Aranose is an original cytostatic, synthesized in the Russian Cancer Research Center, belongs to the class of nitrosourea derivatives (this class of drugs also including streptozotocin). In preclinical trials, Aranose has shown its activity in neuroendocrine tumors (NETs). Prospective clinical studies have confirmed high efficacy and good tolerability of the drug in different lines of treatment of patients with NET G1 and G2. Median PFS while Aranose treatment in a single mode or in combination with capecitabine, doxorubicin and temozolomide did not differ significantly (15.3 vs 15.8, 15.3 and 17.9 months, respectively, p = 0.791). After updating the histological classification and highlighting the prognostically unfavorable subgroup of NET G3, a prospective single-center clinical study of Aranose in the first line of NET G3 therapy was conducted. The standard dosage regimen of the drug was used: 500 mg/m² from the first to the third days, a cycle of 21 days. On average, patients received nine courses of Aranose chemotherapy, but in case of an increase in the radiological response treatment continued until disease progression or unacceptable toxicity. Median PFS in the Aranose group was 12 months, in the group of patients receiving capecitabine and oxaliplatin combination – 5 months, in capecitabine and temozolomide combination – 7 months, in the etoposide with cisplatin or carboplatin group only 4 months. The frequency of objective responses in the Aranose group was 37 % (10/27), no complete responses were recorded. Disease stabilization was achieved in 40.7 % (11/27), thus, the frequency of disease control was 77.7 % (21/27). Disease control was maintained after 6 months or more in 63 % of patients. 

Hepatocellular cancer (HCC) is one of the most common and, at the same time, little-known gastrointestinal oncopathologies in wide clinical practice. HCC ranks 5th in the world in the structure of oncological morbidity and 3rd in cancer mortality. HCC accounts for 70–85 % of all primary liver tumors. The involvement of doctors from various specialties is considered the most effective approach to cancer treatment in today’s dynamic and complex healthcare system. One of the nosologies where the introduction and application of a multidisciplinary consultation system is extremely important is HCC, because a large number of clinicians of various specialties are involved in the treatment of these patients. The effectiveness of an interdisciplinary approach in patients with HCC has been confirmed by clinical studies. However, the creation of such multidisciplinary consultations for patients with HCC has quite objective difficulties: A low percentage of curable patients at the time of detection of this disease and diagnosis, either due to the initially disseminated tumor process, or due to the initially low functional status of these patients. Overcoming these obstacles and creating such teams, their wide replication and integration into clinical practice will increase the number of patients detected at earlier stages and naturally improve the immediate and long-term results of treatment of such patients

The heterogeneity of breast cancer (BC), which determines various clinical scenarios of the disease, is still inaccessible to our understanding. Heterogeneity is based primarily on intrinsic subtypes of breast cancer, determined using genomic tests. Currently, four intrinsic subtypes are generally recognized: luminal A and B, HER-enriched (HER2-E) and basal-like. HER2-E subtype in luminal HER-negative (ER+HER–) breast cancer accounts for 11–22 per cent of cases. The efficacy of a combination of hormone therapy (HT) and the CDK4/6 inhibitor ribociclib in the HER2-E subtype was evaluated in a large exploratory analysis of MONALEESA-2, -3, and -7 trials. The gain in progression-free survival (PFS) and overall survival (OS) from the addition of ribociclib to HT was observed in all intrinsic subtypes, except for basal-like, and reached maximum in HER2-E subtype: Ribociclib increased the median PFS to 16.4 months from 5.5 months on HT (HR = 0.389; p < 0.0001) and median OS to 40.3 months from 29.4 months (HR = 0.600; p = 0.0180). The significant frequency of occurrence of the HER2-E subtype in ER+HER-BC, the low efficiency of monoHT in this subtype is another argument in favor of prescribing combination therapy in early lines. Information about the intrinsic subtype not only brings us closer to understanding tumor heterogeneity, but may also become a significant factor in determining treatment tactics in the future.

Introduction. The success in pediatric oncohematological disorders treatment cause increasing scrutiny not only to remission achievement and long-term patient survival, but also to supportive dysfunctions, which go with malignancy and anti-tumor treatment. Blood tumors cause all organs and systems disorders, and psychic dysfunctions of these are not in the last place.

Aim. To characterize mental health and psychic disorders types in children and adolescents with oncohematological diseases during hospital stay.

