Purpose of the study. Assessment of clinical safety and effectiveness of radium‑223 in patients with bone metastases from castration-resistant prostate cancer.

Patients and methods. The study involved materials on 15 patients with bone metastases from castration-resistant prostate cancer aged 58–81 years, with the mean age of 67.2 ± 6.5 years, who were examined and received full treatment with 6 intravenous injections of radium‑223 chloride [223Ra] at the National Medical Research Centre for Oncology. Most patients (73.3 %) showed ECOG 1 performance status. Pain syndrome before the treatment was registered in 12 (80 %) patients.

Results. Evaluation of the tolerability of radium chloride did not show hematological reactions such as anemia and thrombocytopenia. One patient had grade II intestinal toxicity after the 3rd injection managed with medication. Assessment of indirect signs of the treatment effectiveness demonstrated that 6 people showed an increase in PSA during treatment, while alkaline phosphatase levels were within normal range indicating no bone destruction. 8 of 12 patients with pain syndrome showed its relief during the therapy. The following results were obtained during a follow-up examination after 3 months in 15 patients who received the full treatment course: stabilization in 8 patients; improvement in 4 patients with decreased metabolic activity and lower numbers of metastatic foci; progression with the appearance of new metastatic foci in the bones in 3 patients.

Conclusion. Radium chloride showed good results in the treatment of patients with bone metastases from castration-resistant prostate cancer. Low toxicity and improvement in the quality of life by pain relief make this treatment technique promising.

Purpose of the study. To conduct a comparative analysis of E-cadherin expression in inoperable patients with non-small cell lung cancer (NSCLC) cells and with different survival rates.

Materials and methods. The study included 96 patients with inoperable NSCLC: 84 (87.5 %) men and 12 (12.5 %) women, whose average age was 62.4 ± 0.68 years. Squamous cell carcinoma (SCC) was diagnosed in 78 (81.25 %) patients, and adenocarcinoma (AC) with a tumor differentiation grade of G2-G3 in 18 (18.75 %). The patients were treated and monitored at the National Medical Research Centre for Oncology. The expression of cadherins was determined in the tumor cells of the biopsy specimens. The obtained data have been processed using the Statistica 13.0 program (StatSoftInc., USA). The studied data have been checked for compliance with the normal distribution using the Shapiro-Wilk criterion.

Results. The following distribution of patients with NSCLC was noted: IIA – 2 (2.1 %), IIB – 14 (14.6 %), IIIA – 51 (53.1 %), IIIB – 29 (30.2 %), i. e. the frequency of stage III is higher than stage II (83.3 % (n = 80) versus 16.7 % (n = 16), p < 0.001). Fatal outcome occurred in the SCC group within 1 year in 28 patients, within 1 to 2 years – in 30, 20 patients survived for 3 years or more. For AC, these figures were 6,5 and 7 respectively. The analysis revealed that E-cadherin expression was noted in both squamous cell carcinoma and lung adenocarcinoma: Me 55 [LQ 37; UQ 65] and Me 50 [LQ 40; UQ 70], respectively.

Conclusions. 1. The analysis revealed that E-cadherin expression was observed in both squamous cell carcinoma and lung adenocarcinomas without statistically significant differences between the compared groups (p = 0.25). 2. Statistically significant differences in the levels of E-cadherin expression were noted in the biopsy samples of the 2 groups only with survival up to 1 year and up to 3 years or more (p < 0.05).

Purpose of the study. To improve the treatment results of patients suffering from CRC with oligometastatic lesion by determining the most effective combination of treatment methods.

Patients and methods. The results of treatment of 71 patients with oligometastases of colorectal cancer were analyzed. All patients were divided into 2 groups depending on the treatment methods. The first group included 35 patients who underwent simultaneous removal of the primary tumor and metastatic foci at the first stage of complex treatment. The second group includes clinical data on 36 patients who underwent primary lesion removal at the first stage of complex treatment followed by drug antitumor therapy.

Results. In the primary tumor removal group, the response was received in 3 (8.3 %) cases, stabilization was achieved in 14 (38.9 %) cases, and progression of the tumor process was detected in 19 (52.8 %) cases. The median disease-free survival was 9.2 ± 3.2 months. One-year, two- and three-year survival rates in the group of simultaneous removal of the primary tumor and oligometastases and in the group of primary tumor removal were 97.1 %, 88.6 %, 77.1 % and 100 %, 80.5 %, 72.2 %, respectively. The overall survival rate in the group of simultaneous removal of the primary tumor and oligometastases was 63 ± 3.9 months, in the group of primary tumor removal – 58 ± 3.8 months.

