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Biomedical subjects

V M Sotnikov

Publications and source records attributed to V M Sotnikov.

At least 19 recordsLinked to original sources
PubMed2006

[Ten-year outcomes of lymphogranulomatosis treatment according to the protocol MOPP-ABVD+radiotherapy].

AIM: To analyse overall recurrence-free survival of lymphogranulomatosis (LGM) patients given polychemotherapy (PCT) MOPP (mustargen-caryolisin, vincristine, natulan, prednisolone) - ABVD (adriamycin, bleomycin, vinblastin, dacarbasin) in combination with radiotherapy (RT) for 10 years. MATERIAL AND METHODS: The trial included 211 LGM patients admitted to Hematological Research Center in 1990-1996 from other hospitals without random selection. The patients were examined by the standard program including biopsy of the affected organ or lymph node, bilateral trephine biopsy. Splenectomy was performed in 17 patients, 83 patients received PCT in other hospitals, 128 untreated patients received MOPP-ABVD therapy (3 courses of MOPP and 3 courses of ABVD). Forty one patients had defects in PCT, 16 of them rejected PCT and RT. The latter was performed 4 weeks after the 6th course, contraceptives were not prescribed to women. At LGM stage II-III RT was performed by the subradical program (no radiation to ilioinguinal lymph nodes) in doses 40-44 Gy on the foci and 32-36 Gy preventively, on massive and residual foci after PCT - 5-10 Gy additionally. RESULTS: Ten-year overall and recurrence-free survival in the untreated group reached 83 and 80%, respectively, for pretreated patients - 46 and 36%, respectively. Causes of death of 26 patients were LGM progression, infection (tuberculosis, as a rule), secondary tumors and acute myeloblastic leukemia (AML). After remission 25 women gave birth to a healthy child and 12 healthy children were born to 9 males. CONCLUSION: MOPP-ABVD plus radiotherapy program according to subradical and radical variants was in the past effective but invalidating rescue therapy. Present-day programs consider the histological variant, stage and prognostic factors allowing an individual therapeutic approach with step-by-step reduction of RT in the treatment of LGM patients. Involvement of the bone marrow in primary patients had no influence on the treatment results. This refers this affection not to a generalized stage IV, but to stage III along with involvement of the lymph nodes and the spleen.

Adolescent↗
PubMed2006

[Five-year outcome of a new combination chemotherapy with CEA/ABVD for advanced Hodgkin's disease with poor prognosis].

Data are presented on our 5-year experience with combination chemotherapy of stage II-IV Hodgkin's disease (110), the unfavorable prognosis group, using a novel regimen of chemotherapy--CEA/ABVD (belustin, etoposide, doxorubicin, bleomycin, vinblastine, dacarbazine). Complete remission after 4 courses of CEA/ABVD chemotherapy was reported in 31.8%, unconfirmed complete remission--45.5%, objective effect--100% and an 80% regression of tumor mass--93.2%. No chemo-resistant forms were identified. Five-year actuarial relapse-free survival was 96.4%; overall 5-year survival--97.7%. Death from complications recorded during medication period occurred in 2.3% (1 out of 44), recurrence--2.3% (1 out of 44). Recurrence-free survival rose by 25% (p < 0.05) while overall survival--by 20% (p = 0.04 in year 3), as compared with COOP(MOPP)/ABVD (179 patients with poor prognosis). Our regimen opens up new vistas in managing Hodgkin's disease.

Adult↗
PubMed2006

[Prognostic models for Hodgkin's disease].

A prognostic model for Hodgkin's disease was worked out using the data on disease-free survival among patients receiving 4-8 courses of COOP(MOPP)/ABVD plus (sub)total irradiation. Patients with stage I-II Hodgkin's disease (less then 4 lesions) without large involved mediastinal masses, intoxication symptoms and focal splenic involvement were referred to the favorable prognosis group. The poor prognosis group featured stage III(2)-IV tumor as well as large masses of involved mediastinal tissue, focal splenic involvement at any stage plus 7 or more lesions. An assessment of tumor advancement across lesions is more significant for radiotherapy planning rather than that of organ involvement. It is reasonable to distinguish two substages--III(1) and III(2). Our model was compared with GHSG and it was suggested that ways be found to use both of them in prognosing of disease outcome.

Hodgkin Disease↗
PubMed2005

[Novel approaches to combination therapy of Hodgkin's disease].

Data on 668 patients receiving 4-8 cycles of chemotherapy were used to suggest the following approach to complex therapy of Hodgkin's disease: devise a simplified model for Hodgkin's disease, develop a new modality of chemotherapy, demonstrate feasibility of only four chemotherapy cycles in the poor prognosis group, partial response as the ultimate goal of chemotherapy as well as the importance of subtotal dosage under 26-36 Gy sufficient for irradiation of the entire lymphatic collector. Said measures will, in their totality, offer fresh opportunities in treatment of Hodgkin's disease.

