Pub Date : 2022-03-31DOI: 10.52532/2521-6414-2022-1-63-47-50
T. Sadykova, M. Kuzikeev, B. Sarsembaev, E. Orazbek
Relevance: Surgical intervention is the most radical method in the complex specific therapy of malignant neoplasms. Oncosurgical operations are among the most traumatic; the volume of surgical intervention depends on the stage of the tumor process and its prevalence, the presence of metastases, germination in neighboring tissues and organs, and concomitant diseases. Particular importance is attached to the anesthetic management of the perioperative period. Regional anesthesia is practically not used for several reasons in oncosurgical reconstructive and plastic interventions on the abdominal organs. In choosing the method of anesthesia, the qualification of the anesthetist plays a role, especially when performing high epidural anesthesia, which is quite technically complicated. The emergence of highly effective anesthetics and high-quality sets for epidural anesthesia has significantly expanded the scope of this type of anesthesia in oncosurgical practice. This study aimed to demonstrate the possibilities and advantages of epidural anesthesia in the perioperative period using the described clinical case as an example. Methods: Patient N. was admitted to the clinic for surgical treatment for a malignant neoplasm of the transverse colon without clinical signs of obstruction of the lumen of the large intestine. She underwent laparotomy, subtotal colectomy with anastomosis, resection of the omentum, and lymph node dissection. Epidural anesthesia with catheterization of the epidural space and administration of ropivacaine and morphine was used as an anesthetic aid. Results: Adequate pain relief, relaxation, the absence of clinically significant autonomic reactions in the intraoperative period, and adequate pain relief without narcotic analgesics in the postoperative period were achieved. The patient was activated on Day 3-5 after surgery. Subjectively, the patient emphasized the comfortable course of the perioperative period. Conclusion: Thus, our experience in the use of regional (epidural) anesthesia in oncosurgical practice as an isolated method of anesthesia, subject to technically competent and accurate execution of the procedure, allows us to recommend it as a reasonable alternative or component of generally accepted traditional general anesthesia in order to reduce the risk of anesthesia, adequate and effective anesthesia in the perioperative period and optimization of economic and logistical costs in the postoperative period.
{"title":"EXPERIENCE OF USING EPIDURAL ANESTHESIA IN ONCOSURGERY: \u0000A CLINICAL CASE","authors":"T. Sadykova, M. Kuzikeev, B. Sarsembaev, E. Orazbek","doi":"10.52532/2521-6414-2022-1-63-47-50","DOIUrl":"https://doi.org/10.52532/2521-6414-2022-1-63-47-50","url":null,"abstract":"Relevance: Surgical intervention is the most radical method in the complex specific therapy of malignant neoplasms. Oncosurgical operations \u0000are among the most traumatic; the volume of surgical intervention depends on the stage of the tumor process and its prevalence, the presence of \u0000metastases, germination in neighboring tissues and organs, and concomitant diseases. Particular importance is attached to the anesthetic management of the perioperative period. \u0000Regional anesthesia is practically not used for several reasons in oncosurgical reconstructive and plastic interventions on the abdominal organs. In choosing the method of anesthesia, the qualification of the anesthetist plays a role, especially when performing high epidural anesthesia, \u0000which is quite technically complicated. The emergence of highly effective anesthetics and high-quality sets for epidural anesthesia has significantly \u0000expanded the scope of this type of anesthesia in oncosurgical practice. \u0000This study aimed to demonstrate the possibilities and advantages of epidural anesthesia in the perioperative period using the described clinical case as an example. \u0000Methods: Patient N. was admitted to the clinic for surgical treatment for a malignant neoplasm of the transverse colon without clinical signs \u0000of obstruction of the lumen of the large intestine. She underwent laparotomy, subtotal colectomy with anastomosis, resection of the omentum, and \u0000lymph node dissection. Epidural anesthesia with catheterization of the epidural space and administration of ropivacaine and morphine was used \u0000as an anesthetic aid. \u0000Results: Adequate pain relief, relaxation, the absence of clinically significant autonomic reactions in the intraoperative period, and adequate \u0000pain relief without narcotic analgesics in the postoperative period were achieved. The patient was activated on Day 3-5 after surgery. Subjectively, \u0000the patient emphasized the comfortable course of the perioperative period. \u0000Conclusion: Thus, our experience in the use of regional (epidural) anesthesia in oncosurgical practice as an isolated method of anesthesia, \u0000subject to technically competent and accurate execution of the procedure, allows us to recommend it as a reasonable alternative or component of \u0000generally accepted traditional general anesthesia in order to reduce the risk of anesthesia, adequate and effective anesthesia in the perioperative \u0000period and optimization of economic and logistical costs in the postoperative period.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82927406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.52532/2521-6414-2022-1-63-11-16
O. Shatkovskaya
Relevance: Drug supply is a prerequisite for drug treatment of malignant neoplasms. Drug therapy is an essential component of cancer treatment. The potential of drug therapy is not the same in different human tumors. Providing an oncological patient with a full range of modern medicines is one of the main tasks of the healthcare system. Currently, the problem of the availability of drug provision for cancer patients is relevant. Today, there is a regional disparity in the provision of drug care in the country: the availability of drugs for patients is highly dependent on the economic development of the region of their residence. Drugs, especially targeted and immuno-oncological drugs, are more available in the cities of republican significance and the capital city. The study aimed to analyze the problems and find ways to improve drug provision for cancer patients in the Republic of Kazakhstan. Methods included the analysis of the current drug provision for cancer patients in the Republic of Kazakhstan, identifying problematic issues, finding solutions, and developing correct unified approaches to determining the needs of cancer patients for drugs at all stages of care. The study results highlight the current problems of drug supply for cancer patients and allow the development of ways to improve it, including in the context of combating the COVID-19 pandemic. Conclusion: Breakthrough technologies and new regimens of cancer treatment appear almost every month. Therefore, it is essential to make balanced and rational decisions in this area, rather than applying simplified administrative schemes for orders and purchases. Today, the oncologists of Kazakhstan can choose therapy for each cancer patient when they possess the results of relevant molecular genetic studies, know the characteristics of the tumor and the body, and have а conclusion of the multidisciplinary team. All the above gives hope for a transition to a more humane attitude towards patients when the drug choice depends on the chosen therapy’s clinical efficacy and purposefulness instead of the drug origin or price. The damage from ineffective drugs often exceeds by far the cost of effective drugs and technologies, while these effective drugs will not always be the most expensive. It is a great art to choose the drug that a particular oncological patient needs.
