Aim. To present data on the structure of bacterial pathogens causing infectionsin cancer patients atthe N.N. Blokhin National Research Center of Oncology and analyze them in comparison with data of domestic and foreign literary sources.

Materials and methods. The data of 11,853 microorganisms isolated from patients hospitalized in the N.N. Blokhin National Research Center of Oncology in 2023 were analyzed.

Results. Bacteria accounted for 90.0 % of all isolated microorganisms and only 10.0 % were fungal pathogens. Despite the fact that gram-negative pathogens have given way to gram-positive pathogens in absolute numbers, gram-negative microorganisms (60.7 %) still prevail in “clinically significant” biomaterials (blood, spinal fluid, urine, wound discharge, BAL, etc.), primarily Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and others. With the exception of Escherichia coli, a high percentage of carbapenem-resistant strains is noted for other pathogens: Klebsiella pneumoniae – 34 %, Pseudomonas aeruginosa – 50 %, Acinetobacter baumannii – 69 %. Real-time polymerase chain reaction revealed the leading carbapenemases: in Klebsiella pneumoniae strains – KPC or OXA-48 carbapenemases were detected in 55 % of cases, and NDM metallo-β-lactamasesin 45 %; in Pseudomonas aeruginosa strains – VIM metallo-β-lactamases were registered in 29 % of cases. Among gram-positive microorganisms, the most problematic is vancomycinresistant Enterococcus faecium. It accounts for 45 % of all E. faecium strains.

Conclusion. Along with modern diagnostics and infection control measures, knowledge of the leading microbiota in a particular clinic will prevent the spread of infection and provide timely medical care to patients.

Aim. To investigate the methods of early diagnosis of oxaliplatin-induced peripheral neuropathy (PN).

Materials and methods. The study included 52 patients with diagnosis of metastatic colorectal cancer receiving 1st line polychemotherapy per the mFOLFOX6 scheme ± targeted therapy who prior to each cycle filled out the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy (EORTC QLQ CIPN 20) and were subject to neurological examination using the Neuropathy Disability Scale (NDS).

Results. The analysis included 28 patients who completed polychemotherapy: 16 (57,2 %) men and 12 (42,8 %) women, mean age 60.0 ± 10.0 years. Fridman’s two-way analysis of variance by ranks showed significant changes in the scores (sensory, motor, autonomic) of the EORTC QLQ CIPN 20 questionnaire with the increase in the number of chemotherapy cycles (р = 0.001). Significant increase in the sensory and motor scores was observed after the 3rd cycle, in the autonomic – after the 6th cycle. Significant increase in NDS score was observed starting at the 3rd cycle, and vibration sensitivity on the medial ankle or at the base of the 1st toe significantly decreased after the 1stcycle. Median number of cycles at which oxaliplatin dose was reduced or the drug was discontinued due to clinically significant symptoms of PN irrespective of questionnaire results and neurological examination was 6.

Conclusion. According to the results of the study, the following conclusions were made: 1) sensory scale of the 3-part EORTC QLQ CIPN 20 questionnaire (9 questions of 20) or motor scale (7 questions of 20), vibration sensitivity can be considered as stand-alone informative tests; 2) in a large patient cohort, NDS score increase to 5, EORTC QLQ CIPN 20 sensory scale score increase to 12 and higher or decreased vibration sensitivity on the medial ankle or at the base of the 1st toe to 4.5 arbitrary units should be considered early manifestations of PN; 3) for a routine algorithm, it is acceptable to consider a combination of 9 questions of the sensory or 7 questions of the motor scales of the EORTC QLQ CIPN 20 questionnaire and evaluation of vibration sensitivity on the medial ankle or at the base of the 1st toe to decide on oxaliplatin dose reduction or measures for prevention of peripheral neuropathy symptom worsening. 