Adult↗
PubMed2002

[The cardiovascular system of patients with lymphogranulomatosis in long-time remission].

AIM: To study the cardiovascular system in patients with lymphogranulomatosis (LGM) at prolonged remission. MATERIALS AND MATERIALS: 78 patients received radiation and chemotherapy for lymphogranulomatosis in 1973 to 1995. All the patients underwent electro- and echocardiography (EchoCG), 40 patients had radioisotopic ventriculography (RVG). RESULTS: EchoCG revealed nonspecific changes in the ST segment in 19 (24.3%) patients. Systolic function was decreased vto 46% only in 1 patient. RVG showed a significant reduction in ejection fraction in the experimental group as compared to the control one (55.5 +/- 9.5 and 68.4 +/- 8.0, respectively; p < 0.05). CONCLUSION: Cardiac disorders revealed in patients with LGM at prolonged remission are mainly insignificant. The risk for cardiac events is not a guide for reducing radiation doses and the intensity of chemotherapy.

Adult↗
PubMed2000

[The 1st results of the combined therapy of recurrent and refractory forms of lymphogranulomatosis (polychemotherapy, radiation therapy and the removal of the residual mediastinal formation)].

AIM: To achieve a maximal complete remission rate in patients with recurrent and refractory Hodgkin's disease. To find out a group of patients in whom surgical removal of the residual mediastinal mass would be most effective. MATERIAL AND METHODS: 46 patients with Hodgkin's disease received Dexa-BEAM chemotherapy followed by radiotherapy. Surgical removal of the residual mediastinal mass was made in 12 patients. RESULTS: Second-line Dexa-BEAM therapy produced a 50% complete remission rate. Overall survival was 45.5%, the disease-free survival--43.5%. Removed mediastinal masses were indicative of Hodgkin's disease in 7 cases and fibrosis in 4 cases. CONCLUSION: Dexa-BEAM is an effective program in the treatment of recurrent and refractory Hodgkin's disease. Surgical removal of the residual mediastinal mass with radiotherapy and high-dose chemotherapy improves prognosis in very unfavorable, primary progressive form of Hodgkin's disease.

Adolescent↗
PubMed2000

[Experience with and perspectives of an extended radical regimen of radiotherapy for Hodgkin's disease with prophylactic irradiation of the liver and the lungs].

The end-results of extended radical radiotherapy for stage II-III Hodgkin's disease with apparent factors of risk of relapse in the lung and/or liver are presented. The procedure included prophylactic irradiation of both organs. Ten-year relapse-free survival in the lung-irradiation group was 85.9%, overall 10-year survival--94.0%; the liver-irradiation group--90.0 and 94.7%, respectively. Preventive irradiation was shown to significantly decrease the influence of such risks as extended lesions of the mediastinum and spleen. Relapse in the lung was recorded in one case (1.6%) only, with no tumor progression defected in the liver. Significant increase in 5- and 10-year relapse-free survival was established in the lung-irradiation group, as a result of a comparison of the study group and that of controls who showed characteristic signs of intrathoracic risk. Significant difference in overall survival was recorded for the first three years only. As far as the liver-irradiation factor is concerned, the rise in both categories of survival was significant for the 10 years. It is suggested that patients with stage II-III Hodgkin's disease receive prophylactic irradiation whenever they reveal significant signs of risk of relapse in the lung and/or liver.

Adult↗
PubMed1997

[Expert system for establishing indications for radiation and combined therapy of patients with non-hodgkin's lymphoma].

Mathematical procedures have been employed which enable to carry out automatic selection within small groups of patients with primary non-Hodgkin's disease, with a view to choose between chemoradiation, radiation or drug therapy. The study included 670 patients, aged 15-79, who were followed up for 1-10 years. Groups were formed on the basis of the following prognostically-significant parameters: sex and age, histological pattern and stage, primary localization and maximal size of tumor (involvement of the mediastinum, bone marrow and peripheral blood). Each group was conceived on the basis of two or three parameters. The efficacy of each therapeutical modality was assessed using the data on overall and recurrence-free survival. A computerized program was used for making prognosis for each patient which, in turn, determined the choice of the most effective type of treatment.

Adolescent↗
PubMed1996

[The grouping of morphological variants of non-Hodgkin's lymphomas (lymphosarcomas) by the degree of malignancy].

The authors stated that WHO classification allows identification of two groups of morphological variants of non-Hodgkin's lymphomas: low- and high-grade malignancy. These differ by principal clinical characteristics, incidence of complete and partial remissions, survival duration. The analysis of clinical course, long-term and short-term treatment outcomes is provided for 674 patients with the above lymphomas.

Adolescent↗
PubMed1996

[Early peripheral cancer of the lung: long-term results of combined therapy using sparing resection techniques].