{"title":"PROBLEMS OF DRUG PROVISION FOR CANCER PATIENTS \u0000IN THE REPUBLIC OF KAZAKHSTAN","authors":"O. Shatkovskaya","doi":"10.52532/2521-6414-2022-1-63-11-16","DOIUrl":"https://doi.org/10.52532/2521-6414-2022-1-63-11-16","url":null,"abstract":"Relevance: Drug supply is a prerequisite for drug treatment of malignant neoplasms. Drug therapy is an essential component of cancer treatment. The potential of drug therapy is not the same in different human tumors. Providing an oncological patient with a full range of modern medicines is one of the main tasks of the healthcare system. Currently, the problem of the availability of drug provision for cancer patients is relevant. \u0000Today, there is a regional disparity in the provision of drug care in the country: the availability of drugs for patients is highly dependent on the \u0000economic development of the region of their residence. Drugs, especially targeted and immuno-oncological drugs, are more available in the cities \u0000of republican significance and the capital city. \u0000The study aimed to analyze the problems and find ways to improve drug provision for cancer patients in the Republic of Kazakhstan. \u0000Methods included the analysis of the current drug provision for cancer patients in the Republic of Kazakhstan, identifying problematic issues, \u0000finding solutions, and developing correct unified approaches to determining the needs of cancer patients for drugs at all stages of care. \u0000The study results highlight the current problems of drug supply for cancer patients and allow the development of ways to improve it, including \u0000in the context of combating the COVID-19 pandemic. \u0000Conclusion: Breakthrough technologies and new regimens of cancer treatment appear almost every month. Therefore, it is essential to make \u0000balanced and rational decisions in this area, rather than applying simplified administrative schemes for orders and purchases. Today, the oncologists of Kazakhstan can choose therapy for each cancer patient when they possess the results of relevant molecular genetic studies, know the \u0000characteristics of the tumor and the body, and have а conclusion of the multidisciplinary team. All the above gives hope for a transition to a more \u0000humane attitude towards patients when the drug choice depends on the chosen therapy’s clinical efficacy and purposefulness instead of the drug \u0000origin or price. The damage from ineffective drugs often exceeds by far the cost of effective drugs and technologies, while these effective drugs will \u0000not always be the most expensive. It is a great art to choose the drug that a particular oncological patient needs.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91157936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.52532/2663-4864-2022-1-63-4-10
J. Alimov, N. Karimova
Relevance: According to GLOBOCAN 2020, the number of newly reported head and neck tumors worldwide, without division by sex and age, was 369,980 cases, with the number of deaths – of 367,285 people. The incidence of malignant neoplasms (MN) of the head and neck is growing steadily in the Republic of Uzbekistan and worldwide. In the Republic of Uzbekistan, the head and neck MN prevalence increased in realistic figures from 2,906 cases in 2016 to 2,951 points in 2020, with a growth of 45 cases compared to 2016. The study aimed to assess the epidemiological trends of head and neck tumors globally and in the Republic of Uzbekistan from 2015 to 2020. Materials and Methods: The global situation with head and neck tumors was analyzed based on GLOBOCAN data. The object of the study was statistical data on all cases of head and neck malignancies in the Republic of Uzbekistan according to the reported data provided by oncological institutions, according to the adopted state form of accounting and reporting documentation Ministry of Health of the Republic of Uzbekistan No. 7ССВ "Information on diseases of malignant neoplasms." In the Republic of Uzbekistan, an assessment of the incidence, prevalence, and mortality from MN of the head and neck was carried out with the definition of trends and the average annual average age of patients with head and neck tumors. Results: World trends in morbidity and mortality from head and neck malignancies show differences depending on the territories and the level of economic development. In 2020, 13,552 deaths from head and neck malignancies were recorded in Uzbekistan (including 6323 and 7229 male and female patients, respectively). The mortality rate from head and neck malignancies per 100,000 population of the Republic of Uzbekistan was 40.0‱₀, being 0.35% higher than in 2019 and 28.7% higher than in 2009. Conclusion: Analysis of the epidemiological situation regarding head and neck malignancies in the Republic of Uzbekistan showed an increase in this disease. This determines the need for further research on the diagnostics of head and neck malignancies
