ABSTRACT
Radical prostatectomy or radiotherapy has comparable results in the treatment of localized prostate cancer. High dose external irradiation entails a prolonged 7-8 weeks of treatment with significant inconvenience to elderly patients. Hypofractionated regimen in prostate cancer depends on the distinctive radiobiological properties of prostate cancer cells; their relative low alpha beta ratio compared to that for late-reacting rectal tissue allows for significant dose escalation per fraction without expected increase in late normal tissue reaction. Between July 2012 and December 2013, twenty patients were blindly randomized into two groups. The planning target volume in the study group received 65Gy to 67.5Gy/25 fractions over 5 weeks. The patients in the control arm received 74Gy to 78Gy in 2Gy/fraction. Cost-benefit was evaluated for both regimens. Both groups were comparable regarding risk factors, with no significant statistical differences. Four patients in the study group developed grade 2 urinary toxicity and one patient had grade 3 during treatment, At six months no patient had urinary symptoms, In the control arm 4 patients have grade 2 toxicity during treatment which disappeared at six months, The two groups showed no statistical difference in the mean quality of life. Serum PSA reached a nadir value of 0.02 and 0.04 in the study and control groups respectively at 3 month post-treatment. The cost of treatment for the study group was 25000 L.E, per patient compared to 40000 L.E. in the control group. The hypofractionated group consumed 31138 MU compared to 45611 MU for the control group with ap-valueof 0.015. Hypofractionated IMRT with concomitant boost for localized cancer prostate is a feasible option with lesser cost and comparable toxicities. Longer follow-up is required to assess the late effects before recommending it as a standard of care
ABSTRACT
This retrospective study included 55 patients with gestational trophoblastic tumors [GTT] who attended the department of Clinical Oncology and Nuclear Medicine [NEMROCK] from January 1980 to December 1990. Cases were designated as metastatic or nonmetastatic. All nonmetastatic cases received single agent methotrexate, while metastatic high risk patients received combination chemotherapy [Methotrexate, Actinomycin D and Chlorambucil]. GTT represented a relative frequency incidence of 6.25% of female genital cancer with a mean age of 30 years. In this study, 91.3% of nonmetastatic patients who received either single agent or salvage chemotherapy achieved one year disease free survival. Metastatic cases showed such a result in 72.7%, within this group, patients with lung metastases showed a higher response than those with liver or brain deposits [85.7% versus 50% respectively]. The overall one year disease free survival in these cases was 85.2%