Response rate and toxicity of Docetaxel / Cisplatin /5FU in comparison with cisplatin / 5FU induction chemotherapy in locally advanced head and neck squamous cell carcinoma

Introduction: Response to chemotherapy is a reliable marker for radiation sensitivity in patients with locally advanced head and neck squamous cell carcinoma. We compared the response rate and toxicity after two cycles of chemotherapy using Docetaxel / Cisplatin /5FU or Cisplatin / 5FU among these patients

Materials and Methods: We randomly assigned 16 to 75 years old patients with stage III or IV non-metastatic locally advanced head and neck squamous cell carcinoma to receive either DCF or CF every 3 weeks for two cycles. All patients who received at least one and two cycles of chemotherapy were considered for toxicity and response evaluation respectively

Results: Seventy patients underwent randomization, 36 and 34 patients were assigned to Docetaxel / Cisplatin /5FU and Cisplatin / 5FU groups respectively. Three and 8 patients were excluded after randomization and before receiving any chemotherapy in Docetaxel / Cisplatin /5FU and Cisplatin / 5FU groups respectively. Finally 30 and 25 in Docetaxel / Cisplatin /5FU group and 25 and 23 patients in Cisplatin / 5FU group were evaluated for toxicity and response respectively. Response rate [complete and partial response] was%83 [35% complete and 48% partial response] and%84[16% complete and 68% partial response] in Cisplatin / 5FU and Docetaxel / Cisplatin /5FU groups respectively [P= 0.28]. There was no differences in complete response rate between two groups [P=0.18]. Neutropenia, phlebitis and mucositis were more common in Cisplatin / 5FU group without statistically significant difference. Constipation was significantly more common in Cisplatin / 5FU group [P= 0.008]. Diarrhea, alopecia and febrile neutropenia were significantly more common in Docetaxel / Cisplatin /5FU group [P= 0.006, 0.01 and 0.03 respectivly]

Conclusion: We could not find any significant differences between response to Docetaxel / Cisplatin /5FU and Cisplatin /5FU combination chemotherapy among Iranian patients with locally advanced head and neck squamous cell carcinoma. However, for better evaluation, larger studies with better designs are being conducted in our center

presence of amorpha-4, 11-diene synthase, a key enzyme in artemisinin production in ten Artemisia species

Artemisinin is one of the most effective medicine against malaria, which is produced naturally by Artemisia annua in low yield. It is produced in a metabolic pathway, in which several genes and gene products are involved. One of the key genes in this pathway is am1, which encodes amorpha-4, 11-diene synthase [ADS], a key enzyme in artemisinin biosynthesis pathway. The aim of this study was to determine the presence of this gene in ten Artemisia species in order to increase the yield of production of Artemisinin. The experiments were carried out using PCR. Specific primers were designed based on the published am1 gene sequence obtained from A. annua [NCBI, accession number AF327527]. The amplification of this gene by the specific primers was considered as a positive sign for the potentiality of artemisinin production. Since the entire am1 gene was not amplified in any of the 10 species used, four parts of the gene, essential in ADS enzyme function, corresponding to a] pair site of Arg10-Pro12 in the first 100 amino acids, b] aspartate rich motif [DDXXD], c] active site final lid and d] active site including farnesyl diphosphate [FDP] ionization sites and catalytic site in the ADS enzyme, were investigated. The sequence corresponding to ADS active site was amplified only in A. annua, A. aucheri and A. chamaemelifolia. The negative results obtained with other species could be due to some sequence alteration, such as point mutations or INDELs. We propose A. aucheri and A. chamaemelifolia as two potential candidate species for further characterization, breeding and transferring am1 gene for artemisinin overproduction

Dosimetry limitations and pre-treatment dose profile correction for sliding window IMRT

This work investigated the dosimetry limitations of the random and systematic uncertainties of sliding window [SW] intensity modulated radiation therapy [IMRT]. A Varian 21EX linear accelerator, Pinnacle[3] treatment planning system and radiographic film dosimetry was used. The limitations of the SW were studied using beam modulation ranging from 2 to 100 MU/beam, DR from 100 to 600 MU min[-1], LV from 1 to 5 cm [s-1] and field size up to 12 x 12 cm[2]. The random and systematic errors were investigated using clinical and flat beams, as well as beams of high profile modulation including linear, exponential, and sinusoidal profiles. The leading edge and plateau of the SW profiles have a significant deformation for higher DR and for beams of < 10 MUs/beam. It was found that the error is directly proportional to the DR and LV, and inversely proportional to the number of MU/beam. The high DR and LV are limiting factors, producing random profile deformation when SW beams of small number of MU/beam are delivered. A very good agreement was found between the planned and delivered geometrical and clinical dose profiles when beams > 10 MUs irradiated by a DR from 100 to 600 MU min[-1] and LV from 1 to 5 cm s[-1]. After the proposed correction, an average difference < 0.5% for clinical profiles was measured for beams irradiated with DR = 600 MU min[-1] and LV= 5 cm s[-1]. It was concluded that this correction methodology may serve as a pre-treatment Quality Assurance tool for SW IMRT beams

[Comparison of hearing results in two different techniques on 408 patients with otosclerosis]

Otosclerosis is common disease of the ear and surgery on stapes is very fine operation. There are two techniques for surgical treatment of otosclerosis: stapedectomy [partial, Total] and stapedotomy. This is a retrospective clinical study that performed in referral center [university hospital] on four hundred and eight patients with otosclerosis treated by surgery. Surgery on 285 patients were stapedotomy and 89 were stapedectomy. Preoperative and postoperative hearing thresholds were compared. In this study hearing results after stapedectomy were better in comparison with small fenestrationstapedotomy. Skill and experience of the surgeon has a significant role in stapes surgery. As stapes surgery is a very fine operation it is recommended not to be done by unexperienced surgeon