{"title":"DYNAMICS OF MORBIDITY AND MORTALITY IN MALIGNANT NEOPLASMS OF THE HEAD AND NECK IN THE WORLD AND THE REPUBLIC OF UZBEKISTAN","authors":"J. Alimov, N. Karimova","doi":"10.52532/2663-4864-2022-1-63-4-10","DOIUrl":"https://doi.org/10.52532/2663-4864-2022-1-63-4-10","url":null,"abstract":"Relevance: According to GLOBOCAN 2020, the number of newly reported head and neck tumors worldwide, without division by sex and age, was 369,980 cases, with the number of deaths – of 367,285 people. The incidence of malignant neoplasms (MN) of the head and neck is growing steadily in the Republic of Uzbekistan and worldwide. In the Republic of Uzbekistan, the head and neck MN prevalence increased in realistic figures from 2,906 cases in 2016 to 2,951 points in 2020, with a growth of 45 cases compared to 2016. \u0000The study aimed to assess the epidemiological trends of head and neck tumors globally and in the Republic of Uzbekistan from 2015 \u0000to 2020. \u0000Materials and Methods: The global situation with head and neck tumors was analyzed based on GLOBOCAN data. The object of the \u0000study was statistical data on all cases of head and neck malignancies in the Republic of Uzbekistan according to the reported data provided by oncological institutions, according to the adopted state form of accounting and reporting documentation Ministry of Health of the \u0000Republic of Uzbekistan No. 7ССВ \"Information on diseases of malignant neoplasms.\" In the Republic of Uzbekistan, an assessment of the incidence, prevalence, and mortality from MN of the head and neck was carried out with the definition of trends and the average annual average age of patients with head and neck tumors. \u0000Results: World trends in morbidity and mortality from head and neck malignancies show differences depending on the territories and the level of economic development. In 2020, 13,552 deaths from head and neck malignancies were recorded in Uzbekistan (including 6323 \u0000and 7229 male and female patients, respectively). The mortality rate from head and neck malignancies per 100,000 population of the Republic of Uzbekistan was 40.0‱₀, being 0.35% higher than in 2019 and 28.7% higher than in 2009. \u0000Conclusion: Analysis of the epidemiological situation regarding head and neck malignancies in the Republic of Uzbekistan showed an increase in this disease. This determines the need for further research on the diagnostics of head and neck malignancies","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87142632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.52532/2663-4864-2022-1-63-36-40
Y. Filippenko, Z. Amankulov, Zhamilya Zholdybay, Zh. Zhakenova, A. Panina, S. Kasenova
Relevance: Chronic obstructive pulmonary disease (COPD) associated with lung can-cer is common in smoking patients. Computed tomography (CT) is vital in detecting lung cancer, assessing regional lung parenchymal destruction, and airway remodeling in COPD. The study aimed to determine the CT features of COPD associated with lung cancer. Methods: This retrospective study included chest CT exams of 56 patients over the age of 40 with a smoking history of 10 years and more and with suspected COPD. 46.43% of patients had CT signs of lung cancer associated with COPD. Results: Barrel-shaped chest (19.23%), saber-sheath trachea(7.69%), and bronchiecta-sis (15.38%) were less common in patients with lung cancer. 96.15% were diagnosed with paraseptal and centrilobular emphysema, bullae – 73.33%. Bronchial narrowing of the lumen and wall thickening were identified for all lobar bronchus, segmen-tal bronchus, and subsegmental bronchus. Conclusion: Paraseptal and centrilobular emphysema and bullae in the upper lobes of the lungs were predominant CT features in patients with COPD associated with lung cancer. Lumen narrowing and wall thickening of lobar bronchus, segmental bronchus, and subsegmental bronchus were also revealed.
{"title":"COMPUTED TOMOGRAPHY FEATURES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE ASSOCIATED WITH LUNG CANCER","authors":"Y. Filippenko, Z. Amankulov, Zhamilya Zholdybay, Zh. Zhakenova, A. Panina, S. Kasenova","doi":"10.52532/2663-4864-2022-1-63-36-40","DOIUrl":"https://doi.org/10.52532/2663-4864-2022-1-63-36-40","url":null,"abstract":"Relevance: Chronic obstructive pulmonary disease (COPD) associated with lung can-cer is common in smoking patients. Computed \u0000tomography (CT) is vital in detecting lung cancer, assessing regional lung parenchymal destruction, and airway remodeling in COPD. \u0000The study aimed to determine the CT features of COPD associated with lung cancer. \u0000Methods: This retrospective study included chest CT exams of 56 patients over the age of 40 with a smoking history of 10 years and \u0000more and with suspected COPD. 46.43% of patients had CT signs of lung cancer associated with COPD. \u0000Results: Barrel-shaped chest (19.23%), saber-sheath trachea(7.69%), and bronchiecta-sis (15.38%) were less common in patients with \u0000lung cancer. 96.15% were diagnosed with paraseptal and centrilobular emphysema, bullae – 73.33%. Bronchial narrowing of the lumen \u0000and wall thickening were identified for all lobar bronchus, segmen-tal bronchus, and subsegmental bronchus. \u0000Conclusion: Paraseptal and centrilobular emphysema and bullae in the upper lobes of the lungs were predominant CT features in \u0000patients with COPD associated with lung cancer. Lumen narrowing and wall thickening of lobar bronchus, segmental bronchus, and subsegmental bronchus were also revealed.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86596687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.52532/2663-4864-2022-1-63-70-80
A. Murina, A. Uaisova, A. Ergalieva
Relevance: Cancer is the second leading cause of death globally and is expected to be responsible for approximately 19.3 million new cases and 10 million deaths in 2022. With an unprecedented understanding of the molecular pathways that drive the development and progression of human cancers, novel targeted therapies have become an exciting new development for anticancer medicine. These targeted therapies, also known as biologic therapies, have become a primary treatment modality by blocking the growth of cancer cells by specifically targeting molecules required for cell growth and tumorigenesis. However, due to their specificity, these new therapies are expected to have better efficacy and limited adverse side effects than other treatment options, including hormonal and chemotherapy. The study aimed to present an overview of the advantages and prospects of targeted therapy in oncological practice. Methods: The search was carried out in the following databases: Scopus, Medline, Cochrane, PubMed, and Science Direct for 2016- 2021. Sources were searched for the following keywords: clinical trials, immunotherapy, monoclonal antibodies, small molecular weight inhibitors, and targeted therapy. Results: This review explores the clinical development, successes, and challenges facing targeted anticancer therapies, including small molecule inhibitors and antibody-targeted therapies. The authors describe targeted therapies to epidermal growth factor receptor, vascular endothelial growth factor, human epidermal growth factor receptor 2, anaplastic lymphoma kinase, BRAF, T-cell mediated immune response inhibitors, cytotoxic T-lymphocyte-associated protein 4, and programmed cell death protein-1/PD-1 ligand. Conclusion: Over the past decade, there have been significant changes in cancer treatment, including targeted therapy, which has become more common. However, targeted drugs show low activity in monotherapy. In addition, the selection of patients for targeted therapy remains a difficult task since there are not enough reliable biomarkers to predict the action of most targeted agents. Therefore, it requires a deeper study of molecular biology, namely signaling pathways that determine the pathogenesis of cancers.
{"title":"ADVANTAGES AND PROSPECTS OF TARGETED THERAPY IN ONCOLOGICAL PRACTICE: A LITERATURE REVIEW","authors":"A. Murina, A. Uaisova, A. Ergalieva","doi":"10.52532/2663-4864-2022-1-63-70-80","DOIUrl":"https://doi.org/10.52532/2663-4864-2022-1-63-70-80","url":null,"abstract":"Relevance: Cancer is the second leading cause of death globally and is expected to be responsible for approximately 19.3 million \u0000new cases and 10 million deaths in 2022. With an unprecedented understanding of the molecular pathways that drive the development \u0000and progression of human cancers, novel targeted therapies have become an exciting new development for anticancer medicine. These \u0000targeted therapies, also known as biologic therapies, have become a primary treatment modality by blocking the growth of cancer cells \u0000by specifically targeting molecules required for cell growth and tumorigenesis. However, due to their specificity, these new therapies are \u0000expected to have better efficacy and limited adverse side effects than other treatment options, including hormonal and chemotherapy. \u0000The study aimed to present an overview of the advantages and prospects of targeted therapy in oncological practice. \u0000Methods: The search was carried out in the following databases: Scopus, Medline, Cochrane, PubMed, and Science Direct for 2016- \u00002021. Sources were searched for the following keywords: clinical trials, immunotherapy, monoclonal antibodies, small molecular weight \u0000inhibitors, and targeted therapy. \u0000Results: This review explores the clinical development, successes, and challenges facing targeted anticancer therapies, including small \u0000molecule inhibitors and antibody-targeted therapies. The authors describe targeted therapies to epidermal growth factor receptor, vascular \u0000endothelial growth factor, human epidermal growth factor receptor 2, anaplastic lymphoma kinase, BRAF, T-cell mediated immune response \u0000inhibitors, cytotoxic T-lymphocyte-associated protein 4, and programmed cell death protein-1/PD-1 ligand. \u0000Conclusion: Over the past decade, there have been significant changes in cancer treatment, including targeted therapy, which has \u0000become more common. However, targeted drugs show low activity in monotherapy. In addition, the selection of patients for targeted \u0000therapy remains a difficult task since there are not enough reliable biomarkers to predict the action of most targeted agents. Therefore, it \u0000requires a deeper study of molecular biology, namely signaling pathways that determine the pathogenesis of cancers.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76522172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.52532/2663-4864-2022-1-63-64-69
N. Chichua, A. Bainazarova, M. Dmitrenko, K. Smagulova, R. Abdrakhmanov, A. Kemelzhanov
Relevance: Cancer during pregnancy is uncommon and found in 1/1000 pregnant women. An increasing number of women worldwide plan childbearing at 30 years when the risk of malignant diseases increases. During pregnancy, cancers inherent with the reproductive period in women are more likely. These cancers include breast cancer and cervix cancer. This article reviews the principles of treating pregnant women with these cancers. The study aimed to systematize relevant literature reviews for the past decade to efficiently choose diagnostic and treatment tactics for pregnant women with breast cancer and cervix cancer without harming the fetus and gravid. Methods: We analyzed the literature sources from different authors on the frequency of cancer of such localizations as breast cancer and cervical cancer associated with pregnancy in patients of reproductive age. When selecting literary sources, attention was paid to the history of the disease, complaints, features of diagnostic methods, and the choice of optimal treatment methods. The analysis was based on comparative data from the studied literary sources for the past ten years. Results: The value and the adequacy of different diagnostic methods of research that have no threat to gravid and fetus and are recommended for pregnant patients were established. Considering a patient’s condition, gestation, and stage of the disease, the best treatment options for those cancer types were identified. Possibilities were studied on preserving patients’ fertility after treatment of these cancers. Conclusion: Malignant tumors of the reproductive system alternating with pregnancy are statistically rare. However, medical oncologists have to solve the problem of the diagnosis and treatment of pregnant patients. The choice of the diagnostic methods and the type of treatment must be individual. Having appropriate examinations and the staging done, Multidisciplinary Tumor Board approves the patient management plan. Practitioners face the problematic issue of choosing optimal diagnostic and treatment measures, and this situation requires further investigations and methodological developments in pregnancy management complicated with oncological diseases
