An analytical review of the current state of proton therapy in the world and in Russia is given, in particular, in the area of the relative biological effectiveness of proton irradiation, clinical indications for its use, the cost of proton therapy, the prospects for its further development, etc.

Results of radiation therapy of 92 patients with acute edematous (interstitial) pancreatitis are presented. Efficacy of roentgenotherapy was evaluated in correlation with total nidal dose and size of irradiated fields of the pancreas. Efficacy of acute edematous (interstitial) pancreatitis radiation therapy was clinically confirmed in local irradiation of involved parts and main innervation zones of the pancreas, with total nidal dose being up to 1 Gy.

Long-term outcomes of multimodality treatment patients with locally, radioresistance recurrent breast cancer. The 8-year survival rate in patients without repeated breast cancer recurrence was 87.5 ± 6.9 % after neutron and neutron-photon therapy and 43.7 ± 8.1 % after electron beam therapy (p = 0.0001). Neutron therapy was well tolerated and 1-2 grade radiation skin reactions were the most common.

Purpose: To examine the possibility of elastography in the intra-group differential diagnosis of soft-tissue sarcoma

Material and methods: The results of 82 ultrasound investigations of 41 patients with soft-tissue sarcoma are presented. All patients were tested by the ultrasound device Philips IU22 in two stages. In the first stage, a multipositional study was carried out in B-mode. In the second stage, compression elastography was investigated in order to assess the qualitative and quantitative indicators of the rigidity of the SMT. Quantitative assessment was based on the calculation of the stiffness coefficient of the Strain Ratio (SR). Next, shear wave elastography was performed to evaluate quantitative indicators of tumor stiffness measured in kilopascals (kPa).

Results: On the basis of the data provided, malignant tumors of soft tissue were mapped as 2^d, 3^d, 4^th and 5th elastographic type characterizing different morphological types of tumors. In 65.9 % of the cases soft tissue sarcomas (SMT) had the 4^th and 5^th type of staining, typical only for malignant tumors. Stiffness coefficient ranged from 5 to 7, and had a stiffness 11-20 kPa. For synovial sarcomas, the 4th and 5th elastographic type with a stiffness coefficient higher than 5 was typical. Myxoid liposarcomas had 2^d and 3^d type of staining, stiffness coefficient 5-6 and stiffness index 0-10 kPa. MPNST were characterized by a stiffness coefficient above 5, 4^th elastographic type and a stiffness index is 11-20 kPa.

Conclusion: Thus, an ultrasound study with the help of the elastography mode provides an opportunity to qualitative and quantitative assessment of the stiffness of malignant tumors, thereby allowing to get closer to the morphological verification of the tumor.

Purpose: To evaluate the capability of CEUS in the detection of CRLM in comparison with conventional grayscale B-mode.

Material and methods: 18 patients with CRLM underwent CEUS using the contrast agent SonoVue® (Bracco, Italy). The patients were divided into two groups: the first group - 10 patients (55 %) before to chemotherapy; the second group - 8 patients (45 %) after chemotherapy with the stabilization of the process. The enhancement patterns of liver metastases were evaluated during the vascular phases: arterial, venous, and delayed.

Results: The enhancement patterns of liver metastases on CEUS were categorized as diffuse homogeneous enhancement (30 % - in the first group; such enhancement wasn’t observed in the second group), rim-like hyperenhancement (70 % of the patients from the first group, 75 % of patients from the second group) and isoenhancement, such as intact liver parenchyma (25 % of the patients from the second group). There were detected additional metastases in 4 (22,2 %) of patients in the delayed phase. There were significant differences in time of the beginning the vascular phases between patients from the first and second groups. The latest beginning of the wash-in stage was observed in liver metastases in patients from the second group (25.8 s from the injection of the contrast). The earliest beginning of the wash out stage was observed in liver metastases in patients from the first group (42.4 s from the injection of contrast).

Conclusion: CEUS improves visualization of CRLM, in comparison with the grayscale B-mode. It is also possible to apply this technique in the assessment of chemotherapy in patients with CRLM, as there was a difference between the moments of the beginning wash-in and wash-out stages.

Ovarian cancer is the most frequent oncological disease in women. Annually more than 239 000 new cases are registered and more than 152 000 women die from this malignant tumor. Diagnosis of an early ovarian cancer is difficult because of the lack specific methods, which can help to detect tumors in early stages. In this article we analyzed the literate data according to the primary laboratory and instrumental methods of diagnosis, their role in diagnostics and treatment of patients with ovarian cancer.

The most frequently used terms and definitions associated with radiation accidents and medical errors in medicine are considered. The main differences in terminology used in Russian and international practice are analyzed. Identified problems in the definition of the concepts of excessive medical exposure. The issues of accounting for adverse situations associated with excessive and insufficient exposure of the patient are considered. The differences between medical errors, negligence and unavoidable adverse situations of medical exposure are discussed. The possibilities of introducing near-miss terms and events close to emergency in Russia have been analyzed. Conclusions about possible solutions to the problems raised in the article. This article may be useful to radiotherapists, radiologists and medical physicists, as well as public health authorities and regulatory authorities to understand the criteria for detection and procedures in the event of radiation accidents in medical practice.

We demonstrate the clinical case of malignant pancreatic insulinoma. The diagnostic algorythm in gastroenteropancreatic neuroendocrine tumors and measures, taken on different stages of treatment, are described. We show the potential of ⁶⁸Ga-DOTA-TATE positron-emission tomography combined with computed tomography in locating insulinoma, which is very difficult to find, using standart visualisation techniques. ⁶⁸Ga-DOTA-TATE is a new radiotracer, synthetic somatostatin analogue. The article comes with a short literature review.

This report presents the experience of effective use of combined radiation therapy in the combined treatment of distal locally advanced rectal cancer. The use of the proposed method as a component of the combined treatment of patients with rectal cancer, can increase the percentage of organ-preserving operations, as a consequence, to accelerate the process of rehabilitation and improve the standard of living, this category of patients.