Invasive fungal infections (IFI) - a significant problem in the particular group of immunocompromised patients. Understanding of the epidemiology of IFI in hospitals helps to set a step by step set of actions needed to prevent the development of invasive fungal infections. The first step is to identify groups of patients with a high risk of IFI, the establishment of risk factors, analysis of the epidemiological profile of the genera and species of fungal pathogens, as well as their level of resistance to anti- fungal drugs. Secondly, it is necessary to establish mechanisms to prevent the permanent impact of potential fungal pathogens, to work out recommendations, including control over the quality of air and water in medical facilities. In addition to the timely implementation of these measures, it is important to pay special attention to the use of antifungal drugs for the prevention of IFI, which should be conducted in patients with very high risk of invasive fungal infections.

Treatment of patients with malignant tumors, largely involves the use of chemotherapy, targeted therapy and endocrine therapy (anti-hormonal and hormonal drugs). Depending on the location and nature of the tumor, surgical interventions aiming to remove some endocrine organs (in particular, ovarian, testicular, thyroid and endocrine portion of the pancreas, etc.) can lead to disruption of their function. The objective of presented study is to focus our attention mainly on the effects (including the steroid and non-steroidal components) of anticancer treatment in the endocrine system and in the outcomes associated with hormonal and metabolic changes, clinical and phenotypic features. These effects are manifested not only by changes of laboratory and instrumental parameters, but also accompanied by changes in the clinical manifestations of the disease and the patient's subjective feelings. The therapy often has adverse effects, as the anticipated final results of influence of such processes as weight gain, dyslipidemia, impaired glucose tolerance, lack of ovarian, adrenal, growth hormone and testicular function, osteopenia, hot flushes, chronic fatigue e.t.c., which often limits the success of treatment. Passive registration of such violations, and the silent watching them – is only one side of the problem rather frequent enough, the other side - are the questions about modern approaches of their correction and its feasibility. In part, this problem has a genetic basis, which, along with other indicators, can determine not only the response to anti-tumor therapy, but the severity of endocrine changes, their potential prognostic role, as well as the indications for their prevention and elimination. There are many clinically significant situations that are need to be analysed and discussed, such as: complete androgen blockade in prostate cancer patients, endocrine effects of adjuvant chemotherapy and hormonal therapy in breast cancer patients of reproductive and postmenopausal age, the expected increase of the frequency of performing of preventive salpingoovariectomies in carriers of mutations in BRCA1 and BRCA2 genes, thyroid (in particular) and adrenocortical tropism of targeted therapy, consequences of high doses of corticosteroid support therapy, etc., that demonstrate the importance of this problem, considering these facts in clinical practice and the establishment of standards for the management of patients with these problems.

Development of surgery in last century allowed to move from performing abdominoperineal extirpation of the rectum for all patients with rectal cancer to performing sphincter-preserving operations for the majority of patients without compromising oncological radicality. This article is focused on possibility of performing various surgical procedures in cases of tumors localized in the middle third of the rectum. Not only short- and long-term outcomes have a significant importance in a modern approach in the treatment of such patients, but quality of life associated with the adequacy of preserving of sphincter function.

Tumors of the gastrointestinal tract (GIT) - is an extremely heterogeneous group of tumors and characterized by a variety of morphological, genetic characteristics and different approaches to treatment. Most of the tumors can be removed surgically, but as the results of follow-up show, even in case of radical surgical treatment at least half of patients die because of distant metastases. It means that at the time of radical surgery a large number of patients have undetectable micrometastases and therefore the disease is systemic. Adjuvant therapy is a drug therapy after radical surgery, aimed to eradicate distant micrometastases in order to increase overall and disease-free survival. There is no doubt that strong attention of oncologists to the adjuvant treatment of gastrointestinal tumors is dictated by a will to achieve increase in progression-free survival after radical surgery. This period of life of a cancer patient can be equated to a period of temporary "recovery" when the patient for a considerable length of time does not need any special treatment, leads an active lifestyle and may even go back to work. From the point of view of the public healthcare adjuvant chemotherapy (CT) is the most important. For today research and the searching of optimal regimes of adjuvant chemotherapy of gastrointestinal tumors continue. The basic principle of adjuvant therapy regimen selection - is proved high efficiency in the treatment of metastatic disease. At the same time neoadjuvant regimens are studied. The aim of neoadjuvant chemotherapy is to reduce tumor size, to provide partial destruction of tumor cells (ideally - to achieve complete morphological regression), that allows to performs the operation of smaller volume than the operation that would be performed without neoadjuvant chemotherapy. Currently, principles based on randomized clinical trials with a high level of evidence are established for the selection a regimen of adjuvant and neoadjuvant chemotherapy of gastrointestinal tumors.

Oropharynx is the complex anatomical and topographical area, the boundaries of which begin behind oral cavity, and despite the visual localization, it not always easily to provide its appropriate inspection. This is particularly evident in cases of mandible dysfunction such as a limitation of mouth opening, certain anatomical features, pronounced vomiting reflex and hypertrophy of the tonsils. These factors, as well as low cancer alertness of general practitioners, are largely the reason for the neglect of oropharynx tumors.

