It has been determined the prognostic importance of P-53 suppressor in 26 patients with osteogenous sarcoma of long tubular bones of lower extremities. Tumour localized in femoral bone in 14 observations (53,9%), in shin bone-11 (42,2%) and in fibular bone-1 (3,9%).

According to methods of treatment, all patients were divided into two groups:

I group: 18 patients received chemical and beam therapy. Treatment in this group was carried out by following scheme: intraneous metrotrexat, 25 mg/kg for 24 hours with leucovorin, intraneous cisplatin, 100 mg/m² for 4 hours. OOD-2,2Gy, SOD 60Gy beam therapy (telegammatherapy) was conducted after 4 courses of chemotherapy, 5 courses of chemotherapy by above-mentioned scheme was made after the end of beam therapy course.

Of 26 patients in 2 (7,8%) was noted complete effect, in 16 (61,5%) – partially effect, in 2 (7,8%) – stabilization of the process and in 6 (22,9%) – tumour progressing.

To estimate study results and determination of medicamental resistance of sarcoma there studied the rates of P-53 suppressor, as study results showed, in 6 (23%) observed moderate or high P-53 suppressor expression in tumor cells, and in 20 (77%) cases did negative and low-positive tumor or low negative and immunohistochemical tumor response. There established that low rates of P-53 suppressor correlated with high sensitivity of tumor to chemo-beam therapy, otherwise there obtained reverse reaction.

Conclusions: study results showed that P-53 suppressor rates have a significant importance in the determination of treatment strategy, tumor sensitivity to chemo-beam therapy and clinical outcome.

The aim of the research was to improve the results of complex ray diagnostics and monitoring in the treatment stages of patients with malignant neoplasms of soft tissues and bones using ultrasound dopplerography (US-dopplerography).

US-dopplerography data in 38 patients with tumors of soft tissues and bone tumors with infiltrated soft tissues are studied in the course of treatment. The following criteria were investigated by dopplerography: arterio-venous blood-flow, venous blood-flow, maximal velocity (Vmax) of blood, minimal velocity (Vmin) of blood, index of resistance (IR), pulse index (PI).

In 7of 38 patients US-dopplerography was performed repeatedly in dynamics. In 2 patients with fibrosarcoma character of neoplasm tissue blood-flow changed: in 1 patient after combined chemo- and ray-therapy neoplasm tissue blood-flow was not registered practically, in the 2nd patient indices of blood-flow decreased after chemotherapy. In 8 patients presented with fibrosarcoma blood-flow was not detected in the structure of neoplasm, and in 3 patients with the same diagnosis moderate peripheral blood-flow in the neoplasm was revealed. In one patient with osteosarcoma parameters of blood-flow in soft tissues infiltration were not changed even after 4 courses of chemotherapy. In the second patient parameters of blood-flow increased after 1st course of chemotherapy treatment, and after 3rd course blood-flow in the damaged area practically could not be detected. In 2 patients, presented with neuroblastoma and Khodjkin’s lymphoma, parameters of blood-flow decreased until complete disappearance after 2 courses of chemotherapy. In one patient with rhabdomyosarcoma blood-flow indices did not actually change in the process of treatment.

Parameters of US-dopplerography in dynamic control can serve as an indicator in the treatment efficacy assessment in patients with soft tissue and bone tumors.

We observed the 55 patients with local spread tumours of bones and soft tissues of shoulder girdle. There were 43 (78,2%) men, 12 (21,8%) women; the average age was 38,8. In 23 patients the tumour became localized into proximal part of humerus, 2 were in lateral end of clavicle, 4 were in shoulder blade, 18 were in soft tissues of upper two thirds of shoulder, 4 were in soft tissues of axiila, 3 were in soft tissues of shoulder blade and 1 was metastases of sarcoma of forearm soft tissues in armpit lymph nodes. In 8 cases the bone tumours were presented with osteosarcoma, 12 – hondrosarcoma, 5 – malignant giant celled tumour, 1 – Ewing’s sarcoma, 1 – reticulosarcoma, 2 – fibrosarcoma of bone. Among tumours of soft tissues, the fibrosarcoma and synovial sarcoma prevailed over 10 and 8.

Regard for local spread of tumour and degree of anatomical structures drawing in process, 47 patients performed interscapulothoracic amputation and 8 were interscapulothoracic resection (Tikhoff-Linberg operation). In pre- and post operative period the chemical and/or radiotherapy were performed in 43 patients. Selection the scheme and regimen of treatment depended on histological type of tumour.

The dates of observation were from 6 month to 14 years. The acute disorder of cerebral blood circulation was developed in one patient after interscapulothoracic amputation in early postoperative period. The local recurrence of tumour was revealed in 4 patients (8,4%) after interscapulothoracic amputation and in 3 patients (37,5%) after interscapulothoracic resection, in 14 (29,7%) and 4 (50%) were metastases conditionally. All patients had local recurrence in soft tissues. In 2 patients with local recurrence the amputation of extremities were performed.

There fore, the interscapulothoracic resection is used in local spread tumours of proximal part of humerus, shoulder blade, acromical part of clavicle and soft tissues of shoulder girdle, with some anatomical structures involved in process, but without affection of vascular-nerve fascicules. Involving in tumor process vascular and nerve plexus are statement for performing interscapulothoracic amputation.