Medical Radiology and Radiation Safety. 2022. Vol. 67. № 3

N.L. Proskuryakova

Criteria for assessing professional risks of employees of nuclear industry enterprises

A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia

Contact person: N.L. Proskuryakova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: Substantiate the indicators of occupational risks of employees of nuclear energy use facilities.

Material and methods: In order to methodologically substantiate the indicators of professional risk assessment, data from literary sources and normative and methodological documentation were used.

Results: It is established that the existing system of professional risk assessment in the nuclear industry needs to be improved. The currently used results of a special assessment of working conditions for harmfulness and danger should be supplemented with the results of a special assessment of working conditions for the radiation factor, taking into account the category of potential radiation hazard of the object. When choosing biomedical indicators of occupational risks, the data of periodic medical examinations and mandatory psychophysiological examinations should be taken into account first of all. At the same time, the health status of the employee should be assessed not only by the presence/absence of nosological forms of diseases, but also by prenosological criteria. It is proposed to use as such indicators the level of psychophysiological adaptation of an employee and his cytogenetic status, estimated according to the buccal micronucleus test of the frequency of occurrence of cells with pronounced genome damage (chromosomal aberrations, micronuclei, nuclear protrusions).

Conclusion: A conceptual model of indicators of occupational risks of employees is proposed, which includes: 1) class of working conditions according to the harmfulness and danger according to the results of the special assessment of working conditions; 2) class of working conditions according to the effects of IR according to the results of the Special assessment of working conditions; 3) category of radiation hazard of the object; 4) health group according to the results of periodic medical examinations; 5) class of prenosological condition according to the results of periodic psychophysiological examinations. The scientific novelty of the proposed model lies in its complexity and taking into account the early signs of an employee’s health condition, which makes it possible to increase the effectiveness of professional risk assessment and management.

Keywords: nuclear industry, personal, occupational risk, conceptional model of indicators

For citation: Proskuryakova NL. Criteria for assessing professional risks of employees of nuclear industry enterprises. Medical Radiology and Radiation Safety. 2022;67(3):36–40. (In Russian). DOI:10.33266/1024-6177-2022-67-3-36-40

References

1. Guidelines for the Hygienic Assessment of Factors of the Working Environment and the Labor Process. Criteria and Classification of Working Conditions. Manual R 2.2.2006-05 (In Russian).

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3. Hygienic Criteria for Special Assessment and Classification of Working Conditions when Working with Ionizing Radiation Sources. Manual R 2.6.5.07-2019 (In Russian).

4. Radiation Safety Standards (NRB-99/2009). SanPiN 2.6.1.2523-09 (In Russian).

5. Simakov A.V., Kochetkov O.A., Abramov Yu.V., Scientific Substantiation of Hygienic Criteria of Working Environment Assessment Regarding Ionizing Radiation Sources Interaction. Aktualnyye voprosy radiatsionnoy gigiyeny = Current issues of radiation hygiene in Proceedings. Proceedings of the Conference Title. St. Petersburg Publ., 2004. P. 36-38 (In Russian).

6. Simakov A.V., Abramov Yu.V. Assessment and Classification of Working Environment Regarding Ionizing Radiation Sources Interaction. 50 let Golovnogo TSGSEN Federalnogo upravleniya «Medbioekstrem» = 50 years Head CSSES of Federal department «Medbioekstrem». Moscow Publ., 2004. P. 164-169 (In Russian).

7. Simakov A.V., Abramov Yu.V. Certification of Workplaces Regarding Ionizing Radiation Sources Interaction. Book II. Materials of the X Russian Congress of Hygienists and Sanitary Doctors. Moscow Publ., 2007. P. 1253-1256 (In Russian).

 PDF (RUS) Full-text article (in Russian) 

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 17.01.2022. Accepted for publication: 15.03.2022.

Medical Radiology and Radiation Safety. 2022. Vol. 67. № 3

E.V. Golub, V.V. Polkin, G.F. Mikhailova, 
T.G. Shkavrova, V.V. Tsepenko, F.E. Sevrukov, V.S. Medvedev

Detection of Radiosensivity of Patients with Oral Cancer Using the Frequency of Cells
with Polysomy 7 and 11 Chromosomes in Process of Fractionated Gamma-Radiotherapy

A.F. Tsyb Medical Radiological Research Center, Obninsk, Russia

Contact person: E.V. Golub, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: To study the dynamics of frequency of tumor cells with polysomy 7 and 11 chromosomes in patients with oral cancer during fractionated gamma-radiotherapy. 

