Background. Currently, the use of the principles of evidence-based medicine is an integral part of assessing the effectiveness and safety of modern technology for the diagnosis and treatment of any disease or clinical condition. Differential diagnosis of pancreatic cancer and chronic pancreatitis is one of the most controversial issues in surgical pancreatology. The reduced number of cases of resectable pancreatic cancer indicates the need to develop programs for the differentiation of these pathologies with the wide implementation of modern diagnostic methods.
Purpose − to compare the results of diagnostic methods (which are standardly used in accordance with clinical guidelines for the diagnosis of chronic pancreatitis) based on evidence-based medicine and quantitative assessments of their specificity, sensitivity, and general accuracy in terms of the differential diagnosis of chronic pancreatitis and pancreatic cancer in order to determine the most significant results for the differentiation of these pathologies.
Materials and methods. The results of diagnostic methods were compared in 80 patients, among them 38 (47.5%) had pancreatic cancer, and 42 (52.5%) − chronic pancreatitis with predominant lesion of the pancreatic head. The patients underwent general clinical blood and urine tests, biochemical blood tests, and the following procedures and examinations available in the clinic: ultrasound examination of the abdominal organs, spiral computed tomography, fibrogastroduodenoscopy, endoscopic retrograde cholangiopancreatography, magnetic resonance imaging, CA 19-9 tumor marker test, ultrasound-guided percutaneous puncture of the pancreas, aspiration of pancreatic juice, urgent intraoperative biopsy, and histological examination of surgically resected areas of the pancreas. Based on the received data, we performed a comparison of their quality, accuracy, and informativeness.
Results. Ultrasound imaging is a screening method for suspected pancreatic cancer, however, the overall accuracy, sensitivity, and specificity of the method are quite low (82.5%, 76.32%, 88.10%, respectively). When analyzing the qualitative characteristics of endoscopic retrograde cholangiopancreatography, the overall accuracy, sensitivity, and specificity indicators for the differential diagnosis of pancreatic cancer were 71%, 78.6%, and 63.3%, respectively. The interval assessment of the accuracy of the method of transcutaneous biopsy of the pancreas aimed at determining chronic pancreatitis was (34.9; 96.8)%; for pancreatic cancer – (8.5; 75.5)%. The interval assessment of the accuracy of the method of endoscopic aspiration of pancreatic juice for chronic pancreatitis was (6.8; 93.2)%; for pancreatic cancer – (19.4; 99.4)%. An increase in the level of CA 19-9 was found in 40.5% of patients (CI95% from 27.0% to 55.5%), while the average level was significantly higher in pancreatic cancer. The level of the CA 19-9 tumor marker depended on the size of the
现代成像方法的进步不能取代组织学检查作为正确确定这些胰腺病变形态学基础的“金标准”。
{"title":"Determination of the diagnostic potential of research methods in the differentiation of pancreatic cancer and chronic pancreatitis based on evidence-based medicine","authors":"N.M. Нoncharova, I.A. Kryvoruchko, A.S. Нoncharov, М.М. Nessonova","doi":"10.46879/ukroj.3.2023.271-284","DOIUrl":"https://doi.org/10.46879/ukroj.3.2023.271-284","url":null,"abstract":"Background. Currently, the use of the principles of evidence-based medicine is an integral part of assessing the effectiveness and safety of modern technology for the diagnosis and treatment of any disease or clinical condition. Differential diagnosis of pancreatic cancer and chronic pancreatitis is one of the most controversial issues in surgical pancreatology. The reduced number of cases of resectable pancreatic cancer indicates the need to develop programs for the differentiation of these pathologies with the wide implementation of modern diagnostic methods.
 Purpose − to compare the results of diagnostic methods (which are standardly used in accordance with clinical guidelines for the diagnosis of chronic pancreatitis) based on evidence-based medicine and quantitative assessments of their specificity, sensitivity, and general accuracy in terms of the differential diagnosis of chronic pancreatitis and pancreatic cancer in order to determine the most significant results for the differentiation of these pathologies.
