Introduction. Erythropoiesis-stimulating agents (ESAs) hold the key place in the treatment of anemia in patients with cancer. Their clinical effectiveness is confirmed by the results of numerous studies, including meta-analyses. However, the impact of ESA on overall survival and progression-free survival remains a matter of debate due to the heterogeneity of results and differences in clinical trial design. In this regard, we conducted a meta-analysis of randomized controlled trials to evaluate the efficacy and safety of ESA in cancer patients with anemia.

Aim. To evaluate the effect of ESA on overall survival, progression-free survival, objective response rate, and incidence of venous thromboembolic events in anemic patients receiving anticancer therapy for malignancies with metastasis.

Materials and methods. A systematic review and meta-analysis of results of controlled randomized clinical trials conducted during 2012–2025 and evaluating effect of EpA on the survival of patients with malignancies with metastatic involvement and anemia have been performed. In 6 databases, 529 publications on this topic were found. The analysis included 4 randomized clinical trials involving 5,117 patients 18 years and older with cancer and anemia. The effects of ESA on overall survival, progression-free survival, objective response rate, and incidence of venous thromboembolic events were evaluated.

Results. There was no statistically significant differences between patients from groups with ESA therapy and control groups (placebo, red blood cell transfusion, or no treatment) (n = 2,957 vs n = 2,145; hazard ratio (HR) 0.98; 95 % confidence interval (CI) 0.90–1.05), progression-free survival (n = 2713 vs n = 1937; HR 1.00; 95 % CI 0.91–1.11), objective response rate (n = 1,440 vs n = 1,428; HR 1.12; 95 % CI 0.18–7.12) and incidence of venous thromboembolic events (n = 2,915 vs n = 2,071; HR 1.67; 95 % CI 0.81–3.45).

Conclusion. In the analyzed population of patients with malignancies and anemia, ESA therapy does not worsen overall survival, progression-free survival, objective response rate, and does not increase the risk of venous thromboembolic events.

Introduction. Oral mucosal cancer is one of the most complex tumors of the head and neck. most patients seek help with a locally advanced process where the tumor affects surrounding organs and tissues. Surgical treatment in such cases is accompanied by significant functional and aesthetic disorders, and 5-year disease-free survival does not exceed 50 %. In this regard, additional treatments for oral mucosal cancer, such as neoadjuvant chemotherapy, which can improve survival rates, are being actively investigated.

Aim. To evaluate the efficacy of neoadjuvant chemotherapy and its impact on survival in patients with locally advanced oral mucosal cancer.

Materials and methods. The study included 188 patients with resectable locally advanced stage III–Iv oral mucosal cancer (T2 – T4N0–2c) who were treated at the N. N. Blokhin National Oncology Research medical Center from 2013 to 2023. patients were divided into 2 groups. group 1 (n = 38) included patients who underwent neoadjuvant chemotherapy followed by surgery, group 2 (n = 150) included patients who underwent surgical treatment with adjuvant radiation / chemoradiation therapy. In 55.3 % of cases, the DCf regimen (docetaxel, cisplatin, 5-fluorouracil) was used, in 18.4 % – Cp (carboplatin, paclitaxel), in 26.3 % – pf (cisplatin, 5-fluorouracil). Clinical and morphological responses were assessed by solid tumor response criteria (Response evaluation criteria in solid tumors, RECIST 1.1). Statistical analysis was performed using IBm SpSS Statistics 27 software.

Results. In 44.7 % of patients with locally advanced oral mucosal cancer, neoadjuvant chemotherapy provides a clinical response to treatment, in 25 % of patients – with a pronounced morphological tumor response (grade III–Iv). It was found that in the neoadjuvant chemotherapy group, the incidence of disease progression is significantly lower than in the surgical treatment group (34.2 % versus 53.3 %), overall survival rates are better (48.7 % versus 40.4 %). In patients with a pronounced morphological response after neoadjuvant chemotherapy, the recurrence rate was lower than in patients with a worse response: in 12.5 and 29.2 % of cases, respectively. Nevertheless, there were no significant differences in survival rates between the neoadjuvant and surgical treatment groups (p = 0.063).