Conclusion. In the presented clinical study, a comparative assessment of the effectiveness of the treatment of patients with colorectal cancer with oligometastases was carried out, depending on the option of an integrated approach. The results obtained turned out to be multidirectional – the response to treatment and progression were obtained in 54.3 % and 45.7 % of cases in the group of simultaneous removal of the primary tumor and oligometastases versus 47.2 % and 52.8 % of cases in the group of removal of the primary tumor without oligometastases, respectively. The median recurrence-free survival was shorter in the group of primary tumor removal without metastases. Complete removal of the primary tumor and oligometastases can significantly increase the overall survival rates of patients.

Purpose of the study. To improve the results of treatment of patients with unresectable metastases of colorectal cancer in the liver that are not controlled by systemic chemotherapy.

Materials and methods. The study includes clinical data on the treatment of 76 patients with metachronous metastases of colorectal cancer in the liver that are not controlled by systemic chemotherapy. Patients underwent removal of the primary tumor according to urgent indications at the first stage of complex treatment, followed by systemic chemotherapy in an adjuvant mode. After 24.5 ± 0.2 months, patients were diagnosed with metastatic liver damage, and therefore systemic chemotherapy was initiated. After changing two lines of drug therapy with a registered progression of the oncological process, liver metastases were recognized as uncontrolled by systemic chemotherapy. After that patients were included in the given study and divided into two groups. The study group included 40 patients who underwent regional chemotherapy. The control group included 36 patients who continued systemic chemotherapy with subsequent line changes. The effectiveness was evaluated according to the RECIST 1.1 and mRECIST scales, as well as the overall one-year, two- and three-year survival rates.

Results. The median overall survival of patients in the control and study groups was 30.0 ± 0.8 and 41.5 ± 0.5 months, respectively, p < 0.05. The total one-year, two- and three-year survival of patients in the control and study groups was 94.4 %, 69.4 %, 33.3 % and 100 %, 82.5 %, 57.5 %, respectively, p < 0.05. The median life expectancy of deceased patients in the control and study groups was 22.5 ± 0.4 and 27.0 ± 0.4 months.

Conclusions. As a result of a comparative analysis of the detection of adverse events and complications of the treatment, patients of the study group underwent treatment much easier than patients of the control group – in patients in the group of systemic chemotherapy, moderate and severe complications were detected in 44.4 % of cases, in the study group – in 2.5 % of cases. According to the results of a clinical study, regional chemotherapy is an effective method of treating patients with colon cancer metastases in the liver that are not controlled by systemic chemotherapy and is associated with a statistically significant increase in overall survival (p < 0.05). For a more detailed study of the benefits of regional chemotherapy in this category of patients, further prospective clinical studies are necessary.

Adenoid cystic carcinoma of the lung is a relatively rare malignant tumor, accounting for 0.04–0.2 % of all primary malignant tumors of the respiratory system. This carcinoma can occur at any age, but it is more common in the 40–60 age group and usually in women. The main treatment method for adenoid cystic carcinoma is surgical. Since tumors of this histological form are often centrally located, options for bronchoplastic operations are considered. In childhood, adenoid cystic carcinoma is extremely rare, and performing bronchoplastic lobectomies in children is associated with several difficulties, such as the smaller diameter of the bronchi compared to adult patients, complicating surgical intervention and subsequent rehabilitation. This clinical case demonstrates the experience of performing a bronchoplastic operation on a 15-year-old patient at the Department of Thoracic Oncology of the National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation. The patient was hospitalized complaining of prolonged cough, shortness of breath, and chest pain. Adenoid cystic carcinoma of the central type was identified during diagnostics, which included bronchoscopy, computed tomography, and biopsy. The surgical intervention involved performing a bronchoplastic lobectomy, during which the affected lobe of the lung was removed with resection and reconstruction of the bronchus. The operation was performed taking into account the anatomical features of the child's body, which required high precision and surgical skills. The postoperative period proceeded without significant complications, and the patient was under the supervision of a multidisciplinary team of specialists.