 Materials and methods. The results of diagnostic methods were compared in 80 patients, among them 38 (47.5%) had pancreatic cancer, and 42 (52.5%) − chronic pancreatitis with predominant lesion of the pancreatic head. The patients underwent general clinical blood and urine tests, biochemical blood tests, and the following procedures and examinations available in the clinic: ultrasound examination of the abdominal organs, spiral computed tomography, fibrogastroduodenoscopy, endoscopic retrograde cholangiopancreatography, magnetic resonance imaging, CA 19-9 tumor marker test, ultrasound-guided percutaneous puncture of the pancreas, aspiration of pancreatic juice, urgent intraoperative biopsy, and histological examination of surgically resected areas of the pancreas. Based on the received data, we performed a comparison of their quality, accuracy, and informativeness.
 Results. Ultrasound imaging is a screening method for suspected pancreatic cancer, however, the overall accuracy, sensitivity, and specificity of the method are quite low (82.5%, 76.32%, 88.10%, respectively). When analyzing the qualitative characteristics of endoscopic retrograde cholangiopancreatography, the overall accuracy, sensitivity, and specificity indicators for the differential diagnosis of pancreatic cancer were 71%, 78.6%, and 63.3%, respectively. The interval assessment of the accuracy of the method of transcutaneous biopsy of the pancreas aimed at determining chronic pancreatitis was (34.9; 96.8)%; for pancreatic cancer – (8.5; 75.5)%. The interval assessment of the accuracy of the method of endoscopic aspiration of pancreatic juice for chronic pancreatitis was (6.8; 93.2)%; for pancreatic cancer – (19.4; 99.4)%. An increase in the level of CA 19-9 was found in 40.5% of patients (CI95% from 27.0% to 55.5%), while the average level was significantly higher in pancreatic cancer. The level of the CA 19-9 tumor marker depended on the size of the ","PeriodicalId":36128,"journal":{"name":"Ukrainian Journal of Radiology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135083408","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}
Background. Glioblastoma (GB) is the most common primary brain tumor that is malignant, and its incidence increases with age. The prognosis for elderly patients with GB (GBe) is significantly worse than that of younger patients. Due to the global trend of aging population and age-related features of the GB cohort, the number of GBe patients is expected to increase. Although there is no full consensus regarding the clinical management of GBe, hypofractionated radiation therapy (RT) has become a common therapeutic option for elderly and/or poor prognosis GB patients.
Purpose. To analyze the survival of patients with glioblastoma in the age group ≥60 years old after standard and hypofractionated regimens of adjuvant radiation therapy.
Materials and methods. A retrospective single-center non-randomized study based on a total cohort of 53 patients (≥60 years old) with histogically verified diagnosis of GB was performed at the State Institution «Romodanov Neurosurgery Institute of the National Academy of Medical Sciences of Ukraine» over the period of 6 years, from 2014 to 2020. According to the RT regimen, patients were stratified into 2 groups: standard RT (SRT group) – 16 (30.2%) patients (30 fractions, 2.0 Gy per fraction, total radiation dose – 60.0 Gy) and hypofractionated RT (HRT group) – 37 (69.8%) patients (15 fractions, 3.5 Gy per fraction, total dose – 52.5 Gy). Cancer-specific survival (CSS) and progression-free survival (PFS) were analyzed in the total cohort and both groups separately.
Results. With a median follow-up of 21.9 months (95% CI (confidence interval) 20.7 – 32.3), the median CSS in the total cohort was 15.0 (95% CI 13.3 – 17.3) months; the median PFS – 9.0 (95% CI 8.0 – 10.6) months. In the HRT group, the median CSS was 14.7 (95% CI 10.5 – 18.5) months; in the SRT group – 15.0 (95% CI 12.4 – 19.3) months. In the HRT group, the median PFS was 9.0 (95% CI 7.0 – 11.9) months; in the SRT group – 9.0 (95% CI 8.0 – 11.0) months. Before and after the stratification point of 15 months, the HRT and SRT groups did not differ significantly in CSS (Log-rank test p = 0.0588 and p = 0.2009, respectively). There was no significant difference in PFS between the HRT and SRT groups before and after the stratification point of 9 months (Log-rank test p = 0.0653 and p = 0.0722, respectively). Conclusions. Improving survival of GBe pts is an urgent issue, especially taking into account global trends in population aging and age-specific features of GB. The proposed hypofractionated RT regime can be considered as an optional approach in the complex treatment of GBe pts.
