Consilium Medicum
Peer-review medical journal
Editor-in-chief
- Prof. Victor V. Fomin, MD, Dr. Sci. (Medicine)
ORCID ID: https://orcid.org/0000-0002-2682-4417
Publisher
- CONSILIUM MEDICUM LLC
WEB: https://omnidoctor.ru/
About
Professional medical multidisciplinary journal , based on the principles of evidence-based medicine. Consilium Medicum magazine has been issued since 1999.
The journal publishes national and international recommendations, reviews, lectures, original works, and clinical cases dealing with the most actual problems of the modern medicine, as well as interviews with experts within the different fields of medicine and conferences, congresses and forums reviews.
The journal is practically-oriented and publishes articles by leading clinicians who are professional in the special field of medicine in Russia, Ukraine, Belarus, and includes the high level of scientific information.
Consilium Medicum journal is the most popular journal among medical practitioners. There are 12 thematic issues per year. The journal is designed for therapeutists, pediatricians, cardiologists, endocrinologists, gastroenterologists, pulmonologists, dermatologists, obstetrician-gynecologists, urologists, nephrologists, neurologists, rheumatologists and physicians in other specialties, as well as for resident physicians, post-graduate students and senior students at medical universities.
Types of accepted articles
- reviews, systematic reviews and meta-analysis
- original research
- clinical case reports and series of clinical cases
- letters to the editor
- hystorical articles in medicine
Research fields
- Internal medicine
- Endocrinology
- Otorhinolaryngology
- Cardiology
- Neurology
- Phthisiology
- Surgery
- Rheumatology
- Urology
- Pulmonology
- Gastroenterology
- Gerontology and geriatrics
Publication, distribution and indexation
- Russian and English full-text articles;
- issues publish monthly, 12 times per year;
- no APC, Platinum Open Access
- articles distributr under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0).
Indexation
- Russian Science Citation Index (elibrary.ru)
- DOAJ
- CrossRef
- Google Scholar
- WorldCat
- Ulrich's Periodicals Directory
- CyberLeninka
Current Issue
Vol 26, No 6 (2024): Персонализированная онкология в реальной клинической практике
Articles
Efficacy of concomitant therapy with ademetionine in antitumor drug therapy: A review
Abstract
Liver injury caused by antitumor therapy is a common disorder in patients with malignancies. It is due to the introduction of new innovative drugs into the treatment, which significantly increases the duration and quality of life, but also the frequency of side effects with liver damage of varying severity. The rate of hepatotoxicity during chemotherapy ranges from 5% to 100%. The spectrum of morphological changes in the liver is diverse and includes acute and chronic liver injury with damage to hepatocytes and outcome in fibrosis. The clinical features of the diagnosis of various types, variants, and phenotypes of drug-induced liver injury in the chemotherapy of solid tumors and hematological malignancies are addressed. The article reviews the literature on concomitant treatment with ademetionine to reduce metabolic disorders and hepatic toxicity caused by cytotoxic therapy. Clinical and biochemical effects persist for a long time after treatment. The results of using ademetionine to correct clinical symptoms such as fatigue are described in detail. The presented data supports a practical revision of the role of concomitant therapy with ademetionine to prevent and reduce the manifestations of hepatotoxicity induced by polychemotherapy. This approach contributes to a personalized approach to patients with malignancies, thereby significantly improving medical care and increasing the duration and quality of life.
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Efficacy of immunotherapy in small cell lung cancer: A retrospective stude
Abstract
Background. Small cell lung cancer (SCLC), predominantly due to smoking, is a highly differentiated, rapidly growing epithelial cell carcinoma of high malignancy originating from bronchial neuroendocrine cells. Almost 70% of SCLC patients have metastases at the time of diagnosis, which requires the use of drug therapies, including immunotherapy.
Aim. To evaluate the efficacy and safety of immune checkpoint inhibitors in patients with small cell lung cancer.
Materials and methods. One hundred and twenty one patients (90 men and 31 women) aged 44 to 84 years were included in the retrospective multicentre non-randomised study. The majority (90.9%) of patients were treated in the 1st line of therapy. IT were administered in the 2nd line and subsequent lines of treatment in 9.1% of patients. Weakened (ECOG 2–3) state at the time of treatment initiation was noted in 30 (24.8%) patients.
