient treatment.

Journal of Modern Oncology. 2023;25(4):490-497
pages 490-497 views

Alopecia prevention during chemotherapy: from the benchmark to real clinical practice. A prospective study

Lyadova M.A., Nersesova T.A., Zhuravleva A.A., Fedorinov D.S., Dudnik A.A., Denisova E.A., Nosova M.V., Pardabekova O.A., Lisitsyna K.N., Tuleiko V.M., Bikmurzina O.A.

Abstract

Background. Alopecia is one of the main side effects of anticancer chemotherapy and has a significant impact on patients’ appearance, quality of life, social adaptation and mental health of cancer patients. Estimated number of new cancer diagnosis increases annually alongside with the proportion of patients receiving chemotherapy. That means an annual increase in the global burden of chemo-induced alopecia and associated negative consequences. The development of various methods for the prevention of alopecia in cancer patients has continued for decades. However, convincing data have been obtained only for the scalp hypothermia method. In this point, the Paxman company’s cooling systems (UK) – the Orbis and Orbis II devices – have been most widely studied. Despite the fact that Orbis devices were approved in Russia more than 10 years ago, since then just a small amount of real clinical practice has been accumulated and questions regarding the effectiveness of scalp hypothermia in patients with variable cancers still remain open.

Aim. Analysis of local clinical practice with scalp hypothermia via the Orbis II device for the prevention of alopecia in patients receiving various chemotherapy regimens.

Materials and methods. An open, prospective, single-center study included patients with various cancer types who were indicated for chemotherapy. Orbis II device was used for prophylactic hypothermia. The severity of alopecia was assessed according to the CTCAE version 5.0 at baseline and during anticancer therapy.

Results. From June 2022 to May 2023, scalp cooling procedures were performed in 51 patients, of them 78% of all procedures were performed in female cancers: breast tumors – 109 (52.2%) procedures, ovarian cancer– 33 (15.8%), and cervix cancer – 22 (10.5%). The effectiveness of scalp hypothermia in preventing of severe alopecia was 73%.

Conclusion. Scalp cooling can be considered as an effective method for the prevention of chemotherapy induced alopecia. Further studies are needed to assess larger patient populations to identify favorable and negative factors that affect potency of the hypothermia.

Journal of Modern Oncology. 2023;25(4):498-503
pages 498-503 views

Radiation injuries of organs and tissues: mechanisms of occurrence, methods of prevention and treatment: A review

Balaeva D.A., Romanov D.S., Trofimova O.P., Gadzhibabaeva Z.Z., Gorchak Y.Y., Gariaev G.A.

Abstract

In modern medicine, radiation therapy (RT) is one of the main therapies for cancer. According to the World Health Organization, about 70% of patients diagnosed with cancer require RT at some stage of treatment. Development and improvement of methods for early diagnosis of cancers, multimodal therapy for cancer patients, including surgical intervention, new drug treatment regimens, modern methods of conformal 3D-RT and proton therapy significantly improved the treatment outcomes of patients and increased their life expectancy. Modern RT is a high-tech chain of sequential use of complex technical devices and mathematical calculations to destroy the tumor without adversely affecting the surrounding normal tissues. Some patients develop radiation injuries to normal organs and tissues that reduce their quality of life. Prevention and treatment of such injuries are urgent problems of modern oncology. The article addresses the pathogenesis and mechanism of the development of systemic and local radiation responses, as well as methods of treatment and prevention of some of them. Three electronic databases, including PubMed, Cochrane and EMBASE, and Russian radiotherapists' publications, were used for systematic review in the information retrieval process.

Journal of Modern Oncology. 2023;25(4):504-512
pages 504-512 views

Scalp hypothermia for the prevention of chemotherapy-induced alopecia in breast cancer

Ognerubov N.A., Barsukov S.V.