{"title":"Survival of elderly patients with glioblastoma after hypofractionated radiation therapy","authors":"O.V. Zemskova, O.Ya. Glavatskyi, A.B. Gryazov, V.A. Stulei, V.P. Starenkyi, A.O. Zakrutko","doi":"10.46879/ukroj.3.2023.255-270","DOIUrl":"https://doi.org/10.46879/ukroj.3.2023.255-270","url":null,"abstract":"Background. Glioblastoma (GB) is the most common primary brain tumor that is malignant, and its incidence increases with age. The prognosis for elderly patients with GB (GBe) is significantly worse than that of younger patients. Due to the global trend of aging population and age-related features of the GB cohort, the number of GBe patients is expected to increase. Although there is no full consensus regarding the clinical management of GBe, hypofractionated radiation therapy (RT) has become a common therapeutic option for elderly and/or poor prognosis GB patients.
 Purpose. To analyze the survival of patients with glioblastoma in the age group ≥60 years old after standard and hypofractionated regimens of adjuvant radiation therapy.
 Materials and methods. A retrospective single-center non-randomized study based on a total cohort of 53 patients (≥60 years old) with histogically verified diagnosis of GB was performed at the State Institution «Romodanov Neurosurgery Institute of the National Academy of Medical Sciences of Ukraine» over the period of 6 years, from 2014 to 2020. According to the RT regimen, patients were stratified into 2 groups: standard RT (SRT group) – 16 (30.2%) patients (30 fractions, 2.0 Gy per fraction, total radiation dose – 60.0 Gy) and hypofractionated RT (HRT group) – 37 (69.8%) patients (15 fractions, 3.5 Gy per fraction, total dose – 52.5 Gy). Cancer-specific survival (CSS) and progression-free survival (PFS) were analyzed in the total cohort and both groups separately.
 Results. With a median follow-up of 21.9 months (95% CI (confidence interval) 20.7 – 32.3), the median CSS in the total cohort was 15.0 (95% CI 13.3 – 17.3) months; the median PFS – 9.0 (95% CI 8.0 – 10.6) months. In the HRT group, the median CSS was 14.7 (95% CI 10.5 – 18.5) months; in the SRT group – 15.0 (95% CI 12.4 – 19.3) months. In the HRT group, the median PFS was 9.0 (95% CI 7.0 – 11.9) months; in the SRT group – 9.0 (95% CI 8.0 – 11.0) months. Before and after the stratification point of 15 months, the HRT and SRT groups did not differ significantly in CSS (Log-rank test p = 0.0588 and p = 0.2009, respectively). There was no significant difference in PFS between the HRT and SRT groups before and after the stratification point of 9 months (Log-rank test p = 0.0653 and p = 0.0722, respectively). Conclusions. Improving survival of GBe pts is an urgent issue, especially taking into account global trends in population aging and age-specific features of GB. The proposed hypofractionated RT regime can be considered as an optional approach in the complex treatment of GBe pts.","PeriodicalId":36128,"journal":{"name":"Ukrainian Journal of Radiology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135083409","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}
Background. There has been a recent increase in the incidence of kidney cancer, which is explained not only by the improvement in the diagnosis of neoplasms but also by a true increase in the incidence of renal cell cancer. This led to the need for in-depth study and solution of the following problem: to prove the benefits of multi-target scintigraphy for the assessment of the functional capacity of kidneys in establishing the diagnosis of kidney cancer and early detection of secondary lesion of the skeleton during the primary full examination of the patient, as well as in monitoring of the disease.
Purpose. For the first time to prove diagnostic significance of a multi-target scintigraphic examination with a radiopharmaceutical drug with renal and osteotropic kinetics, in the form of a sequential combination of dynamic renal scintigraphy and osteoscintigraphy (as one diagnostic examination) in the early detection of secondary lesion of the bones of the skeleton and simultaneous determination of the functional capacity of kidneys in the pre-treatment period and in monitoring of the course of kidney cancer.
