BACKGROUND:The treatment of breast cancer involves a multidisciplinary approach in which radiotherapy plays a key role.AIM:The conformity index and the homogeneity index are two analysis tools of a treatment plan using conformal radiotherapy. The purpose of this article is an analysis of these two parameters in the assessment of the treatment plans in 58 patients undergoing postoperative radiotherapy of the whole breast.MATERIALS AND METHODS:All 58 patients participating in the study had a conservatively treated early-stage breast cancer. The treatment was performed using a standard regimen of fractionation in 25 fractions up to a total dose of 50 Gy. Dose-volume histograms were generated for both plans with and without segmental fields.RESULTS:Pair samples t-test was used. The technique with segmental fields allowed us more homogeneity distribution when compared to standard two tangential field techniques. The HI values were 1.08 ± 0.01 and 1.09 ± 0.01 for segment and technique with two tangential fields (p < 0.001). The DHI values were 0.92 ± 0.02 and 0.901 ± 0.01 for segment and technique with two tangential fields (p < 0.001). The CI values were 1.38 ± 0.02 and 1.43 ± 0.3 for segment and technique with two tangential fields (p = 0.0018).CONCLUSION:The results showed that the conformity and the homogeneity index are important tools in the analysis of the treatment plans during radiation therapy in patients with early-stage breast cancer. Adding segment fields in the administration of radiotherapy in patients with conservatively treated breast cancer can lead to improved dosage homogeneity and conformity.

BACKGROUND: Primary mediastinal seminomas most commonly occur in young men, and they are localised in the anterior mediastinum. CASE PRESENTATION: The presented study is a case report of a 34-year-old man suffering from a mediastinal tumour in size of 19 cm, with pleural and pericardial effusion. The patient complains of cough, difficulty breathing, weight loss, and pronounced tiredness. CT of lungs and biopsy of the mediastinal change was performed. The histopathological analysis was in favour of a primary mediastinal seminoma. The patient initially had pronouncedly increased levels of LDH and β-hCG tumour marker. Pericardiocentesis was realised due to threatening tamponade of the heart, followed by 4 cycles of chemotherapy by BEP protocol. Following 2 cycles of chemotherapy, normalisation of LDH and β-HCG levels and significantly improved the clinical condition in the patient was found. Upon completion of 4 chemotherapy cycles by BEP protocol, the patient performed an FDG-PET scan with partial response and reduced dimension of a primary tumour in the mediastinum. Radiotherapy of residual tumour mass up to a total dose of 40Gy in 20 fractions was realised. Control FDG-PET scan had a finding of complete response to a tumour and absence of FDG uptake. The last follow-up examination was performed in October 2018, and the patient was disease-free for 54 months. CONCLUSION: Multimodality treatment approach of chemotherapy followed by radiation consolidation ensured long-term survival in primary advanced mediastinal seminoma.

Cumulative evidence obtained in this series of studies has guided the logic behind the development of a novel composite dsDNA-based preparation whose therapeutic application according to the specific regimen completely cures the mice engrafted with otherwise lethal Krebs-2 ascites. The likely mechanism involves elimination of TAMRA+ tumor-inducing stem cells (TISCs) from Krebs-2 tumors. We performed quantitative analysis of TISC dynamics in Krebs-2 Совокупность всех данных, полученных в работах настоящего цикла исследований, определила основную логику создания нового сложнокомпозиционного препарата на основе двуцепо-чечной ДНК, применение которого в рамках нового терапевтиче-ского режима привело к полному вылечиванию мышей от асцита Кребс-2. Рассматривается предполагаемый механизм разрушения туморогенного начала опухоли Кребс-2, который заключается в элиминации из опухоли TAMRA+ стволовых инициирующих раковых клеток (СИРК). Проведен анализ изменения количества СИРК Кребс-2 в нативном асците и асците после обработки цито-статиком циклофосфаном (ЦФ). В нативном асците количество СИРК осциллирует на определенном уровне. После обработки циклофосфаном их количество относительно оставшихся после масштабного апоптоза коммитированных раковых клеток увели -чивается по сравнению с исходным, что предполагает понижен ную чувствительность СИРК к действию циклофосфана. Тем не менее произошедшая в результате проведенных обработок синхрони-зация СИРК в чувствительной фазе клеточного цикла делает их доступными для действия терапевтических агентов. Охарактери-зо ван режим синергичного воздействия циклофосфана и препа-рата ДНК на развивающуюся асцитную опухоль Кребс-2, приводя-щего к полному вылечиванию 50 % экспериментальных живот ных. Этот режим включает трехкратные инъекции цитостатика цикло-фосфана в конечные точки каждого из трех последователь ных репаративных циклов, дополненные инъекциями препарата двуцепочечной ДНК через 18 ч после каждой инъекции цикло-фосфана, и финальную обработку цитостатиком и препаратом ДНК в момент синхронизации клеток асцита в чувствительной фазе клеточного цикла после первичных обработок. Первые три инъекции «ЦФ + ДНК» необходимы для ареста всех асцитных клеток Кребс-2 в поздней S-G2-M-фазе и их синхронного выхода в G1-S-фазе следующего клеточного цикла. Момент такого син-хронного выхода определен как принципиальная временная

BACKGROUND:Merkel cell carcinoma (MCC) is a rare, very aggressive tumour. The pathogenesis remains unclear, but UV radiation, immunosuppression, and the presence of Merkel cell polyomavirus in the tumour genome appear to have a key role. Merkel cell carcinoma is a highly aggressive tumour that often has a lethal end.CAS REPORT:A patient at 93 years of age comes for an examination by a dermatologist due to a rapidly growing nodular tumour growth in the forehead area. A tumour was about 3 cm in size. It had no signs of basal-cell carcinoma, no arborising vascularisation, no pigmentations on dermoscopy. Clinically, an eventual Merkel cell carcinoma was considered for the patient, but other primary skin tumours had to be excluded, as well as the possibility that regarding the patient’s age, it may be a metastatic deposit. A skin biopsy was performed, as well as H-E examination and immunohistochemical analyses (positive CD56, positivity of neuroendocrine markers synaptophysin, chromogranin) which were in favour of Merkel cell carcinoma of the skin. After setting the diagnosis, our patient was treated with therapy which led to a complete withdrawal of a tumour. However, after 3 months the patient had repeated relapse of a tumour at the same site on the forehead and metastases in the retroauricular lymph nodes bilaterally. It shows that the radiotherapy as monotherapy has a great effect on the removal of the tumour formation, but unfortunately, it has no impact on lesion recurrence. It is also compatible with the literature data.CONCLUSION:In many adult patients, as our case suggests, radiotherapy could be a good palliative treatment opportunity that should be considered, as well as a combination of radiation therapy with other oncologic therapeutic options.

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