[Radiation pneumonitis in the treatment of early-stage breast cancer]

Despite of improvement of radiotherapy techniques and increasing usage of conformal radiation therapy which provides decrease of dose for normal tissues and organs, cases of radiation-induced injuries are still registrated. The aim of this study is to determine frequency and severity of lung toxicity in 513 breast cancer patients with Tis-2N0-2M0 disease after breast conserving surgery and chemotherapy depending from radiation therapy technique and irradiation volume. It is quite clear that in breast cancer patients frequency of lung toxicity after breast conserving surgery and RT increases from 20-24% when irradiating only breast to 37-41% when irradiating breast and regional lymph nodes. In our analysis the frequency of lung toxicity was quite similar for 2D conventional therapy (27,4%) and for 3D conformal therapy (28,7%). The risk of developing radiation pneumonitis increases dramatically with extension of V20 for ipsilateral lung more than 30%, mean lung dose more than 18 Gy, in patients with initial small volume of the lung (less than 110 cm3).

[Multiple endocrine neoplasia type 1 syndrome with three classical components and chiasm glioma: specific features of target organ lesions and a clinical observation]

The article briefly reviews the specific features of target-organ lesions in multiple endocrine neoplasia type 1 (MEN1) syndrome and a clinical case of genetically confirmed MEN1 syndrome in a young female patient. Despite the relative rarity of this disease, timely diagnosis, treatment and screening for its main components are very important for the overall prognosis of patients with MEN1 and their first-degree relatives who are MEN1 gene mutation carriers. The described case is noteworthy for a number of specific features. The authors could find no account of optic chiasm glioma within the framework of MEN1 in the literature. Moreover, therapy-resistant somatoprolactinoma engages attention, which points to its aggressive nature with pituitary adenoma that is not been clearly visualized on magnetic resonance imaging. Of interest is the order of detection of neoplasms, in particular the manifestation of hypoglycemic episodes as a sign of organic hyperinsulinism. which have been initially regarded as epileptic seizures, after the use of sustained-release somatostatin analogues for the treatment of acromegaly.

[Endoscopic diagnosis of multiple primary cancer of the upper airways]

The authors analyze the results obtained at comprehensive examination of 123 patients with multifocal synchronous and metachronous cancer of the upper respiratory tracts and the lungs. Cancer of the larynx and the lungs was registered in 107 patients, multifocal cancer of the pharynx and lungs in 16 patients. Synchronous and metachronous cancer of the larynx and the lungs was diagnosed in 48 (44.9%) and 59 (55.1%) patients, respectively. High efficacy of endoscopic diagnosis is shown for multifocal cancer of the larynx and lungs, pharynx and lungs.