Nnblokhin Russian Cancer Research Center

Russia

Nnblokhin Russian Cancer Research Center

Russia
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Sokolovsky A.V.,Nnblokhin Russian Cancer Research Center | Sokolovsky V.A.,Nnblokhin Russian Cancer Research Center | Aliev M.D.,Nnblokhin Russian Cancer Research Center
Voprosy Onkologii | Year: 2016

Purpose: To investigate beneficial advantages of the ultrasonic method of bone cement removing in compare with mechanical as well as to qualitatively improve the technology of bone cement removing in revision arthroplasty. Material and methods: The study included 55 patients with benign, primary and metastatic malignant tumors. From March 2014 to January 2016 there were performed 56 revisions. In 36 cases revisions were made using ultrasound system "Oscar Ultrasonic 3", mechanically the cement mantle was removed in 20 cases. The quality control of bone cement extraction was carried out by endoscopic stand "Storz". The quality of stem fixation was evaluated radiologically. Results: Mean follow-up after surgery was 11.5 months. One patient had second revision after mechanical extraction of bone cement due to aseptic loosening. In the group of patients after ultrasonic extraction of the cement mantle deterioration of the cement fixation was not revealed. The average time of surgery using ultrasonical and mechanical technology of bone cement removal was 154.5 and 158.1 min. in replacement of one stem, 200 and 182 min. in replacement of two stems respectively. The average blood loss was 427 and 430 ml. in a time of one stem revision, 445 and 525 ml in a time of two stem revision after using ultrasound and mechanical technology respectively. In one stem revision with using ultrasound extractor was achieved the reduction in blood loss at 10% and in two stem revision at 16%. There were no any complications in using ultrasonic extractor. Conclusion: The use of ultrasonic technology in the revision arthroplasty can improve the quality of cement fixation, reduce the amount of bleeding and severity of surgical treatment regardless of the surgery time, improve economic efficiency. Further enhancement of the ultrasonic method for cement mantle extraction has a potential to improve its effectiveness.


Fedyaev D.V.,Financial Research Institute | Ignatieva V.V.,Academy of Public Administration | Derkach E.V.,Russian National Research Medical University | Zyryanov S.K.,Nnblokhin Russian Cancer Research Center | And 2 more authors.
Voprosy Onkologii | Year: 2017

Background: Preliminary results of the study of clinical effectiveness and safety of afatinib in comparison with gefitinib as the first line therapy for the patients with the metastatic non-small-cell lung cancer (NSCLC) and activating EGFR mutation have been reported in December of 2015. According to this study afatinib has significantly increased the rate of progression-free survival (PFS) (RR = 0.73; 95% CI, 0.57, 0.95; p = 0.0165), as well as the time before treatment discontinuation (TTD) (RR = 0.73; 95% CI, 0.58, 0.92; p = 0.0073) in comparison with gefitinib and the objective response rate (ORR) (70% vs 56%, p = 0.0083). The aim of the present study: Economic evaluation of afatinib in comparison with gefitinib as the first line therapy during the long-term treatment of locally advanced or metastatic NSCLC in the patients with the activating EGFR mutation. Methods: The cost-effectiveness analysis has been performed using Markov model. The model has been constructed on the basis of the results of clinical study LUX-Lung 7, taking into account the results of the study LUX-Lung 3. The direct medical costs have been taken into account: The cost of drug treatment of metastatic NSCLC during the first and second line therapy, the expenses for palliative care, correction of adverse events, as well as for the follow-up of patients in the course of the treatment. The cost/effectiveness ratio (CER) (Rubles/ Quality adjusted life year, or QALY) has been calculated for afatinib and gefitinib. In the baseline scenario (all patients with frequent activating mutations) the cost-effectiveness of afatinib for all patients with activating EGFR mutation has been evaluated; in addition the costs and outcomes in patients with Del 19 and L858R mutation have been analyzed separately. The probabilistic sensitivity analysis of the analysis results to the variability of initial parameters has been performed. Results: In the baseline scenario the cost of first year treatment with afatinib as the first line therapy has been by 13.56% cheaper than the cost of treatment with gefitinib and amounted to 1.058 million Rubles for afatinib and 1.224 million Rubles for gefitinib. The general expenses for the first year of treatment have amounted to 946 726 Rubles for afatinib, and 1 024 096 Rubles for gefitinib. In the baseline scenario the modeled progression-free survival for afatinib has amounted to 13.15 months and for gefitinib to 10.65 months. The total direct medical costs for first 3 years of treatment for afatinib have amounted to 1.577 million Rubles, for gefitinib 1.585 million Rubles, the number of QALY gained - 1.341 and 1.280 correspondingly. CER for afatinib has amounted to 1.176 million, for gefitinib - 1.239 million Rubles/QALY. In the additional scenarios the same results have been demonstrated: CER for afatinib was less than for gefitinib. Conclusions: The administration of afatinib leads to the better clinical results, expressed by the increase of the rate of progression-free survival and longer-term therapy on retention of life quality of the patients in comparison with the administration of gefitinib accompanying by the cost advantage. Subsequently the cost - effectiveness ratio for afatinib is better than for gefitinib. Afatinib is the dominant alternative for the treatment of NSCLC during first line therapy in comparison with gefitinib. The prescription of afatinib offers the possibility to spare funds in the health system and is appropriate from pharmacoeconomic standpoint.


