Metastatic neck lymph nodes in massive lesion of their tissue with tumor cells are accompanied by extracapsular extension to the adjacent structures in a number of cases. The greatest problem in clinical oncology is when even extended radical neck dissection fails to completely remove tumor tissue that is macroscopically detectable after surgical resection. In this situation, there is a continued growth of tissue mass that is left on the neck. Thus, the unresectable extracapsular spread of neck lymph node metastases to the adjacent tissues reduces the duration of life in the patients and worsens its quality.

The basis for this investigation is clinical observations of patients who have been operated on at the Nizhny Novgorod Regional Clinical Oncology Dispensary (Hospital Two) in the period 2005 to 2016. Histologically, the tumors were squamous cell carcinomas. In this period, there have been 24 Crile operations (radical neck dissection) that are cytoreductive. A primary tumor has been (n = 15) or has not been (n = 9) previously excised. The extracapsular spread of metastatic lymph nodes corresponded to levels IIa, IIb, and III. Cytoreductive cervical lymphadenectomy with the pectoralis musculocutaneous flap covering an unresectable tumor for extracapsular unresectable squamous cell carcinoma metastasizing to the neck lymph nodes should be considered the operation of recovery. This type of surgery is warranted, as tumor mass reduction by eliminating the source of intoxication allows further antitumor treatment (radiotherapy or chemotherapy or their combination) that is contraindicated in patients with tumor lysis in the neck. When the cause of death is the exceedingly continued growth of an unresectable component of radio- and chemoresistant variants of tumor tissue on the neck, the covering of the component with a pectoralis major flap delays a fatal outcome in incurable patients to improve a number of quality-of-life indicators.

Annually in Russia primary diagnosis of new-onset pharyngeal cancer is made in approximately 6–7 thousand people. To modern methods of diagnosing pharyngeal cancer belong: direct and indirect laryngoscopy, microlaryngoscopy, stroboscopy, fibrolaryngoscopy, X-ray study examination, computed tomography, multispiral computed tomography, magnetic resonance tomography, ultrasonographic examination of the throat and organs of the neck, acoustic analysis of voice and morphological studies.

Recent years witnessed the development of novel methods of both conservative and surgical management of patient with pharyngeal cancer. Treatment of patients with stage T1–2 and in some patients with stage T3 includes the following methods: radiotherapy, chemoradiotherapy, endolaryngeal surgery with laser, photodynamic therapy, open functionally sparing operations. According to the data of the authors, today currently there is no common algorithm for treatment of stage T1–3 pharyngeal malignant neoplasms.

Locally disseminated tumors of the throat and laryngopharynx, corresponding to stages T3–4N0–2M0 as a rule are treated by combined management with pre- or postoperative irradiation. Such approach results in leads to impairment of all functions of the organ and invalidity disablement of patients. The most important task after combined treatment is rehabilitation of the voice function, which may be restored by means of logopedic methods, voice-forming devices and reconstructive plastic operations.

Hence novel approaches to treatment of pharyngeal cancer – both conservative and surgical have recently been worked out. However the problem concerning regarding therapeutic decision-making followed by rehabilitation of patients remains disputable.

The article is devoted to the actual problem of ensuring a radical surgical treatment of patients with tumors of oropharyngeal zone. We analyzed initial nutritional status of patients and its dynamics at the stages of preparation and implementation of major surgery. Developed and presented in the form of a flow chart of nutritional support on an outpatient and inpatient. We present the our own results, which show a decrease in the number of postoperative complications, and hospital stay-days due to the use of the developed algorithm.

The article contains information about current trends of treatment of the locally advanced oropharynx cancer. We analyzed the results of chemoradiation treatment, and surgery treatment of patients with rudimentary tumors after the chemoradiation therapy, taking into account the tumor margin, which gives capacity to perform an adequate operation with good oncological results.

Lung cancer is mostly common occurring oncological disease in the developed countries. Currently lung cancers are subdivided into nonsmall-cell (adenocarcinoma, large-cell, squamous cell) and small-cell. The difference in the clinical and morphological picture leads to the necessity of choosing therapeutic approaches to patients of various groups.

Lung cancer should be referred to encephalotropic diseases since metastatic lesion of the central nervous system is sufficiently common complication. Successes of complex treatment of primary tumor result in increase of total longlivety currently ther is ageing of patients suffering lung cancer. These factors increase the risk of metastatic lesions of the brain.

Interest to the problem of neurosurgical treatment of patients suffering lung cancer is determined by frequency of lesion, varicosity of morphological variants of the disease, requiring various algorithms of treatment and diagnosis.

The main role of neurosurgical intervention in cerebral metastases of lung cancer consist in creation of the paled of carrying out combined therapy. Ideally, a neurosurgical operation should be carried out with clearcut observance of oncological principles of ablasty.

Adequate comprehensive approach to treatment or patients with cerebral metastases of various forms of lung cancer with the developed of optimal tactics of and stages of treatment would make it possible to increase duration and quality of life of patients.