Material and methods: The study was carried out using fluorescence in situ hybridization (FISH) on smears of 19 patients with oral cancer before treatment, after first total focal dose of gamma-radiotherapy (up to 18 Gy) and after second total focal dose (up to 32 Gy). As for control oral smears of 12 healthy donors were taken. Molecular cytogenetic abnormalities were examined in taken samples.

Results: The average group frequency of cell with polysomy 7 and 11 chromosomes in controls was 0.7 ± 0.2 % and 0.3 ± 0.1 % respectively. The average frequency of cells with chromosome 7 polysomy in group oral cancer patients before treatment was 32.3 ± 4.5 %, after first focal dose was 15.7 ± 2.9 % and after second focal dose was 8.0 ± 2.3 %. Dynamics analysis of these values revealed the significant decreasing (р < 0.05) in cells with chromosome 7 polysomy during radiotherapy. The average group frequency of cells with polysomy
11 in cancer patients before treatment was 25.8 ± 5.6 %, 12.2 ± 2.4 % and 5.4 ± 0.9 % after first and second focal dose respectively. These values was significantly (р < 0.01) higher compare with the one in the control group. After radiotherapy the 16 (84 %) patients with polysomy chromosomes 7 and/or 11 had significant decreasing (р < 0.05) in aberrant levels. Some of them (6 persons – 32 %) had decreasing frequency up to the control levels. 4 persons (21 %) observed firstly the increasing of cells with polysomy but after there was the reduction. 5 patients (26 %) over full course of gamma-radiotherapy demonstrated the gain in frequency of cells with polysomy or the same value as it was before treatment.

Conclusion: Thus, the study of molecular cytogenetic abnormalities in cells of oral cancer patients before and after radiotherapy was shown the polysomy of chromosomes being the marker of genome instability could indicate the tumor response ongoing therapy.

Keywords: oral cancer, polysomy chromosomes, FISH, radiosensitivity, fractionated radiotherapy

For citation: Golub EV, Polkin VV, Mikhailova GF, Shkavrova TG, Tsepenko VV, Sevrukov FE, Medvedev VS. Detection of Radiosensivity of Patients with Oral Cancer Using the Frequency of Cells with Polysomy 7 and 11 Chromosomes in Process of Fractionated Gamma-Radiotherapy. Medical Radiology and Radiation Safety. 2022;67(3):47–52. (In Russian). DOI:10.33266/1024-6177-2022-67-3-47-52

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3. Sato H., Uzawa N., Takahashi K.I., Myo K., Ohyama Y., Amagasa T. Prognostic Utility of Chromosomal Instability Detected by Fluorescence in Situ Hybridization in Fine-Needle Aspirates from Oral Squamous Cell Carcinomas. BMC Cancer. 2010;10:182. doi: 10.1186/1471-2407-10-182.

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 PDF (RUS) Full-text article (in Russian) 

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 17.01.2022. Accepted for publication: 15.03.2022.

Medical Radiology and Radiation Safety. 2022. Vol. 67. № 3

E.M. Ivanov, G.I. Klenov, V.I. Maksimov, V.S. Khoroshkov, A.N. Chernykh

Prospects for the Development of Proton Therapy in Russia

National Research Centre “Kurchatov Institute”, Moscow, Russia

Contact person: A.N. Chernykh, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRAKT

It is generally accepted that a proton therapy is one of the most effective method of external beam radiotherapy. Proton therapy has the highest conformal factor even compared with the most modern facilities for radiotherapy which use electron beam or gamma rays. Accuracy of combination of the 90–95 % isodose surface with PTV is better and dose gradients outside PTV is steeper, also integral dose of radiation from proton therapy for a healthy tissue is less than two times that for gamma irradiation. We can clearly see it comparing a HDV of treatment plan for gamma irradiation and proton therapy for the same clinical cases. In last years a lifespan of patient after radiotherapy treatment is a quit extended, so a question for quality of life for them is more significant. Decreasing of integral dose for a healthy tissue reduces a chance of negative effects from radiotherapy that would mostly appear after a lot years after treatment, so named late side effects. Quality of life is even more important in the case of pediatric oncology, when we not only expect a long healthy life for them, but also have aim to exclude side effects from their development.