Conclusion. Neoadjuvant chemotherapy contributes to improved treatment outcomes for locally advanced oral mucosal cancer. An increase in the number of patients with a pronounced morphological response can lead to a statistically significant increase in survival rates.

Introduction. Anaplastic thyroid cancer (ATC) accounts for less than 1 % of thyroid neoplasms, but is characterized by high aggressiveness and death in the vast majority of cases. The median survival in this pathology is <6 months. Despite development of multimodal approaches to treatment of ATC (surgery, chemotherapy, radiation therapy), local and systemic control of the disease remains unsatisfactory in most patients. The use of targeted drugs and immunotherapy opens up new possibilities for increasing the survival rate of patients with ATC, but the effectiveness of their combination with surgery and also long-term results remain poorly understood. The role of surgical treatment of primary tumor is subject of discussion: on the one hand, radical resection can improve local control of the disease and reduce symptoms of compression, and on the other, aggressive operations often involve a high risk of complications and do not always lead to increase in life expectancy. Of particular difficulty is definition of criteria for selecting patients who could actually benefit from surgical treatment.

Aim. To evaluate the effectiveness of surgical treatment with various options for combined treatment and determine criteria for its feasibility in ATC.

Materials and methods. The multicenter prospective study included 65 patients with morphologically confirmed stage IvA–C ATC treated in 2016–2022 at the pirogov High medical Technology Clinic of St. petersburg State university, the National medical Research Center of Radiology and the National medical Research Center of Endocrinology. patients are divided into 4 groups: 1) surgical treatment (n = 23); 2) surgical treatment and chemotherapy (n = 26); 3) surgical treatment, chemotherapy and radiation therapy (n = 5); 4) surgical treatment, chemotherapy and targeted therapy (n = 9). patient survival was assessed using the kaplan–meier method. Comparison of clinical-anamnestic data from 3 independent groups was performed using the kruskal–wallis test with further post-hoc analysis; comparison of the study groups – using Cox regression.

Results. median of overall survival in the surgical treatment, chemotherapy, and targeted therapy group was 20 months (95 % confidence interval 12–24), in the surgical treatment group was 2 months (hazard ratio, 0.075; p <0.001). partial response was recorded in 56 % of patients receiving targeted therapy, in other groups it was not observed (p <0.001). Comparison of data from patients who underwent R0 / R1- and R2 resection was not possible due to small number of patients who underwent conditionally radical surgery (n = 12)

Conclusion. Surgical intervention in ATC can be justified only as part of an integrated approach using agnostic targeted therapy. The results of the study highlight the need for molecular genetic testing and interdisciplinary consultation in each case. In the future, it is necessary to study new combinations of targeted drugs and immunotherapy in neoadjuvant regimen.

Introduction. Laryngeal cancer is an important malignancy of the head and neck, with an estimated incidence of 238,000 cases per year. The main risk factors are smoking, human papillomavirus infection, and exposure to occupational carcinogens. Treatment of laryngeal cancer with T1–2 includes surgery and radiation therapy, but both methods have disadvantages: there is a risk of relapse after radiation therapy, and functional impairment after surgery, which necessitates optimization of treatment methods. photodynamic therapy is a promising organ-preserving method based on the targeted destruction of tumor cells by activating the photosensitizer accumulated in them with visible red light.

Materials and methods. The study analyzed the results of combined treatment with intraoperative photodynamic therapy in 74 patients with laryngeal cancer from 2017 to 2023. Inclusion criteria: morphologically confirmed squamous cell carcinoma of the larynx, T1–2 tumor extent and absence of distant metastases. patients were administered photosensitizer (chlorin E6) intravenously 3 hours before surgery. Surgical treatment included endolaryngeal or open laryngeal resections followed by intraoperative photodynamic therapy on the bed of the removed tumor. Oncological and functional results were then assessed for 24 months.