The annual incidence of breast cancer (BC) in the world is 1,383,000 cases. Genetic predisposition is one of the major risk factors for breast cancer and ovarian cancer (OC). The proportion of hereditary breast cancer ranges from 5 to 10%, which amounts 69 150-138 000 cases. Family history of accumulation of breast cancer and tumors of the female reproductive system have 25% of patients. Thus, patients with hereditary forms and family breast cancer account 345,700 of all diagnosed cases of breast cancer. Hereditary ovarian cancer occurs in 10-17% cases. Hereditary breast and ovarian cancer are characterized by autosomal dominant inheritance with high (incomplete) penetrance, incidence in early age and pronounced phenotypic and genotypic heterogeneity. According to numerous studies, 20-50% of hereditary breast cancer cases and 90-95% of hereditary ovarian cancer cases in women, and from 4 to 40% of breast cancer cases in men are caused by germinal mutations in the BRCA1 and BRCA2 genes. Considering the syndromic pathology of hereditary BC and OC and can also be associated with mutations in genes TP53, CHEK2, MLH1, MSH2, PALB2, PTEN, NBS1, ATM, BRIP1, RAD50, BLM, FGFR2, and others.

The development of surgical technique has led to decrease in local recurrence and improved survival in rectal cancer (RC) patients. And relation to the combined treatment has changed. Currently, radiation therapy planning should be carried out taking into account the prognostic factors affecting on the rate of local recurrence. Crucial are the distance from the tumor to the circumferential resection margin, determined by magnetic resonance imaging (MRI), the distance from the anal verge to the lower border of the tumor and the presence of metastases in regional lymph nodes. Discussing tactics of treatment of patients on the medical council with the participation of the surgeon, radiologist, radiation therapist and pathomorphologist improves local control and survival in patients with rectal cancer.

Success in the treatment of cancer in children, made in the past decade is caused by the introduction of multimodal treatment programs, in which chemotherapy plays a leading role. Its effectiveness is due not only the development of pharmacology, but also the intensification of treatment protocols - increasing doses of chemotherapy, the number of courses and a reduction in the intervals between the courses. This, in turn, requires an accompanying complex therapy for the prevention and correction of complications and side effects. Because of the main route of administration as the chemotherapeutic and accompanying drugs is intravenous, it imposes strict requirements on the systems of central venous access. They must be secure, easy to use, once installed on the entire treatment period, to have a minimum percentage of complications during the installation and using and also not to reduce the quality of life of patients. Such conditions are especially important in pediatric oncology as any central venous catheterization in children is invasive procedure requiring general anesthesia. Currently, implantable venous port systems are met all of the above requirements.

The problem of anemia in cancer patients is relevant and multilateral. One of the causes of anemia is iron deficiency. The absolute or functional iron deficiency reduces the efficiency of recombinant erythropoietin used for the treatment of chemotherapy-induced anemia. Numerous studies have shown that intravenous forms of iron, as opposed to oral, effectively replenish iron deficiency necessary for optimal erythropoiesis. Modern American and European recommendations (ESMO, NCCN) for the treatment of anemia in cancer patients include the mandatory use of intravenous forms of iron.

The introduction of innovative technical developments: the three-dimensional planning, using multileaf collimator, simulated by the intensity radiation therapy, improved methods of fixation significantly improved ability of accurate delivering and escalating of doses of ionizing radiation to the selected volume of tissues. This has changed the perception of the role of radiation therapy in the treatment of liver metastases. Foreign authors data suggest the possibility of reaching 95% local control one year after stereotactic radiotherapy, 92% - after two years (and 100% for tumors smaller than 3 cm.) with the development third or higher degree of radiation damage near in 2%. In 2011, after the technical upgrading of Blokhin Cancer center, the method of stereotactic radiosurgery (SBRS) was introduced in clinical practice for the treatment of patients with liver metastases. This method allows to create a high-dose ionizing radiation in metastatic tumor and cause the destruction of the tumor. This is a promising direction in the treatment of metastatic liver cancer significantly expanded the capabilities of the combined treatment. The article provides an overview of the literature on the treatment of liver metastases, and we publish the results of the use of stereotactic radiosurgery at thirty-five patients with liver metastases and clinical case of successful application of this method in patient with significant co-morbidity.

Treatment of malignant oropharyngeal tumors - one of the most difficult problems of modern oncology. This is caused by the intensive growth of incidence, a large proportion of advanced cancers at the time of primary visit to a doctor and low 5-year survival.  The aim of this study is to improve the efficiency of treatment of patients with oropharyngeal cancer by implementation of the use of self- or neoadjuvant chemoradiotherapy.

