Purpose of the study. To evaluate the effectiveness of the targeted drug bevacizumab (Avegra®) in the complex treatment of patients with common forms of ovarian cancer after suboptimal cytoreductive surgical interventions. Materials and methods. For the period from January 2017 to November 2018. A clinical study included and treated 71 patients with a diagnosis of ovarian cancer, stage IIIC-IV disease. The prevalence of the tumor process was estimated according to the classification of FIGO and TNM (2009). Patients were randomized into two groups. The first group included 31 patients, the treatment was carried out according to the scheme: paclitaxel 175 mg/m2, carboplatin AUC 6, bevacizumab 15 mg/kg with an interval of 21 days. The second group (control group) included 40 patients who received standard drug therapy. Interval suboptimal cytoreductive surgery was performed in all patients - hysterectomy with appendages, epiploic resection, peritonectomy. Evaluation of the effectiveness of immediate and remote The results were carried out by the method of statistical processing using the program Statistic 6.0. Results. According to the criteria of RESIST 1.1 in the first group, a complete response was registered in 25.8%, a partial response in 51.6%, stabilization of the disease in 12.9%, progression of 9.6% of cases. In the second group, the complete response was in 20% of cases, a partial response was 45%, stabilization was 22.5%, progression was 12.5%. The median overall survival in the first group was 16.5 months аgainst 10.1 months in the second group.
Background. The proportion of malignant neoplasms detected at the IIIIV stages of the disease in Chelyabinsk region is large and 43.9%. Breast cancer in 2018 was detected at stages IIIIV at 24% and cervical cancer at 51.14%. Despite the fact that malignant neoplasms of vulva and vagina are diagnosed annually in isolated cases, the level of neglect reaches 66.7 and 100% respectively, which makes it necessary to develop organizational measures. Aims to increase the level of detection of visual localities OF female reproductive system organs in the early stages with the involvement of oncologists of regional clinics in the primary diagnosis. Materials and methods. Patients with malignant neoplasms of the reproductive system of visual localizations, first identified in the examining cabinet of the polyclinic of the central district hospital, geographically located and functionally subordinate oncologist of the rural municipal district. Comparative assessment of early detection of tumors in an area with high breast cancer and cervical cancer and results following the introduction of a new organizational structure. Results. Patients with malignant neoplasms of the reproductive system of visual localizations, first identified in the examining cabinet of the polyclinic of the central district hospital, geographically located and functionally subordinate oncologist of the rural municipal district. Comparative assessment of early detection of tumors in an area with high breast cancer and cervical cancer and results following the introduction of a new organizational structure. Conclusions. The involvement of oncologist of territorial polyclinics to participate in preventive examinations, which were previously within the competence of the medical assistant of the Examining Cabinet, during the first year of work increased detection and reduced the incidence of breast and cervical cancer by 8.3 and 3.7% respectively. The creation of the Breast Pathology Center in the regional oncology center, at the third level of specialized medical care on the profile of oncology, allowed to reduce the frequency of malignancy of benign and pre-cancer breast diseases.
Aim. To study the relationship between the symptoms of nutritional insufficiency and systemic inflammation in cancer palliative patients. Methods. 106 palliative cancer patients were examined at Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine: 54 (50.9%) men and 52 (49.1%) women aged 61 [54; 67] years. All patients underwent laboratory and instrumental examination within the approved standards of specialized medical care. Systemic inflammation was assessed by the levels of acute phase proteins (C-reactive protein, fibrinogen). The study of integrated clinical and laboratory, somatometric parameters was carried out. The nutritional risk index was assessed. Results. Palliative cancer patients showed a statistically significant decrease in the concentration of hemoglobin, lymphocytes, and albumin. The activation of systemic inflammation that manifested by hyperfibrinogenemia and an increase in the level of C-reactive protein was revealed. The study of somatometric parameters revealed a statistically significant decrease in body mass index, shoulder circumference, subscapular skinfold thickness, and a tendency to reduce lean body mass. The nutritional risk index assessment showed mild nutritional insufficiency in 22 (20.8%) of the examined patients and severe nutritional insufficiency in 28 (26.4%) patients. The maximum diagnostic significance of the level of C-reactive protein for prediction the nutritional insufficiency was achieved at 80.4% sensitivity and 52.7% specificity (AUC=0.671, 95% confidence interval [0.573; 0.759], p=0.001), which corresponded to a C-reactive protein threshold of 31 mg/l. Conclusion. 50 (47.2%) of the examined patients showed signs of nutritional insufficiency, a statistically significant decrease in hemoglobin and albumin concentration, as well as lymphocyte count, activation of systemic inflammation, manifested by hyperfibrinogenemia, and an increase in the level of C-reactive protein; it was revealed a statistically significant relationship between C-reactive protein level and malnutrition.
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