Brachytherapy (BT) is a method of radiation therapy with radioactive source contacting the tumor. It was proposed by P. Moore and H. Stallard in 1929. Despite those 50 years of experience with the use of BT in ophthalmic oncology, there are only a few studies on the use of Ru-106 BT for retinoblastoma (RB), and no publications on the use of Sr-90 BT have been found.

Purpose. To present our own experience with the use of ruthenium and strontium ophthalmic applicators for BT in retinoblastoma.

Materials and methods. 120 patients (137 eyes and 194 RB foci) received BT as a local treatment in the period from 2007 to 2020. At the time of treatment the age of the patients varied from 4 to 109 months (mean age 26 months). In 32% of cases (44 eyes) there were monofocal lesions, and in 68% of cases (93 eyes) — multifocal. In 36 cases (30%) BT was performed in the single eye. 79 patients (87 eyes) were treated with the use of ruthenium ophthalmic applicators (OAs), 25 patients (26 eyes) — with the use of strontium OAs, and for the treatment of 16 patients (24 eyes) both ruthenium and strontium OAs were used.

Results. Clinically complete tumor regression was achieved in 62 % of cases (120 foci), partial tumor regression — in 31% of cases (60 foci). In 6% of cases (12 foci) continuous tumor growth was observed, and tumor recurrence occurred in 1% of cases (2 foci) within 4 to 6 months after BT. Local tumor control was achieved in 93% of cases.

The single eyes were preserved in 92% of cases. BT complications of different intensity were reported in 38% of cases (46 patients — 49 eyes) with the mean follow-up duration of 55 months (3 to 157 months). In 92 % of cases (42 patients — 45 eyes) complications were associated with the use of ruthenium OAs, and only in 8% of cases (4 patients — 4 eyes) — with the use of strontium OAs. Risk factors for radiation-induced complications were identified: focus size (height more than 2.5 mm [P =0.0005], extension more than 7.3 mm [P <0,0001]), sclera dose more than 626 Gr (P = 0,0002), and the central localization of the tumor (P <0.0001).

Conclusions. Ruthenium-106 and strontium-90 brachytherapy is a highly effective treatment modality for the management of RB.

Objective. To assess the capabilities of computed tomographic pneumogastrography in determining the types of gastric cancer according to the Lauren classification at the stage of clinical staging.

Materials and methods. This study is a single-center retrospective study with 202 patients with gastric cancer included who was treated at the National Medical Research Center of Oncology named after N. N. Petrov from 2015 to 2018. All patients underwent subtotal gastric resection or gastrectomy and computed tomographic pneumogastrography at the stage of clinical staging. For patients undergoing neoadjuvant chemotherapy, CT was performed twice: before chemotherapy and after, immediately before surgery. We studied quantitative and qualitative imaging biomarkers, measured densitometric indices of stomach tumor density in the arterial, portal and delayed phases of scanning at five different points. For patients receiving NACT, all density indices were recorded twice — both before the start of therapeutic treatment, and after, immediately before the surgery.

Results. The distribution of gastric cancer types according to Lauren»s classification was as follows: in 59 (29,2 %) intestinal type, 69 (34,2 %) — diffuse, 16 (7,9 %) — mixed, 58 (28,7 %) — indeterminate type. Based on visual characteristics, taking into account the characteristics of tumor growth, 3 main CT-PGG of the gastric cancer type were identified: 1 — tuberous (n = 68, 34,0 %), 2 — intramural (n = 57,3 %) and 3 — mixed (n = 77,4 %). CT-PGG tumor type is associated with Lauren type (χ² = 185,19, p <0,001). With a tuberous CT-PGG type, it is possible to assume that the tumor is of an intestinal or indeterminate Lauren type; sensitivity 0,58 (95% CI: 0,49-0,67), specificity 0,1 (95% CI: 0,96-0,1). With an intramural CT-PGG type, the diffuse type of tumor according to Lauren is most likely; sensitivity 0,75 (95% CI: 0,64-0,85), specificity 0,96 (95% CI: 0,91-0,99). With a mixed CT-PGG type, the definition of the type according to Lauren is difficult. In the definition of mixed tumor type according to Lauren, the sensitivity and specificity of mixed CT-PGG tumor type are 0,94 (95% CI: 0,70% -0,1) and 0,67 (95% CI: 0,59-0,73) respectively.