Materials and methods. Dynamic renal scintigraphy and subsequent (within the next 3 hours) osteoscintigraphy with 99mTc-methylenediphosphonic acid (99mТс-MDP) (activity of 370–740 MBq) were performed on the SPECT-1 gamma camera «AMCRIS-H Limited» (Ukrainian-American enterprise) with computer software «Spect Work» (Ukraine) at the premises of the Department of Radiology and Radiation Medicine of Bogomolets National Medical University in the Department of Radionuclide Diagnostics of communal non-commercial enterprise
«Kyiv City Clinical Hospital No.18». 20 patients with a morphologically established diagnosis of kidney cancer, aged from 38 to 68 years, were examined before the full diagnosis was established according to TNMx. As a control group, 8 patients with ultrasonography-confirmed cystic lesions of the kidneys were examined.
Results. Using a radiopharmaceutical drug with renal and osteotropic kinetics in the form of a simultaneous sequential combination of dynamic renal scintigraphy and osteoscintigraphy (as one diagnostic examination) allowed us to assess the degree of deterioration of the filtering and excretory capacity of the kidneys regardless of the origin of the expansive process. The results of dynamic renal scintigraphy with 99mТс-MDP made it possible to assess functional capacity of the kidneys no worse than specific renal imaging agents in subsequently given possibility to determine secondary lesion of the bones of the skeleton in osteoscintigraphy. We established indicators of development of renal compensation process and subsequent decompensation process of the contralateral kidney. It was especially noticeable when analyzing the asymmetry of the fixation of the radiopharmaceutical in the functioning kidney parenchyma, depending on the degree of the disease progression.
20 patients with kidney canc
{"title":"Advantages of multi-target scintigraphy in the diagnosis of kidney cancer","authors":"M.M. Tkachenko, Н.O. Romanenko, O.V. Mironova, A.G. Mazur, A.V. Makarenko, N.V. Goryainova","doi":"10.46879/ukroj.3.2023.285-302","DOIUrl":"https://doi.org/10.46879/ukroj.3.2023.285-302","url":null,"abstract":"Background. There has been a recent increase in the incidence of kidney cancer, which is explained not only by the improvement in the diagnosis of neoplasms but also by a true increase in the incidence of renal cell cancer. This led to the need for in-depth study and solution of the following problem: to prove the benefits of multi-target scintigraphy for the assessment of the functional capacity of kidneys in establishing the diagnosis of kidney cancer and early detection of secondary lesion of the skeleton during the primary full examination of the patient, as well as in monitoring of the disease.
 Purpose. For the first time to prove diagnostic significance of a multi-target scintigraphic examination with a radiopharmaceutical drug with renal and osteotropic kinetics, in the form of a sequential combination of dynamic renal scintigraphy and osteoscintigraphy (as one diagnostic examination) in the early detection of secondary lesion of the bones of the skeleton and simultaneous determination of the functional capacity of kidneys in the pre-treatment period and in monitoring of the course of kidney cancer.
 Materials and methods. Dynamic renal scintigraphy and subsequent (within the next 3 hours) osteoscintigraphy with 99mTc-methylenediphosphonic acid (99mТс-MDP) (activity of 370–740 MBq) were performed on the SPECT-1 gamma camera «AMCRIS-H Limited» (Ukrainian-American enterprise) with computer software «Spect Work» (Ukraine) at the premises of the Department of Radiology and Radiation Medicine of Bogomolets National Medical University in the Department of Radionuclide Diagnostics of communal non-commercial enterprise
 «Kyiv City Clinical Hospital No.18». 20 patients with a morphologically established diagnosis of kidney cancer, aged from 38 to 68 years, were examined before the full diagnosis was established according to TNMx. As a control group, 8 patients with ultrasonography-confirmed cystic lesions of the kidneys were examined.
 Results. Using a radiopharmaceutical drug with renal and osteotropic kinetics in the form of a simultaneous sequential combination of dynamic renal scintigraphy and osteoscintigraphy (as one diagnostic examination) allowed us to assess the degree of deterioration of the filtering and excretory capacity of the kidneys regardless of the origin of the expansive process. The results of dynamic renal scintigraphy with 99mТс-MDP made it possible to assess functional capacity of the kidneys no worse than specific renal imaging agents in subsequently given possibility to determine secondary lesion of the bones of the skeleton in osteoscintigraphy. We established indicators of development of renal compensation process and subsequent decompensation process of the contralateral kidney. It was especially noticeable when analyzing the asymmetry of the fixation of the radiopharmaceutical in the functioning kidney parenchyma, depending on the degree of the disease progression.
