ABSTRACT
Gastric cancer is an important health problem across the world. Chemotherapy in combination with local treatment is the standard treatment for locally advanced gastroesophageal junction [EGJ] cancers. The purpose of this study was to evaluate response and tolerability to neoadjuvant regimen combining epirobicin, oxaliplatin and capecitabin [EOX] in locoregionally advanced gastric cancer. We recruited 28 patients with histologically confirmed advanced gastric or EGJ adenocarcinoma in this study performed in the Cancer Institute of Imam Khomeini Hospital in Tehran, Iran in 2010-2011. Staging workup included chest and abdominal computed tomography [CT] scans, upper gastrointestinal endoscopy, endoscopic ultrasonography [EUS], measurement of carcinoembryonic antigen [CEA], complete blood cell count [CBC], and liver and renal function tests. After three treatment cycles with EOX regimen, we evaluated response to the neoadjuvant chemotherapy by performing endoscopic ultrasonography [EUS] and chest and abdominal CT scans. The mean age of the patients was 56.64+/-11.08 years [ranging from 37 to 78 years]. Most patients were classified as having stage III [98.8%] cancer before chemotherapy while most were classified as stage II [57.14%] after the treatment. Only 28.5% of tumors were resectable before chemotherapy, but 82.1% of them were resectable upon the treatment. 75% of tumors were downstaged after chemotherapy. Regarding the acceptable response and downstaging of tumors and low toxicity of EOX regimen in locoregionally advanced gastric cancer, evaluation of this regimen as a neoadjuvant chemotherapy in larger phase III clinical trials in Iranian patients would be both necessary and logical
ABSTRACT
More than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard of treatment for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultaneously with radiation. Thirty Women with untreated invasive squamous-cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in Radiation Oncology department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty mg/m2 gemcitabine followed by 35 mg/m2 cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment. The mean age of the participants was 58.13 +/- 11.83 [29-78] years. After 3 months of treatment, 73.3% had complete and 26.7% had partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients. According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation by gemcitabine in advanced cervical cancers
Subject(s)
Humans , Female , Chemoradiotherapy , Deoxycytidine/analogs & derivatives , Cisplatin , Carcinoma, Squamous Cell , Neoplasm InvasivenessABSTRACT
BACKGROUND: Carcinoma of the uterine cervix is the sixth most common malignant neoplasm in women worldwide. Early stage diagnosis increases the cure rate of disease. Radiotherapy with or without concurrent chemotherapy is one of the most effective treatment modalities. After radiotherapy, accurate and regular follow-up results in early diagnosis and effective treatment of recurrence. METHODS: In this retrospective study, we evaluated 346 cases of cervical carcinoma who have been treated with radiotherapy in the Radiation Oncology Department of the Cancer Institute of Imam Khomeini hospital from 1995 to 2001. RESULTS: Age of the study group ranged from 26 to 78 (mean=50.5, SD=11). 30.4 percent of patients were early stage and 69.6 percent had advanced stage of disease. Some 92.2 percent of cases were squamous cell carcinomas and adenocarcinomas made up the 6.4 percent . Radical radiotherapy was most frequent radiotherapy setting and adjuvant radiotherapy (post-op) was the second. Most of the patients (43.7 percent) were followed for a short time, and a considerable number did not return for follow-up. CONCLUSION: According to our results, patients do not pay enough attention to disease follow-up. An acceptable training plan, with emphasis on regular follow-up, is recommended.