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Rectal cancer is one of the most prevalent cancers in the world. In many countries, the current standard of care is long-course chemoradiation (CRT), followed by total mesorectal excision. Some efforts have been made by intensifying radiation or chemotherapy components of the neoadjuvant therapy to further decrease the local recurrence and augment surgery’s feasibility and improve the oncological outcomes. This paper reviews recent intensified neoadjuvant interventions in locally advanced rectal cancer (LARC) in terms of efficacy and treatment-related toxicity. Many maneuvers have been made so far to improve the oncological outcomes of rectal cancer with intensified neoadjuvant long-course CRT. Some of these approaches seem compelling and deserve further study, while some have just increased the treatment-related toxicities without evident benefits. Those endeavors with greater pathological complete response than the standard of care may make us await the long-term results on survival rates and chronic treatment-related toxicity. After introduction of neoadjuvant CRT for LARC there have been many efforts to improve its outcomes. Here, this study gathered most of these efforts that intensified the neoadjuvant therapy with some being promising and some being futile.
ABSTRACT
Rectal cancer is one of the most prevalent cancers in the world. In many countries, the current standard of care is long-course chemoradiation (CRT), followed by total mesorectal excision. Some efforts have been made by intensifying radiation or chemotherapy components of the neoadjuvant therapy to further decrease the local recurrence and augment surgery’s feasibility and improve the oncological outcomes. This paper reviews recent intensified neoadjuvant interventions in locally advanced rectal cancer (LARC) in terms of efficacy and treatment-related toxicity. Many maneuvers have been made so far to improve the oncological outcomes of rectal cancer with intensified neoadjuvant long-course CRT. Some of these approaches seem compelling and deserve further study, while some have just increased the treatment-related toxicities without evident benefits. Those endeavors with greater pathological complete response than the standard of care may make us await the long-term results on survival rates and chronic treatment-related toxicity. After introduction of neoadjuvant CRT for LARC there have been many efforts to improve its outcomes. Here, this study gathered most of these efforts that intensified the neoadjuvant therapy with some being promising and some being futile.
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Purpose@#Colorectal cancer is becoming an increasing concern in the middle-aged population of Iran. This study aimed to compare the preliminary results of short-course and long-course neoadjuvant chemoradiotherapy treatment for rectal cancer patients. @*Materials and Methods@#Patients in group I received three-dimensional conformational radiotherapy with a dose of 25 Gy/5 fractions in 1 week plus concurrent XELOX regimen (capecitabine 625 mg/m2 from day 1–5 twice daily and oxaliplatin 50 mg/m2 on day 1 once daily). Patients in group II received a total dose of 50–50.4 Gy/25–28 fractions for 5 to 5.5 weeks plus capecitabine 825 mg/m2 twice daily. Both groups underwent delayed surgery at least 8 weeks after radiotherapy completion. The pathological response was assessed with tumor regression grade. @*Results@#In this preliminary report on complications and pathological response, 66 patients were randomized into study groups. Mean duration of radiotherapy in the two groups was 5 ± 1 days (range, 5 to 8 days) and 38 ± 6 days (range, 30 to 58 days). The median follow-up was 18 months. Pathological complete response was achieved in 32.3% and 23.1% of patients in the short-course and long-course groups, respectively (p = 0.558). Overall, acute grade 3 or higher treatment-related toxicities occurred in 24.2% and 22.2% of patients in group I and II, respectively (p = 0.551). No acute grade 4 or 5 adverse events were observed in either group. Within one month of surgery, no significant difference was seen regarding grade ≥3 postoperative complications (p = 0.333). @*Conclusion@#For patients with rectal cancer located 5 cm above the anal verge, short-course radiotherapy with concurrent and consolidation chemotherapy and delayed surgery is not different in terms of acute toxicity, postoperative morbidity, complete resection, and pathological response compared to long-course chemoradiotherapy.