Results. Progression-free survival in patients with SCLC receiving 1st-line treatment was 5.82 (95% CI 3.92–7.72) months, and 2nd-line and beyond was 6.21 (95% CI 0.76–11.66) months. Survival in patients with small-cell lung cancer receiving 1st-line IT was 8.0 (95% CI 6.18–9.81) months, and 2nd-line or longer was 11.3 months (95% CI 4.31–18.29) months (p=0.108). Objective response was achieved in 43 (35.5%) patients, of whom 38 (34.5%) were on first-line IT and 5 (45.5%) patients were on 2nd or more. iAEs grade 3–4 was observed in only 18 (14.9%) patients.
Conclusion. Immunotherapy for SCLC allows achieving high rates of objective response and disease control. This method of treatment is characterized by insignificant number of grade 3–4 immune-mediated adverse events, which indicates an acceptable safety profile.
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Experience of organizing BCG therapy for localized bladder cancer in outpatient cancer care centers
Abstract
Background. The clinical course of non-muscle-invasive bladder cancer is characterized by a tendency to develop local recurrences and the ability to tumor progression. The most effective method of preventing disease progression after transurethral resection of the bladder in patients of intermediate and high-risk groups is intravesical therapy with BCG antitumor vaccine containing attenuated Mycobacterium tuberculosis. Taking into account the increasing incidence non-muscle-invasive bladder cancer in Moscow, the organization of adequate use of BCG vaccine in clinical practice requires the involvement of significant organizational and human resources.
Aim. To develop and validate an organizational model for the delivery of BCG therapy for non-muscle-invasive bladder cancer at an outpatient cancer care center using hospital-substitution technologies.
Materials and methods. In the period from June 2023 to May 2024, BCG therapy has been performed in Oncology Center №1 of Yudin Moscow City Hospital in 180 patients with verified non-muscle-invasive bladder cancer of intermediate and high-risk groups.
Results. The study revealed a trend towards an increase in the absolute number of early bladder cancer in Moscow in the period 2018–2023. According to clinical guidelines, treatment of patients with non-muscle-invasive bladder cancer includes determination of the risk of recurrence and tumor progression with subsequent formation of indications for intravesical BCG therapy. The regimen of administration depending on the risk of recurrence includes 18–42 instillations for 12–36 months after transurethral resection of the bladder with follow-up examinations every three months. The procedure of intravesical BCG therapy takes 1–2 hours and does not require hospitalization. An organizational model of treatment an outpatient cancer care center based on various forms of hospital-substitution technologies is presented.
Conclusion. Intravesical BCG therapy is a highly demanded method for the treatment of non-muscle-invasive bladder cancer. This method can be widely used in outpatient settings through the use of hospital-substitution technologies.
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Cervical cancer: Epidemiology, treatment, complications, and rehabilitation. A review
Abstract
Background. Cervical cancer (CC) is a malignant neoplasm of external localization, with incidence ranking 5th among genital tumors in Russia. A significant part of the cases involve women of working age. The management of cervical cancer depends on the stage of the disease, as well as the age and comorbidities. In most cases, radical surgery or chemoradiotherapy is performed alone or in various combinations. Surgery may include conization/amputation of the cervix, radical trachelectomy, or hysterectomy of various types, depending on the tumor stage. The interventions involve the resection of 2/3 of the vagina and the removal of parametrium at the level of the musculoskeletal walls of the pelvis minor. These types of interventions are traumatic and can lead to a deterioration in the quality of life of patients.
Aim. To analyze available rehabilitation methods for patients undergoing radical treatment for cervical cancer.
Materials and methods. The review presents data from Russian and foreign articles on this topic in the PubMed system.
Results. There are various surgical and non-surgical methods for correcting a short vagina in congenital malformations. However, there is still no universal and comprehensive approach to solving this issue in women after surgery for cervical cancer.
Conclusion. Cervical cancer remains one of the most serious medical and social problems of modern society. The very fact of diagnosis, which poses a threat of disability, social isolation, and death, as well as the antitumor treatment, negatively affects the physical and psycho-emotional state of women, significantly worsening their quality of life. Vaginal correction should be the next stage of postoperative treatment to restore sexual relations. However, the decision to use a particular method must be made in cooperation with the patient, considering all the risks and benefits for a particular case.
