Background. Being diagnosed with cancer is a dramatically stressful condition for a human. Radiation therapy (RT), which is an essential of combination antineoplastic treatment, can cause physical and emotional state changes. Realizing these changes is an additional stress factor that results in impaired life quality of a cancer patient as well refusal to undergo further treatment. At present, there is no distinct system of providing psychological aid for cancer patients in Ukraine. Purpose. To carry out analysis and generalization of research literature data in terms of providing psychological aid for cancer patients at RT stage and to present own findings of psychological study enrolling 55 female patients diagnosed with endometrial cancer at RT stage at SO «Grigoriev Institute for Medical Radiology and Oncology» within the period from 2015 to 2018. Materials and methods. The literature review involved available contributions obtained via literature search in domestic (Vernadsky National Library of Ukraine) and foreign databases (Scopus, Web of Science Core Collection, PubMed, BMC, ScienceDirect, Wiley Online Library, RNB). Fifty-five patients with endometrial cancer of stage I–II (T1b-c N0 M0 – T2a -b N0 M0) underwent clinical and laboratory examination. The diagnosis of adenocarcinoma was confirmed by means of a histologic study. All patients underwent panhysterectomy and postsurgery course of distant gamma-therapy on “РОКУС-АМ” device by split fractionation. Fifteen patients were provided with psychological correction at RT stage. In order to assess life quality, SF-36 (Health Status Survey) was used. An assessment of the severity of psychosomatic disorders in patients with endometrial cancer was made by means of EORTC QLQ-C30 survey. Results. The paper analyzes psychological aid provided to oncology patients at radiation therapy stage in Ukraine and overseas. It presents the peculiarities of patients’ psychological responses during irradiation and possible consequences of higher mental function impairment. The targets of psychological correction and factors influencing life quality of a patient have been considered as well as the effectiveness of psychotherapeutic interventions outcomes of different approaches has been provided. The study states that, currently, medical and psychological follow-up of cancer patients does not consist only in reassuring talk and drug correcting of their psychological state aimed to reduce distress, anxiety and depression level, but also in psychocorrection, psychoeducation, the access to psychotherapeutic groups, individual psychotherapy. The efficiency of applying own developed schemes of medical and psychological correction of emotional state of women with EC is presented, the use of which has made it possible to reduce the manifestations of sleep disorders, cognitive function and fatigue. Conclusions. Following a differentiated strategy when choosing methods of psychological aid for oncology patients and their families at radiation therapy stage via psychocorrection of emotional, cognitive and behavioral spheres, psychoeducation or psychotherapeutic interventions will make it possible to significantly improve their psychological status and quality of life.

Radiation and polychemotherapy significantly affect the immune system of a cancer patient, unabling to adequately respond to infectious agents and provide effective antitumor protection. Rehabilitation of immune disorders is an urgent task, the solution of which will contribute to the generalization of experience when suing the immune modulators in cancer patients. To summarize the existing data on the use of concomitant immune therapy in antitumor treatment, the reports published within 30 years in Pubmed, Cochrane Library, ScienceDirect and the Vernadsky National Library of Ukraine were analyzed. It is expedient to use immune correction at different stages of antitumor treatment in the case of compliance with certain criteria for the prescribing the immune modulatory drugs. Their use is most justified after the primary tumor removal, even in the presence of metastases, because the increase in antitumor resistance is achieved in the absence of tumor cells in the patient's body or their presence in minimal quantities. Possibilities and goals of concomitant immune therapy in cancer patients should be considered taking into account the stage of treatment. Immune modulators with additional properties (detoxification, antioxidant) can serve as universal drugs. In the early post−surgery period, it is advisable to use the drugs, affecting the cells of the mononuclear phagocyte system for the prevention of postoperative infectious complications. During radiation and chemotherapy, preference should be given to the drugs with antitoxic effects and capable of preventing the leukopenia development. Thus, the prescribing of concomitant immune therapy in the combined treatment of cancer patients is an important task, demanding a balanced approach. Key words: immune therapy, immune modulators, quality of life, cancer patients.