{"title":"PRINCIPLES OF TREATMENT OF PREGNANCY-ASSOCIATED MALIGNANT DISEASES: A LITERATURE REVIEW","authors":"N. Chichua, A. Bainazarova, M. Dmitrenko, K. Smagulova, R. Abdrakhmanov, A. Kemelzhanov","doi":"10.52532/2663-4864-2022-1-63-64-69","DOIUrl":"https://doi.org/10.52532/2663-4864-2022-1-63-64-69","url":null,"abstract":"Relevance: Cancer during pregnancy is uncommon and found in 1/1000 pregnant women. An increasing number of women worldwide \u0000plan childbearing at 30 years when the risk of malignant diseases increases. During pregnancy, cancers inherent with the reproductive \u0000period in women are more likely. These cancers include breast cancer and cervix cancer. This article reviews the principles of treating \u0000pregnant women with these cancers. \u0000The study aimed to systematize relevant literature reviews for the past decade to efficiently choose diagnostic and treatment tactics for \u0000pregnant women with breast cancer and cervix cancer without harming the fetus and gravid. \u0000Methods: We analyzed the literature sources from different authors on the frequency of cancer of such localizations as breast cancer \u0000and cervical cancer associated with pregnancy in patients of reproductive age. When selecting literary sources, attention was paid to the \u0000history of the disease, complaints, features of diagnostic methods, and the choice of optimal treatment methods. The analysis was based on \u0000comparative data from the studied literary sources for the past ten years. \u0000Results: The value and the adequacy of different diagnostic methods of research that have no threat to gravid and fetus and are recommended for pregnant patients were established. Considering a patient’s condition, gestation, and stage of the disease, the best treatment \u0000options for those cancer types were identified. Possibilities were studied on preserving patients’ fertility after treatment of these cancers. \u0000Conclusion: Malignant tumors of the reproductive system alternating with pregnancy are statistically rare. However, medical oncologists have to solve the problem of the diagnosis and treatment of pregnant patients. The choice of the diagnostic methods and the type of \u0000treatment must be individual. Having appropriate examinations and the staging done, Multidisciplinary Tumor Board approves the patient \u0000management plan. Practitioners face the problematic issue of choosing optimal diagnostic and treatment measures, and this situation requires further investigations and methodological developments in pregnancy management complicated with oncological diseases","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86810099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.52532/2663-4864-2022-1-63-47-50
T. Sadykova, M. Kuzikeev, B. Sarsembaev, E. Orazbek
Relevance: Surgical intervention is the most revolutionary method in the complex specific therapy of malignant neoplasms. Oncosurgical operations are among the most traumatic; the volume of surgical intervention depends on the stage of the tumor process and its prevalence, the presence of metastases, germination in neighboring tissues and organs, and concomitant diseases. Particular importance is attached to the anesthetic management of the perioperative period. Regional anesthesia is practically not used for several reasons in oncosurgical reconstructive and plastic interventions on the abdominal organs. First, the anesthetist’s qualification plays a role in choosing the anesthesia method, especially when performing high epidural anesthesia, which is technically challenging. The emergence of highly effective anesthetics and high-quality sets for epidural anesthesia has significantly expanded the scope of this type of anesthesia in oncosurgery. This study aimed to demonstrate the possibilities and advantages of epidural anesthesia in the perioperative period using the described clinical case as an example. Methods: Patient N. was admitted to the clinic for surgical treatment for a malignant neoplasm of the transverse colon without clinical signs of obstruction of the lumen of the large intestine. She underwent laparotomy, subtotal colectomy with anastomosis, resection of the omentum, and lymph node dissection. Epidural anesthesia with catheterization of the epidural space and administration of ropivacaine and morphine was used as an anesthetic aid. Results: Adequate pain relief, relaxation, the absence of clinically significant autonomic reactions in the intraoperative period, and adequate pain relief without narcotic analgesics in the postoperative period were achieved. The patient was activated on days 3-5 after surgery. Subjectively, the patient emphasized the comfortable course of the perioperative period. Conclusion: Thus, our experience of using regional (epidural) anesthesia in oncosurgery as an isolated method of anesthesia, subject to technically competent and accurate execution of the procedure, allows us to recommend it as a reasonable alternative or a component of generally accepted traditional general anesthesia to reduce the risk of anesthesia, adequate and effective anesthesia in the perioperative period and optimization of economic and logistical costs in the postoperative period.
