Kryzhanivska A. Locally advanced cervical cancer: treatment strategy and prognosis

Dissertation is devoted to the decision of issue of the day of modern oncogynecology to increase the efficiency of therapy of patients on natively widespread cervical cancer (NWCC) by the choice of optimum method of treatment on the basis of determination the clinical and molecular - biological features of tumour and application of technology of neuron networks. In basis of dissertation work are fixed results of complex investigation and treatment of 321 patients of NWCC. Application of courses of platen neoadjuvant chemotherapy on the first stage of treatment allows to attain a resectable tumour in 88,4 % cases, patomorfosis of ІІ - ІV degree in 95,9 % patients, and also to decrease the amount of reccurence on 34,6 % (p<0,05) and an amount of complications is 28,3 % (p<0,05), to increase general 5-years-old survival on 22,9 % (p<0,05), by comparison to a complete course of united radial therapy with potential of chemodrugs. It is selected molecular biological factors, related to survivability of patients on NWCC. To increase the expression of СОХ-2 and VEGF in the tumour cells of patients on NWCC for certain (p<0,001) correlates with clinical tumour's answer on neoadjuvant treatment (stabilizing is processing/partial regression) and by the II degree of medical patomorfosis for patients with the recurrence of disease. Connection of high expression of Ki-67 is set in tumour cells with the origin of recurrence of disease and the lowest indexes of survivability (p<0,01). A presence is set statistically reliable direct cross-correlation connection: an origin of reccurence of disease is with a pain syndrome to beginning of treatment, by localization of tumour, degree of medical patomorfosis, expression of COX-2 and VEGF; and also pain syndrome with the form of growth and localization of tumour; forms of growth of tumour with its localization, expression of COX-2 and VEGF. Technology of neuron networks and neat informing criteria is applied for determination of the most acceptable method of treatment of patients on NWCC, that are confirmed by high exactness - 94 %.