ABSTRACT
<p><b>BACKGROUND</b>Xerostomia is one of the most common side effects of radiation therapy among patients with head and neck cancers (HNC). However, conventional medicine lacks an effective treatment for radiation-induced xerostomia.</p><p><b>OBJECTIVE</b>Synthesizing the traditional use of Alcea digitata and Malva sylvestris with their known beneficial effects from recent studies, we evaluated the efficacy of the herbs in the quality of life (QOL) of HNC patients with radiation-induced xerostomia.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>This study is a randomized, double-arm, open-label active-controlled clinical trial. We evaluated the effect of A. digitata and M. sylvestris on QOL of HNC patients with radiation-induced xerostomia compared with Hypozalix (artificial saliva). Patients were enrolled from the Imam Hossein Hospital's oncology clinic in Shahid Beheshti University of Medical Sciences, Tehran, Iran.</p><p><b>MAIN OUTCOME MEASURES</b>Primary outcome measures in this trial were changes in patients' QOL assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Head and Neck Module (EORTC QLQ-H&N 35).</p><p><b>RESULTS</b>Between-group analysis showed that the intervention group patients obtained significantly lower (better) total EORTC QLQ-H&N 35 scores as compared to the control group at the end of the intervention period (P = 0.007). Mean scores of dry mouth of EORTC QLQ-H&N 35 was also significantly lower (better) in the intervention group as compared to the control group (P = 0.017).</p><p><b>CONCLUSION</b>Traditional Persian medicine preparation of hollyhocks and common mallow should be considered as a suitable treatment for xerostomia and improving QOL in HNC patients with radiation-induced xerostomia.</p><p><b>TRIAL REGISTRATION</b>The trial was registered in ClinicalTrials.gov with Identifier: NCT02854358.</p>
ABSTRACT
Background: Evidences about survival of the patients with head and neck squamous cell carcinoma [HNSCC] have been scant in our region
Objectives: The aim of current study was to determine clinico-pathological and treatment-related factors, influencing outcome of these patients
Patients and Methods: We have reviewed all patients with a new diagnosis of HNSCC admitted between 2008 and 2014 in "Jorjani Cancer Center", Tehran, Iran. Overall survival [OS] and event free survival [EFS] of the patients, and their relation with demographic and clinico-pathological factors have been analyzed
Results: Among 119 included patients, 90 were male and 29 were female with mean age of 58 years. Larynx was the most common primary tumor site [55% of all patients]. With a median follow-up period of 28 months, OS and EFS of the study patients was 61.2% and 52.4%, respectively. Tumor stage was the only parameter has significantly influenced the patients' OS. Patients with normal BMIs had significantly higher mean EFS compared with patients with bellow or above normal BMIs. Surgical treatment modalities have resulted in the same prognosis as non-surgical approaches
Conclusions: Our study seems to be the first that investigated outcome of Iranian patients with head and neck cancer and its influencing factors
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Head and Neck Neoplasms/therapy , Carcinoma, Squamous Cell , Disease-Free Survival , Survival Rate , PrognosisABSTRACT
Background: Environmental contamination by chromium [Cr] has become an important issue due to its adverse effects on human health and environment. This study was done to evaluate the application of modified bentonite using sulfuric acid as an adsorbent in the removal of hexavalent Cr from aqueous solution
Methods: Adsorbent features were determined using x-ray diffraction [XRD], fourier transformed infrared spectroscopy [FTIR] and scanning electron microscope [SEM] techniques. Thereafter, the effect of pH, contact time, adsorbent dosage and different concentrations of Cr was investigated. The experimental data was fitness in terms of kinetic and equilibrium adsorption processes
Results: The maximum capacity [Qm] of Cr[VI] according to Langmuir model was obtained at 4.21 mg/g. The experimental data properly obeyed the Longmuir and pseudo-second-order models. The highest percentage of Cr[VI] adsorption was observed at pH = 3 and the process after 60 minutes reached the equilibrium state
Conclusion: In Langmuir expression, the dimensionless constant separation term [RL] values for the adsorption of Cr onto the modified bentonite was in the range of 0-1, indicating that the adsorption is a favorable process and the modified bentonite has good potential in removing hexavalent Cr using sulfuric acid
