Aim. The present study aims to investigate the efficacy of a modified combination neoadjuvant polychemotherapy (NACT) with a sonodynamic component in patients diagnosed with stage IIA2 locally advanced cervical cancer.
Materials and methods. The study encompassed data from 82 patients diagnosed with locally advanced cervical cancer, classified as stage IIA2 (T2a2N0M0). All patients underwent NACT courses according to the cisplatin and bleomycetin regimen. Patients in the control group (n = 32) underwent intravenous NACT, while patients in the main group (n = 50) underwent intravenous NACT in conjunction with contact sonodynamic chemotherapy comprising 5-fluorouracil. The number of NACT courses ranged from two to three, contingent upon the immediate treatment outcomes. Following the attainment of complete or partial regression of the tumor, an extended nerve-sparing extirpation of the uterus, including the appendages, was performed. In instances where the initial treatment did not yield the desired outcome, that is, stabilization of the process, the subsequent treatment plan involved the administration of chemoradiation therapy.
Results. The study revealed that patients in the experimental group demonstrated a substantially higher degree of resectability following two cycles of NACT with a sonodynamic component when compared to the control group. The observed values were 94 and 56.2 %, respectively (p <0.05). A greater proportion of patients in the control group required the third course of NACT, with 43.75 % of patients requiring this intervention, compared to 6 % of patients in the main group (p <0.05). The prevalence of drug-induced pathomorphosis grades III–IV in the main group was documented in 64.3 % of cases, while in the control group drug-induced pathomorphosis grades I–II were predominant (60 %). The overall 5-year survival rate of patients in the primary cohort was notably higher than that of the control group. The study revealed that 82.1 % of the subjects in the first group exhibited a positive response, in contrast to 63.6 % of the subjects in the second group (p <0.05). The five-year relapse-free survival rate in the primary cohort was 78.8 ± 9.5 %, while in the control group, it was 58.8 ± 6.2 % (p <0.05). Conclusion. The application of accelerated regression of cancer tumors under the influence of combined NACT has been demonstrated to result in a reduction in the number of NACT courses and an increase in the number of optimal radical surgeries. The efficacy of the method was substantiated by the findings of morphological and immunohistochemical studies, as evidenced by the indicators of 5-year overall and relapsefree survival for this patient population.

Background. Multiple myeloma is often accompanied by the development of hyperproteinemia, an increased level of pathological protein in blood serum resulting from excessive secretion of free light chains or immunoglobulins by clonal plasma cells. Hyperproteinemia is associated with life-threatening complications such as hyperviscosity syndrome, cryoglobulinemia, impaired renal dysfunction, and coagulation disorders. Рlasmapheresis (PF) sessions are among the methods used to rapidly reduce the level of paraprotein in the blood serum.
Aim. To analyze the treatment results of newly diagnosed multiple myeloma (NDMM) patients complicated by hyperproteinemia who underwent PF. Materials and methods. We analyzed the data of 32 patients with NDMM patients who underwent PF and received complex therapy at the N.N. Blokhin National Medical Research Center of Oncology in the period from January 2000 to December 2020.
Results. Indications for PF included hyperviscosity syndrome in 3 (9.4 %) patients and serum total protein levels exceeding 120 g/L in 29 (90.6 %) patients. The median number of PF sessions performed was 3 (range 1–11). As induction therapy, 16 (50 %) patients received bortezomib-based regimens: VCP (bortezomib + cyclophosphamide + prednisolone) – 3 (9.3 %) patients, VCD (bortezomib + cyclophosphamide + dexamethasone) – 12 (37.6 %) patients, and VMP (bortezomib + melphalan + prednisolone) – 1 (3.1 %) patient. Another 16 (50 %) patients received chemotherapy regimens such as CP (cyclophosphamide + prednisolone) – 3 (9.3 %) patients, VAD (vincristine + doxorubicin + prednisolone) – 9 (28.2 %) patients, and VMCP (vincristine + melphalan + cyclophosphamide + prednisolone) – 4 (12.5 %) patients. Overall response rate was achieved in 18 (56.2 %) patients.
Of the 32 patients included in the study, 27 (84.4 %) were younger than 65 years and formally eligible for high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT). Auto-HSCT was performed in 12 (44.4 %) patients. After auto-HSCT, improvement of hematologic response was observed in 8 (66.8 %) patients: 2 (16.6 %) patients with very good partial response and 1 (8.3 %) patient with partial response achieved complete response, while 5 (41.7 %) patients with partial response reached very good partial response. With a median follow-up of 26.5 months (95 % confidence interval (CI) 1–119 months), median progression-free survival was 36 months (95 % CI 15–56 months), and median overall survival was 73 months (95 % CI 15–109 months). Multivariate analysis revealed statistically significant effects of the presence of bone plasmacytomas on progression-free survival (hazard ratio (HR) 0.090; 95 % CI 0.018–0.466; p = 0.004) and overall survival (HR 0.111; 95 % CI 0.024–0.517; p = 0.005), as well as the type of chemotherapy regimen administered on progression-free survival (HR 6.426; 95 % CI 1.075–38.433; p = 0.041) and age on overall survival (HR 0.072; 95 % CI 0.006–0.798; p = 0.032).
Conclusion. The use of plasmapheresis combined with bortezomib-based induction therapy in NDMM patients and hyperproteinemia effectively reduces the level of pathological protein and stabilizes the patientsʼ condition. PF decreases the risk of severe complications associated with hyperviscosity syndrome, allowing the safe administration of full-dose induction therapy.