Patyutko Yu.I.,Nnblokhin Russian Cancer Research Center | Kotelnikov A.G.,Nnblokhin Russian Cancer Research Center | Mamontov K.G.,Altai Branch Of The Nnblokhin Russian Cancer Research Center | Podluzhny D.V.,Nnblokhin Russian Cancer Research Center
Voprosy Onkologii | Year: 2015

The current study aimed at improvement of treatment effects for patients with resectable metastases of colorectal cancer in the liver with a poor prognosis. Overall 437 patients were enrolled with metastatic colorectal cancer in the liver exhibiting at least one adverse factor of long-term prognosis: multiple metastases, bilobar liver metastases, large metastases, the presence of extrahepatic metastases, etc. Combined treatment was performed for 339 (78%) patients: combined treatment with adjuvant systemic chemotherapy (163 patients), combined treatment with perioperative systemic chemotherapy (54 patients), or combined treatment of perioperative regional chemotherapy (122 patients). Surgical treatment was performed in 66 (15%) patients. The remaining group of 32 (7%) patients with resectable metastases who received only systemic chemotherapy was considered separately. All liver resections were extensive due to the widespread metastases. The complication rate stood at 56%. Lethality among operated patients was 4%. Postoperative lethality and complications as well as the intraoperative blood loss were not statistically different in two groups. Adding bevacizumab to preoperative chemotherapy did not increase blood loss. After combined treatment with adjuvant chemotherapy a 5-year survival was 26±4% that significantly outperforming a 5-year survival rate after surgery (17±5%), after just drug treatment a 5-year survival has not been reached, and also after combined treatment with perioperative systemic chemotherapy (13±5%) and not statistically significant exceeded a 5-year survival after combined treatment with perioperative regional chemotherapy (20±5%). Thus our study demonstrates the benefits of combined treatment with adjuvant systemic chemotherapy for resectable metastases of colorectal cancer in the liver with a poor prognosis For initially unresectable metastases with extrahepatic manifestations of the disease treatment should be begun with systemic chemotherapy. To liver resection in the latter cases there are resorted only after the transfer of patients in operable condition.


PubMed | Nn Blokhin Russian Center, Hospital Of La Santa Creu I Sant Pau, Washington, Johns Hopkins University and 3 more.
Type: Journal Article | Journal: Medical physics | Year: 2016

This workshop is jointly organized by the AAPM, the Spanish (SEFM) and the Russian (AMPR) Medical Physics Societies, as part of formal educational exchange agreements signed by the AAPM with each one of these two societies.With the rapid technological advances in radiation therapy both for treatment and imaging, it is challenging how physics is taught to medical physicists practicing in radiation therapy. The main Objectives: of this workshop is to bring forth current status, challenges and issues related to education of radiation therapy physicists here in the US, Spain and Russia. Medical physicists from each one of these countries will present educational requirements of international recommendations and directives and analyze their impact on national legislations. Current and future educational models and plans for harmonization will be described. The role of universities, professional societies and examination boards, such as the American Board of Radiology, will be discussed. Minimum standards will be agreed upon.1. Review medical physics educational models supported by AAPM, SEFM, and AMPR. 2. Discuss the role of governmental and non-governmental organizations in elaborating and adopting medical physics syllabi. 3. Debate minimum educational standards for medical physics education based on country-specific resources.


Khochenkova Yu.A.,Nnblokhin Russian Cancer Research Center | Solomko E.Sh.,Nnblokhin Russian Cancer Research Center | Ryabaya O.O.,Nnblokhin Russian Cancer Research Center | Stepanova E.V.,Nnblokhin Russian Cancer Research Center | Khochenkov D.A.,Nnblokhin Russian Cancer Research Center
Voprosy Onkologii | Year: 2017

The discovery for effective combinations of anticancer drugs for treatment for breast cancer is the actual problem in the experimental chemotherapy. In this paper we conducted a study of antitumor effect of the combination of sunitinib and bortezomib against MDA-MB-231 and SKBR-3 breast cancer cell lines in vitro. We found that bortezomib in non-toxic concentrations can potentiate the antitumor activity of sunitinib. MDA-MB-231 cell line has showed great sensitivity to the combination of bortezomib and sunitinib in vitro. Bortezomib and sunitinib caused reduced expression of receptor tyrosine kinases VEGFR1, VEGFR2, PDGFRoc, PDGFR0 and c-Kit on HER2" and HER2+ breast cancer cell lines.


