The results of the previous study (Volchegorsky I.A., Vazhenin A.V., Alekseeva A.P., 2022) allow us to consider emoxypine, ethoxydol and mexidol as equally effective maintenance therapy means that improve the quality of life at the stage of postoperative radiation treatment of patients with uterine corpus cancer. In such a situation, the decision on the purchase of an optimal drug by a medical institution is closely related to the market price of the drug and the cost-effectiveness pharmacoeconomic indicator, which makes it possible to select a drug from the analyzed group based on the minimum cost of the "unit of effect". Objective: to conduct a comparative analysis of the cost of the "unit of effect" of emoxypine, ethoxydol and mexidol, used to improve the quality of life of women receiving radiation therapy af ter surgical treatment of uterine corpus cancer.

The successes of modern medicine in the treatment of malignant neoplasms have led to increased interest in the study of quality of life (QOL), which is considered one of the endpoints of modern clinical research in oncology. This study aimed to identify the main features of the current state and patterns of further development in assessing the QOL of patients with cancer. This study was based on a bibliographic search in PubMed and Google Scholar. A literature search was conducted using pairs of keywords quality of lifeoncology, quality of lifecancer, quality of lifequestionnairesoncology, patient-reported outcome (PRO)oncology, and quality-adjusted life-year (QALY)oncology for articles published from 2017 to 2022 in Russian and English. Further, the articles were identified manually through the article link lists. PROs are currently considered the generally accepted standard for collecting data on the subjective perception of patients with cancer regarding their health status. Numerous questionnaires for assessing QOL are available, but the Functional Assessment of Cancer TherapyGeneral and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire are preferred. The combination of advanced technologies allows the collection of more reliable PRO data. Thus, unified approaches for the application of PRO results in large clinical trials are necessary.

Aim. Comparative analysis of the effect of methylethylpiridinol (Emoxipine), ethylmethylhydroxypyridine malate (Ethoxidol) and ethylmethylhydroxypyridine succinate (Mexidol) on the self-assessment of nonspecific clinical symptoms in women receiving adjuvant radiation therapy after radical surgical treatment of uterine body cancer. Materials and methods. A short-term, prospective, simple blind, placebo-controlled, randomized study of the effect of 14-day course use of emoxipine (150 mg [0.87 mmol] per day intravenously), ethoxidol (225 mg [0.83 mmol] per day intravenously) and mexidol (225 mg [0.88 mmol] daily intravenously) on the dynamics of self-assessment of nonspecific clinical symptoms in patients during radiotherapy after surgical treatment of endometrial cancer was conducted. Self-assessment of clinical symptoms and quality of life (QOL) was studied using the MDASI questionnaire (M.D. Anderson Symptom Inventory). The emotional complaints were assessed using the Giessen questionnaire. Results. The 14-day use of Emoxipine, Ethoxidol and Mexidol in almost eqimolar single doses prevented the negative impact of radiation therapy on the self-assessment of clinical symptoms and QOL according to MDASI. This was manifested by a significant decrease in weakness, sadness and depression, as well as the prevention of nausea and appetite disorders during radiation therapy. At the same time, the emotional coloring of stomach and heart complaints, exhaustion and pressure of complaints decreased according to the Giessen questionnaire. The positive effect of Emoxipine, Ethoxidol and Mexidol on the self-assessment of the clinical condition and the emotional coloring of the corresponding complaints was accompanied by an improvement in such components of QOL as general activity, mood, ability to work, relationships with other people and ability to enjoy life. The studied drugs did not differ in the intensenty of the identified effects. Conclusion. Emoxipine, Ethoxidol and Mexidol significantly improve the multidimensional self-assessment of the clinical condition of patients receiving radiation therapy after surgical treatment of endometrial cancer. The results obtained allow us to consider Emoxipine, Ethoxidol and Mexidol as equally effective means of maintenance therapy at the stage of postoperative radiation treatment of patients with endometrial cancer.