 20 patients with kidney canc","PeriodicalId":36128,"journal":{"name":"Ukrainian Journal of Radiology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135083411","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}
Background. The World Health Organization (WHO) has confirmed the outbreak of covid infection and defined it as a global pandemic. Recently, complications have been increasingly reported in patients who have had COVID-19. At the same time, clinical symptoms of the long-term course of this disease overlap, differing from acute manifestations of the infection, and may persist in recovered patients for several weeks, months or years, adding a number of other problems. Therefore, the importance of a thorough study of the post-COVID-19 syndrome as a modern phenomenon has increased. And this syndrome requires proper research to improve the efficiency of its prevention and treatment.
Purpose. To evaluate the current state of the problem of post-COVID-19 syndrome, in particular in cancer patients.
Materials and methods. A literature review was performed based on the array of digital publications found in the world databases PubMed, Scopus and Web of Science Core Collection for 2020–2023. The sources were systematized in separate groups, i.e., issues related to post-Covid, in particular, the mechanisms and pathogenesis of its development; treatment features, including cancer patients; long-term consequences in recovered patients, etc.
Results and discussion. The terminology on the subject of the study has been analyzed: post-COVID, post-COVID syndrome, PASC, long-COVID, acute COVID, chronic COVID, etc. The views regarding the pathogenesis of post-COVID syndrome and its main symptoms were systematized. It is determined that in the field of oncology, research is conducted in certain fields and the risk of progression and occurrence of cancer in the post-COVID period is evaluated; the efficiency of the process of cancer care organization in the post-COVID period and the level of complications and mortality of cancer patients who have suffered from COVID-19. The pandemic has also led to multiple changes in the field of radiological diagnosis of the consequences of cancer patients with COVID. Evaluating the impact of the pandemic on the outcomes and adaptation of radiotherapy and chemotherapy, it was determined that delays in the provision of timely care and changes in treatment regimens will affect long-term survival of cancer patients.
Conclusion. Assessing the current state of the problem of post-COVID syndrome, most researchers believe that cancer progression during delay in cancer care will negatively affect the long-term survival of cancer patients, and coincidence of cancer-related symptoms and symptoms of long-term COVID is another major challenge for oncologists in the future.
{"title":"Current issues of post-covid syndrome consequences","authors":"M.V. Krasnoselskyi, V.P. Starenkyi, N.O. Artamonova, H.V. Kulinich, E.B. Prokhorova, M.V. Havrylenko","doi":"10.46879/ukroj.3.2023.325-352","DOIUrl":"https://doi.org/10.46879/ukroj.3.2023.325-352","url":null,"abstract":"Background. The World Health Organization (WHO) has confirmed the outbreak of covid infection and defined it as a global pandemic. Recently, complications have been increasingly reported in patients who have had COVID-19. At the same time, clinical symptoms of the long-term course of this disease overlap, differing from acute manifestations of the infection, and may persist in recovered patients for several weeks, months or years, adding a number of other problems. Therefore, the importance of a thorough study of the post-COVID-19 syndrome as a modern phenomenon has increased. And this syndrome requires proper research to improve the efficiency of its prevention and treatment. 
 Purpose. To evaluate the current state of the problem of post-COVID-19 syndrome, in particular in cancer patients.
 Materials and methods. A literature review was performed based on the array of digital publications found in the world databases PubMed, Scopus and Web of Science Core Collection for 2020–2023. The sources were systematized in separate groups, i.e., issues related to post-Covid, in particular, the mechanisms and pathogenesis of its development; treatment features, including cancer patients; long-term consequences in recovered patients, etc.
 Results and discussion. The terminology on the subject of the study has been analyzed: post-COVID, post-COVID syndrome, PASC, long-COVID, acute COVID, chronic COVID, etc. The views regarding the pathogenesis of post-COVID syndrome and its main symptoms were systematized. It is determined that in the field of oncology, research is conducted in certain fields and the risk of progression and occurrence of cancer in the post-COVID period is evaluated; the efficiency of the process of cancer care organization in the post-COVID period and the level of complications and mortality of cancer patients who have suffered from COVID-19. The pandemic has also led to multiple changes in the field of radiological diagnosis of the consequences of cancer patients with COVID. Evaluating the impact of the pandemic on the outcomes and adaptation of radiotherapy and chemotherapy, it was determined that delays in the provision of timely care and changes in treatment regimens will affect long-term survival of cancer patients.