Two hundred-thirty patients were operated on for peripheral lung cancer TIN0M0 in 1960-1990. Pheumonectory was performed in 3 cases, lobectomy-123, segmentectomy-40, wedge-like resection-57 and removal of tumor-in 7 cases. Limited resection in 20 patients was not followed by radiation therapy, Radiation treatment was given to 15 patients preoperatively, 53-postoperatively and 16 patients-pre-and postoperatively, Five-year survival after combined treatment was recorded in 70.5%, while without this treatment-68.7%. Local recurrences following limited intervention were usually detected 3-5 years later, regional and distant metastases developing within the first 24 months. A reverse correlation was established between extent of surgery and local recurrence incidence. Reoperation such as lobectomy or pneumonectomy is feasible in cases of timely diagnosis. The highest 5-year survival rates were registered for segmentectomies carried out in combination with postoperative radiotherapy (77.2%). Prognosis proved best in cases of adenocarcinoma and tumor arising in the cicatrix. Paliative surgery appeared preferable for primary tumor 1.5 cm in diameter and less. Even in small-size malignancy, removal of tumor is not radical enough, Wedge-like resection is admissible in small-size subpleural lesions only. Preoperative radiotherapy results proved inferior to those of other procedures of combined treatment. Pronounced radiation-induced pneumonitis involving re-hospitalization for symptomatic treatment occurred in 7 (5.5%) cases of lobectomy combined with radiotherapy and in 2 (1.9%) cases of limited resection.

Humans↗
PubMed1993

[Radiation therapy of Kaposi's sarcoma with accelerated electrons].

Kaposi's sarcoma and AIDS-associated Kaposi's sarcoma resistant to chemotherapy were irradiated locally in 14 and 1 patient, respectively, and followed up for 1--6 years. The energy (10 MeV) in the total focal dose of 24--40 Gy was emitted as high-speed electrons from a medical accelerator. An immediate response was obtained in all the patients. The recurrence occurred in AIDS-associated sarcoma only. It is recommended that Kaposi's sarcoma should be treated by high-speed electron radiation covering the lesion and adjacent sites of the intact skin. Total focal dose must not exceed 30 Gy, in case of circulatory disturbances in the low limbs the dose is to be reduced to 20 Gy.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[The characteristics of the clinical course of lymphosarcomas when using combined therapy including splenectomy].

The authors relate the results of a clinico-morpho-instrumental analysis of the clinical course of lymphosarcomas in 38 patients with different morphological patterns of the disease with primary injury to the spleen. The patients received multimodality therapy including splenectomy. It has been established that later the short-term effect of splenectomy permits the implementation of different polychemotherapy programs, favouring a better lymphosarcoma prediction.

Adult↗
PubMed1991

[Risk factors and survival prognosis in lymphogranulomatosis: a statistical analysis].

To examine risk factors and to design prognostic models for the total, relapse-free and after-relapse survival, use was made of the Cox model for unifactorial and multidimensional analysis based on the retrospective estimation of the results of the treatment of 235 patients with lymphogranulomatosis, stages II-III. Radiotherapy according to the radical program was carried out in conjunction with polychemotherapy according to the COPP scheme. The number of areas of damage, massiveness of injury to the mediastinum, involvement of the spleen into the process appeared the most informative risk factors for predicting both total and relapse-free survival. The prediction of the after-relapse survival was considerably influenced by the age combined with carrying out of not less than 3 cycles of polychemotherapy given to the patients during initial treatment or with the presence of intoxication symptoms and increased ESR. The tables of the survival probability were calculated.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[The characteristics of the clinical course of lymphosarcomas in conformity with the morphological variants of the WHO and Working Formulation classifications].

Histological and cytological preparations of the lymph nodes, spleen, bone marrow and other tumors from 140 patients with different variants of lymphosarcomas were subjected to a comparative clinicomorphological analysis. The data obtained were correlated to the WHO classification and the working formulation of non-Hodgkin's lymphomas intended for clinical use. It has been found desirable that the working formulation may be used for predicting the disease course and elaboration of the programs of lymphosarcoma treatment.

Adolescent↗
PubMed1990

[The combined treatment of lung cancer with one-time large-fraction preoperative irradiation].

A procedure of preoperative large single dose (7.5 Gy) irradiation of lung cancer was developed. Irradiation field included regional lymph node-bearing areas. Treatment was employed in 93 lung cancer patients. Postoperative complication and lethality rates were 14 and 2.2%, respectively. Patients presenting with metastases in the regional lymph nodes were postoperatively irradiated to the lung hilus and mediastinum (30 Gy in 10 fractions). The treatment was well tolerated. Eighty-eight patients were followed, of whom 43.3% survived 3 years. The above modality assured ablastics of surgery and allowed to minimize duration of preoperative radiotherapy.

Adenocarcinoma↗
PubMed1989

[Optimal conditions for irradiating central cancer of the lung using high-energy photon beams].

The authors describe optimum plans of irradiation of central lung cancer of patients with different stature in a restricted number of radiation directions and without such restrictions. The recommendations obtained are compared with routine methods of irradiation. The description of a single dose field by transformed curves of axial distribution, taking into account the heterogeneity of a medium, are used in computation.

Humans↗