Respiratory system cancer (cancer of the nasal cavity, middle ear, paranasal sinuses (C30-31), larynx (C32), trachea, bronchi and lung (C33-34) is one of the most common malignancies in the Tomsk region, comprising 12.9% of all cancer cases. The purpose of the study was to analyze the respiratory system cancer incidence among the population of the Tomsk region. Materials and methods. The study was based on cancer register data collected at the Cancer Research Institute and Tomsk Regional Cancer Center, and covered the period 2005-2016. Results. Respiratory system cancer is the most common cancer in men, comprising 21.7% and the 6-th most common cancer in women, comprising 5.1. The incidence of respiratory system cancer decreased in men and showed an increasing tendency in women. The age-standardized incidence rates in the Tomsk region were expected to be 58.3 per 100,000 males and 12.8 per 100,000 females by 2020. Conclusion. Early detection and prediction of respiratory system cancer should play a vital role in the diagnosis process and also increase the survival rate of patient.

Томский НИИ онкологии, г. Томск 1 ГБОУ ВПО «Сибирский государственный медицинский университет» Министерства здравоохранения РФ, г. Томск 2 634009, г. Томск, пер. Кооперативный, 5, e-mail: OdintsovaIN@oncology.tomsk.ru 1 аннотация Томская область относится к территориям повышенного риска развития злокачественных новообразований, среди которых рак верхних дыхательных путей и гортани составляет 2,0 %. Ежегодно выявляется около 83 случаев заболевания (~70 -у мужчин), при этом число заболевших растет. В 2014 г. стандартизованный показатель заболеваемости РВДП на оба пола составил 7,3 на 100 тыс. населения. У мужчин заболеваемость в 6,7 раза выше, чем у женщин. Наиболее часто и у мужчин (67,7 %), и у женщин (60,0 %) диагностируются опухоли гортани. В структуре смертности от злокачественных новообразований среди опухолей верхних дыхательных путей более значим удельный вес рака гортани (2,0 %). Показатель смертности от этого заболевания составил 2,7 на 100 тыс населения области. Среди больных, состоящих на учете на конец 2014 г., диагноз рака гортани имели 1,1 %, рака глотки -0,3 %. Показатель распространенности рака гортани в области меньше, чем в СФО и РФ. При этом остаются низкими показатели выявляемости больных раком глотки и гортани на профилактических осмотрах (5,9 и 1,5 % соответственно) и ранней диагностики (I-II стадия) (5,6 %, и 29,3 % соответственно), высокими -одногодичной летальности (65,2 % и 28,6 %). Внедрение в клиническую практику программы по диагностике предопухолевых заболеваний и раннего рака гортани в Томском НИИ онкологии позволило в 16,3 % случаях выявить ошибки на этапе первичной диагностики, в 20,6 % верифицировать рак гортани и сформировать группу риска развития заболевания. Ключевые слова: злокачественные новообразования верхних дыхательных путей, эпидемиология, томская область. 31 Одинцова Ирина Николаевна, OdintsovaIN@oncology.tomsk.ru СИБИРСКИЙ ОНКОЛОГИЧЕСКИЙ ЖУРНАЛ. 2015. ТОМ 15, № 1. С. 31-36Key words: cancer of the upper respiratory tract, cancer incidence, tomsk region.

A significant role in the development of lung tumor resistance to drug therapy play so called mono resistance genes that determine resistance/sensitivity of tumor cells to distinct chemotherapeutic agents, they include BRCA1, RRM1, ERCC1, TOP1, TOP2a, TUBB3, TYMS, ABCC5 genes. It is shown that the use of these biomarkers as a criteria to appoint the adequate postoperative chemotherapy is associated with the forecast. However in the course of neoadjuvant chemotherapy change the expression profile of these genes can occur, which can lead to misinterpretation of results. In this regard perspective is the development of new relevant prognostic factors, which take into account occurred molecular genetic alterations in lung tumors after preoperative therapy. We presented the results of the combined treatment of 52 patients with NSCLC IIA - IIIB stage, based on the analysis of chemotherapy resistance/sensitivity gene expression for appointment the suitable drugs. It was found that the lack of expression of ERCC1 gene in lung tumor derived after neoadjuvant chemotherapy is associated with high rates of disease-free survival (P. = 0,00913). Low level expression of RRM1 gene (less than 0.5) is also associated with high rates of patient's survival (log-rank test P. = 0,01808), while a high level is a marker of poor prognosis. It is found that the combination of enhanced expression (>0.5) of any two or three genes: RRM1, ABCC5, TYMS, are the indicators of poor disease-free survival. We have shown that expression of ERCC1 gene is the independent prognostic factor. At zero ERCC1 expression in lung tumors, regardless of high or low level of expression of RRM1, ABCC5, TYMS genes, a high recurrence-free survival is observed. Thus, the data suggest the prognostic significance of the expression of ERCC1, TUBB3, RRM1, ABCC5 and TYMS genes in the lung tumor after neoadjuvant chemotherapy.

Breast cancer is the most common malignancy among women in the Republic of Buryatia estimating 18.4 % of all female cancers. From 1999 to 201З the average standardized incidence rate for breast cancer was 34.2±1.2 per 100,000 in the Republic of Buryatia and 42.3±0.8 in Russia. During a 15-year study period the overall increase in breast cancer incidence rate in the Republic of Buryatia was lower than that in Russia being 20.0 % and 22.9 %, respectively. In 2015 the Government of the Republic of Buryatia and the Ministry of Health approved the Individual Risk Assessment Program developed by the Tomsk National Research Medical Center (No. 2010616823 dated October 13, 2010) to improve cancer care for patients with breast cancer. The program was implemented in 27 medical institutions of the Republic.

Targeted therapy significantly increases the survival of patients with metastatic kidney cancer. The additional costs when transferring patients with metastatic kidney cancer to sequential therapy according to the scheme of sunitinib-axitinib are economically highly effective and allow achieving maximum survival.