{"title":"EXPERIENCE OF USING EPIDURAL ANESTHESIA IN ONCOSURGERY: A CLINICAL CASE","authors":"T. Sadykova, M. Kuzikeev, B. Sarsembaev, E. Orazbek","doi":"10.52532/2663-4864-2022-1-63-47-50","DOIUrl":"https://doi.org/10.52532/2663-4864-2022-1-63-47-50","url":null,"abstract":"Relevance: Surgical intervention is the most revolutionary method in the complex specific therapy of malignant neoplasms. Oncosurgical operations are among the most traumatic; the volume of surgical intervention depends on the stage of the tumor process and its \u0000prevalence, the presence of metastases, germination in neighboring tissues and organs, and concomitant diseases. Particular importance \u0000is attached to the anesthetic management of the perioperative period. \u0000Regional anesthesia is practically not used for several reasons in oncosurgical reconstructive and plastic interventions on the abdominal organs. First, the anesthetist’s qualification plays a role in choosing the anesthesia method, especially when performing high epidural \u0000anesthesia, which is technically challenging. The emergence of highly effective anesthetics and high-quality sets for epidural anesthesia \u0000has significantly expanded the scope of this type of anesthesia in oncosurgery. \u0000This study aimed to demonstrate the possibilities and advantages of epidural anesthesia in the perioperative period using the described \u0000clinical case as an example. \u0000Methods: Patient N. was admitted to the clinic for surgical treatment for a malignant neoplasm of the transverse colon without clinical \u0000signs of obstruction of the lumen of the large intestine. She underwent laparotomy, subtotal colectomy with anastomosis, resection of the \u0000omentum, and lymph node dissection. Epidural anesthesia with catheterization of the epidural space and administration of ropivacaine and \u0000morphine was used as an anesthetic aid. \u0000Results: Adequate pain relief, relaxation, the absence of clinically significant autonomic reactions in the intraoperative period, and \u0000adequate pain relief without narcotic analgesics in the postoperative period were achieved. The patient was activated on days 3-5 after \u0000surgery. Subjectively, the patient emphasized the comfortable course of the perioperative period. \u0000Conclusion: Thus, our experience of using regional (epidural) anesthesia in oncosurgery as an isolated method of anesthesia, subject \u0000to technically competent and accurate execution of the procedure, allows us to recommend it as a reasonable alternative or a component \u0000of generally accepted traditional general anesthesia to reduce the risk of anesthesia, adequate and effective anesthesia in the perioperative \u0000period and optimization of economic and logistical costs in the postoperative period.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86928263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.52532/2521-6414-2022-1-63-17-24
D. Tuleuova, G. Serikbayev, А. Kurmanalyev, Z. Pyssanova, А. Yelekbayev
Relevance: Sarcomas are a heterogeneous group of malignant neoplasms (MNs) of mesenchymal origin. The peak incidence of bone tumors falls on a socially significant age: with osteosarcoma and Ewing’s sarcoma – 10-25 years, with chondrosarcoma – 35-40 years. Bone sarcomas are the most aggressive human MNs. This urges to determine the prognostic factors of the disease, timely assess the treatment effect, and identify possible relapses. The study aimed to improve the early diagnosis of bone sarcomas, to improve and increase the oncological alertness of doctors by establishing the trends in bone sarcoma incidence and mortality in the Republic of Kazakhstan in 2010-2019, and this disease incidence and mortality in 2019 by age, gender, bone tumor histotype and region of the country. Methods: The study included the data of patients registered at the RK National Cancer Registry in 2010-2019 with a “bone sarcoma” diagnosis (ICD-10 code: C40-C41). The incidence of bone sarcomas was presented as absolute and crude rates per 100,000 population. Absolute standardized morbidity and mortality were calculated using the World Standard. MS Excel 2016 was used to display the results graphically. Results: By the end of 2019, 1587 patients were registered with bone sarcomas in the RK. From 2010 to 2019, the incidence of bone sarcoma in the RK decreased by 39%, including 36% among men and 40% among women. Mortality decreased by 37% to 0.8% per 100,000 population. Bone sarcoma is not among the 20 most common types of cancer in the RK; it accounts for 0.7% of all new cases of MN (2010-2019). The peak incidence of bone sarcoma was observed at the age below 20 years (20%), and mortality – in the age group of 45-54 years (22%). Conclusion: The rare occurrence of bone MNs can cause misdiagnosis during the initial examination. Bone sarcomas account for 0.8% of all MNs diagnosed in the RK; however, the aggressiveness of the course and rapid hematogenous metastasis causes a high percentage of neglect of this disease during the initial visit. In addition, bone sarcomas are more common than other MNs in young adults and adolescents. The prognosis of primary bone sarcomas depends on many factors.