In this article presented data on pregnancy, childbirth in patients with Hodgkin's lymphoma (HL) after radiation and chemoradiation therapy, health status of born children. A total of 340 women who later had pregnancies ended with childbirth were observed. The treatment period: from 1970 to 2011. Median age during this period was 20 years (range 14 to 35 years). 241 patients (70,9%) had I and II stage of HL, 44 patients (13,0%) - III, 55 patients (16.1%) – IV; 110 (30.2%) people had common symptoms. Treatment: radiation of lymph nodes in the area above the diaphragm and spleen with 40 Gy of total focal dose (77 people); PCT COPP + similar radiotherapy (224 patients); PCT COPP / ABV, ABVD, BEACOPP + radiation of affected foces with 20-30 Gy of total focal dose (33 patients); PCT COPP, BEACOPP (6 patients), extranodal foci (16 patients). Use of chemotherapy was not associated with ovarian hormone protection. Pregnancy for most women was normal. Miscarriages preceded childbirth in 6 patients. Pregnancy in one women was aborted at 24 weeks in connection with Dandy-Walker syndrome of the fetus, and there was one intrauterine fetal death due to diseases of the urinary system of the fetus. A total of 338 women (range 18 to 38, median age 24) had 406 births. A median duration of period after treatment and before childbirth was 3.4 months (range 10 to 17 months).  Most births were urgent - 391 (96.3%), spontaneous - 380 (93.6%). 411 children were born. Two were stillborn, 4 died in the first days of life. 387 (94%) children were full-term. Height and weight were not different from the norm. Most children were born healthy and their further physical and mental state and the frequency and nature of their diseases did not differ from those in the general population, except in 3 of them who had HL. Congenital diseases were diagnosed in 12 children (microcephaly - 2, hydrocephaly - 1, heart disease - 3, sensory hearing loss - 2, cleft palate - 1, fibrous dysplasia of bone - 1, multiple exostosis of bones - 1, absence of kidney - 1). Total number of congenital disorders considering two cases of abortion due to fetal abnormalities - 14 (3.4%). The second generation accounts 23 people. Fourteen women had HL recurrence after the childbirth. Pregnancy after treatment of Hodgkin's lymphoma in most cases proceeds normally, without leading to relapse in case of complete remission lasting longer than 2 years. Most children were born healthy.

Aim: to improve the results of treatment of patients with local recurrence of colon cancer and evaluate effectiveness of the combined treatment.
Materials and methods. From 1997 to 2012 in SRCC 71 consecutive patients underwent combined surgery for local recurrence of colon cancer. Of these patients 38 (53.5%) had surgical treatment with intraoperative intraperitoneal chemotherapy. Sixty-five (91.5%) patients had locally advanced recurrent tumor. Localization of local recurrence in patients who underwent combined operations, was as follows: in the area of colonic anastomosis - in 11 (15.5%) patients; in the bed of the removed tumor - in 19 (26.8%); in the area of colostomy - in 10 cases (14.1%); in the stump of distal colon after obstructive procedures - in 31 (43.6%) patients. Mean operative time was 270 ± 45 minutes and mean blood loss - 430 ± 80 ml.
Results. Postoperative complications were observed in 6 (9.8%) of 61 patients. There was no mortality. Sixty-four (90.1%) patients were followed-up, 34 (53.1%) patients of which are currently alive with no signs of the relapse of the disease. Effectiveness of intraperitoneal chemotherapy was evaluated. Repeated local recurrence occurred in 5 (14.3%) of the 35 followed-up patients who underwent intraperitoneal chemotherapy, and in 6 (20.7%) of the 29 followed-up patients who received surgery alone (p = 0.2). Distant metastases were found in 9 (25.7%) and in 5 patients (17.2%) patients, respectively (p = 0.17), and peritoneal carcinomatosis in 1 (2.9%) and 4 (13.8%) cases, respectively (p = 0.09). Disease-free 5-year survival rate in patients who received intraperitoneal chemotherapy was 57.1%, and in patients received only surgical treatment - 48.3% (p = 0.15).

In recent years there has been a significant improvement in the approaches of the treatment of patients with liver metastases of colorectal cancer. This is caused by improved diagnostics modalities. Modern possibilities of CT and MRI in combination with liver-specific contrast agents enable to localize tumor very precise, evaluate its location relative to blood vessels and other anatomic structures and, thus, carefully plan surgery. Ultrasound with contrast agents can add some important information.
Multidisciplinary approach in treatment.
Current chemotherapeutic drugs are becoming more specific, thereby increasing their effectiveness. Currently used regimens can be effective in about 60% of patients. Individual approach to chemotherapy using mutational analysis in some cases, makes possible to estimate beforehand efficacy and thus reduce the probability of treatment failure, followed by a high load for the patient. A good example in this case can serve K-Ras gene mutation that caused ineffectiveness therapy with Cetuximab. Conversely, wild forms of K-Ras oncogene allow to carry out this kind of treatment. Advances in chemotherapy make possible to perform complete removal of the tumor in approximately 20% of patients with primary inoperable tumors.