Ultrasound accuracy in determining the tumor depth for boost field radiotherapy in breast cancer in comparison with CT scan plus clips

Background: There are miscellaneous methods of boost field determination with different levels of accuracy. One of the important parameters in boost field planning is the tumor bed depth, as it is important for determining electron energy

Objectives: The purpose of present research was the determination of ultrasound accuracy to estimate the appropriate depth for the tumor bed

Patients and Methods: Patients who were undergone breast conservative surgery with placing of 5 clips in the tumor bed [lower, upper, medial, lateral, and posterior] were included. The depth and location of the tumor bed were determined using ultrasonography. The optimum field boost was planned with an appropriate 2.5 cm margin. After putting the marker on the field boost, the CT simulation was done and then the obtained depth of the ultrasound report and that of the CT scan-clips were compared

Results: Twenty five patients were included. The average depth reported by the ultrasound was about 18 mm +/- 3 mm [range 10-26 mm], and the average obtained from the CT scan-clips was about 48 mm +/- 13 mm [range 24-80 mm], [P Value = 0.001]. In almost all cases, the depth obtained from the ultrasound was less than that obtained from the CT scan- clips

Conclusions: Ultrasound is not an accurate method to determine the appropriate depth and field for determination of breast field boost. Thus, it is better not to use ultrasound to estimate the tumor cavity depth; the CT scan images with surgical clips should be used instead

[Neoadjuvant chemotherapy of epirobicin, oxaliplatin, capecitabine regimen in patients with advanced gastric cancer: a two year study]

Gastric cancer is an important health problem across the world. Chemotherapy in combination with local treatment is the standard treatment for locally advanced gastroesophageal junction [EGJ] cancers. The purpose of this study was to evaluate response and tolerability to neoadjuvant regimen combining epirobicin, oxaliplatin and capecitabin [EOX] in locoregionally advanced gastric cancer. We recruited 28 patients with histologically confirmed advanced gastric or EGJ adenocarcinoma in this study performed in the Cancer Institute of Imam Khomeini Hospital in Tehran, Iran in 2010-2011. Staging workup included chest and abdominal computed tomography [CT] scans, upper gastrointestinal endoscopy, endoscopic ultrasonography [EUS], measurement of carcinoembryonic antigen [CEA], complete blood cell count [CBC], and liver and renal function tests. After three treatment cycles with EOX regimen, we evaluated response to the neoadjuvant chemotherapy by performing endoscopic ultrasonography [EUS] and chest and abdominal CT scans. The mean age of the patients was 56.64+/-11.08 years [ranging from 37 to 78 years]. Most patients were classified as having stage III [98.8%] cancer before chemotherapy while most were classified as stage II [57.14%] after the treatment. Only 28.5% of tumors were resectable before chemotherapy, but 82.1% of them were resectable upon the treatment. 75% of tumors were downstaged after chemotherapy. Regarding the acceptable response and downstaging of tumors and low toxicity of EOX regimen in locoregionally advanced gastric cancer, evaluation of this regimen as a neoadjuvant chemotherapy in larger phase III clinical trials in Iranian patients would be both necessary and logical