Results. Local recurrence was recorded in 2 (2.7 %) patients in the 1^st year and in 3 (4.17 %) patients in the 2^nd year. Overall survival was 100 %, larynx preservation was 95.9 %. In the group with a positive resection margin (n = 11), progression was noted in 2 patients. Respiratory, swallowing and vocal functions were restored in all patients. No complications associated with photodynamic therapy were registered.

Conclusion. The high efficiency of a combined approach involving the use of intraoperative photodynamic therapy in early-stage laryngeal cancer has been demonstrated. This method has provided good oncological and functional results. In some cases, it allows you to avoid adjuvant radiation therapy, reduce the risk of complications and shorten the rehabilitation period. further studies of the long-term results of such a combined method will help assess the prospects for its implementation in clinical practice.

Introduction. Squamous cell carcinoma of the nasal cavity and paranasal sinuses is one of the rare malignancies. In about 80 % of cases, this pathology is diagnosed at stage III–Iv, which causes an unfavorable prognosis of the disease.

Aim. To evaluate effectiveness of an integrated approach to treatment of stage III–Iv squamous cell carcinoma of the nasal cavity and paranasal sinuses.

Materials and methods. The study included 126 patients with locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses who were treated and observed during 2000–2020 at the N. N. Blokhin National medical Research Center for Oncology. Depending on the choice of treatment tactics at the 1^st stage, patients were divided into 3 groups. group 1 (n = 55) included patients who underwent conservative treatment (radiation or chemoradiation) therapy in an independent version, group 2 (n = 31) – patients who underwent surgery with adjuvant radiation therapy, group 3 (n = 40) – patients who underwent induction radiation or chemoradiation therapy with subsequent surgery. Results. Overall 5-year survival rates did not differ between the 3 groups (p >0.05). At the same time, 5-year progression-free survival in group 2 (surgery + adjuvant radiation or chemoradiation therapy) was significantly higher (50.5 %) as compared with groups 1 (conservative treatment) (17 %; p = 0.021) and 3 (induction radiation or chemoradiation therapy + surgery) (25.5 %; p = 0.031). The five-year progression-free survival of patients with T3 tumor in group 2 was 59.4 %, which was significantly higher than in groups 1 (17.9 %; p = 0.021) and 3 (27.1 %; p = 0.031). However, there were no between-group differences in progression-free survival in patients with T4 tumor.

Conclusion. Local recurrence is the most common cause of disease progression. Surgery with adjuvant radiation therapy, especially in patients with T3 tumor, improves the prognosis of the disease. At the same time, it is advisable to conduct conservative treatment to patients with T4 tumor.

Introduction. The incidence of oropharyngeal cancer is steadily increasing, mainly due to an increase in the number of cases of Hpv (human papillomavirus) infection. This is an important trend from a clinical point of view, since Hpv-positive oropharyngeal cancer is associated with a better prognosis and treatment results. Despite its visually accessible location, the diagnosis of oropharyngeal cancer can be challenging due to the complexity of its anatomical structure. The active development of minimally invasive transoral microsurgery, combined with fluorescent technologies, demonstrates the effectiveness of early diagnosis of oropharyngeal tumors.

Aim. To improve the diagnosis of oropharyngeal tumors, introduction into clinical practice of transoral microsurgical resections with double contrasting.

Materials and methods. In the clinic of plastic surgery of the first moscow medical university named after I.M. Sechenov, a method for early diagnosis of oropharyngeal cancer was developed. The method consisted in intraoperative sequential double contrasting of the mucous of the oropharynx with indocyanine green and methylene blue, followed by autofluorescent videopharyngoscopy, transoral microsurgical, video-assisted resection based on the use of an operating microscope and rigid end-point optics (endoscope). Eleven surgeries were performed successfully.

