Background. Combined radiation therapy is the «gold standard» for the treatment of stages IIB-IVA of cervical cancer (cervical cancer). Given the data of statistical indicators of cervical cancer, the study of new approaches to treatment and implementation in clinical practice of modern technologies of radiation therapy of widespread cervical cancer is an extremely important area. Purpose – evaluate the benefits of using CT topometric preparation in planning brachytherapy for cervical cancer. Materials and Methods. 3D planning of brachytherapy of 24 patients with locally advanced cervical cancer (FIGO IIIB stage), who underwent a radical program of combined radiation therapy (remote radiation therapy with chemical modification with cisplatin followed by HDR-brachytherapy (High dose rate brachytherapy)). Results. The paper presents the results of the analysis of differences in brachytherapy planning according to orthogonal images and CT images. The analysis of the influence of the constitutional features of patients revealed that there are differences in the topographic anatomy of the pelvis depending on the surface area of the body. In patients with a body surface area of up to 1,65 m2 , a more intimate fit of the intestine to the target volume of irradiation was noted. No similar planning difficulties were found in patients with a body surface area above 1,65 m2 . Conclusions. The use of 3D images in the planning of intracavitary irradiation in patients with cervical cancer provides precision brachytherapy by simultaneously visualizing the irradiated volumes and spatial relationships of the anatomical structures of the pelvis, the introduced endostats and the corresponding volumetric dose distributions.

Background. Timely diagnosis of recurrence of malignant tumors of the ovaries can improve treatment outcomes. Purpose – determine the feasibility of using the tumor marker HE-4 in case of recurrence of malignant ovarian tumors. Materials and methods. To analyze the levels of HE-4 and CA-125 in patients with recurrence of malignant ovarian tumors and determine the feasibility of using HE-4 at this stage of monitoring, 29 patients with known indicators of HE-4 and CA-125 at the time of recurrence and their baseline data were selected. Results and discussion. The paper presents the results of the study of the HE-4 and CA-125 tumor markers levels in 29 patients with a proven recurrence of malignant ovarian neoplasms depending on the timing of its appearance – up to 12 months (n = 9), 13–24 months (n = 11) and after 24 months (n = 9). The values of the tumor-associated HE-4 marker were decreased during the relapse compared to baseline expression levels. When analyzing of the HE-4 serum, their significant difference was revealed only in the event of relapse in the period of up to one year (1207.00 pmol/l) from recurrence rates in the periods of 13–24 and of over 24 months (567.00 and 655.50 pmol/l, respectively). Conclusions. Only the baseline expression of HE-4 is prognostically significant for determining the timing of recurrence of ovarian malignancies.

Relevance. The development of ideas of critical attitude to medical information led to the concepts of evidence-based medicine (EM) in the late 1980s. The main postulates of EM are following: – every doctor’s decision must be based on scientific data; – the weight of each fact is greater, the stricter the method of scientific research in the course of which it was obtained. Correct planning of the research design and qualified statistical analysis are the most important for obtaining reliable, scientifically based results. The application of modern information technologies to arrays of catamnetic data of patients with cervical cancer (CRC) provides an opportunity to conduct a scientific study on the detection of the dependence of the appearance of oncological consequences of CRC treatment (metastases, relapses, secondary cancers) and manifestations of radiation toxicity on the clinical and biological characteristics of the patient and the features of the performed chemoradiation treatment. A necessary component of the success of such research is strict adherence to the principles of evidence-based medicine at all stages, in particular research planning. The main task at this stage is to determine the informative constitutional and biological, biometric, and social characteristics of the patient, parameters of treatment and the development of the disease in order to create a relevant informational model of the research database. The purpose of the work is to create an infological model of the catamnetic database of patients with CRC in order to determine the risk factors of local and distant metastasis and radiation toxicity during radical chemoradiation treatment of patients with CRC. Materials and methods: scientific literature with a level of evidence of primary data not lower than 2+, analysis of own experience, specialized analytical system «Database of patients». Results and discussion. An infological model of the database of catamnetic data of patients with CRC has been created, which provides the most complete representation of the subject area, contains all the entities and their attributes necessary for implementation. It is shown which parameters, factors and features of the disease should be taken into account when creating a database to obtain informationally significant results based on the accumulated data. Conclusions. The relevant informational model of the research database created in accordance with the approaches of evidence-based medicine is a necessary component for obtaining scientifically based results based on the catamnetic data of patients with CRC.