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Objective[s]: radiation therapy for breast cancer can induce myocardial capillary injury and increase cardiovascular morbidity and mortality. A prospective cohort was conducted to study the prevalence of myocardial perfusion abnormalities following radiation therapy of left-sided breast cancer patients as compared to those with right-sided cancer
Methods: to minimize potential confounding factors, only those patients with low 10-year risk of coronary artery disease [based on Framingham risk scoring] were included. All patients were initially treated by modified radical mastectomy and then were managed by postoperative 3D Conformal Radiation Therapy [CRT] to the surgical bed with an additional 1-cm margin, delivered by 46-50 Gy [in 2 Gy daily fractions] over a 5-week course. The same dose-adjusted chemotherapy regimen [including anthracyclines, cyclophosphamide and taxol] was given to all patients. Six months after radiation therapy, all patients underwent cardiac SPECT for the evaluation of myocardial perfusion
Results: a total of 71 patients with a mean age of 45.3 +/- 7.2 years [35 patients with leftsided breast cancer [exposed] and 36 patients with right-sided cancer [controls]] were enrolled. Dose-volume histogram [DVH] [showing the percentage of the heart exposed to >50% of radiation] was significantly higher in patients with left-sided breast cancer. Visual interpretation detected perfusion abnormalities in 42.9% of cases and 16.7% of controls [P=0.02, Odds ratio=1.46]. In semiquantitative segmental analysis, only apical [28.6% versus 8.3%, P=0.03] and anterolateral [17.1% versus 2.8%, P=0.049] walls showed significantly reduced myocardial perfusion in the exposed group. Summed Stress Score [SSS] of>3 was observed in twelve cases [34.3%], while in five of the controls [13.9%],[Odds ratio=1.3]. There was no significant difference between the groups regarding left ventricular ejection fraction
Conclusion: the risk of radiation induced myocardial perfusion abnormality in patients treated with CRT on the left hemi thorax is not low. It is reasonable to minimize the volume of the heart being in the field of radiation employing didactic radiation planning techniques. Also it is advisable to screen these patients with MPI-SPECT, even if they are clinically asymptomatic, as early diagnosis and treatment of silent ischemia may change the outcome
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The objective of this study was to determine and compare Cystatin C changes before and after radiotherapy in patients with stomach cancer who were candidate for radiotherapy. This study was conducted as a prospective cohort one. Eighteen patients with definite diagnosis of stomach cancer under treatment by radiotherapy who presented to Radiotherapy-Oncology Center of Imam Hossein Hospital, Tehran-Iran, and the treatment in all cases was simultaneous chemoradiation with Xeloda were included. In all patients before radiotherapy and after radiotherapy serum creatinine [Cr] and Cystatin C were measured simultaneously. Mean cystatin level before treatment [1.2 +/- 0.4] was significantly lower than that of post-treatment [1.6 +/- 0.36], [P=0.001]. Serum Cr level before treatment was 1.15 +/- 0.33 and after radiotherapy was 1.08 +/- 0.24 and did not show significant difference. Glomerular filtration rate [GFR] of the patients before radiotherapy was-46.8 +/- 21.0 and after radiotherapy was 43.8 +/- 15.8 that did not have significant difference [P=0.146] and also blood urea nitrogen [BUN] before radiotherapy was 20.72 +/- 3.7 and 20 +/- 6.38 after radiotherapy that did not have significant difference [P=0.6]. Comparison of the Cystatin C difference with total radiation dose of the kidneys that are put in three dose groups in radiotherapy field had association that in dose of less that 18 gray [Gy] the Cystatin C change showed significant and positive association [P=0.027; r=0.52] and about 18-24 Gy the Cystatin C difference showed significant and negative association [P=0.023, r=-0.53]. It seems that for evaluating the renal function, serum Cystatin C measurement is preferable than serum Cr. level
Subject(s)
Humans , Female , Male , Adult , Middle Aged , Aged , Stomach Neoplasms/radiotherapy , Creatinine/blood , Kidney Function Tests , Prospective Studies , Cohort StudiesABSTRACT