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PURPOSE: This study aimed to assess complications and outcomes of a new approach, that is, combining short course radiotherapy (SRT), concurrent and consolidative chemotherapies, and delayed surgery. MATERIALS AND METHODS: In this single arm phase II prospective clinical trial, patients with T3-4 or N+ M0 rectal adenocarcinoma were enrolled. Patients who received induction chemotherapy or previous pelvic radiotherapy were excluded. Study protocol consisted of three-dimensional conformal SRT (25 Gy in 5 fractions in 1 week) with concurrent and consolidation chemotherapies including capecitabine and oxaliplatin. Total mesorectal excision was done at least 8 weeks after the last fraction of radiotherapy. Primary outcome was complete pathologic response and secondary outcomes were treatment related complications. RESULTS: Thirty-three patients completed the planned preoperative chemoradiation and 26 of them underwent surgery (24 low anterior resection and 2 abdominoperineal resection). Acute proctitis grades 2 and 3 were seen in 11 (33.3%) and 7 (21.2%) patients, respectively. There were no grades 3 and 4 subacute hematologic and non-hematologic (genitourinary and peripheral neuropathy) toxicities and perioperative morbidities such as anastomose leakage. Grade 2 or higher late toxicities were observed among 29.6% of the patients. Complete pathologic response was achieved in 8 (30.8%) patients who underwent surgery. The 3-year overall survival and local control rates were 65% and 94%, respectively. CONCLUSION: This study showed that SRT combined with concurrent and consolidation chemotherapies followed by delayed surgery is not only feasible and tolerable without significant toxicity but also, associated with promising complete pathologic response rates.
Subject(s)
Humans , Adenocarcinoma , Antineoplastic Combined Chemotherapy Protocols , Arm , Capecitabine , Combined Modality Therapy , Consolidation Chemotherapy , Drug Therapy , Induction Chemotherapy , Iran , Proctitis , Prospective Studies , Radiotherapy , Radiotherapy, Conformal , Rectal NeoplasmsABSTRACT
Background: Anabolic steroid drugs, especially dianabol, were used as energy producer drug for growth and enhancement of muscles in athletes. Using of anabolic-androgenic steroids among athletes is extended. However, there are limited information about the adverse effects of mentioned drugs on genital system. This study aimed to evaluation of protective effects of vitamin E against damages caused by dianabol on male genital system
Materials and methods: In this experimental study, 72 male mice grouped randomly to one control group and seven experimental groups [n=9]. Mice in experimental groups 1, 5, 6 and 7 received vitamin E with dose 100 IU/kgBW. Experimental groups 5, 6 and 7 were administrated dianabol with doses 5, 10 and 20 mg/kgBW after 4 hours of vitamin E reception. Mice in experimental groups 2, 3 and 4 received just dianabol with doses 5, 10 and 20 mg/kgBW. Administration method in all groups was orally by gavage for 42 days. 24 hours after last treatment, blood samples were collected from heart and sperm characteristics were evaluated
Results: Results showed significant decrease in total antioxidant capacity [TAC] and increase in malondialdehyde [MDA] in serum; vitamin E administration remarkably improved above mentioned parameters. Also, vitamin E administration caused improvement in sperm parameters and blood testosterone level
Conclusion: This study showed that vitamin E, as inhibitor of free radical, can decrease oxidative damages caused by dianabol
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Background: The present study was carried out to investigate the possible protective effects of royal jelly [RJ] on oxymetholone [OXM]-induced oxidative liver injuries in mice
Methods: In total, 32 adult male NMRI mice were divided into four groups of eight mice each. Mice in groups 1 and 2 were orally administered 5 mg/kg/day OXM for 30 days. At the same time, mice in group 3 received RJ at a dose of 100 mg/kg/day. Saline control and RJ control groups were also included in this study
Results: Administration of 5 mg/kg OXM resulted in a significant decrease in total antioxidant capacity and catalase activity, as well as a significant increase in malondialdehyde [P<0.05]. In addition, OXM-administrated mice showed a slight increase in liver enzymes, including alanine amino transferase, aspartate amino transferase, and alkaline phosphatase. Although OXM caused histopathological changes in the liver, RJ could significantly improve all of the above-mentioned parameters at a dose of 100 mg/kg
Conclusion: The results of the present study indicated that RJ has a partially protective effect on OXM-induced liver toxicity in mice
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Objective: To determine bilateral effects of unilateral iatrogenic vas deferens trauma [UIT] on epididymal sperm characteristics and in vitro fertilizing capacity in an experimental mouse model