There was a long term clinical investigation in 1954–1990 years in ten experimental centers (among them clinical data: 50% in USA, 30% in USSR/Russia) that had confirmed the described advantages of proton therapy. These clinical results formed a foundation of quick development proton therapy clinical centers in developed countries in 1990s. These centers are based on oncology and multidisciplinary hospitals and treat 1000 and more patients per year. There are 96 working and 38 constructing PTCs in the world for today. Although we have a lot of experience in proton therapy in Russia, we didn’t take part in this new stage. In fact a patient treatment was over in all of three experimental PTCs (Moscow, Dubna, St. Petersburg) up to 2014. Thus we have a delay in a development of proton therapy for 30 years from a world level.

Government of the Russian Federation Decree № 287 of 16^th March 2020 establishes Program, which has to overcome this delay in development. Main science executer of the Program is National Research Center «Kurchatov Institute», which has an experience, scientific potential and competence for it.

The main aims, stages and objects of the Program are presented.

Keywords: proton beam therapy (PBT), synchrotron, PBT clinical center, prospects

For citation: Ivanov EM, Klenov GI, Maksimov VI, Khoroshkov VS, Chernykh AN. Prospects for the Development of Proton Therapy in Russian. Medical Radiology and Radiation Safety. 2022;67(3):41–46. (In Russian). DOI:10.33266/1024-6177-2022-67-3-41-46

References

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2. WWW.PTCOG (Proton Therapy Co-Operative Group), Particles Newsletters, 1990, № 5, р.9.

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The video streams of the meeting (Track 1 to 4) 

4. Карпунин В.О., Кленов Г.И., Хорошков В.С. Первый в России специализированный, клинический центр протонной лучевой терапии // Альманах клинической медицины. 2008. № 17-1. С. 316-319. [Karpunin VO, Klenov GI, Khoroshkov VS. Russia’s First Specialized Clinical Center for Proton Beam Therapy. Almanac of Clinical Medicine (In Russ.)].

5. Ломанов М.Ф., Ерохин И.Н., Канчели И.Н., Орлов Д.Г., Рудской И.В. Разработка метода планирования протонного облучения внутриглазных новообразований // Медицинская физика. 2012. № 4. С. 43–51. [Lomanov MF, Erokhin IN, Kancheli IN, Orlov DG, Roudskoy IV. Development of Treatment Planning Methods for Proton Irradiation of Intraocular Neoplasms. Medical Physics. 2012;№ 4:43–51. (In Russ.)].

6. Орлов Д.Г., Владимирова О.М., Ерохин И.Н., Ломанов М.Ф., Саакян С.В., Вальский В.В. и др. Представление модели глаза для использования в системе дозно-анатомического планирования лучевой протонной терапии внутриглазных новообразований // Российский офтальмологический журнал. 2013. Т.6, № 4. С. 48-54. [Orlov DG, Vladimirova OM, Erokhin IN, Lomanov MF, Saakyan SV, Valsky VV, et al. Presenting an eye model for the application in dosage and anatomic planning for proton therapy of intraocular tumors. Russian Ophthalmological Journal. 2013;6(4):48-54. (In Russ.)].

7. Бородин Ю.И., Вальский В.В., Ерохин И.Н., Канчели И.Н., Ломанов М.Ф., Люлевич В.И. и др. Инновационные разработки технических средств для протонной терапии внутриглазных новообразований. Часть I // Российский офтальмологический журнал. 2015. Т.8, № 2. С. 14-20. [Borodin YuI, Valsky VV, Erokhin IN, Kancheli I.N, Lomanov MF, et al. Technical innovations for proton therapy of intraocular neoplasms. Part I. Russian Ophthalmological Journal. 2015;8;2:14-20. (In Russ.)].