Background. The era of sentinel lymph node diagnostics has a vector of reducing surgical aggression in the area of regional lymph outflow. This was due to the studies that have been conducted, which have made it possible to understand that lymph node involvement is not always a call for removal of the entire lymphatic collector, as it does not affect the treatment results.
Aim. To study the effects of sentinel lymph node biopsy and lymphadenectomy on survival rates in patients with primary operable breast cancer (сT0–2N0/N0–1).
Materials and methods. The retrospective study included 524 women with ductal/lobular breast cancer stage I–IIB. Depending on the extent of surgical intervention on the lymphatic collector, patients were divided into the following groups: group 1, where sentinel lymph node biopsy was performed in 111 (21.2 %) patients; group 2, where axillary lymph node dissection was performed in 413 (78.8 %) patients (280 patients after sentinel lymph node biopsy).
Results. The average follow-up time for patients was 61.3 ± 22.8 months (from 18.1 to 140 months, median 57.7 months). The median age was 51 [42.0; 61.0] years. Depending on the clinical stage according to TNM, the distribution of patients was as follows: T1N0M0 – 277 patients, T2N0M0 – 213, T1N1M0 – 3, T2N1M0 – 31. Neoadjuvant chemotherapy was administered to 137 (26.2 %) patients. The frequency of neoadjuvant chemotherapy statistically significantly increased with increasing clinical stage, from 2.2 % (n = 6) for T1N0M0 to 100 % (n = 31) for T2N1M (p = 0.00001). Surgical treatment included sectoral resection in 50.6 % (n = 265) and radical mastectomy in 49.4 % (n = 259). Death occurred in 14 (2.7 %) patients, progression was detected in 36 (6.9 %) patients. The 5-year progression-free survival and overall survival rates in groups 1 and 2 did not differ significantly, amounting 98.2 ± 1.3 % versus 92.93 ± 1.6 % and 100 % versus 97.9 ± 0.9 %, respectively. The median overall survival and progression-free survival were not reached.
Conclusion. In patients with T0–2N0/N0–1 breast cancer who underwent lymphadenectomy, overall survival and progression-free survival were not inferior to those who underwent sentinel lymph node biopsy.

Currently, breast reconstruction with silicone endoprostheses has become widespread. This was facilitated by the simplicity of the surgical technique, rapid recovery of patients, and the availability of high-quality synthetic and biological materials. With one-stage breast reconstruction, optimal aesthetic results can be achieved in one surgical intervention. However, some factors can make adjustments to the reconstruction result. Most foreign and Russian publications are devoted to the effect of radiation therapy on the development of complications after the use of silicone endoprostheses/tissue expanders. In our article, we analyzed studies devoted to the analysis of the influence of various factors that can provoke the development of infection, implant protrusion, and other complications. Taking into account all possible criteria at the preoperative, postoperative stages, and directly during surgery, it is possible to significantly reduce the risks of implant loss and reoperations.

Modern risk-adapted therapy for Hodgkin lymphoma makes it possible to achieve complete remission and sustained long-term event-free survival in the overwhelming majority of patients. However, the problem of developing late treatment-related complications remains relevant. These include secondary malignant neoplasms, cardiovascular and endocrine diseases, reproductive dysfunction, among others.
This article presents a review of the literature on the most frequently occurring late complications of therapy for newly diagnosed classical Hodgkin lymphoma in children, adolescents, and young adults. The need for their early diagnosis and long-term medical follow-up is substantiated. The expediency of developing a strategy to reduce the risk of these complications is determined, which, along with the high effectiveness of antitumor treatment, will make it possible to improve long-term prognosis and quality of life.

