ABSTRACT
To evaluate the role of VEM regimen in downstaging patients with locally advanced breast cancer to allow surgery
Patients and Methods: Between January 2000 to January 2002, 16 patients with locally advanced breast cancer were enrolled, they received VEM regimen [Vinorelbine 25 mg/irf, epirubicin 35 mg/rrf, and methotrexate 20 mg/m" given at day 1 and 8 every 28 days]. Responding patients after 4 courses received 2 more courses and then referred to surgery
Results: Downstaging was obtained in 86% of the patients with a pathological complete response ;raite of 8%. At 3D months mf follow-up, median survival Unas not teen reached. The most common lhematoI0jpc loxicity was neutropenia grade %
Conclusion: VEM represents an effective and well tolerated regimen for patients with locally advanced breast cancer
ABSTRACT
Brain stem tumors are special challenge because primarily of their location and the neurologic effect caused by these groups of tumors [Paul 1997]. Radiation therapy improves survival for brain stem tumors and stabilizes or reverses neurologic dysfunction in 75-90% of patients. The main domain of applicability of hyperfractionation would be in tumor sites where the dose limiting tissue is late reacting and whose effective control requires the delivery of doses beyond tolerance [Awwad, 1990], hence the rationale for the use of hyperfractionation in brain stem lesions. The purpose of this work is to find out the best radiation protocol in this group of patients comparing conventional fractionation and hyperafractionation. This study included 46 patients which brainstem tumors treated in Radiation Oncology and Neurosurgery Departments Ain Shams University between February 1998 and May 2000. These patients had been randomly distributed in 2 groups A and B. The first group treated by conventional radiotherapy protocol and the second group treated by hyperfractionation radiation protocol. By the end of the study, the median over all survival and median time for disease progression were calculated for each group. Age, neurologic status at presentation and anatomical location were significant prognostic factors. By the end of this study clicinal evalualion had no significant difference between both groups but the median over all survival for the two groups was 10.5 months, the median survival for group A was 9.4 months and that for group B was 11.5 months which was statistically significant P < 0.02. On the other hand the percentage of patient with one year survival for group A and B [22%, 32%] respectively. The rate of acute [early] reaction of radiation is slightly higher in hyperfracticmaticm than conventional fractionation but the late reactions occur with same frequency with both regimens