Methods: Experiments were performed on three equal groups each comprising six adult male mice. Following anaesthesia, UIT was induced by clamping left vas deferens with a mosquito clamp in fully locked fashion for 2 minutes in UIT group. Control-sham mice only had exposure of the left vas deferens through a groin incision. Control animals only received ceftriaxone [100 mg/kg] intraperitoneally at the day of experimental UIT induction. Ipsilateral and contralateral epididymal sperm characteristics and in vitro fertilizing capacity were evaluated after 35 days
Results: UIT significantly decreased sperm concentration, motility and viability as well as fertilization, two-cell embryos, blastocysts and hatched blastocysts rates. Moreover, incidence of DNA damage and abnormality in spermatozoa was significantly higher in UIT group
Conclusion: The findings suggest that a non-recognized iatrogenic vas deferens trauma may have detrimental effects on spermatozoa leading to infertility
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Diabetes mellitus has a variety of structural and functional effects on the male reproductive system. Diabetes results in reduced sperm parameters and libido. The present study aims to investigate the effects of royal jelly [RJ] on reproductive parameters of testosterone and malondialdehyde [MDA] production in diabetic rats. This experimental study was conducted on adult male Wistar rats. The animals were divided into four groups [n=8 per group]: control, RJ, diabetic and diabetic treated with RJ. Diabetes was induced by intraperitoneal injection of 60 mg/kg body weight [BW] of streptozotocin [STZ]. RJ, at a dose of 100 mg/kg BW was given by gavage. The duration of treatment was six weeks. After the treatment period the rats were sacrificed. The testes were weighed and changes in sperm count, motility, viability, deformity, DNA integrity and chromatin quality were analyzed. Serum testosterone and MDA concentrations of testicular tissue were determined. Data were analyzed by one-way ANOVA with p<0.05 as the significant level. STZ-induced diabetes decreased numerous reproductive parameters in rats. Testicular weight, sperm count, motility, viability and serum testosterone levels increased in the diabetic group treated with RJ. There was a significant decrease observed in sperm deformity, DNA integrity, chromatin quality, and tissue MDA levels in diabetic rats treated with RJ compared to the diabetic group [p<0.05]. RJ improved reproductive parameters such as testicular weight, sperm count, viability, motility, deformity, DNA integrity, chromatin quality, serum testosterone and testicular tissue MDA levels in diabetic rats
Subject(s)
Reproduction , Diabetes Mellitus, Experimental , Streptozocin , Rats, Wistar , Spermatozoa , Testosterone , MalondialdehydeABSTRACT
The current systematic study has reviewed the therapeutic potential of gold nanoparticles as nano radiosensitizers for cancer radiation therapy. This study was done to review nano radiosensitizers. PubMed, Ovid Medline, Science Direct, SCOPUS, ISI web of knowledge, Springer databases were searched from 2000 to September 2013 to identify appropriate studies. Any study that assessed nanoparticles, candidate of radio enhancement at radiotherapy on animals or cell lines was included by two independent reviewers. Gold nanoparticles can enhance radiosenstivity of tumor cells. This effect is shown in vivo and in vitro, at kilovoltage or megavoltage energies, in 15 reviewed studies. Emphasis of studies was on gold nanoparticles. Radiosensitization of nanoparticles depend on nanoparticles' size, type, concentration, intracellular localization, used irradiation energy and tested cell line. Study outcomes have showed that gold nanoparticles have been beneficial at cancer radiation therapy
Subject(s)
Nanoparticles , Radiation-Sensitizing Agents , Radiotherapy , NeoplasmsABSTRACT
Imaging of infection and inflammation is an important issue in nuclear medicine as it may have relevant implication for the management of patients with infections or inflammatory diseases. In this regard the synthesis of human polyclonal immunoglobuline G [IgG] radiolabeled with technetium-99m [99mTc] by a novel method, via a nicotinamide hydrazine derivative, was performed. The biological behavior, stability and its high specific activity make this radiopharmaceutical a suitable reagent for radiolabeling of proteins and peptides. In this article the method for synthesis of a sterile and apyrogen 99mTc-HYNIC-hIgG kit is presented. The preparation of the kit consists two steps, in the first step 740 MBq pertechnetate was added in Kit No.1, which contains SnCl2 and tricine. After 5 minutes the aliquot in Kit No.1 was added to Kit No.2, which contains HYNIC-hIgG. 99mTc-HYNIC-hIgG complex is stable in cysteine and serum with a labeling efficiency more than 90% after one hour