Background. The detection of cancer and its subsequent treatment contribute to the development of depression. This circumstance illustrates the need for proactive prevention of affective status disorders in cancer patients, its dynamic control and timely correction. Aim. Comparative analysis of the effect of hydrochloric, malic and succinic salts of 2-ethyl-6-methyl-3-oxypyridine (methylethylpyridinol, ethylmethylhydroxypyridine malate, ethylmethylhydroxypyridine succinate) on the dynamics of self-assessment of depression manifestations in women recieving radiation therapy after surgical treatment of uterine cancer. Material and methods. A short-term, prospective, simple blind, placebo-controlled, randomized study of the effect of methylethylpyridinol, ethylmethylhydroxypyridine malate and ethylmethylhydroxypyridine succinate on the severity of depression symptoms in patients receiving radiation therapy after extended extirpation of the uterus with appendages was performed. The study was completed by 96 patients. Course two-week administration of drugs in almost equimolar single doses (0.830.88 mmol) was started simultaneously with radiation therapy. The treatment effectiveness was assessed using the Beck Depression Inventory 2 and 4 weeks after the start of the study. Statistical comparison of related samples was carried out using the Friedman test and post hoc analysis using the paired Wilcoxon test with the Bonferroni correction. Independent samples were compared using the KruskalWallis test with a post hoc analysis using the DanBonferroni test. Results. Radiation therapy was found to cause a clinically significant increase in the severity of depressive symptoms in 14 and 28 days after the start of the study (p 0.010). Two-week administration of methylethylpyridinol, ethylmethylhydroxypyridine malate, and ethylmethylhydroxypyridine succinate reduced the severity of depressive symptoms to the normal level (p 0.001), mainly due to a decrease in the severity of symptoms of the cognitive-affective cluster (p 0.001). The studied drugs with equal severity prevented the escalation of depression symptoms according to the Beck Depression Inventory (p ˃0.05). Conclusion. Hydrochloric, malic and succinic salts of 2-ethyl-6-methyl-3-oxypyridine are equally effective in preventing the development of depression during postoperative radiation treatment of patients with ute-rine cancer.

Проведено краткосрочное, проспективное, простое «слепое», плацебо-контролируемое, рандомизированное исследование влияния эмоксипина, этоксидола и мексидола на динамику «связанного со здоровьем качества жизни» (health-related quality of life (HRQoL)) у пациенток, получающих лучевую терапию после хирургического лечения рака тела матки. Установлено, что адьювантная лучевая терапия после хирургического лечения рака тела матки вызывает снижение HRQoL по данным генерического (SF-36) и онкоспецифического (FACT-En) инструментов самооценки HRQoL. Наиболее выраженное снижение (на 20 – 30 % от исходного уровня; p < 0,001) отмечается для таких компонентов HRQoL, как «VT — жизненная активность» (по SF-36) и «PWB — физическое благополучие» (по FACT-En). Внутривенное капельное введение эмоксипина, этоксидола и мексидола в практически эквимолярных разовых дозах (0,83 – 0,88 ммоль) в течение 14 дней на фоне лучевой терапии предотвращает её негативное влияние на HRQoL (по SF-36), вызывая прирост «VT — жизненной активности», «SF — социального функционирования», «МН — психического здоровья», «PH — физического компонента здоровья» и «МН — психологического компонента здоровья» на 4 – 93 % по сравнению с «активной плацебо-терапией» (p < 0,001). Наиболее выраженный прирост (в 3 – 4 раза; p < 0,001) отмечается для «RP — ролевого физического функционирования» и «RE — ролевого эмоционального функционирования». Одновременно все изученные препараты улучшали онкоспецифичные параметры HRQoL (по FACT-En). Это проявилось нарастанием «PWB — физического благополучия», «EWB — эмоционального благополучия», показателя добавочной шкалы для больных раком эндометрия («EnCS») и интегрального показателя FACT-En («TS») на 13 – 38 % по сравнению с «активной плацебо-терапией» (p < 0,001). Наиболее выраженной HRQoL-протекторной активностью обладал этоксидол, оказавшийся единственным из изученных препаратов способным повышать онкоспецифичный показатель «FWB — функциональное благополучие» (на 13 % в сравнении с «активной-плацебо-терапией»; p = 0,01).