Materials and methods. It was analyzed mental health of 169 children and adolescents with hemoblastoses, who were treated at Pediatric Oncology and Hematology Research Institute of National Research Cancer Centre n. a. N. N. Blokhin (Moscow, Russia) in 2022 year. 50 (29.6 %) patients needed a psychiatric consultation. Among oncohematological disorders acute lymphoblastic leukemia was predominated – 25 (50 %), lymphomas – 17 (34 %) and acute myeloid leukemia – 8 (16 %) patients. Mental health data assessed after examination/consultation of clinical psychologist and psychiatrist.

Results. Asthenia was found in all 50 (100 %) patients, who were recommended a psychiatrist consultation, in 47 (94 %) – adjustment disorder, in 15 (30 %) – vexatious and neurotic disorder, in 16 (32 %) – affective syndromes, less often (18 and 14 % respectively) – behavioral deviations and eating disorders. As single cases in 2 (4 %) patients an intellectual disability and in 1 (2 %) a psychotic syndrome were diagnosed. As a role the most pronounced psychopathological conditions were upon admission to the hospital and decreased during the treatment and adaptation.

Conclusions. One third of children and adolescents, hospitalizing to oncohematological clinic need a psychiatrist consultation. Multidisciplinary care for such patients with pediatric oncologist, psychiatrist and clinical psychologist can cure psychogenic disorder effectively, improving the stay of patient at the hospital and best compliance between the doctor and patient.

The non-melanoma skin cancer is a leader among malignant tumours over last decades. Also, the incidence of multiple primary malignant neoplasms is increasing. We reported the case of a 68-year-old woman with locally advanced multiple primary synchronous malignant skin neoplasms (basal cell carcinoma and sarcomatoid carcinoma of skin) who was successfully treated. Thanks to individualized multimodal treatment, the basis of which is radical surgical intervention, careful follow-up was possible to achieve a complete cure of the patient with a good cosmetic and functional result. Our case report represents the need to increase the level of oncological alertness among primary care specialists and conduct educational work among the population in order to early diagnose tumors.

Carcinoid heart disease (CHD) is a rare manifestation of the carcinoid syndrome, but eventually occurs in most patients and is a major cause of cardiovascular mortality. The development of CHD is known to be a negative prognostic factor in patients with advanced neuroendocrine tumors. The mechanism of CHD pathophysiology remains poorly understood. Progress in early diagnosis and improvement of therapeutic approaches over the last decade has reduced hospital mortality in this cohort of patients. In this clinical case we summarize clinical features of the examination, treatment of and demonstrate modern pathogenetic aspects of the development of this condition. 

The aim of this work is to evaluate the results of treatment of patients with progression of primary cerebral ependyma in adults. The study included 10 patients who have been hospitalized at the Chelyabinsk Regional Center for Oncology and Nuclear Medicine since 2016 to 2022. The mean age of the patients was 33.0 ± 11.21 years. In 60 % (n = 6) progression of grade 3 ependymoma was diagnosed, in 40 % (n = 4) relapse of grade 2 ependymoma was noted. All patients were female. The mean time to recurrence was 29.6 months (from 11 to 44 months). According to the method of relapse treatment, in 60 % (n = 6) of cases patients received monochemotherapy with temozolomide, 20 % (n = 2) of patients underwent stereotaxic radiotherapy on the CyberKnife device with a single focal dose (SOD) of 5.5 Gy in five fractions, before summing up the total focal dose (SOD) of 27.5 Gy, two patients underwent repeated external beam radiation therapy in the traditional mode of fractionation with SOD 40 Gy. The median overall survival (OS) for all patients was 48 months. Indicators of 1-year OR were 100 %, 2-year – 83.3 %, 3-year – 50 %. The median progression-free survival was 20 months. In the neurological status after the completion of the special treatment, a decrease in motor deficit and one aphatic disorder was noted.

Breast fibrosarcoma is a rare tumor and accounts for less than 1 % of malignant breast tumors. This article describes a case of breast sarcoma in a 32-year-old patient who developed a rapidly growing malignant breast fibrosarcoma with a diameter of more than 30 cm. The young age of the patient and the use of all methods of treatment (surgical treatment; radiation therapy; chemotherapy) make this case special.

Introduction. Cytoreductive surgery in patients with advanced ovarian cancer often involves extensive combined surgical interventions, which can affect the development of postoperative complications.

Aim. To evaluate the results of surgical treatment in patients with advanced ovarian cancer.

