Currently, replacement of major joints and bones with endoprosthesis in patients with bone tumors is the golden standard in the treatment of this category of patients. The most frequent complications are instability of prosthesis (fractures, aseptic loosening), infection of the bed of the implant, dislocation of the implants. In the department of general oncology 625 joint replacement 518 patients were performed. Dislocations frequency after prosthetics of a humeral joint was observed in 4,1% (3/73), 7,6% (6/79) - after prosthetics of proximal part of femurs, 18% (7/39) after total replacement with endoprosthesis of the femur. Thus, among all the cases 30,6% (191/625) were endoprosthesis replacement of proximal femoral and humeral bones and total replacement of a femur with endoprosthesis. Currently the intraoperative reconstruction of the capsular apparatus of large joints using synthetic materials is considerable.

Background. To evaluate the method of percutaneous vertebroplasty as the way of treatment, that increase quality of life in patients with spinal metastasis. Methods. Since 2001 to 2009 years in N.N. Blokhin Cancer Research Center was made 235 vertebroplastic surgeries in 168 patients with spinal metastasis. Predominantly vertebroplasty was made in patients with metastasis of kinder cancer, breast cancer, multiply myeloma. The main indication for this procedure was pain syndrome from the tumor invasion in the vertebral column and prophylaxis of pathologic vertebral fracture. Results. Increase of quality of life after percutaneous vertebroplasty was observed in 84% of patients. Coclusion. Comparative simplicity of vertebroplasty, its high effectiveness and safety allow wide using this method in clinical practice.

Purpose. To evaluate the influence of resection width on the rate of local recurrence in patients with soft tissues sarcomas. Materials and methods. 30 patients (16 male, 14 female) were observed. The mean age was 44 years old. There were 14 (47%) patients with initial tumors, and 16 (53%) with local recurrence after the treatment. All patients receive neoadjuvant chemotherapy. Neoadjuvant radiation therapy was performed in 6 (19%) patients. All patients had surgical treatment done in time. The mean tumor volume was 1540 cm³. The adjuvant treatment was performed in 18 (69%) patients (chemotherapy inll, radiology in 4, both methods in 1 and surgical treatment of lungs metastasis in 2 patients). Results. The mean size of resection margins was 20mm. The mean follow up was 26 months. The local control rate was 87%. Disease free interval was 19 (63%), overall survival - 22 (73%). Resume. Combined method with radiology in treatment of patients with soft tissues sarcomas has specific advantages in a contrast with surgical treatment alone, and provides better disease free interval and overall survival.

Data on radio- and thermoradiotherapy of 83 patients with extra-abdominal desmoid tumors are discussed. In a group of 57 patients followed up for 10 years or less, the relapse-free survival rates, in thermoradiotherapy-treated cases, were significantly higher (74,4 and 28,6%) than in those receiving radiotherapy (9,3 and 57,1%). Monitoring tumor temperature during local hyperthermia is a factor of relapse-free survival of vital importance.

This is a literature review on soft tissue sarcomas (STS) chemotherapy that brings up a new spin of treatment strategies development. During the past two decades there were almost no changes in this part of medical oncology and the new era in the treatment of the advanced disease recently started. New approaches nowadays maybe noticed not only in the treatment development but also in the evaluation and methodology of tumor responses because time to progression and overall survival are more clinically significant then short-term tumor shrinkage. According to histological subtype there are a lot of new treatment options- taxanes in angiosarcomas, temozolomide and bevacizumab in hemangiopericytomas, docetaxel and gemcitabine in leiomyosarcomas.The new antitumor agent trabectedine (ecteinascidine, Yondelis) isolated from tunicate Ecteinascidia turbinata shows encouraging antitumor activity and is approved by EMEA in European Union and in Russia. Pooled analysis of phase II studies of trabectedine showed 51,4 % of disease control rate (objective response + SD) in STS patients that failed conventional ifosfomide- antracycline regimens. Twenty nine percent (29%) of patients were alive after 2 years and overall survival was 10.3 month. Leiomyosarcomas and liposarcomas appeared to be particularly sensitive to the drug with noncumulative manageable toxicity. Many new molecules are under clinical investigation now that showed antitumor activity in STS such as bevacizumab, sorafenib, pazopanib, masatinib and many others, based on preliminary publications. So the new approach should be used for chemotherapy administration based on the tumor morphological subtype and grade.