{"title":"CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF BONE SARCOMAS \u0000IN THE REPUBLIC OF KAZAKHSTAN IN 2010-2019","authors":"D. Tuleuova, G. Serikbayev, А. Kurmanalyev, Z. Pyssanova, А. Yelekbayev","doi":"10.52532/2521-6414-2022-1-63-17-24","DOIUrl":"https://doi.org/10.52532/2521-6414-2022-1-63-17-24","url":null,"abstract":"Relevance: Sarcomas are a heterogeneous group of malignant neoplasms (MNs) of mesenchymal origin. The peak incidence of bone tumors \u0000falls on a socially significant age: with osteosarcoma and Ewing’s sarcoma – 10-25 years, with chondrosarcoma – 35-40 years. Bone sarcomas \u0000are the most aggressive human MNs. This urges to determine the prognostic factors of the disease, timely assess the treatment effect, and identify \u0000possible relapses. \u0000The study aimed to improve the early diagnosis of bone sarcomas, to improve and increase the oncological alertness of doctors by establishing \u0000the trends in bone sarcoma incidence and mortality in the Republic of Kazakhstan in 2010-2019, and this disease incidence and mortality in 2019 \u0000by age, gender, bone tumor histotype and region of the country. \u0000Methods: The study included the data of patients registered at the RK National Cancer Registry in 2010-2019 with a “bone sarcoma” diagnosis (ICD-10 code: C40-C41). The incidence of bone sarcomas was presented as absolute and crude rates per 100,000 population. Absolute \u0000standardized morbidity and mortality were calculated using the World Standard. MS Excel 2016 was used to display the results graphically. \u0000Results: By the end of 2019, 1587 patients were registered with bone sarcomas in the RK. From 2010 to 2019, the incidence of bone sarcoma in \u0000the RK decreased by 39%, including 36% among men and 40% among women. Mortality decreased by 37% to 0.8% per 100,000 population. Bone \u0000sarcoma is not among the 20 most common types of cancer in the RK; it accounts for 0.7% of all new cases of MN (2010-2019). The peak incidence \u0000of bone sarcoma was observed at the age below 20 years (20%), and mortality – in the age group of 45-54 years (22%). \u0000Conclusion: The rare occurrence of bone MNs can cause misdiagnosis during the initial examination. Bone sarcomas account for 0.8% of all \u0000MNs diagnosed in the RK; however, the aggressiveness of the course and rapid hematogenous metastasis causes a high percentage of neglect of \u0000this disease during the initial visit. In addition, bone sarcomas are more common than other MNs in young adults and adolescents. The prognosis \u0000of primary bone sarcomas depends on many factors.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80522970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.52532/2521-6414-2022-1-63-64-69
N. Chichua, A. Bainazarova, M. Dmitrenko, K. Smagulova, R. Abdrahmanov, A. Kemelzhanov
Relevance: Cancer during pregnancy is uncommon and found in 1/1000 pregnant women. An increasing number of women worldwide plan childbearing at 30 years when the risk of malignant diseases increases. During pregnancy, cancers inherent with the reproductive period in women are more likely. These cancers include breast cancer and cervix cancer. This article reviews the principles of treating pregnant women with these cancers. ОБЗОР ЛИТЕРАТУРЫ Онкология и радиология Казахстана, №1 (63) 2022 69 The study aimed to systematize relevant literature reviews for the past decade to efficiently choose diagnostic and treatment tactics for pregnant women with breast cancer and cervix cancer without harming the fetus and gravid. Results: The value and the adequacy of different diagnostic methods of research that have no threat to gravid and fetus and are recommended for pregnant patients were established. Considering a patient’s condition, gestation, and stage of the disease, the best treatment options for those cancer types were identified. Possibilities were studied on preserving patients’ fertility after treatment of these cancers. Conclusion: Malignant tumors of the reproductive system alternating with pregnancy are statistically rare. However, medical oncologists have to solve the problem of the diagnosis and treatment of pregnant patients. The choice of the diagnostic methods and the type of treatment must be individual. Having appropriate examinations and the staging done, Multidisciplinary Tumor Board approves the patient management plan. Practitioners face the problematic issue of choosing optimal diagnostic and treatment measures, and this situation requires further investigations and methodological developments in pregnancy management complicated with oncological disease.
相关性:怀孕期间的癌症并不常见，约为1/1000的孕妇。全世界越来越多的妇女计划在患恶性疾病的风险增加的30岁生育。在怀孕期间，女性更容易患上生殖期固有的癌症。这些癌症包括乳腺癌和宫颈癌。本文综述了治疗这些癌症的孕妇的原则。ОБЗОР ЛИТЕРАТУРЫ Онкология радиология Казахстана，№1(63)2022 69本研究旨在系统梳理近十年来的相关文献综述，以便在不伤害胎儿和妊娠的情况下，有效地选择乳腺癌和宫颈癌孕妇的诊断和治疗策略。结果:确立了对妊娠和胎儿无威胁并推荐给妊娠患者的不同诊断方法的研究价值和充分性。考虑到患者的病情、妊娠和疾病的阶段，确定了这些癌症类型的最佳治疗方案。研究了在治疗这些癌症后保留患者生育能力的可能性。结论:生殖系统恶性肿瘤与妊娠交替发生在统计学上是罕见的。然而，医学肿瘤学家必须解决怀孕患者的诊断和治疗问题。诊断方法和治疗方式的选择必须因人而异。在适当的检查和分期完成后，多学科肿瘤委员会批准患者管理计划。从业人员面临着选择最佳诊断和治疗措施的问题，这种情况需要进一步的调查和方法的发展，在妊娠管理合并肿瘤疾病。
{"title":"PRINCIPLES OF TREATMENT OF PREGNANCY-ASSOCIATED MALIGNANT DISEASES : \u0000A LITERATURE REVIEW","authors":"N. Chichua, A. Bainazarova, M. Dmitrenko, K. Smagulova, R. Abdrahmanov, A. Kemelzhanov","doi":"10.52532/2521-6414-2022-1-63-64-69","DOIUrl":"https://doi.org/10.52532/2521-6414-2022-1-63-64-69","url":null,"abstract":"Relevance: Cancer during pregnancy is uncommon and found in 1/1000 pregnant women. An increasing number of women worldwide plan childbearing at 30 years when the risk of malignant diseases increases. During pregnancy, cancers inherent with the reproductive period in women are \u0000more likely. These cancers include breast cancer and cervix cancer. This article reviews the principles of treating pregnant women with these cancers. \u0000ОБЗОР ЛИТЕРАТУРЫ \u0000Онкология и радиология Казахстана, №1 (63) 2022 69 \u0000The study aimed to systematize relevant literature reviews for the past decade to efficiently choose