Results. The postoperative period was smooth and uncomplicated in all patients. According to the data presented, local recurrence was confirmed in 18 % (2 patients out of 11) after special treatment for oropharyngeal cancer using our method.

Conclusion. Modern treatment of cancer patients requires not only cure, but also careful monitoring of the disease. The use of transoral video-assisted and microsurgical resection based on double contrasting is an alternative method for early diagnosis of both primary oropharyngeal cancer and its recurrence.

Introduction. A significant proportion of patients with malignant neoplasms of the head and neck have protein and energy deficiency, which is associated with the localization of the tumor in close proximity to the proximal digestive tract, its aggressive growth, the presence of complications of the tumor process, as well as drug and / or radiation treatment. If there is a violation of the full replenishment of the need for nutrients in a natural way, the need for longterm nutritional support at the stages of antitumor treatment and the preservation of the function of the gastrointestinal tract, the method of choice is the formation of a gastrostomy. In addition to the effects of its direct purpose, gastrostomy promotes social adaptation of patients, as well as eliminates the risks associated with the installation and prolonged use of a nasogastric tube, and is compatible with other surgical procedures at the stages of antitumor treatment, symptomatic and palliative care.

Aim. To evaluate the clinical and social significance of performing gastrostomy in patients with squamous cell carcinoma of the head and neck.

Materials and methods. The present study included 150 patients with squamous cell carcinoma of the head and neck organs who underwent minimally invasive gastrostomy (133 / 150; 88.7 %), open-label (11 / 150; 7.3 %) or interventional under CT control (6 / 150; 4 %). In 88 (58.7 %) patients, gastrostomy was combined with other medical procedures (tumor biopsy, tracheostomy, selective intraarterial embolization). Descriptive statistics methods and the t-test were used to evaluate the results of the study. The differences were considered significant at p <0.05.

Results. Postoperative complications were observed in 12.7 % of patients, hospital mortality was 2 %. The average length of stay of patients in the hospital with uncomplicated course of the postoperative period was 7.1 ± 5.0 days, in the presence of complications – 18.2 ± 18.5 days. Among patients receiving antitumor treatment after gastrostomy drainage, the median time between gastrostomy and its onset was 20 days, and the median overall survival was 261.5 days. for patients under medical supervision, the median overall survival reached 621 days. This indicator in patients who did not receive antitumor treatment after gastrostomy and patients referred to the palliative Care Center was 52 and 61 days, respectively.

Conclusion. performing gastrostomy in a minimally invasive manner is an essential component of the prehabilitation of debilitated patients with complicated squamous cell carcinoma of the head and neck organs. This manipulation allows you to start or resume antitumor treatment, as well as increase overall survival.

Introduction. Squamous cell carcinoma of the oropharynx associated with Human papilloma virus (Hpv) has been identified as a distinct nosological unit among squamous cell carcinoma of the head and neck. This is due to the peculiarities of the disease and localization (the tumor mainly occurs in the palatine or lingual tonsils). primary squamous cell carcinoma of the oropharynx often debuts in the form of cancer metastases from an undiagnosed primary focus.

Aim. To show relationship between presence of the Hpv marker p16 in patients with metastases from an undiagnosed primary focus with primary squamous cell carcinoma of the oropharynx.

Materials and methods. The retrospective study included 151 patients with cervical lymph node metastases from an undiagnosed primary focus, treated from 2014 to 2024 in the Oncology Department of Surgical methods of Treatment No. 10 of the N. N. Blokhin National medical Center of Oncology, 83 of whom were found to have p16 – a surrogate marker of Hpv.

Results. The findings suggest a strong relationship between the presence of Hpv in the metastatic focus and oropharyngeal squamous cell carcinoma. The difficulty of identifying the primary focus is most likely due to the small size of this focus and its submucosal location, as well as with early metastasis to the lymph nodes.