Introduction. Causes of the development onset of primary malignant cerebral neoplasms have not yet been determined. Not excluded is a possibility of unfavorable effect of the environment, genetic abnormalities, changes alterations in the hormonal background as well as metabolism, ionizing radiation: possible is also the role of viral infections and injuries. One of the main most severest complications of malignant tumors remain are metastatic lesions of the central nervous system whose proportion increases as with the patients’ longlivity. Cerebral metastases of malignant tumors are encountered more often than primary neoplasms of the central nervous system. The brain is not only a hormone-dependent organ the effect of sex hormones as early the embryonic state conditions normal development of the body as a whole and controls the sex related differentiation. It is known that neurons and glyocites like gonads and adrenal glands are able to produce steroid hormones. The enzymes responsible for the synthesis of neurosteroids were detected in the brain tissue in the embryonic period of the development. The human brain is not only a hormone-dependent organ effect influence of sex hormones as early as in the embrional state conditiones normal development of the body as a whole and controls sexual gender differentiation. It is known that neurons and glyocytes like gonads and adrenal glands are able to produce steroid hormones. Enzymes responsible for synthesis of neurosteroids were revealed in cerebral tissue both in during the embryonic period of the development and in adult condition. Besides there are have been obtained large amount of data on the presence in the cerebral cells of receptors to steroidal hormones. In various periods of life the influence effect exerted by steroids on nervous cells can change the morphofunctional state of the brain and manifests as altering myelinization, neuronal growth, and differentiation of nerve cells.

The present study was aimed at comparing the level of certain some hormones in tissue of glioblastomes, metastases of breast cancer into the brain and meningiomas, as well as the respective peritumoral zones.

Materials and methods. Examined were samples of tissue obtained from a total of 56 patients admitted for operative treatment to our Department. Of these, 24 glioblastomas, 19 breast cancer metastases to the brain, 13 meningiomes without peritumoral edema. The histological control was carried out in all cases. The patients’ age varied form 35 to 72 years. During operative interventions we carried out removed neoplasms of the brain followed by biochemical study of the samples of tumor tissue and immediately adjoining to the tumorous foci tissue (perifocal zone). In 10 % of cytozolic fractions of tissue prepared on the potassium-phosphate buffer of pH 7.4 containing 0.15 of Tween-20 and 1 % of bovine serum albumin by means of immunoenzymatic assay (IEA) using standard test systems we determined the level of steroid hormones – cortisole, testosterone, progesterone, estradiole, estriole, prolactine (IEA, HEMA, Russia) estrone (IEA, DBC, Canada) as well as sex-steroid-binding globulin (IEA, Alcor-Bio, Russia) and hormones of adrenohypophysis – adrenocorticotropine (ACTH) and somatotropic hormone (STH).

Results. The obtained findings showed that the most hormonally saturated were metastases of breast cancer. In them along with elevated levels of cortisole, prolactine ACTH and STH concentrations whose concentrations increased virtually in any proliferative process we determined growth of saturation of tissues with estrone and free testosterone on the background of decrease level of active metabolite of estrogens – estriole. Besides, disorders of the steroid metabolism also touched the perifocal zone. Presence of glioblastoma turned out characteristic of identity of tumorous tissue and the perifocal zone by the level of cortizole, which is not found observed if tumors of other genesis. In case of glioblastoms and their perifocal zones the ratio of cortizole to ACTH excedded the norm 2.1–2.5-fold. Meningiomas revealed high concentration of cortisole, ACTH, prolactine, STH, testosterone and sex-binding globulin, as well as a low level of progesterone. In the present study meningiomas turned out liders of production of prolactine and STH as well as estriolle with sufficiently low activity. However alterations of the hormonal background of meningiomas are local isolated form the rest tissues of the brain. Probably, increase of the level of prolactine and STH in tumor tissue is a marker of proliferation, but not malignant cell transformation

The material for the study was the medical records of 40 patients with oropharyngeal cancer who had undergone cryogenic treatment at the N.N. Blokhin Russian Cancer Research Center in the period 1975 to 2009. Analysis of the long-term results of cryogenic treatment for primary cancer, recurrences, and traditional therapy-untreated tumor showed its efficacy in 60 % of the patients. Cancer recurrence occurred in 31 (25.8 %) patients who had completed the treatment: in 25.0 % of the primary patients and in 27.3 % of the patients with previous recurrences or previously untreated tumors. No local complications due to ipsilateral wound were noted. The cryogenic technique is recommended for use in oncological practice; its indications and contraindications in oropharyngeal cancer are defined.

It has been held studying of the remote results of treatment of 80 patients sick of a bazalioma by 30 % glyciphon ointment in the Republican Oncologic Dispensary of the Ministry of Health of Republic of Tatarstan. It is established that daily use of glyciphon ointment during the 20– 30 days cures patients with primary tumours, both single, and initially-plural I and II stages, in 98,3 % cases. The preparation is effective at recidivations of bazalioma arising after radiotherapy, surgical treatment, criotherapy. The using at recidivations after the combined treatment is inexpedient. Reduction of an exposition of ointment from 24 hours till 6 hours gives good clinical effect with absence of relapses of recidivations of tumors.

None of the variants of therapy currently available for patients with differentiated thyroid cancer (DTС) refracted to therapy with radioactive iodine 131I (RAI) is not radical and does not allow to obtain full complete recovery including this is related to traditional chemotherapy regimens increasing toxicity of treatment contribute to improvement of the clinical effect. With the introduction of multicinase inhibitors into clinical practice made it possible to increase improve therapeutic outcomes. In December of 2015 in the Russian Federation was registered lenvantinib for therapy of patients with progressing DTC resistant to RAI therapy, which according to opinion may substantially improve the results of treatment of such patients and has a potential to change current clinical practice. The article deals with description of 5 clinical cases of inoperable patients with DTС refractory to RAI therapy receiving treatment with lenvatinib in the frameworks of the international randomized clinical trial phase III SELECT. The range of therapeutic effects varied from complete regression of the tumour to stabilization.

Tracheoesophageal bypass with endoprosthesis is one of the most important approaches for surgical ways of voice restoration after laryngectomy. Within after-surgery rehabilitation logopedic techniques may be practiced successfully for the patients undergone laryngectomy with tracheoesophageal bypass and voice prosthesis.

Профессору Рубену Ильичу Азизяну – 55 лет.