Colon cancer represents a heterogenous disease group, which differ by cancerogenesis mechanisms, molecular alterations, prognosis and treatment possibilities. In modern clinical practice assessment of KRAS and NRAS genes status is already necessary in order to prescribe anti-EGFR treatment for metastatic disease. A separate poor prognosis group are patients with BRAF mutation. In this review we will focus on biological features of BRAF-mutant colorectal cancer, its epidemiology, clinical features on different stages, treatment choice and promising new treatment possibilities.

This is a review of the literature on the application of magnetic resonance imaging as a method of preoperative staging of colorectal cancer, total mesorectal excision with pathologic evaluation of the lateral resection margin and the clinical significance of molecular markers of drug therapy.

A new combined treatment scheme with short-course chemoradiotherapy and 2 selective radiosensitizers (metronidazole in a polymeric composition and local hyperthermia) is investigated in this article.

Material and methods. 77 T1–3N0–2M0 rectal cancer patients treatment data was analyzed. All patients received 5 Ч 5 Gy radiotherapy with capecitabine 1300 mg/m2 days 1–5 per os and radiosensitization with local hyperthermia and metronidazole.

Results. Investigated treatment scheme has acceptable toxicity and leads to high local control rate (none of the patients experienced local recurrence). 7 (9.1 %) patients developed distant metastases. 59 (76.6 %) patients had sphincter-sparing surgery. Median followup was 65.6 months. 5-year survival rate was 81.7 %.

Conclusion. Developed treatment scheme is safe and leads to high local control rate.

Background. At present liver resection combined with chemotherapy is the only treatment for isolated resectable colorectal cancer liver metastases that potentially can achieve cure. Effective preoperative chemotherapy allows us to evaluate chemoresponsiveness of the tumor and increase metastases resectability.

Materials and methods. Between 2006 and 2011, 60 patients with potentially resectable colorectal cancer liver metastases were included in the study. All patients received preoperative oxaliplatin- or irinotecan-based chemotherapy; average duration of treatment was 3.6 ± 0.11 months. Liver resection was performed after chemotherapy: 29 (48.3 %) pts underwent hemihepatectomy, 11 (18.3 %) pts – extended hemihepatectomy and 20 (33.4 %) pts – segmentectomy. Pathologic response in liver metastases was assessed to analyze efficacy of preoperative chemotherapy.

Results. Objective response to preoperative chemotherapy was observed in 33 (55 %) pts. 23 (38.3 %) patients had stable disease. The maximum effect of preoperative chemotherapy was achieved in patients with bilobar liver metastases, receiving combination with oxaliplatin – in 23 (63.9 %) cases. Side effects of 334 cycles of preoperative chemotherapy were assessed. In most cases, adverse events were not clinically significant. Side effects of grade III/IV in 18 (5.4 %) cycles were observed in 12 (20 %) patients. 52 (86.7 %) patients underwent R0-resections; 8 pts had R1 (n = 5) и R2 (n = 3) resections of metastases. There were no postoperative deaths. Pathologic response was observed in 55/60 (91.7 %) cases: grade I was seen in 17 (28.3 %) cases; grade II – in 14 (23.3 %); grade III – in 20 (33.3 %) and grade IV – in 4 (6.8 %) cases. Pathologic response of grade III/IV occurred in 63.6 % patients with partial treatment response and 13 % pts – with stable disease (р = 0.01).

Conclusions. Highest efficacy of preoperative chemotherapy in combined treatment of colorectal cancer was achieved in patients with bilobar liver metastases. Safety of two-component chemotherapy regimens was confirmed. This study presents significant correlation between preoperative chemotherapy efficacy and pathologic response in liver metastases.

Purpose. To conduct retrospective analysis of first line therapy with bevacizumab received by patients treated in Perm Regional Oncology Dispensary.

Methods. Analysis of treatment results of 28 patients who received first line metastatic colorectal cancer (mCRC) treatment including bevacizumab in Perm Regional Oncology Dispensary. Patients received bevacizumab 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks in combination with FOLFOX, XELOX or capecitabin monotherapy in first line treatment until disease progression. Patients continued bevacizumab with change of chemotherapy regimen after first disease progression if it was possible due to performance status.

Results. Disease control was reached in 21 (75 %) cases. Complete remission was detected in 3 (10.7 %) of patients, partial remission in 9 (32.15 %), disease stabilization in 9 (32.15 %) and disease progression in 7 (25.0 % ) of patients. Median time to progression was 12 months (from 4 to 36 months). R0 liver metastases resection was performed in 9 (35.7 %) patients after treatment. Median Overall Survival was 25 months.

Conclusions. The results of retrospective analysis are in line with the data of International Clinical Trials of bevacizumab in the mCRC therapy. Continuous bevacizumab treatment from first line with the following maintenance until disease progression and further continuation in second line treatment with the chemotherapy regimen change until progression made possible to increase the efficacy and survival of patients. Bevacizumab demonstrated good tolerability and did not increase toxicity of chemotherapy.

Introduction. Palliative care for oncological patients requires dealing with multiple disease symptoms and requires multi-drug therapy. The search for wide-spectre drugs which can affect different pathological pathways is a pressing matter.

Methods. The effect of hydralazine sulfate on life quality of 63 palliative care oncological patients ECOG > 3, who stopped all specific therapy was investigated.

Results. Positive correlation between hydralazine sulfate use and dose of analgetics was observed, as well as reduction of need for symptomatic therapy. The median daily use of tramadol slightly increased from 263.5 ± 4.7 to 317.2 ± 3.4 mg. In 19.4 % patients after 1 month of hydralazine sulfate therapy pain was reduced to “low” and tramadol was cancelled. Decrease in symptomatic therapy need was observed in 85 % patients.

Conslusion. Use of hydralazine sulfate in palliative oncological care improves treatment and life quality.

A clinical case of a sigmoid cancer patient with solitary lung metastasis is discussed in this article. Use of minimally invasive surgical technologies allowed to perform a simultaneous combined surgery on abdominal and thoracic cavities and improve rehabilitation time and time to systemic chemotherapy initiation. In presented clinical case patient was comorbid with stage III obesity, which was considered as a contraindication to laparoscopic surgery for a long time.