55 ВведениеПроблема рака предстательной железы (РПЖ) приобрела на сегодняшний день особую актуальность вследствие неуклонного роста заболеваемости и смерт-ности, а также в связи с трудностями своевременной диагностики. Первоначальное определение степени распространенности злокачественного процесса при РПЖ является основой определения тактики лечения больных. Выявление распространения опухоли за пре-делы органа -основное условие выбора между ради-кальной простатэктомией (РПЭ) и нехирургическими методами лечения (дистанционная или сочетанная лучевая терапия и гормональное лечение), поскольку с увеличением степени экстракапсулярного распро-странения опухоли возрастает риск развития рециди-вов после операции [1,2]. Важно определение опухо-левой инвазии семенных пузырьков -существенного фактора, значительно ухудшающего прогноз ввиду высокого риска развития местного рецидива или отда-ленных метастазов [3,4].

Aim. Study of the frequency of radiation therapy complications in patients with prostate cancer. Methods. The study included 142 patients who underwent radiation therapy combined with hormonal therapy in 2001-2015. Average age of patients was 68 years. All of them received 3D-conformal radiotherapy by linear accelerators with 6 to 15 MV photon beams. Single boost dose was 2 Gy, total boost dose was 75 Gy. We studied frequency and severity of acute hematological toxicity and early and late gastroenterological and urological complications of the treatment. Treatment-related toxicity was assessed by RTOG/ EORTC and CTCAE v. 4.0 scales. Results. Early radiation-induced proctitis of I, II and III degree were registered in 95 (66.9%), 32 (22.5%) and 8 (5.6%) patients, respectively. Acute cystitis of I, II and III degree were noted in 22 (15.5%), 87 (61.3%) and 16 (11.3%) patients, respectively. Signs of late radiation-induced proctitis of I degree was diagnosed in 21 (14.8%) cases. Late radiation-induced cystitis of I degree was diagnoswed in 37 (26.1%) patients. No late complications of higher severity occurred. Conclusion. The results of the conducted study showed that use of high-tech precision external-beam radiotherapy techniques in the treatment of prostate cancer along with high efficacy allows to reduce the number of early and late complications.

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Aim. The study of the results of chemoradiotherapy for cervical cancer with the use of two-fraction brachytherapy. Methods. The article presents analysis of the examination and treatment results of 17 patients with IIB-IIIB stage cervical cancer. The average age was 51±4.6 years (44 to 62 years). External beam radiotherapy was performed with single boost dose of 1.8 Gy to total dose of 45 Gy. Also the patients received 40 mg/m2 of weekly cisplatin. Intracavitary/interstitial high dose-rate brachytherapy with insertion of parametrial needles consisted of two weekly fractions of 10.0 Gy. Results. Due to the use of interstitial needles the average dose was 82.2 Gy when recalculated to classical 2 Gy fractions. The median follow up was 16±3,2 months. The used radiotherapy modality for cervical cancer allowed achieving complete tumor involution in 16 (94.1%) patients and partial involution only in 1 (5.9%) case. All females had favorable tolerance and received the entire regimen of planned radiation. Conclusion. The first experience of the use of concurrent chemoradiotherapy for locally advanced cervical cancer with external beam radiotherapy, two-fraction intracavitary/interstitial adaptive brachytherapy with single boost dose of 10 Gy and 5 weekly infusions of 40 mg/m2 of cisplatin showed high probability of complete and partial tumor response rate with favorable tolerance and acceptable incidence and severity of toxicity.

Treatment and investigation results of 128 IIA - IIIB stage cervical cancer patients treated by concurrent chemoradiother-apy with combined intracavitary and interstitial brachytherapy were analyzed. Interstitial brachytherapy allowed significantly increase a dose to high risk clinical target volume without elevation of the dose to surrounding organs at risk. Three-year relapse free survival did not differ significantly between intracavitary and interstitial brachytherapy groups. However analysis of local control rates depending on tumor size ant treatment modality showed higher three year relapse free survival rate for tumors > 5 cm treated by interstitial brachytherapy. Therefore interstitial brachytherapy for locally advanced cervical cancer is quite safe and effective treatment modality and could be used in daily clinical practice. But to do final conclusions we need to recruit more patients and longer follow up.