8. Бородин Ю.И., Вальский В.В., Ерохин И.Н., Канчели И.Н., Ломанов М.Ф., Люлевич В.И. и др. Инновационные разработки технических средств для протонной терапии внутриглазных новообразований. Часть II // Российский офтальмологический журнал. 2016. Т.9, № 2. С. 11-17. [Borodin YuI, Valsky VV, Erokhin IN, Kancheli IN, Lomanov MF, Lyulevich VI, et al. Technical Innovations for Proton Therapy of Intraocular Neoplasms. Part II. Russian Ophthalmological Journal. 2016;9;2:11-17. (In Russ.)].

9. Минкин Д.Ю., Максимов В.И., Иванов Е.М., Хорошков В.С., Кленов Г.И., Черных А.Н. Онкоофтальмологический комплекс в НИЦ «Курчатовский институт» – ПИЯФ. Исследования и практика в медицине. 2018. Т.5, № 52. С. 181. [Minkin DYu, Maksimov VI, Ivanov EM, Khoroshcov VS, Klenov GI, Chernykh AN. Onco-Ophthalmologic Complex in NRC “Kurchatov Institute” – PNPI. Research’n Practical Medicine Journal. 2018;5;52:181. (In Russ.)].

 PDF (RUS) Full-text article (in Russian) 

Conflict of interest. The authors declare no conflict of interest.

Financing. The work was supported by the National Research Center «Kurchatov institute» (order dated October 28, 2021 No. 2751).

Contribution. Article was prepared with equal participation of the authors.

Article received: 17.01.2022. Accepted for publication: 15.03.2022.

Medical Radiology and Radiation Safety. 2022. Vol. 67. № 3

Combination Therapy of Breast Cancer Patients (_СT_1-2N_0-1M₀) after Skin-Sparing
and Nipple-Sparing Mastectomy with Immediate Implant Based Reconstruction

D.V. Bagdasarova¹, A.D. Zikiryakhodzhaev^1-3, F.N. Usov¹,
E.V. Khmelevsky¹, A.N. Gerasimov², I.S. Duadze²,
D.Sh. Dzhabrailova¹

¹ P.A. Hertzen Moscow Oncology Research Institute, Moscow, Russia.

² I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

³ People’s Friendship University of Russia, Moscow, Russia.

Contact person: Bagdasarova Daria Valerievna, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: indications for determination of radiation therapy in patients with primary operable breast cancer (сT1-2N0-1M0) after skin-sparing/nipple-sparring mastectomy with immediate breast reconstruction.

Material and methods: The study analyzed 203 patients who underwent skin-sparing (58 cases (28.6%)) or nipple-sparring (145 cases (71.4%)) mastectomy with immediate breast reconstruction as part of  combined or complex treatment from January 2008 to March 2018. Radiation therapy was performed in 98 (48,2 %)  cases on the reconstructed breast and the area of regional lymph nodes.

Results: The presence of metastatic axillary lymph nodes (p=0.008) and lymphovascular invasion (p=0.048) correlates with deterioration in deseese-free survival. There were no significant differences in the rates of recurrence (p=0.734) and progression (p=0.432) in groups of patients with and without RT. However, due to the inclusion of an initially favorable group of patients and a small number of adverse outcomes, it was found that RT changes the risk of developing a relapse of the disease by no more than 3-4 times.

Conclusions: Additional RT allowed to obtain the same results in the group цшер poor prognosis as in the group цшер favorable prognosis. The preliminary conclusion that RT does not affect treatment outcomes in the group with favorable prognosis should be validated in a study with larger number of observations.

Keywords: breast cancer, mastectomy, immediate breast reconstruction, radiotherapy, implant.

For citation: Bagdasarova DV, Zikiryakhodzhaev AD, Usov FN, Khmelevsky EV, Gerasimov AN, Duadze IS, Dzhabrailova DSh. Combination Therapy of Breast Cancer Patients (СT1-2N0-1M0) after Skin-Sparing and Nipple-Sparing Mastectomy with Immediate Implant Based Reconstruction. Medical Radiology and Radiation Safety. 2022;67(3):53-58. DOI: 10.33266/1024-6177-2022-67-3-53-58

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9. Agarwal S, Agarwal J. Radiation Delivery in Patients Undergoing Therapeutic Nipple-Sparing Mastectomy. Ann Surg Oncol. 2015 Jan;22(1):46-51. 

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 PDF (RUS) Full-text article (in Russian)  

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 11.04.2022.  Accepted for publication: 11.05.2022