 Conclusion. Assessing the current state of the problem of post-COVID syndrome, most researchers believe that cancer progression during delay in cancer care will negatively affect the long-term survival of cancer patients, and coincidence of cancer-related symptoms and symptoms of long-term COVID is another major challenge for oncologists in the future.","PeriodicalId":36128,"journal":{"name":"Ukrainian Journal of Radiology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135083410","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}
Background. A malignant tumour of the Gartner’s duct is one of the rarely encountered tumours in gynaecological oncology. Only in rare cases does the epithelium of the Gartner’s duct become a source of vaginal and cervical adenocarcinoma, as the Gartner’s duct is present in 25% of women, and mesonephric cysts occur in 1% of cases.
Purpose. To familiarise the medical community with the peculiarities of the clinical course of malignant tumours of the Gartner’s duct and methods of their treatment.
Materials and methods. Patient L., born in 1974, who underwent special treatment at the State Organization «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine» with a diagnosis of grade II adenocarcinoma of the Gartner’s duct (T2NxM0), clinical group 3.
Results and discussion. After examination, the patient underwent two cycles of neoadjuvant polychemotherapy and a preoperative course of external beam radiation therapy (EBRT) on the vulvar area with a total radiation dose of 30 Gy. Two weeks later, surgery was performed to remove the tumour of the Gartner’s duct from the surrounding tissues. Three weeks after the surgery, the patient’s course of EBRT was extended to the total dose of 50 Gy, and 3 cycles of adjuvant polychemotherapy were performed. The follow-up period was 3 years, with no evidence of disease recurrence.
Conclusions. The dissemination of information about this rare but serious disease will allow doctors to be informed, as well as to predict and diagnose it in a timely manner. As a result, they can plan adequate special treatment and determine the prognosis of this disease.
{"title":"Adenocarcinoma of the Gartner’s duct. A case from practice","authors":"О.A. Mikhanovskij, О.М. Sukhina, Yu.V. Kharchenko, I.М. Krugova, N.М. Shchyt, O.Yu. Zhelezniakov","doi":"10.46879/ukroj.3.2023.353-359","DOIUrl":"https://doi.org/10.46879/ukroj.3.2023.353-359","url":null,"abstract":"Background. A malignant tumour of the Gartner’s duct is one of the rarely encountered tumours in gynaecological oncology. Only in rare cases does the epithelium of the Gartner’s duct become a source of vaginal and cervical adenocarcinoma, as the Gartner’s duct is present in 25% of women, and mesonephric cysts occur in 1% of cases.
 Purpose. To familiarise the medical community with the peculiarities of the clinical course of malignant tumours of the Gartner’s duct and methods of their treatment.
 Materials and methods. Patient L., born in 1974, who underwent special treatment at the State Organization «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine» with a diagnosis of grade II adenocarcinoma of the Gartner’s duct (T2NxM0), clinical group 3.
 Results and discussion. After examination, the patient underwent two cycles of neoadjuvant polychemotherapy and a preoperative course of external beam radiation therapy (EBRT) on the vulvar area with a total radiation dose of 30 Gy. Two weeks later, surgery was performed to remove the tumour of the Gartner’s duct from the surrounding tissues. Three weeks after the surgery, the patient’s course of EBRT was extended to the total dose of 50 Gy, and 3 cycles of adjuvant polychemotherapy were performed. The follow-up period was 3 years, with no evidence of disease recurrence.
 Conclusions. The dissemination of information about this rare but serious disease will allow doctors to be informed, as well as to predict and diagnose it in a timely manner. As a result, they can plan adequate special treatment and determine the prognosis of this disease.","PeriodicalId":36128,"journal":{"name":"Ukrainian Journal of Radiology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135082936","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 : 2023-09-30DOI: 10.46879/ukroj.3.2023.315-324
L.P. Buchatskyi
Background. In many countries, more than 40 oncolytic viruses from 10 different families are undergoing clinical trials (phase I, II, III) against various types of cancer; some of them have already been approved for use. The results of the experimental studies that deal with the development of oncolytic drugs based on autonomous parvoviruses deserve special attention.
Purpose. The purpose of the study was to analyze and summarize literature sources that are concerned with the development of oncolytic drugs based on autonomous parvoviruses.