Abstract

Background. Breast cancer (BC) is a socially significant disease in women all over the world, ranking 1st in the structure and 5th in the number of deaths. Polychemotherapy in the complex treatment of BC accounts for approximately 80%. The main side effect that significantly affects the quality of life is alopecia, which occurs on average in 65% of patients.

Aim. To evaluate the efficacy and tolerability of scalp hypothermia (SHT) for the prevention of chemotherapy-induced alopecia in patients with BC.

Materials and methods. From June 2016 to September 2023, 75 patients with a median age of 44.1 years with stage I–IV BC were observed. All patients received cytotoxic therapy at various stages of treatment. To prevent alopecia, local SHT was used using an Orbis II device (Paxman Coolers, United Kingdom).

Results. Stage I of the disease was observed in 18 (24%) patients, stage II in 22 (29.3%), stage III in 30 (40%), and stage IV in 5 (6.7%). Patients received 5 different neo- and adjuvant regimens of polychemotherapy. Taxane-containing combined regimens prevailed. 364 SHT sessions (4–8 sessions per patient) were performed; 48 (64%) patients received the procedure in full. Complete hair preservation was achieved in 43 (57.3%) patients. Grade 1 alopecia was observed in 19 (25.4%) patients and grade 2 in 9 (12%) patients. Of the 5 patients with advanced BC, grade 2 alopecia was reported in 1 patient, grade 3 in 3, and grade 4 in 1. Side effects were reported in 16% of cases; the most common were a feeling of cold and a slight headache. Due to the intolerance of the cold helmet, 3 patients refused to use it. No scalp metastases were observed during the follow-up. During the procedure, almost all patients noted a high level of comfort.

Conclusion. Local SHT is an effective method of preventing cytotoxic therapy-induced alopecia in patients with BC. It improves the psychological and social adaptation of patients.

Journal of Modern Oncology. 2023;25(4):513-517
pages 513-517 views

Dermatological toxicity in the treatment of malignant tumors in children: A review

Belysheva T.S., Shatokhina E.A., Komarova A.D.

Abstract

Modern antitumor drugs have high antitumor activity. But only a number of them realize their antitumor effect in a targeted manner with minimal manifestations of concomitant toxicity. Damage to the skin and mucous membranes as part of the toxic effects of chemotherapy not only reduces the quality of life of patients, but can lead to disruption of the patient’s nutritional status, infection, and generalization of the infectious process with the development of sepsis. This review describes the major drugs that have dermatological toxicity, the main clinical variants of dermatological toxicity, methods for their prevention and treatment.

Journal of Modern Oncology. 2023;25(4):518-524
pages 518-524 views

The place and role of oral microflora in the pathogenesis of oral mucositis in malignant neoplasms (literature review)

Zavyalov A.A., Tyryshkin A.I., Olesova V.N., Pashchenko N.A., Gurkova M.M.

Abstract

Background. Oral mucositis (OM) is one of the most frequent complications of systemic drug therapy of oncological diseases. Clinically, the disease manifests itself in the form of erythema and ulceration of the non-corneating mucous membrane. Although this condition is self-healing, it can affect the conduct of comprehensive antitumor treatment. Currently, the pathophysiological model of the development of OM is supplemented with new data obtained during studies of the oral microflora. Antitumor treatment can lead to changes in the composition of the resident oral microflora and it is quite possible that the changes that occur may affect the development of damage to the oral mucosa. The expansion of knowledge in this area allows researchers to look for new ways to include oral microbiota in OM management strategies.

Aim. To summarize and update the accumulated data regarding the role of the oral microbiota in the pathogenesis of OM in patients with malignant neoplasms.

Materials and methods. Literature search was performed in Medline, Cochrane Library, Elibrary and Pubmed, including publications demonstrating the current ability to assess the impact of the oral microbiome on OM, as well as developments in this area relating to OM management.

Results. In the review the current views on the position of the oral microbiome in the pathogenesis of OM were highlighted and the promising directions for the use of agents influencing the state of the oral microbiota in various strategies to control this disease were emphasised.