Conclusion. The shape of the stomach tumor, determined by CT-PGG, has a high diagnostic efficiency in determining the types of gastric cancer according to Lauren. The tuberous CT-PGG type is typical for tumors of the intestinal type according to Lauren, and the intramural CT-PGG type is typical for tumors of the diffuse type according to Lauren. Tumors of indeterminate Lauren type have any CT-PGG type and contrast pattern. For tumors of a mixed type according to Lauren, a mixed type according to CT-PGG is characteristic, but differential diagnosis with tumors of a tuberous and diffuse type according to Lauren of an atypical form for them is impossible. Tumors of the intestinal and diffuse Lauren type of the CT-PGG type, which is not typical for them, have an atypical contrast pattern.

Objective: To evaluate the results of retroperitoneal lymph node dissection (RPLND) in patients with advanced non-seminomatous germ cell testicular tumors (NSGCT) and incomplete serological and radiological response to chemotherapy (CT).

Materials and methods: The study included 96 patients with advanced NSGCT who underwent RPLND in N.N. Blokhin Russian Cancer Research Center in 1983-2020. The median age was 27 (15-57) years. All patients (n = 96, 100,0 %) received first-line cisplatin-based CT. Fifty-eight patients (60,4%) received second-line CT. After completion of CT, all patients presented with elevated levels of AFP and/or hCG and detectable tumor lesions (retroperitoneal metastases only in 77 cases (80,2 %), metastases in the retroperitoneal space and other sites in 19 cases (19,8%)). All patients underwent the follow-up surgery after CT completion: RPLND in 96 cases (100,0%) and resection of extra-retroperitoneal lesions in addition to RPLND in 8 cases (8,3%). In total, 29 (30,2%) of 96 patients received CT following surgery. The median follow-up was 39,4 (1-284) months.

Results: Postoperative complications were reported in 10 (10,6%) patients, including grade 3-4 in 3 patients (3,1%). The mortality rate was 1,1%. The complete resection of retroperitoneal tumor lesions was performed in 80 cases (83,3 %), resection of all detectable tumor lesions in 69 cases (71,9%). None of the patients achieved complete response to postoperative CT. Pathological examination of retroperitoneal lesions revealed necrosis and fibrosis, teratomas, and malignant non-seminomatous tumors in 25 (26,0 %), 29 (30,2 %), and 42 (43,8 %) cases, respectively. The long-term overall survival (OS) and cancer-specific survival rates were 60,9 % and 61,7 %, respectively. The relapse-free survival rate in patients who underwent complete resection reached 65,2 %, the progression-free survival rate in patients who underwent incomplete resection was 35,9 %. A multivariate analysis revealed the following independent predictors of unfavorable OS: RPLND after second-line CT (odds ratio [OR] 4,667 (95% confidence interval [CI]: 1,987-10,961)), presence of a residual retroperitoneal mass of a malignant non-seminomatous tumor (OR 3,081 (95% CI: 1,178-8,055), and incomplete removal of residual lesions after CT (OR 4,445 (95% CI: 1,813-10,899)).

Conclusion: Post-CT RPLND may be considered a viable option in the selected group of advanced NSGCT patients with an incomplete serological response to CT eligible for complete resection of all detectable tumor lesions.

Hereditary BRCA1 / 2 mutations affect the strategy of surgical treatment in early cancer and systemic treatment in advanced HER2-negative breast cancer. The article presents the results of a survey of Russian oncologists on various aspects of genetic testing for hereditary BRCA1 / 2 mutations in real-world clinical practice. Indications for testing, testing methods, and funding sources were discussed.

The aim of the study was to develop, implement and evaluate a method for predicting the aggressiveness of primary melanoma after surgical removal.

It was established that the method for predicting tumor aggressiveness allows to determine the degree of aggressiveness, life expectancy, and to identify patients with poor prognosis in order to individualize treatment. The survival rate of patients was found to depend on the degree of aggressiveness of the tumor. A group of patients with stages 0-IIa (16,4 %) and tumor aggressiveness Grade II was identified as having a potentially high risk of progression, which can help individualize treatment for this category of patients. Using the method for predicting disease progression may potentially expand the scope of indications for further personalized treatment.