Background. Endocrine disorders are a significant long-term complication in children who have undergone anti-cancer treatment. Despite the relevance of this issue, the effects of chemotherapy (CT) on pituitary hormonal function in pubertal children with Hodgkin’s lymphoma (HL) remain poorly understood.
Aim. To evaluate the levels of pituitary hormones (somatotropic (growth) hormone (GH), thyroid-stimulating (TSH), adrenocorticotropic (ACTH), luteinizing (LH), follicle-stimulating (FSH) hormones, prolactin) in pubertal children with HL before and after chemotherapy. Materials and methods. The study included 40 pubertal children (11–17 years old, median 13.65 years) diagnosed with HL (20 (50 %) boys and 20 (50 %) girls) – main group. The control group comprised 40 conditionally healthy children of the same age range (median age 15.25 years) with equal gender distribution. Blood samples from the HL group were collected before chemotherapy and after its completion (prior to radiotherapy). Hormone levels (GH, TSH, ACTH, LH, FSH, prolactin) were measured using standard radioimmunoassay and enzyme-linked immunosorbent assay kits. Reference values were based on hormone levels in the control group. Statistical analysis was performed using Statistica 10.
Results. In girls with HL, pre-treatment levels of LH, FSH, and the LH/FSH ratio were elevated by 1.8-, 1.4-, and 1.3-fold, respectively, compared to the norm (p <0.05). GH and ACTH levels were 1.6and 3.1-fold below normal, respectively (p <0.05). After CT, LH levels decreased by 2.8-fold from baseline and by 1.5-fold relative to the norm, while FSH levels remained elevated at 1.6-fold above the norm (p <0.05). The LH/FSH ratio dropped by 2.6-fold relative to the norm and by 3.2-fold compared to baseline. Prolactin levels post-CT were 1.7-fold above the norm and 1.5-fold above baseline (p <0.05). GH levels were 7.8-fold lower than normal and 4.8-fold below baseline, whereas ACTH levels increased by 6.7-fold over baseline and were twice the normal level.
In boys with HL, pre-treatment LH levels and LH/FSH ratio were 1.5and 1.4-fold below normal, respectively (p <0.05). Prolactin was 1.8-fold higher than normal (p <0.05), and GH was 3.6-fold below normal. After CT, LH increased by 1.4-fold compared to baseline, reaching reference values (p <0.05).
Based on FSH levels, patients were divided into two subgroups: in 50 %, FSH remained within the normal range, while in the other 50 %, it increased ten-fold. The LH/FSH ratio remained normal in the first subgroup but was 11-fold below normal and 7.8-fold below baseline in the second. Post-treatment prolactin levels were 3.6-fold above normal and twice the baseline level. GH increased threefold from baseline and normalized. ACTH exceeded both normal and baseline levels two-fold. TSH levels decreased by 1.8-fold compared to both the norm and baseline (p <0.05).
Conclusion. The development of HL in pubertal children is associated with suppression of adenohypophyseal function and an imbalance in the synthesis of tropic hormones. Antitumor therapy does not generally restore normal hormone levels, which may be due to dysregulation of the central endocrine axes or the presence of extrapituitary sources of hormone production.

Pulmonary sequestration is a rare congenital anomaly characterized by the presence of dysplastic lung tissue and an abnormal systemic blood supply. Although pulmonary sequestration may be asymptomatic, many patients suffer from frequent lung infections, cough with sputum and less often hemoptysis. Computed tomography with intravenous contrast should be recommended to patients with this condition for better diagnosis. Surgical resection is a method of choice to achieve better results and reduce the recurrence rate.
We report a case of 32-year-old female with pulmonary sequestration, which was surgically removed by video-assisted thoracic surgery.

This paper presents a literature review on the use of dendritic cell vaccines for lung cancer, prepared based on the analysis of sources from domestic and foreign literature presented in electronic databases of scientific medical literature PabMed, eLIBRARY.RU. The analysis included publications characterizing the current capabilities of laboratory, instrumental and molecular genetic methods for obtaining and using dendritic cell vaccines for lung cancer.
The aim of the work – to highlight the results of international and domestic studies on the production, screening and use of dendritic cell vaccines, as well as immunotherapy strategies for lung cancer.