Methods. The study included 190 primary IIB–IV stage ovarian cancer patients who underwent surgical treatment in the oncogynecological department of the National Medical Research Centre of Oncology n. a. N. N. Petrov (Saint Petersburg, Russia) from August 2017 to August 2020. The dissemination in the peritoneum was assessed by calculating the peritoneal carcinomatosis index (PCI). Surgical complexity score was assessed using Aletti’s classification. Analysis of postoperative complications was carried out in accordance with the Clavien – Dindo classification.

Results. The incidence of postoperative complications depended on the index of surgical complexity score (5 % – with a low index, 15 % – with median, 63 % – with a high one, p < 0.0010). In the group of primary cytoreductive surgeries, cases of median (48.9 %) and high complexity score (24.44 %) prevailed; in the group of interval debulking surgery, cases of low (52.4 %) and median (36.5 %) complexity score prevailed. The index of surgical complexity score depended on the peritoneal carcinomatosis index (PCI). The operation time, the volume of blood loss, the duration of hospitalization, frequency of bowel resection depended on the peritoneal carcinomatosis index and the surgical complexity score (p < 0.0001).

Conclusions. The level of surgical complexity score in patients with advanced ovarian cancer depends on the peritoneal carcinomatosis index. The level of surgical complexity score is higher in the group of primary debulking surgery, which effect on frequency of postoperative complications.

The use of antiangiogenic drugs in a single mode or in combination with immunotherapy in disseminated renal cell carcinoma has made it possible to achieve significant results in the therapy of the metastatic process. The flip side of effective therapy is the development of adverse events. An increase in blood pressure is one of the most frequent complications of antiangiogenic drug therapy with a frequency of up to 80 %.

Introduction. According to the World Health Organization, colorectal cancer is the third most common type of cancer in the world. The surgical method of treatment is the main one in locally advanced stages; however, a large proportion of patients require complex treatment, including adjuvant chemotherapy. When conducting adjuvant chemotherapy, it is extremely important to maintain the rhythm of cycles and minimize adverse events that may lead to dose reduction. Prevention of dose-limiting toxicity allows us to achieve the following goals – improving the quality of life of the patient and adherence to treatment, as well as performing a full-fledged stage of the planned complex treatment.

Aim. Evaluation of the effectiveness of Polisorb MP in the occurrence of gastrointestinal side effects of adjuvant polychemotherapy in patients with colorectal cancer.

Materials and methods. The prospective study included 40 patients with a verified diagnosis of CCR, received treatment and observation at the St. Petersburg City Clinical Oncology Centre from April 2022 to October 2022. All patients received radical surgery and subsequent adjuvant chemotherapy in the XELOX regimen were divided into two groups. The first group of patients (n = 20) received only ACT, patients of group 2 from 16 to 20 days after the completion of each session of ACT received Polysorb MP. Both groups were comparable in terms of gender and age. In the studied cohort of patients there were 20 (50.0 %) men and 20 (50.0 %) women. The age of patients ranged from 31 to 75 years; the median age was 62 years [54.00–68.50]. The quality of life of patients receiving adjuvant polychemotherapy was assessed using the QLQ-C30 questionnaires with the QLQ-CR29, EQ-5D module.

Results. The use of Polysorb MP made it possible to significantly reduce the level of creatinine in the blood of patients, which can increase after one cycle of ACT, especially with the use of platinum preparations. In addition, our results indicate that the use of Polysorb MP after ACT in patients with colorectal cancer can significantly improve the quality of life of patients, both by minimizing the symptoms associated with previous treatment and the adverse effects of the drug treatment itself, as well as by improving the general condition of the patient. In patients who received Polysorb MP as an accompanying therapy against the background of AHT, significant deterioration in general and functional health (according to the results of the analysis of the QLQ-C30 questionnaires), increased severity of disease symptoms and treatment complications (according to the results of the analysis of the QLQ-C29 and QLQ-C30 questionnaires), as well as a significant decrease in the general state of health according to the results of the analysis of the dynamics on the EQ-5D scale, was not detected.

Conclusions. In patients receiving adjuvant polychemotherapy for locally advanced colon cancer, it can be concluded that it is advisable to use Polysorb MP in order to reduce the manifestation of gastrointestinal toxicity and improve the quality of life of patients, which, in turn, allows a full course of treatment, avoiding dose-limiting adverse events.