Conclusion. In order not to miss clinically latent squamous cell carcinoma of the oropharynx, interdisciplinary collaboration and conduct of thorough immunohistological study, especially a surrogate marker test for Hpv p16, are needed.

Introduction. Anemia is a common complication of malignancies and anticancer treatment. In this regard, it is of great importance to predict the most likely outcomes in cancer patients with this pathology in the distant and medium periods.

Aim. To analyze the factors that determine the prognosis in patients with anemia in malignant neoplasms and develop a methodological approach to predicting adverse, including fatal, outcomes in such patients in 3- and 5-year follow-up periods.

Materials and methods. A cohort retrospective study was conducted. A group of patients with anemia in malignant neoplasms who received medical care was identified. To assess the factors that determine the outcome of this pathology, patients are divided according to the binary principle. The minimum sample size was determined using Altman nomograms. methods of non-parametric statistics (χ²-criterium) were used for statistical processing of data. The assessment of factors that cause an unfavorable prognosis in patients with anemia in malignant neoplasms was carried out by calculating the diagnostic coefficient according to A. wald and the informative coefficient according to S. kulbak.

Results. It was found that the greatest role in formation of an unfavorable outcome of cancer is played by cardiovascular diseases, diabetes mellitus and cirrhosis of the liver. Among the therapeutic measures, the pathogenetic treatment of anemia with drugs that stimulate erythropoiesis, started during the period of antitumor therapy, has the greatest effect on the favorable outcome, which causes an increase in frequency of favorable outcomes to 5.5 and 4.8 % over 3 and 5 years, respectively.

Conclusion. The methodological approach developed by us to assess probabilities of formation of adverse outcomes in patients with anemia in malignant neoplasms can be used to solve expert and clinical problems, determination the risk of an unfavorable outcome and justification the indications for the timely start of therapy.

Introduction. A fairly large number of cancer patients with surgical pathology enter a hospital with nutritional insufficiency of varying degrees. According to the international screening study Nutrition Day, weight loss is associated with a higher risk of inpatient death within 30 days in patients undergoing surgery as compared with patients who were not treated surgically. pain syndrome in the postoperative period has a negative effect on all vital systems of the body, increases the wound healing period and creates a risk of adverse hemodynamic events, thromboembolic complications and chronic pain syndrome. Enhanced sympathetic stimulation inhibits peristalsis and enhances the smooth muscles tone of the intestine, which is fraught with the development of postoperative intestinal paresis. Opioid-associated adverse events such as respiratory depression, gastrointestinal disorders (nausea, vomiting, constipation), sleep, endocrinopathies, cognitive impairment, high risk of addiction and drug dependence impair the quality of care provided

Aim. To compare the effectiveness and safety of the innovative Russian analgesic Tafalgin® and morphine in cancer patients with nutritional insufficiency in the early postoperative period.

Materials and methods. The open-label randomized controlled trial included 80 patients who underwent abdominal surgery. patients received multimodal analgesia with either tafalgina or morphine.

Results. According to the data obtained during the study, tafalgin provides analgesia comparable to morphine, while contributing to earlier mobilization, reducing the length of hospital stay, reducing the incidence of postoperative complications, hypoxemia, nausea and vomiting. The drug was also associated with lower severity of sedation and daytime sleepiness.

Conclusion. Tafalgin has demonstrated high analgesic potential and a better safety profile as compared to morphine allowing its use in multimodal analgesia in cancer patients with nutritional insufficiency after abdominal surgery.