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Anemia as a predictor of poor outcomes in colorectal cancer surgery: A literature review
Abstract
Background. Iron deficiency anemia is a frequent consequence of colorectal cancer (CRC) which might lead to poor treatment outcomes.
Aim. To conduct a review analyzing the correlation between preoperative anemia and treatment outcomes (mortality, morbidity, survival) in CRC patients.
Materials and methods. The literature search was conducted in PubMed (NCBI) and Cochrane databases. Key query terms: colorectal cancer, anemia, mortality and survival rates, blood loss, hemotransfusion. The review included articles discussing the prevalence of anemia in CRC and its association with mortality, morbidity, survival.
Results. Anemia was found in 32–52% of CRC patients before surgery. It correlated well with higher incidence of postoperative morbidity and mortality as well as lower overall survival. The same findings were true regarding intraoperative blood loss and perioperative blood transfusion.
Conclusions. Preoperative anemia is a major modifiable prognostic factor in CRC patients along with intraoperative blood loss and perioperative transfusion. Thus, strong efforts should be invested in the development of patient blood management protocols. The most effective method of solving this complex problem is the introduction into clinical practice of the patient blood management concept, which includes the use of intravenous iron preparations at the preoperative stage, correction of coagulopathy, a comprehensive approach to intraoperative blood conservation, an extremely strict approach in determining the indications for hemotransfusion.
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Possibilities of therapy for neuropathic pain caused by chemo-induced polyneuropathy
Abstract
Background. In oncological practice, the study of neuropathic pain syndrome (NPS) in patients receiving chemotherapy (CT) is relevant. This disorder is accompanied by significant motor and autonomic disorders in the upper and lower extremities, which negatively affects the quality of life and daily activity of patients.
Aim. To study the formation and evaluation of the effectiveness of NPS therapy in cancer patients with chemo-induced polyneuropathy (CIPN) at various stages of CT.
Materials and methods. Sixty three oncological patients with different localization and stage of malignant neoplasm, having NPS and undergoing CT were examined. The average age was 56.3±9.4 years. Most often, patients had cancer of the stomach, breast, and ovaries. The main neurotoxic drugs used in the treatment of the tumor process were oxaliplatin, docetaxel, paclitaxel. The combination therapy was dominated by the carboplatin + paclitaxel scheme. As a therapy for NPS, 31 patients were prescribed a drug with antioxidant activity of azoximer bromide; 32 patients were prescribed duloxetine. The control group included 30 patients with cancer and CIPN who did not receive concomitant symptomatic therapy.
Results. During the use of symptomatic therapy, a decrease in the severity of NPS was observed in all patients in the main groups compared with the control group. There was a significant decrease in sensitive disorders, especially in the duloxetine group. In the group of patients receiving azoximer bromide, it was also possible to stabilize the pathological process in the reflex sphere.
Conclusion. CIPN and the associated NPS is an iatrogenic complication in cancer patients undergoing CT. Polyneuropathy not only significantly worsens the quality of life of patients, but also leads to a decrease in the effectiveness of treatment due to the need to correct therapeutic regimens. Therefore, early detection, proper monitoring and competent management of CIPN are important aspects of cancer patient care aimed at improving therapy outcomes and the overall well-being of patients.
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Adverse event management as a pathway to optimal outcomes in head and neck squamous cell carcinoma patients: A clinical case
Abstract
Squamous cell carcinoma of the head and neck is the sixth most common cancer worldwide. However, malignant tumors of the middle ear are extremely rare. Squamous cell carcinoma is the most common histologic type of tumor in this area, accounting for more than 50% of cases. Complex anatomical and topographic features of the inner ear and inapparent clinical symptoms result in delayed diagnosis of this disease. A case of a patient with highly differentiated middle ear squamous cell carcinoma is presented. The patient received complex treatment, including drug antitumor therapy according to the TPEx protocol: docetaxel + cisplatin + cetuximab. Being highly effective, this protocol requires a multidisciplinary approach in order to ensure maximum safety of therapy. The case illustrates the classic “portrait” of a patient with recurrent or metastatic squamous cell carcinoma of the head and neck and also provides a comprehensive description of the spectrum of adverse events faced by such patients and their oncologists. Based on this clinical case, the features of management of such adverse events are analyzed.
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