Materials and Methods. Publications were selected using keywords in PubMed (https://pubmed.ncbi.nlm.nih.gov/) and Google Scholar (https://scholar.google.com/) databases published over the period from 2010 to 2023.
Results. Among autonomous parvoviruses, protoparvoviruses are the most promising for the development of anticancer drugs. They detect CPE mainly in tumor cells, CPE is absent or limited in non-transformed human and rodent cell lines. Many of them are capable of actively replicating in cancer cells without destroying normal body cells. They primarily block the pathways of activation of type I interferons. The main non-structural viral protein NS1 plays a significant role in the manifestations of oncolytic activity of protoparvoviruses.
Conclusions. Numerous studies continue to be directed at studying the mechanisms associated with the oncolytic properties of autonomous parvoviruses. The use of recombinant parvoviruses allows their oncolytic potential to be enhanced.
{"title":"Oncolytic potential of autonomous parvoviruses","authors":"L.P. Buchatskyi","doi":"10.46879/ukroj.3.2023.315-324","DOIUrl":"https://doi.org/10.46879/ukroj.3.2023.315-324","url":null,"abstract":"Background. In many countries, more than 40 oncolytic viruses from 10 different families are undergoing clinical trials (phase I, II, III) against various types of cancer; some of them have already been approved for use. The results of the experimental studies that deal with the development of oncolytic drugs based on autonomous parvoviruses deserve special attention.
 Purpose. The purpose of the study was to analyze and summarize literature sources that are concerned with the development of oncolytic drugs based on autonomous parvoviruses.
 Materials and Methods. Publications were selected using keywords in PubMed (https://pubmed.ncbi.nlm.nih.gov/) and Google Scholar (https://scholar.google.com/) databases published over the period from 2010 to 2023.
 Results. Among autonomous parvoviruses, protoparvoviruses are the most promising for the development of anticancer drugs. They detect CPE mainly in tumor cells, CPE is absent or limited in non-transformed human and rodent cell lines. Many of them are capable of actively replicating in cancer cells without destroying normal body cells. They primarily block the pathways of activation of type I interferons. The main non-structural viral protein NS1 plays a significant role in the manifestations of oncolytic activity of protoparvoviruses.
 Conclusions. Numerous studies continue to be directed at studying the mechanisms associated with the oncolytic properties of autonomous parvoviruses. The use of recombinant parvoviruses allows their oncolytic potential to be enhanced.","PeriodicalId":36128,"journal":{"name":"Ukrainian Journal of Radiology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135083206","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 : 2023-09-30DOI: 10.46879/ukroj.3.2023.303-314
O.V. Tsyhankov, M.O. Chyzh, F.V. Hladkykh
Background. The data of the European Society For Medical Oncology (ESMO) indicate that 64.0% of cancer patients with the fourth stage of cancer have chronic pain syndrome, which is the main factor that significantly affects the quality of life. In 46.0% of patients, it is not possible to obtain a stable analgesic effect with modern methods of analgesia, including interventional methods and pharmacotherapy. Refractory oncological pain stimulates the search for new methods of pain relief.
Purpose – retrospective assessment of the effectiveness of the selective stereo- tactic transnasal transsphenoidal cryoablation of the adenohypophysis in the treatment of chronic pain syndrome in patients with stage IV malignant neoplasms.
Materials and methods. 45 microsurgeries were performed – stereotactic selective transnasal transsphenoidal cryoablation of the adenohypophysis with endoscopy. Over the period from 2014 to 2018, 45 patients with stage IV malignant hormone- dependent neoplasms of various somatic organs and chronic pain syndrome underwent microsurgery.
Results. The analgesic effect appeared 4–6 hours after the microsurgery. In 95.6% of patients, an analgesic effect was achieved to a greater extent (according to the numeric rating scale (NRS) for pain, its intensity decreased from 7–9 points to 1–3 points); in other patients, the analgesic effect was achieved to a lesser extent (according to the NRS, pain intensity decreased from 7–9 points to 3–5 points), regardless of the condition and age of the patient. Accordingly, the dosage was reduced or opioid analgesics were discontinued. Severe complications after the cryoablation of adenohypophysis, such as meningitis, diabetes insipidus, and hypopituitary syndrome were not observed. In the postoperative period, three patients were treated for mild hypopituitary syndrome, and two patients were treated for liquorrhea with conservative therapy for 3–5 days.