Neuroendocrine tumors are a large and heterogeneous group of tumors that develop from neuroendocrine cells. To define this type of tumor, the well-established term “carcinoid” continues to be used in clinical practice for years. In accordance with the characteristics of embryogenesis, three groups of neuroendocrine tumors are distinguished. The source of these tumors are neuroendocrine cells, which are located in almost all organs. The term itself and the concept of “neuroendocrine cell” have historically been repeatedly reassessed. In 1969 A. Pearse, based on the ability of these cells to utilize and decarboxylate amine precursors, introduced the term “APUD system” (aminoprecursor uptake and decarboxylation). Neuroendocrine cells, although they can secrete the same substances as neurons, but, unlike the latter, they participate not in topical, but in paracrine regulation of organs and tissues. They are located in all human organs and are the most important tool for maintaining homeostasis.

In recent years, more and more publications have appeared about the frequent localization of neuroendocrine tumors in the lungs, and new approaches to the diagnosis of this pathology. This review presents the diagnostic features and clinical course of pulmonary neuroendocrine tumors.

The problem of supportive therapy in oncology is extremely important. At every step of specialized therapy, close attention should be paid to the quality of life of patients during treatment. Any drug used with the goal of improving patient’s quality of life is viewed by the clinicians with interest, especially if it’s a Russia-made drug which has recommended itself as effective for this goal.

Pelvic floor muscles training is the main method of treatment for urinary incontinence in prostate cancer patients after radical prostatectomy. For increasing the effectiveness of the method, the authors suggest starting the exercises before surgery and continuing them in the postoperative period. Other researchers modify the classic exercise program by adding exercises aimed at activating fast-twitch and slow-twitch muscle fibers, or combining with vibration therapy, electromyographic biofeedback. Pelvic floor muscles training in various combinations and modifications, as the literature review shows increases the effectiveness of recovery of urinary control function after radical prostatectomy in patients with prostate cancer.

The aim of this work is to describe a clinical case of a serious life-threatening adverse reaction in the form of neurotoxicity (convulsions, apnea requiring mechanical ventilation) to the polymyxin B drug, and also to remind that manifestations of neurotoxicity can be extremely varied and nonspecific, and do not occur after every administration, can be delayed, require vigilance and careful monitoring both from the attending physicians and from anesthesiologistsresuscitators, neurologists, ophthalmologists, etc.

A 62-year-old female patient diagnosed with stage IIIB T4G3N0M0 pleomorphic soft tissue sarcoma of the right thigh, condition after combination treatment, developed infection and necrosis of the postoperative wound (recto-abdominal flap). According to the results of a microbiological study and an antibiogram, the patient received polymyxin B as part of combination antibacterial therapy. On days 4, 5, 6, 7 of polymyxin administration, the patient experienced the following symptoms in various combinations: weakness, numbness of the face, paresthesia, paresis of the limbs, partial convulsions, respiratory depression, and apnea.

After establishing a connection between neurologicalsymptoms and intravenous administration of polymyxin B (the total score on the Naranjo scale was 6 points, the degree of reliability of the “adverse reaction–drug” relationship was probable) and drug withdrawal, manifestations of neurotoxicity completely disappeared and did not reoccur. The patient was discharged in satisfactory condition.

In a patient with symptoms of damage to the nervous system, it is necessary to conduct multiple differential diagnostic search to exclude stroke, epilepsy, encephalitis, hereditary and acquired neurodegenerative diseases, as well as side effects of medications. At the slightest suspicion of the likelihood of an adverse reaction to polymyxin B/colistimethate sodium, the Naranjo algorithm must be used to establish a cause-and-effect relationship between the adverse reaction and the drug.

The aim of this work is to evaluate the possibility of implementing the concept of enhanced recovery after surgery (ERAS) in perioperative treatment of an 80-year-old female patient with gastric stump carcinoma.

Analysis of the clinical case and available literature data was performed. The concept of ERAS demonstrates its effectiveness not only in standard oncosurgical practice, but also can be successfully extended to difficult clinical situations including in elderly patients. However, personalized approach to development of a specific ERAS protocol is necessary taking into account surgery volume, concomitant pathology and individual patient characteristics.

The use of individually selected points of the ERAS protocol taking into account oncological diagnosis, comorbidity, the type and technical features of the upcoming operation make the surgical stage of treatment not only safe, devoid of postoperative complications, but also more comfortable for the patient, positively affecting their quality of life. Our experience can be successfully applied in real clinical practice.