Background. Immune disorders in antitumor treatment of obese patients may depend on the severity of the inflammatory process, which justifies the need to take into account the intensity of the latter in the analysis of complications of antitumor treatment in obese individuals. Purpose – evaluation of immune disorders after radiation therapy in obese patients with different intensity of the inflammatory process.  Materials and methods. 65 patients with stage I–II endometrial cancer underwent pangysterectomy and a postoperative course of remote gamma therapy. Examinations were performed before treatment and after radiation therapy. Subpopulation composition of lymphocytes, phagocytic activity of neutrophils, levels of circulating immune complexes and immunoglobulins G, A, M were determined by standard methods. The SF-3000 «SYSMEX» analyzer was used to evaluate hematological parameters. The level of C-reactive protein (CRP) was determined using an analyzer «RESPONS 910». Insulin and leptin levels were assessed by enzyme-linked immunosorbent assay. Results and discussion. Immune and hematological parameters were evaluated in 3 groups of patients. Group I included patients with normal body weight (BMI < 25), II and III groups consisted of obese patients (BMI > 30). Group II included patients with a CRP level below the median, which was 18,0 mg/l, group III – patients with a CRP level above 18.0 mg/l. In patients of group II there was a higher absolute and relative number of lymphocytes, the absolute number of CD3+-, CD4+- and CD8+-lymphocytes compared with those registered in groups I and III. After radiation therapy, the absolute number of lymphocytes and lymphocyte subpopulations decreased in all groups. As before treatment, higher levels of these indicators were registered in group II. In obese patients, the relative number of NK cells was lower than that determined in patients of group I before and after treatment. Conclusions. Patients with obesity and low intensity of the inflammatory process have less pronounced immune disorders after radiation therapy compared with patients who had a normal body weight and individuals with obesity and high levels of CRP.

Рак грудної залози (РГЗ) входить до найрозповсюдженіших форм злоякісних новоутворень серед жіночого населення України. За статистичними даними РГЗ посідає перше місце у загальній структурі захворюваності на злоякісні пухлини у жінок і є найчастішою причиною смерті від раку. В останні десятиріччя встановлено зв'язок між метаболічними розладами (ожиріння) та ризиком розвитку та/або прогнозом деяких видів раку, включаючи рак грудної залози. Системні зміни, такі як гіперінсулінемія, гіперглікемія, запалення та зміни локального оточення пухлини внаслідок ожиріння, як встановлено, пов'язані з розвитком та прогресуванням злоякісного новоутворення [1][2][3]. Є також свідчення збільшення ускладнень протипухлинного лікування у хворих з ожирінням у порівнянні з хворими з нормальною вагою [4]. Дані щодо особливостей імунних порушень при променевому лікуванні, які можуть сприяти розвитку інфекційних, у хворих з ожирінням вельми обмежені.Метою дослідження було визначення особливостей змін гематологічних показників та субпопуляційного складу лімфоцитів після променевого лікування хворих на рак грудної залози (РГЗ) з ожирінням.Матеріали та методи. Клініко-лабораторне обстеження проведено 45 хворим на РГЗ I-II стадій (T1N0M0 -Т2N0M0) без метастазів в регіонарні лімфатичні вузли. Переважали жінки віком від 51 до 60 років, тобто припадав на менопаузальний період. Усім хворим було проведено пангістеректомію та післяопераційний курс дистанційної гамма-терапії на лінійному прискорювачі «Clinac 600C» методом дробного фракціонування. Сумарна осередкова доза складала 40-45 Гр. Обстеження проводили до лікування та після курсу дистанційної гамма-терапії. Субпопуляційний склад лімфоцитів визначали методом проточної цитометрії на апараті FC-500 «Beckman Coulter». Гематологічні показники визначали за допомогою аналізатора SF-3000 «SYSMEX». Статистична обробка даних здійснювалася за допомогою пакета статистичного аналізу STATISTICA 6.0.Достовірність відмінностей між середніми значеннями показників вважали значущими при р <0,05.

Background. One of the most common responses to surgical stress is the activation of the sympathetic nervous system, leading to a dramatic increase in circulating adrenaline and norepinephrine, which can potentially accelerate the spread of the tumor process in cancer patients. In this regard, it is relevant to review the results of studies devoted to the determination of the antitumor effect of β-blockers and their use in the perioperative treatment of cancer patients. Purpose – to analyze and summarize data on the oncogenic effects of catecholamines and to highlight the experience of using β-blockers in the perioperative treatment of cancer patients. Materials and methods. We used the electronic resources of Vernadsky National Library of Ukraine, Cochrane library and databases (Pubmed, Scopus). We analysed the results of studies conducted before August 2020. Results. A summary of the mechanisms by which excessive release of catecholamines may facilitate metastasis is provided. The analysis of clinical trials devoted to the study of the effects of perioperative use of propranolol and its combination with COX-2 inhibitors in cancer patients is conducted. Conclusions. Short-term perioperative therapy with propranolol and its combination with anti-inflammatory drugs may have antimetastatic effects and neutralize the immunosuppressive effects of surgical stress. Further elucidation of the clinical significance of perioperative propranolol treatment in cancer patients requires a 3–5-year study to assess the long-term relapse-free survival of cancer patients.