No abstract

Cervical cancer is a socially significant illness often impacting women of reproductive and working age. The patients’ young age and social activity warrant the development of effective and safe therapies.The past decades have witnessed the novel radiation techniques to contain cervical cancer: 3DCRT-3D, IMRT, and VMAT, adaptive radiotherapy, CT/MRI-guided intracavitary radiation, combined interstitial and intracavitary radiation, abandoning intracavitary intervention for external beam delivery with sequential or concurrent cervical dose escalation, under brachytherapy unfeasible.Modern equipment and treatment planning systems allow a high dose delivery to the tumour and intracavitary treatment with visual control of the target and organs at risk. Combining of intracavitary and interstitial radiotherapy enables a better dose coverage of the target at a minimal radiation impact on organs at risk.Phasing-out of intracavitary for external radiotherapy may enable a cancericide dose delivery to the tumour under intractable intracavitary treatment.The major goal of technic novelties is the establishment of personalised radiotherapy for improving treatment outcomes and reducing the incidence and/or severity of radiation side effects. The article overviews the radiotherapy techniques for cervical cancer treatment and routes of their development.

Рациональное и эффективное лечение воспалительных заболеваний женских половых органов представляет непростую, но чрезвычайно актуальную задачу. Трудности терапии инфекционных вульвовагинитов смешанной этиологии связаны с необходимостью тщательного бактериологического исследования; сложностью выбора препарата (так как лечение должно быть комплексным и направленным на все виды возбудителей); необходимостью не только подавления патогенной микрофлоры, но и восстановления нормальной микрофлоры влагалища. Цель исследования-изучить эффективность и безопасность препарата Эльжина у пациенток с бактериальным вагинозом и вульвовагинальным кандидозом. Материал и методы. В открытое прямое несравнительное исследование были включены 62 пациентки. Клиническую эффективность терапии оценивали по состоянию биоценоза влагалища при определении методом ПЦР в режиме реального времени с использованием реагентов Фемофлор-13. Результаты. На основании полученных результатов можно констатировать факт о высокой эффективности Эльжина в лечении эпизодов сочетанной инфекционной патологии (вульвовагинальный кандидоз и бактериальный вагиноз) нижних отделов половых путей женщин. Установлены низкая частота побочных эффектов и высокая степень комплаентности терапии.

Introduction. Recent years have witnessed an increased incidence of multiple neoplasms. In multiple combined cancer, the choice of treatment strategy remains challenging, as two or more tumours require treatment in the shortest perspective. However, an intense treatment may induce many and severe complications with co-located organs and systems. No universal protocol or treatment standard for managing multiple primary cancers is accepted in Russia or worldwide.Materials and methods. The clinical case describes radiation treatment of a female patient with synchronous gynaecologic cancer of vagina and endometrium at the “TOOD” medical facility’s radiotherapy unit. Our treatment was designed to maximise the dosage targeting at a minimal off-coverage of healthy tissues. The treatment was conducted in two steps on an Elekta Synergy Platform S instrument, with the total duration of 62 days.Results and discussion. After radiotherapy, the patient had an oncologic and gynaecologic observation for one year. A complete tumour regression in two localities was confirmed visually, cytologically and instrumentally.Conclusion. A treatment strategy in multiple primary cancers should be personalised. With unfeasible “standard therapy”, alternative approaches for the patient’s treatment are to be explored. We report a successful therapy in a woman with synchronous gynaecologic cancer by applying remote conformal radiation in regional uterine cancers with simultaneous integrated boost to the vaginal tumour during the first radiation step. Brachytherapy at the second step was replaced with stereotactic radiation due to vaginal constriction, pain syndrome and unfeasible applicator installation.