diagnostic and treatment tactics for pregnant women with breast cancer and cervix cancer without harming the fetus and gravid. \u0000Results: The value and the adequacy of different diagnostic methods of research that have no threat to gravid and fetus and are recommended \u0000for pregnant patients were established. Considering a patient’s condition, gestation, and stage of the disease, the best treatment options for those \u0000cancer types were identified. Possibilities were studied on preserving patients’ fertility after treatment of these cancers. \u0000Conclusion: Malignant tumors of the reproductive system alternating with pregnancy are statistically rare. However, medical oncologists have \u0000to solve the problem of the diagnosis and treatment of pregnant patients. The choice of the diagnostic methods and the type of treatment must be \u0000individual. Having appropriate examinations and the staging done, Multidisciplinary Tumor Board approves the patient management plan. Practitioners face the problematic issue of choosing optimal diagnostic and treatment measures, and this situation requires further investigations and \u0000methodological developments in pregnancy management complicated with oncological disease.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74367659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.52532/2521-6414-2022-1-63-56-63
A. Almabek, D. Kaidarova, V. Kim, I. Khussainova
Relevance: Breast cancer (BC) is one of the most common diseases among women in developed countries worldwide. BC ranks first in incidence and third in mortality among malignant neoplasms in women. Despite many advances in the treatment of BC, the prognosis for patients with metastatic BC remains poor. The life expectancy of these patients is usually about one year. The accuracy of diagnosis and determining the number and sizes of oligometastases by contrasted brain MRI or PET-CT with methionine is vital for effective cancer treatment. The emergence of treatment techniques, such as stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRSR), significantly improved the disease prognosis. The use of high-tech radiation therapy in patients with oligometastases from breast carcinoma improves local control of intracranial lesions, prevents death, maintains the quality of life, and improves overall survival. The study aimed to analyze the results of key prospective studies on aspects of radiation therapy for BC metastases to the brain. Methods: This review included key randomized trials on the use of radiation therapy for BC metastases in the brain. The search was conducted in the PubMed database for 2005-2020 by the keywords “radiation therapy,” “breast cancer,” and “brain metastases.” Results: Reduced treatment time due to stereotactic radiosurgery and radiotherapy allows for maintaining productive life without expressed neurological symptoms. SRS is efficient in patients with up to five oligometastases in BC. More metastases require total brain exposure, which is a poor prognostic factor. In prospective studies, SRS in BC with brain metastases is recommended to improve the quality of life. Conclusion: The treatment of BC with brain metastases requires a multidisciplinary approach based on the prevalence of the process, previous therapy, general somatic status, comorbidities, and available therapy options. Systemic therapy for BC patients with brain metastases follows several schemes that demonstrate their therapeutic effectiveness.
{"title":"ASPECTS OF RADIOTHERAPY OF BREAST CANCER METASTASES TO THE BRAIN: \u0000A LITERATURE REVIEW","authors":"A. Almabek, D. Kaidarova, V. Kim, I. Khussainova","doi":"10.52532/2521-6414-2022-1-63-56-63","DOIUrl":"https://doi.org/10.52532/2521-6414-2022-1-63-56-63","url":null,"abstract":"Relevance: Breast cancer (BC) is one of the most common diseases among women in developed countries worldwide. BC ranks first in incidence and third in mortality among malignant neoplasms in women. Despite many advances in the treatment of BC, the prognosis for patients with \u0000metastatic BC remains poor. The life expectancy of these patients is usually about one year. The accuracy of diagnosis and determining the number \u0000and sizes of oligometastases by contrasted brain MRI or PET-CT with methionine is vital for effective cancer treatment. The emergence of treatment \u0000techniques, such as stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRSR), significantly improved the disease prognosis. The use of \u0000high-tech radiation therapy in patients with oligometastases from breast carcinoma improves local control of intracranial lesions, prevents death, \u0000maintains the quality of life, and improves overall survival. \u0000The study aimed to analyze the results of key prospective studies on aspects of radiation therapy for BC metastases to the brain. \u0000Methods: This review included key randomized trials on the use of radiation therapy for BC metastases in the brain. The search was conducted \u0000in the PubMed database for 2005-2020 by the keywords “radiation therapy,” “breast cancer,” and “brain metastases.” \u0000Results: Reduced treatment time due to stereotactic radiosurgery and radiotherapy allows for maintaining productive life without expressed \u0000neurological symptoms. SRS is efficient in patients with up to five oligometastases in BC. More metastases require total brain exposure, which is a \u0000poor prognostic factor. In prospective studies, SRS in BC with brain metastases is recommended to improve the quality of life. \u0000Conclusion: The treatment of BC with brain metastases requires a multidisciplinary approach based on the prevalence of the process, previous \u0000therapy, general somatic status, comorbidities, and available therapy options. Systemic therapy for BC patients with brain metastases follows \u0000several schemes that demonstrate their therapeutic effectiveness.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87395029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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