Conclusion. A better understanding of the pathogenesis of OM and the inclusion of new factors, such as the oral microbiome, into the picture of pathogenesis is likely to enable the formation of more effective management strategies for this disease in the future. This direction seems very promising, and developments in this area show promising results.

Journal of Modern Oncology. 2023;25(4):525-531
pages 525-531 views

Correction of lower limb lymphedema in patients with cervical cancer after combination treatment: A case report

Obukhova O.A., Dibirova P.A., Kurmukov I.A., Allakhverdiyan G.S., Shagina N.Y., Mustafina E.А., Knyazev R.I., Pajanidi J.G.

Abstract

Lymphedema is the tissue fluid accumulation that arises as a consequence of impaired lymphatic drainage. Secondary lower limb lymphedema after surgery in cervical cancer is a result of combined antitumor treatment and significantly reduces the quality of life. The management of lymphedema by physical therapists usually includes a combination of skin care, physiotherapy, external pressure, exercise, and massage. This case report describes the course of treatment for a 53-year-old female with stages IIIB secondary lymphedema. The goal of physical therapy intervention was as restoration of the functionality of the affected lower limb. The rehabilitation tasks were as to reduce total limb volume, return of the stereotype of gait, decrease in the level of anxiety. Decongestive lymphedema therapy was effective in treating this patient with secondary lymphedema of the lower extremities. Although the goal of rehabilitation was partially achieved, the patient was discharged from the hospital in a good mood, her anxiety level decreased, her gait stereotype improved, and her endurance increased. Improving the functionality of the limb, improving its appearance had a positive impact on the quality of life and allowed her to return to work. This case report testifies to the effectiveness of complete decongestive therapy even in the case of severe lymphedema. The clinical result of such rehabilitation programs makes it possible to increase the adaptive potential and social independence of cancer patients.

Journal of Modern Oncology. 2023;25(4):532-539
pages 532-539 views

Rare inflammatory myofibroblastic lung tumor with multi-organ metastasis: A case report

Budurova M.D., Trifanov V.S., Bagrov V.A., Lozhkin M.V., Chernichenko M.A., Surkova V.S., Poluektov S.I., Lyubchenko L.N.

Abstract

Inflammatory myofibroblastic tumors (IMTs) are extremely rare neoplasms, accounting for 0.04–0.7% of all tumors. Data on their clinical presentation, pathogenesis, and biological behavior are scarce. They can occur at any age, involving equally males and females. IMTs have been described as benign neoplasms with intermediate malignant potential, as local recurrence and distant metastasis may occur. IMTs are characterized by a solid growth type, and a multifocal type is uncommon. Definitive surgery is the treatment of choice. We describe a clinical case of a malignant IMT with multi-organ metastasis 6 years after definitive surgery on the primary tumor. There is no standard of care in such a clinical situation, especially given the absence of mutations in the primary and metastatic tumors.

Journal of Modern Oncology. 2023;25(4):540-546
pages 540-546 views

Evaluation of follow-up strategies for women with epithelial ovarian cancer following completion of primary treatment [Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review]

Abstract

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Zachou G, El-Khouly F, Dilley J. Evaluation of follow-up strategies for women with epithelial ovarian cancer following completion of primary treatment. Cochrane Database Syst Rev. 2023;8(8):CD006119. DOI: 10.1002/14651858.CD006119.pub4

Journal of Modern Oncology. 2023;25(4):547-548
pages 547-548 views

Hyperbaric oxygen therapy for the treatment of the late effects of radiotherapy [Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review]

Abstract

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Lin ZC, Bennett MH, Hawkins GC, Azzopardi CP, Feldmeier J, Smee R, Milross C. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database Syst Rev. 2023;8(8): CD005005. DOI: 10.1002/14651858.CD005005.pub5

Journal of Modern Oncology. 2023;25(4):548-548
pages 548-548 views


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