Although current treatment options for cervical cancer rely on platinum-based chemoradiotherapy, individualized approaches to therapy may improve response or reduce unnecessary toxicity. Over expression of Excision repair cross-complementing 1 [ERCC1] has been associated with Cisplatin resistance in some tumors. We hypothesized that ERCC1 over expression is related to treatment response. 32 patients with cervical cancer were enrolled. Malignant tissue was isolated from pretreatment biopsies, and quantitative real-time reverse transcriptase polymerase chain reaction assays were performed to determine ERCC1 expression. Patients were divided to ERCC1 positive and ERCC1 negative. Response to chemoradiotherapy was evaluated and compared among the two groups. The mean age of participants was 56.6 +/- 12 years. Objective response was obtained in 24 patients [75%]. ERCC1 was 2.8 times higher in patients who did not respond to treatment compared with the responders [OR: 2.8]. Assessment of ERCC1 expression in tumoral tissue is possible in the clinical setting and predicts response to chemoradiotherapy. Further studies are necessary for final judgment
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To compare the protection of eyes against visible light [VL] and ultraviolet radiation [UVR] by sunglasses available through the Iranian optician trade union [IOTU] shops and those provided by miscellaneous vendors. Totally, 353 pairs of sunglasses, including 188 pairs from IOTU shops and 165 pairs from miscellaneous vendors were selected based on systematic random sampling. The amount of UVA, UVB and VL transmission of the samples were examined by spectrophotometer. American national standard institute [ANSI] standards were the reference for measuring the UV transmission. All of the sunglasses from IOTU shops met ANSI standards in transmission of UVA, UVB, while these percentages in miscellaneous vendors were 92.1% for UVB and 95.8% for UVA transmission [P<0.05]. Mean of UVB transmission was 0.78% in IOTU shops and 1.8% in miscellaneous vendors. These percentages for UVA transmission was 0.92% and 7.1% respectively [P
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To study the response rate for common chemotherapy regimens, and the progression free survival analysis in ovarian cancer in Tehran. Ninety-eight women with confirmed ovarian cancer who had surgery, followed by chemotherapy at the 3 hospitals in [Fayazbakhsh, Shohadayee Tajrish, and Imam-Hossein], Tehran, Iran, between 1997 and 2003 were enrolled in this retrospective descriptive study. Data regarding age, pathologic variations, surgical procedures, chemotherapy regimens, response rates, and time to progression of the disease were collected. Response rate was evaluated for 51 patients with epithelial cancer. From a total of 98 patients, there were 81 [82.6%] epithelial, 12 [12.2%] germ cell, 4 [4.1%] granulosa cell tumors, and one case of lymphoma. Staging with optimal residue was performed for 18 patients. Stage III was the most common stage [44.9%]. In 71.4% of patients, complete or partial response was seen, while the other patients showed stable, or progressive disease. The most important prognostic factors were the initial stage [p=0.034], and the extent of surgical procedure [p=0.045]. Median disease-free survival was 52.6 months. Although, higher response rate was produced by taxane-based regimen in comparison with cisplatin-cyclophosphamide regimen [78.2% versus 71.4%], but it was not statistically significant [p=0.275]. Median age [49.6 years] of our patients is lower than expected. Besides, a large proportion of the patients are referred in advanced stages. New chemotherapy practically has made no significant higher response rate
Subject(s)
Humans , Female , Ovarian Neoplasms/surgery , Ovarian Neoplasms/diagnosis , Prognosis , Carcinoma , Ovarian Neoplasms/pathologyABSTRACT
Due to high mortality and morbidity of the cervical cancer we decided to compare benefits and advers effects of Gemcitabine plus conventional chemoradiation with conventional chemoradiation with cisplatin alone in Imam Hossein hospital, in Tehran, Iran. This double blind clinical trial, was carried out on 34 patients with documented cervical carcinoma during 2006-07 the patients divided into two sub groups: [A]Conventional concurrent chemoradiation with cisplatin[N=18] versus[B] concurrent chemoradiation with cisplatin plus gemicitabine [N=16]. The patients with clinical stage of IB2-IVA and normal cell blood count with normal renal and liver function tests included in the study. Irradiation was delivered to all patients through external and internal beams with same dose and schedule. The patients followed for 3 months at least. Clinical response rate and adverse events included Neutropenin, Thrombocytopenia, anemia, diarrhea, nausea, and vomiting compared in two groups with fisher exact test, and t-test Despite increasing of complete response rate with adding gemcitabine to conventional treatment[81.2% vs. 66.7%], the difference in two groups was not statistically significant. This study indicated that the addition of gemicatabine to conventional chemoradiation with cisplatinrevealed no significant benefits. All adverse events in combination chemotherapy group were greater than conventional treatment