ABSTRACT
To evaluate acute morbidity, radiation dermatitis and pneumonitis, of Patients treated with whole breast hypo fractionated radiotherapy [RT] after breast-conserving Surgery [BCS], compared to conventional RT and to confirm the equivalence in terms of late effects between two the fractionation schedules of radiotherapy. Sixty patients with Tl-3a breast cancer who underwent breast conserving surgery [B CS] were included in the study. Half of the patients received whole breast irradiation, consisting of 50 Gy/25f/5w+boost 10Gy/5f/l w to tumor bed [group A]. The other half received 45Gy/15f/5weeks+boost 10Gy/5f/1w to tumor bed [group B]. The two groups were comparable otherwise. Early skin reaction were graded according to the Common Terminology Criteria for adverse events version 3.0 by the investigators and late cosmetic results were evaluated with the SOMA-LENT scoring system. A comparison was done between the incidence of these reactions and different variables as: total radiation dose, number of surgically dissected nodes. etc. The majority of patients [64.1%] had grade 0 /11 radiation reaction and 35.9% had grade Ill/TV reaction. On uni-variate analysis, there was no statistically significant difference between the two radiation arms regarding the incidence of radiation reaction. In conventional group [13%] [Grade 0]. Moreover, 15 [50%][, 5 [17%] and [20%] had Grade I, II and III radiation dermatitis, respectively. With the hypo fractionated RT. Furthermore, 8 [60%], 5 [17%] and 4 [13%] bad Grade I, II and III radiation dermatitis, respectively. Regarding radiation pneumonitis] [6%] of conventional fractionation group had Grade I radiation pneumonitis. 5 [17%] had grade 11. Pneumonitis graded III or more was not observed. No patient treated with the hypo fractionated schedule had symptomatic radiation pneumonitis In SOMALENT scoring system Pain. In 3 [9%] and [6%] of both groups respectively had grade2-3. No grade 4 pain was reported. [6%] of group A and [9%] of group B had grade 2 breast edema. No patient of either group had grade 3-4 breast edema. [17%] and [27%] had group 1-2 and grade 2 fibrosis in group A and B, respectively. Telangiectasia grade 2 and grade 1-2 were reported in [6%] of both groups A and B, respectively. [17%] in group A had grade 2 and grade 3 arm edema, respectively. In-group B only 2 patients had grade 2, one patient had atrophy in group 1 while no cases were seen in conventional group and no skin ulceration was seen in either groups. Preliminary results showed that Radiation dermatitis and pneumonitis in patients treated with the Hypo fractionated schedule is acceptable. Especially, radiation dermatitis by the hypo fractionated. Schedule is milder than that by the conventional schedule and that supports the use of a shorter fractionation schedule of 45Gy/l5f/5w plus boost in patients with breast conserving surgery. The study is still going on to study the late effects on a larger number of patients for final evaluation of this regimen
Subject(s)
Humans , Female , Dose Fractionation, RadiationABSTRACT
Undescended testes are a common problem, affecting up to 3% of newborn males. The goals of orchiopexy in humans are to provide adequate scrotal fixation, to prevent recurrent torsion of the testis and spermatic cord or ascent of the testis, and to achieve these goals with minimal trauma to the testis. The best method of achieving fixation remains controversial. The aim of our study is to evaluate our modified extradartose pouch technique in retaining testis in the scrotum. Patients and methods: Between August 2005 and September 2008. Our studied group included 61 patients with 72 orchiopexies age ranged from 5 months to 15 years with the mean age of 58.5 +/- 40 months [4.8 years] all cases had palpable undescended testis 20 pa tients [32.7%] had unilateral left side 30 patients [49.1%] had unilateral right side and 11 patients [18%] had bilateral undescended testis. Testis was located in the superficial inguinal pouch in 33 cases [45.85%], intra-canalicular in 39 cases [54.16%]. Hernial sac was found in 69 cases [95.8%], postoperative wound infection occurred in one case[1.38%] and haematoma formation in two cases [2.77%] no ascent of the testis nor testicular atrophy was observed in the follow up period. which extends now up to 3 years and we still follow up those cases.3 patients [4 orchiopexies] lost follow up. Our modified technique for extradartose pouch fixation seems to be a fast reliable method for orchiopexy however comparative studies and long term assessment is still needed to establish this method
Subject(s)
Humans , Male , Cryptorchidism , Follow-Up StudiesABSTRACT
Background and Aim of work: vascular access in children receiving chemotherapy often poses an important problem. The irritating drugs used destroy peripheral veins, leading to a progressive decrease of available surface vessels. This can delay or prevent the administration of a planned therapy. Several methods of venous access have been developed, from arteriovenous fistula to indwelling right atrial silicon rubber catheters. Totally implanted devices, consisting of a subcutaneous inaction port attached to a silicon catheter, have been tried for those children. We are reporting here our early experience to assess the efficiency of this device
Patients and Method: between February 2001 and February 2004, 28 devices were placed in 28 patients with solid neoplasm or hematologic malignancy. All the catheters were inserted by cut down of the subclavian veins. The age of the patients ranged from 6 months 12 years old. Follow up period ranged from 4 to 20 months
Results: we did not have any early complication of insertion. System obstruction was the most frequent late complication. The mean life of the implanted system was 288 days
Conclusion: totally implanted devices roved safe 6 efficient venous access. Implantation should be performed by experienced surgeon. Obstruction is the most common complication 6 nay be prevented by adequate information and training of the users