Ilnitsky A.P.,Nnblokhin Russian Cancer Research Center
Voprosy Onkologii | Year: 2017

An increase of cancer incidence continues in Russia. According to the author one of the reason is insufficient educational anticancer work among the population registered in the country for decades. The consequence of this situation is a violation of a significant part of the population measures of prevention, delayed appeal of patients for help, a stable high (about 20%) proportion of patients with stage IV of disease among persons with first-ever diagnosis of cancer, the rejection of thousands of cancer patients from treatment (40% of those are with stage I-II of disease), etc. The article analyzes the situation in the country and offers solutions of problem.


Gordeyev S.S.,Nnblokhin Russian Cancer Research Center | Rasulov A.O.,Nnblokhin Russian Cancer Research Center | Gorbounova V.A.,Nnblokhin Russian Cancer Research Center | Tkachev S.I.,Nnblokhin Russian Cancer Research Center | And 4 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2017

Purpose: The goals of this study were to assess safety and efficacy of triplet chemoradiotherapy (CRT) with paclitaxel for squamous cell anal carcinoma (SCAC). Methods: Patients with stage I–IIIB SCAC were enrolled and received 52–58 Gy intensity-modulated radiotherapy (IMRT) (with dose based on the T stage) in consecutive daily 1.8–2.2 Gy fractions. The concurrent chemotherapy consisted of paclitaxel 45 mg/m2 days 3, 10, 17, 24, 31, capecitabine 625 mg/m2 bid on treatment days and mitomycin C 10 g/m2 on day 1. Primary endpoints were complete clinical response at 26 weeks and protocol compliance; secondary endpoints included toxicity, overall survival (OS) and progression-free survival (PFS). Results: Thirty-eight patients were enrolled. The percentage of patients with stage I, II, IIIA, and IIIB disease were 1 (2.6%), 5 (13.2%), 15 (39.5%), and 17 (44.7%), respectively. 32 patients (84.2%) completed CRT without significant alterations. Grade 3–4 toxicity occurred in 23 (60.5%) patients. 33 (86.8%) patients had complete clinical response at 26 weeks. Median follow-up was 25.6 months. Seven (18.4%) patients experienced disease progression: four patients had residual tumor after CRT, 2 patients developed distant metastases and 1 patient developed a local recurrence 12 months after CRT. Two-year OS was 93.6%, 2-year PFS was 83.9%. Conclusions: Investigated treatment scheme is feasible despite high toxicity profile, and may be beneficial for patients with advanced SCAC. Further research is warranted. © 2017 Springer-Verlag GmbH Germany


Rybalkina E.Yu.,Nnblokhin Russian Cancer Research Center | Stromskaya T.P.,Nnblokhin Russian Cancer Research Center | Ovchinnikov L.P.,Research Institute of Protein | Stavrovskaya A.A.,Nnblokhin Russian Cancer Research Center
Voprosy Onkologii | Year: 2013

In this study, we investigated how the protein YB-1 influenced on the expression of genes coding ABC transporters and on drug resistance in several cell lines, in which originally gene MDR1, coding P-glycoprotein, was not expressed. These populations were significantly different in the presence of mRNA YB-1 and the nature of the intracellular localization of the protein YB-1. However incubation of cells in all studied populations in the culture medium with serum after starvation led to translocation of YB-1 in the cell nucleus. The increase of the number of cells with nuclear localization of YB-1 correlated with increased amount of mRNA YB-1. Processing of cells with drug LY-294,002 by PI3K/Akt inhibitor prevented the translocation of the protein YB-1 into the nuclei of cells, and the cells became more sensitive to the toxic action. Thus, we observed that the signaling pathways involved in control of cell proliferation, in particular a signaling cascade PI3K/Akt were involved in the control of the intracellular localization of YB-1 in cell populations of ovarian cancer, melanoma and human prostate cancer. In these cells the nuclear localization of YB-1 correlated with an expression of MDR and MRP1 DCRP genes and with a sensitivity of cells to a number of drugs.


Nechnshkina V.M.,Russian National Research Medical University | Morkhov K.Yu.,Nnblokhin Russian Cancer Research Center | Kuznetsov V.V.,Nnblokhin Russian Cancer Research Center | Egorova A.V.,Russian National Research Medical University
Voprosy Onkologii | Year: 2015

The article is devoted to one of the most controversial issues of modern oncogynecology - the volume of surgery for endometrial cancer of early stages. There are discussed the indications for lymphadenectomy and its volume as well as how correlate performing lymphadenectomy and conducting postoperative radiotherapy.


Allakhverdiev A.K.,Nnblokhin Russian Cancer Research Center | Davidov M.M.,Nnblokhin Russian Cancer Research Center | Davidov M.I.,Nnblokhin Russian Cancer Research Center
Voprosy Onkologii | Year: 2015

In recent years a large number of thoracic clinics in the world recommend the performance of minimally invasive surgical procedures in the early stages of lung cancer arguing that this technique reduces a number of postoperative complications, shortens the period of social rehabilitation of patients and does not significantly affect the long-term results of treatment. This work is devoted to the study of immediate and long-term results of surgical treatment of patients who have had surgery in the volume of thoracoscopic lobectomy at the early stages of non-small cell lung cancer.

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