Malignant soft tissue tumors are very rear and makes less then 1% of all cancers. They are characterized with a rapid aggressive onset, high frequency of local recurrences and high metastatic potential. Even nowadays there are a lot of difficulties during primary diagnostics of this rear group of malignancies that leads to misdiagnosis, wrong treatment algorithms and finally to increased tumor growth. Reasons of late and misdiagnostics are widely discussed in this article.

Treatment of the soft tissue sarcomas requires multidisciplinary approach. Tumor dissection according to the anatomic areas sometimes leads to wide defects with major vessels, nerves or bone skeletization. Introduction of the plastic reconstructive surgery, vascular surgery in the treatment of this group of patients significantly increased percent of limb salvage surgeries, decreased postoperative complications and improved quality of life. Treatment results of 51 pts with locally advanced soft tissue sarcomas were analyzed. Free and transferred flaps were used. Indications, surgery techniques, results and possible complications for rectoabdominal (transferred and free on microvascular anastomosis flaps), transferred sural and thoracodorsal flaps were analyzed. Results showed that using reconstructive and vascular surgery the frequency of limb salvage surgeries maybe significantly increased in that group of patients. Local control results and better quality of life maybe achieved by using transferred regional flaps and free microsurgical autotrasplats.

Giant tumors (diameter more than 20 cm) make 10% of all sarcoma cases. One of possible ways of increasing ablastics and decreasing intraoperation blood loss can be tumor cryosurgery and endovascular embolization of tumor blood supply vessels. We have had 16 patients with giant soft tissue sarcomas under the supervision. The basic group was made of 8 patients, who have undergone cryosurgery and endovascular embolization before and during surgical intervention. At the operative intervention we have noticed significant decrease in blood loss from the disintegrating tumor tissue. The period of supervision for the basic group of patients has made from 3 months up to 1,5 years. There were no signs of tumor relapse. Thus, cryosurgery and endovascular embolization of giant tumor blood supply vessels result in appreciable increase in efficiency of surgical treatment with prospects of good late results

Plastic of defects of integument tissues with a musculocutaneous flap have been applied in the treatment and rehabilitation of 150 patients with skin and soft tissue tumors. Successful plastic facilitated timely implementation of additional antineoplastic treatment. The method has perspectives for further development and implementation in oncology.

Ninety patients with Ewing sarcoma family tumors (ESFT) of the pelvis were treated in the Institute of Pediatric Oncology and Hematology between 1972 and 2007. Three different protocols of chemotherapy were used. Between 1972 to 1988 protocol consisted of VAC for the control group (CG) I: 32 pts, nonmetastatic - 25, disseminated - 7, between 1988 to 1997 of VACP for control group II: 30 pts, nonmetastatic - 23, disseminated - 7. From 1997 till 2007 induction chemotherapy (CT) for pts (28, nonmetastatic - 18, disseminated - 10) of investigation group (IG) III consisted of vincristine 1,5 mg/m²/d, days 1, 8, 15, adriamycin 37,5 mg/m²/d, days 1, 2 as a 24-h infusion, cyclophosphamide 2,1 gr/m²/d, days 1, 2 (1, 3, 5 cycles), and ifosfamide 2,4 gr/m²/d, days 1-5, etoposide 100 mg/m²/d, days 1-5 (2, 4 cycles). Local treatment consisted of radiotherapy in all cases. After local treatment pts of IG received HD CT with melphalan 140 mg/m², busulfan 16 mg/kg. PBCS were reinfused mean 6,0 x 10⁶ CD34+/kg. The 5-year disease-free survival rates were 3,1% for CG I; 13,3 for CG II and 69,8% for IG III. These results are significantly worse for CG I and II than the ones achieved in 28 patients of IG III with new innovative methods for treatment.

We studied type 1 and 2 fibroblast growth factors (FGF-1, FGF-2) and endostatin in the serum obtained from 58 untreated bone tumor patients and in the serum of 21 practically healthy subjects. FGF-1, FGF-2 and endostatin were measured by enzyme immunoassay in the serum using «R&D» kits (USA). Frequency of FGF-1 determination in serum was in 2,5 times higher in patients with bone tumors than in healthy subjects (p=0,004). All samples contained FGF-2 and endostatin. Endostatin levels in practically healthy subjects were lower than in patients with bone tumors (p=0,005). FGF-1 levels in patients with osteosarcoma were significantly lower than in patients with chondrosarcoma (p<0,05), there were no significant differences in FGF-2 concentrations in patients with various types of affected bone. No significant correlations were found between FGF-1, FGF-2 and endostatin levels in practically healthy subjects and in patients with bone tumors. We demonstrated differences in 3-years overall survival in patients with bone sarcomas depending on serum FGF-1 and endostatin levels.