Ощепков В.Н.

Purpose of the study: To improve the results of treatment of patients with localized prostate cancer using the 125I brachytherapy by means of individual prediction of relapse-free survival of patients after implantation.

Materials and methods. The study included 123 patients with low and intermediate risk clinically localized prostate cancer who were implanted with 125I radioactive micro sources in the period from 2000 to 2013. The main evaluation criterion was 5-year biochemical disease free survival bDFS.

The guidelines for treatment of prostate cancer using the HDR-brachytherapy approved during the expert meeting on are presented in this article. The references are given to the guidelines for the technology of prostate brachytherapy. The questions of the diagnostics and patient selection for HDR-brachytherapy are discussed, indications and contraindications are defined for the brachytherapy. Absolute contraindications for brachytherapy are outlined. The treatments strategy is evaluated with regard to the prostate cancer progression risk. The quality control criteria and are presented.

Penile cancer is a rare oncological disease, occurring with a frequency of 0,1-7,9 per 100 000 male population. In Russia, the incidence in 2014 was 0.82 cases per 100 000 male population, and continues to grow steadily in the dynamics of the past 10 years. Clinically, exophytic or flat lesions on the skin of the glans penis characterize the disease or foreskin of the penis, which can infiltrates spongy and / or cavernous corpuses. Now no standard of treatment penile cancer and no consensus concerning radiation therapy.

The guidelines for treatment of prostate cancer using the low-dosage permanent tissue radiation therapy (brachytherapy) approved during the expert meeting of the Russian Brachy-therapeutic Society on 4th October 2014 are presented in this article. The references are given to the guidelines for the technology of prostate brachytherapy from years 2006, 2009 and 2010. The questions of the diagnostics and patient selection for brachytherapy are discussed, indications and contraindications are defined for the brachytherapy.

Materials and Methods. The analysis included 117 patients who meet the following criteria: disease stage T1-T2c, low or intermediate risk of disease (criteria D`Amico), follow-up period of 5 years or more, and performed PDA, which was carried out based on the day 30 CT data. According to the results of PDA patients were divided into 2 groups: group I figure D90 was ≥140 Gray, group II < 140 Gray. Biochemical failure was defined by ASTRO.

Increasing the dose proved to be effective (fewer biochemical recurrence) in external beam radiotherapy for prostate cancer. Underway attempts to extrapolate this relationship to permanent (low-dose) brachytherapy, although the validity of this extrapolation is still in question. In contrast to external beam radiotherapy, brachytherapy requires the implementation of quality control manipulations based от visualization of actual (rather than planned) source distribution within the prostate and calculation of the actual radiation dose.

In recent time interest for new methods of malignant tumors is growing, one of the most promising is immune therapy. The main reason of such interest is caused by the fact that nearly one third of treated patients with prostate cancer have reccurence.

Most frequent prostate cancer radiation therapy complications are radiation, prostatitis cystitis and proctitis, with dysuria of different degree of manifestating. It can be also complicated by infravesical obstruction. α1-Blockers are used for nonsurgical treatment of dysuria and infravesical obstruction. The purpose of our clinical research was to evaluate efficiency of neoadjuvant and adjuvant therapy with α1-blockers in patients with prostate cancer underwent extracorporal radiation treatment or brachytherapy.