Effectiveness and complications of [153]Sm-EDTMP in palliative treatment of diffuse skeletal metastases

The aim of the present study was to evaluate the efficacy and safety profile of bone palliative therapy following administration of [153]Sm-EDTMP in patients with intractable metastatic bone pain. Sixteen patients [9 male, 7 female] aged 29-80 years [57.3 +/- 16.7 years] with severe metastasis-related bone pain resistant to analgesic medications were enrolled in the study. All patients having multiple bone metastases, positive bone scans, and estimated life expectancy of more than 2-3 months were entered the study. All patients received intravenous injection of 1.5 mCi [56 MBq]/kg of [153]Sm-EDTMP. Four subscales for the intensity of pain were recorded: one as the present pain score [PPS] and the other three as maximum pain score [Max PS], minimum pain score [Min PS] and average pain score [APS] over the last 24 hours. Also the mean value of these 4 subscales was calculated as the mean total pain score [MTPS]. The pain mental interference [PMI] was also assessed in 9 separate. Seven patients with breast cancer [43.75%], seven with prostate cancer [43.75%], one with papillary thyroid carcinoma [6.25%] and one with malignant paraganglioma [6.25%] were included in the study. A significant response to therapy, i.e. 2-point reduction in pain score and/or remarkable reduction [>/=25%] in the equivalent narcotic dose, was observed in 11 out of 16 patients [68.7%] by the 2nd week and in 12 patients [75%] by the 8[th] week. Regarding the palliative response to treatment and equivalent narcotic dose reduction, no significant difference between two major types of underlying malignancies [breast and prostate cancer] was found. There was no significant difference regarding response to therapy between two genders and among different age groups. The severity of bone marrow suppression was graded

[Comparing the effects of conventional and hypofractionated radiotherapies on early skin toxicity and cosmetic outcomes after breast cancer conserving surgery]

The high number of breast cancer patients who receive radiation therapy after surgery has caused many to think about a shorter period of radiotherapy, which can significantly reduce the radiotherapy machine time, labor hours, and fewer patient visits. This study was designed to evaluate the acute skin effects and cosmetic outcomes of short course radiotherapy in early-stage breast cancer in comparison with the conventional treatment method. Fifty-two patients with operable breast cancer [pT1-3pN0M0] who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy by either receiving conventional treatment [dose: 50 Gy in 25 fractions] with subsequent electron boost or a short-course hypofractionated radiotherapy [dose: 42.5 Gy in 16 fractions] and a subsequent electron boost. There were no skin changes during the first or the second week of treatment in the two groups. Cutaneous complications began after the third week as grade 1 skin toxicity after termination of the short-course radiotherapy but there were no difference in complication rate after four weeks of treatment. Six months and one year after treatment, there were no differences in terms of skin complications or cosmetic outcomes between the two groups. Although the use of a whole-breast irradiation with a hypofractionated schedule was associated with desirable outcomes, in term of skin toxicity and cosmetics, but longer follow-up periods with larger sample sizes are needed to confirm these results.

[Concurrent chemoradiation with weekly gemcitabine and cisplatin in locally advanced cervical cancer]

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

Chemoradiation in nasopharyngeal carcinoma: a 6-year experience in Tehran cancer institute

To determine the addition of value of neoadjuvant, concurrent and adjuvant chemotherapy to radiation in the treatment of nasopharyngeal carcinoma with regard to the overall survival [OS] and disease free survival [DPS] within a six year period in Tehran cancer institute. Files of all patients with nasopharyngeal carcinoma treated by radiotherapy with or without concurrent chemotherapy in a curative setting in Tehran cancer institute during the period of 1999-2005 were retrospectively reviewed. A total of 103 patients with nasopharyngeal carcinoma had been treated during the study period with radiotherapy or chemoradiotherapy in our institute. There were 29 [28.2%] females and 74 [71.8%] males. The median age at the time of radiotherapy was 47 years old [range 9-75 years]. The patients were followed 2 to 76 months with a median follow-up of 14 months. Time of first recurrence after treatment was 3-44 months with a median of 10 months. Survival in 2 groups of patients treated with radiotherapy alone or chemoradiation did not have a significant difference [P>0.1]. Two-year survival in patients treated with or without adjuvant chemotherapy and had local recurrence after treatment did not have significant difference [P>0.1]. Two-year survival in patients with or without local recurrence after treatment did not have significant difference [P>0.1]. A beneficial effect or a survival benefit of adjuvant/neoadjuvant chemotherapy and concurrent chemoradiation was not observed in Iranian patients

Pathologic characteristics, type of treatment and follow up of patients with uterine cervical carcinoma referred to the Radiation Oncology Department, Cancer Institute, Imam Khomeini Hospital,Tehran, Iran, 1995-2001.

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.

eight-year study of the thyroid cancer cases treated in Tehran cancer institute's radiation-oncology department

A retrospective study was undertaken to examine the thyroid cancer cases referred for external radiotherapy to our department during the period of 1991-99. Within this period, a total of 33 patients had been treated by irradiation for thyroid cancer or its metastases and these cases were evaluated for age, sex, pathology and type of surgery. The reason of patients' referral for external radiotherapy [The main aim of our study] was tumor extensive infiltration of the neck soft tissue and/or lymph nodes in 21 cases [64%], and tumor metastasis in 12 cases [36%]. Twenty-one patients came back for follow-up, who were all symptom-free 12-18 months after irradiation