Vol 18, No 4 (2016)

Hormone therapy of recurrent and metastatic breast cancer has a wide range of drugs possessing different medical effects. However, the main problem is the sequence of endocrine therapy of hormone receptor-positive metastatic BC in the absence of visceral crisis, nowadays. The recommendations of the different professional communities do not contain visible preference in favor of the choice of any specific endocrine therapy or specific treatment sequence. According to the information we have received, at present the optimal treatment path, in the absence of resistance to endocrine therapy and visceral crisis, will be the following: line 1 - fulvestrant 500 mg; line 2 - AIs (for example anastrozole); line 3 - tamoxifen. The choice of the therapy must be based on the characteristics of not only the tumor, but also the patient. One should take into account the age of the patient, the duration of the interval without disease symptoms after adjuvant chemotherapy, the type of the damage and the involvement of internal organs in the process, the presence of concomitant diseases, toxic manifestations of chemotherapy regimens, the price and availability of the drugs.

Neuroendocrine neoplasms of the stomach combine a wide range of tumors with different clinical features and prognosis. They are systematized by three classifications: WHO Classification, clinicopathological classification, TNM classification (UICC, ENETs). The treatment of stomach NENs is still unclear. Surgical method is the main treatment for localized forms and the only one way that can help to achieve a complete cure in patients with NENs. Patients and methods. The results of treatment of 35 patients with gastric NENs who were operated at N.N.Blokhin Russian Cancer Research Center for the period of time from 2001 to 2015 were analyzed. The patients were divided into two groups: well-differentiated tumors (1 and 3 clinicopathological types), poor-differentiated tumors - neuroendocrine cancer. Gender, age of patients, clinical features, type of tumors, locations and number of tumor, stage, time from manifestation to diagnosis, type of surgery, Ki-67 index, five-year survival rate were analyzed. Results. Surgical treatment allows to achieve a good result for the group of patients with well-differentiated tumors of stomach (where EMR is not recommended). The overall five-year survival rate is 79.8%. In the group of patients with NEC of the stomach radical surgery allows you to achieve the best five-year survival compared to palliative (54.8 and 0%, p=0.03, log-rank). Conclusions. The group of patients with well-differentiated neuroendocrine tumors is heterogeneous and requires a more careful and differentiated treatment approach. The main principles for the selection are clinicopathological features and proliferative index. According to our research, the value of Ki-67 to precises determine G1 and G2 is 5%. Surgical treatment allows to achieve the good long-term results for patients with localized NECs of the stomach.

The majority of children during treatment for cancer, have disorders of nutritional status associated both with the presence of main disease and antitumor therapy. This paper deals with the results of the screening study of nutritional status of patients in FSBI Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev on their primary admission to the Centre and during the treatment. It is shown that the part of the patients on the admission, or even before the special therapy, has disorders of nutritional status. We have determined the increase in the number of children with disorders of nutritional status over time and the persistence of somatic protein pool deficiency during the observation. The results show the necessity of adequate correction of nutritional status in this category of patients.