This clinical case provides a detailed description of the results of preoperative diagnostic measures, the stages of the operation, and the postoperative follow-up results. Special attention was paid to the difficulties associated with the small diameter of the bronchi in children, which required the use of specialized instruments and techniques. The importance of using modern diagnostic and treatment methods, as well as close interdisciplinary interaction, is emphasized for a successful treatment outcome.

The experience of performing such operations in childhood is extremely important for improving the quality and safety of surgical treatment of adenoid cystic carcinoma and other rare tumors in children. Further observations will be described in stages.

Pulmonary fibrosis develops both spontaneously and as a result of lung damage by radiotherapy and chemotherapy, infectious diseases, and inhalation of harmful substances and particulate matter. In this case, normal tissue repair is disturbed: instead of regeneration of normal lung cells, the damaged tissue is replaced by fibrotic one consisting of dense collagen fibers. This leads to loss of lung tissue elasticity and impairment of its function, which significantly reduces the quality of patients’ lives. The search for drugs for interstitial fibrotic lung diseases remains an urgent task, since the existing antifibrotic drugs only slow down disease progression and have side effects that significantly reduce the patients’ quality of life. It is believed that natural polyphenolic substances, in particular flavonoids, can be used for the treatment of pulmonary fibrosis. Flavonoids present in various fruits, vegetables, tea and wine show a wide range of biological activities. They have antioxidant, anti-inflammatory and immunomodulatory properties, making them promising for the treatment of various diseases, including pulmonary fibrosis. Some studies have shown that flavonoids can inhibit myofibroblast activation and collagen production, which is directly related to the fibrotic process. Flavonoids are safe and can influence the hallmarks of fibrosis: oxidative stress, inflammation, cell proliferation and differentiation. To date, a large amount of experimental data confirming the antifibrotic effect of flavonoids has been accumulated. In recent years, clinical studies have been conducted to investigate the efficacy and safety of flavonoids in patients with pulmonary fibrosis. For example, quercetin and curcumin are being explored and have shown encouraging results in reducing markers of inflammation and fibrosis in the lung. However, the main obstacle to the widespread introduction of flavonoid substances into clinical practice remains their low oral bioavailability and rapid metabolism. The experimental data on the effect of flavonoids on the development of pulmonary fibrosis is analyzed in this review. The perspectives for improving their bioavailability using modern delivery systems (nanoparticles, liposomes, etc.), as well as dosage forms for topical application, are discussed in this paperwork.

Despite significant advances in the treatment of malignant neoplasms, the issue of therapy resistance mediated by cancer stem cells (CSCs) necessitates the development of new treatment strategies. Studying the role of CSCs and the immune microenvironment in the pathogenesis of cancer, particularly non-small cell lung cancer (NSCLC), is a pressing issue in modern oncology. This paper is based on an extensive analysis of recent research and aims to study the mechanisms underlying the development of NSCLC.

The origin of CSCs, their markers, and the main signaling pathways involved in regulating their activity are considered. Special attention is paid to the influence of CSCs on the progression of lung cancer and the mechanisms underlying their therapy-mediated resistance. Various approaches to treating lung cancer targeting CSCs, focusing on targeted therapy aimed at specific molecular targets, are highlighted.

The important role of the tumor immune microenvironment in the pathogenesis of lung cancer and its impact on CSCs is emphasized. Mechanisms of immune response regulation in tumors and the potential use of immunotherapy to improve lung cancer treatment outcomes are discussed. The article also reviews modern diagnostic and treatment methods, including molecular-genetic and immunohistochemical approaches.

This paper work represents a review of current knowledge on the mechanisms of lung cancer development and is significant for understanding tumor biology and developing new treatment methods. The need for an interdisciplinary approach and comprehensive use of modern diagnostic and therapeutic methods to improve the prognosis and survival rates of NSCLC patients is emphasized. Special attention is given to the prospects of using combined therapeutic approaches, including targeted drugs and immunotherapy, aimed at suppressing CSC activity and modifying the tumor microenvironment.

In conclusion, a deep understanding of the molecular mechanisms regulating CSC activity and their interaction with the tumor microenvironment opens new opportunities for developing effective treatment strategies. This review underscores the need for further research in this area to ensure more successful treatment and improved quality of life for lung cancer patients.