Conclusions. Stereotactic selective transnasal transsphenoidal cryoablation of the adenohypophysis is an effective microsurgery in the treatment of chronic pain syndrome in stage IV cancer patients. It improves the patient’s condition and quality of life. The analgesic effect appears in the first hours after surgery. Due to the use of cryoprobes with a diameter of 1.2 mm and 1.8 mm, the surgery is minimally traumatic and can be performed on patients in critical condition.
背景。欧洲肿瘤医学学会(European Society For Medical Oncology, ESMO)的数据显示，64.0%的癌症第四期患者存在慢性疼痛综合征，这是显著影响患者生活质量的主要因素。46.0%的患者采用现代镇痛方法(包括介入方法和药物治疗)均不能获得稳定的镇痛效果。难治性肿瘤疼痛刺激了对疼痛缓解新方法的探索。
目的:回顾性评价选择性立体定向经鼻经蝶窦腺垂体冷冻消融治疗ⅳ期恶性肿瘤慢性疼痛综合征的疗效。
材料和方法。在内镜下行立体定向选择性经鼻经蝶窦腺垂体冷冻消融术45例。2014 - 2018年，45例4期躯体器官恶性激素依赖肿瘤伴慢性疼痛综合征患者行显微手术治疗。结果。显微手术后4 ~ 6h出现镇痛效果。95.6%的患者获得了更大程度的镇痛效果(根据疼痛数值评定量表(NRS)，其强度从7-9分下降到1-3分);在其他患者中，无论患者的病情和年龄，镇痛效果都较小(根据NRS，疼痛强度从7-9分下降到3-5分)。因此，减少剂量或停用阿片类镇痛药。腺垂体冷冻消融术后未见严重并发症，如脑膜炎、尿崩症、垂体下垂体综合征。术后3例患者因轻度垂体功能低下综合征治疗，2例患者因漏液保守治疗3 ~ 5天。
结论。立体定向选择性经鼻经蝶窦腺垂体冷冻消融术是治疗IV期癌症患者慢性疼痛综合征的有效显微手术方法。它改善了病人的病情和生活质量。镇痛效果出现在手术后的最初几个小时。由于使用了直径1.2 mm和1.8 mm的冷冻探针，手术创伤最小，可以在危重患者身上进行。
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 Purpose – retrospective assessment of the effectiveness of the selective stereo- tactic transnasal transsphenoidal cryoablation of the adenohypophysis in the treatment of chronic pain syndrome in patients with stage IV malignant neoplasms.
 Materials and methods. 45 microsurgeries were performed – stereotactic selective transnasal transsphenoidal cryoablation of the adenohypophysis with endoscopy. Over the period from 2014 to 2018, 45 patients with stage IV malignant hormone- dependent neoplasms of various somatic organs and chronic pain syndrome underwent microsurgery.
 Results. The analgesic effect appeared 4–6 hours after the microsurgery. In 95.6% of patients, an analgesic effect was achieved to a greater extent (according to the numeric rating scale (NRS) for pain, its intensity decreased from 7–9 points to 1–3 points); in other patients, the analgesic effect was achieved to a lesser extent (according to the NRS, pain intensity decreased from 7–9 points to 3–5 points), regardless of the condition and age of the patient. Accordingly, the dosage was reduced or opioid analgesics were discontinued. Severe complications after the cryoablation of adenohypophysis, such as meningitis, diabetes insipidus, and hypopituitary syndrome were not observed. In the postoperative period, three patients were treated for mild hypopituitary syndrome, and two patients were treated for liquorrhea with conservative therapy for 3–5 days.
 Conclusions. Stereotactic selective transnasal transsphenoidal cryoablation of the adenohypophysis is an effective microsurgery in the treatment of chronic pain syndrome in stage IV cancer patients. It improves the patient’s condition and quality of life. The analgesic effect appears in the first hours after surgery. Due to the use of cryoprobes with a diameter of 1.2 mm and 1.8 mm, the surgery is minimally traumatic and can be performed on patients in critical condition.","PeriodicalId":36128,"journal":{"name":"Ukrainian Journal of Radiology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135083205","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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