Inflammation of the submandibular region occurs quite often in dental practice. The ethology and clinical manifestations of this pathology are diverse and despite the great possibilities of conservative therapy, in some cases it is necessary to perform surgical intervention. The causes of inflammation in the submandibular region are odontogenic diseases, lymphadenopathies, sialorrhea, neoplasms of submandibular salivary glands and sialolithiases. The odontogenic abscesses (88.9 % of cases) and phlegmon (2.7–3.4 % of cases) of the maxillofacial region account for 88.9 % of oral infections. Odontogenic diseases are accompanied by impaired colonization resistance of the oral cavity and are of a big problem. Lifadenopathies in the submandibular region occur in 70 % of cases, while surgical treatment is required for 4 % of patients with this pathology, intensive postoperative medical therapy – 1.7 %, lethality occurs in 0.12 % of cases. Sialorrhea often develops in patients with mental retardation, cerebral palsy, autism, and neuromuscular or sensory dysfunctions. with low efficacy of anticholinergic drugs or botulinum toxin arministration, the main treatment is submandibular resection. Benign neoplasms of the submandibular salivary glands occur in 13 % of cases and are malignancies more often than tumors of the parotid gland. Neoplastic diseases of the submandibular glands of the maxillofacial region account for 34 to 54 %. The most common pathology of these glands is salivary stone disease which occurs in 80–90 % of cases.

Aim. To analyze the main causes of inflammation in the submandibular region, requiring surgical intervention

Cancer of the nasal mucosa is a malignant tumor originating from the mucous epithelium of the nasal cavity or paranasal sinuses. Nasal and paranasal sinus cancer accounts for 1.4 % of all malignancies and 3–5 % of head and neck tumors. males are twice as likely to be affected as females, particularly those aged 55 years and older (nearly 80 % of cases). The five-year survival rate is 8 2 % in patients with stage I disease and 43 % in patients with stage Iv disease. Despite the advances in the diagnosis of nasal cancer, over 80 % of new patients are diagnosed with stage III–Iv disease because of nonspecific symptoms in early (I and II) stages. Traditional treatment methods (including surgery, radiation therapy and chemotherapy) often allow us to achieve complete recovery in patients with this disorder. However, in most patients with locally advanced cancer, this approach has a limited effectiveness and is often associated with severe side effects. Considering frequent progression of nasal squamous cell carcinomas on standard regimens, it is necessary to search for new treatment targets to improve outcomes. Extensive molecular testing using multigenic panels based on next-generation sequencing can be helpful in this case. The most common mutations in nasal cancers occur in five genes: TP53 (up to 80 % of cases), EGFR (up to 77 % of cases), IDH2 (approximately 55 % of cases), PIK3CA (14 % of cases), and CDKN2A (9 % of cases). we report a case of successful treatment of a patient with locally advanced, non-resectable, drug-resistant nasal squamous cell carcinoma with a rare driver mutation.

Nasopharyngeal carcinoma (NpC) is a malignant tumor developing from the non-keratinizing epithelium of the nasopharynx. In 2022, more that 530,000 new NpC cases were registered worldwide. The rate of NpC in the Russian federation reaches 0.3 % among all malignancies and up to 2 % of head and neck cancers. The 5-year overall survival rate varies from 90 % in patients with stage I NpC to 40 % in those with stage Iv NpC. Over 40 % of newly diagnosed NpC patients already have stage Iv disease.

In this article, we report a case of successful treatment of a patient with locally advanced recurrent nasopharyngeal carcinoma.

Ductal adenocarcinoma of the gland is a rare malignancy characterized by high rate of metastasis and poor survival. Immunohistochemical findings indicate that 40 % of patients demonstrate overexpression of the human epidermal growth factor receptor 2 (HER2) (2–3+). In patients with distant metastases, targeted anti-HER2 therapy is the only effective method.

This article describes our experience of successful targeted therapy in a patient with HER2-positive ductal adenocarcinoma of the submandibular gland.

The article provides a review of the literature on the problems of voice prosthetics that specialists face in real clinical practice. A comparison of this method with other methods of restoring vocal function is presented, and non-standard clinical cases of treating patients with malignant tumors of the larynx who underwent laryngectomy with tracheoesophageal bypass surgery and the installation of a vocal prosthesis are described.