Radiotherapy and chemotherapy in treatment of primary hepatic tumours

The present study comprised 25 patients who were randomly allocated to receive either intravenous systemic chemotherapy [group A] or chemotherapy coupled with hepatic irradiation [group B]. Subjective response was obtained in about 20 patients, complete disappearance of all symptoms was encountered in 7.7% and 16.6% of patients in group A and group B, respectively. When pain control was evaluated, a statistically significant better response was found in the group of combined chemotherapy and hepatic irradiation. There was no complete objective response to either chemotherapy or chemotherapy coupled with hepatic irradiation, partial response was achieved in 6 patients of group B [combined treatment]. In all patients showed objective response, the response was maintained for more than 4 weeks. No single life threatening complication has been faced. Moreover, the incidence of sever toxicity grade III was much lower than mild, moderate [I, II] toxicities in both treatment modalities. Mean overall survival in [months] in groups A was 4.86 +/- 1.31 versus 5.6 +/- 1.8 in group B

Correlation between radioactive isotope scan and ultrasonography of the thyroid in patients with different thyroid diseases

In a prospective series of 114 patients, radioisotope scan [RIS] and ultrasonic scan [US] of the thyroid gland were compared in detail. US is the most sensitive test in detecting multi-nodularity [47 percent] versus [25 percent] by RIS and [16 percent] by clinical examination. While RIS is the most sensitive test in detection of residual or recurrence after thyroidectomy [11 percent] versus [7 percent] by US and [5 percent] by clinical examination. Solitary nodules were [46 percent] clinically, 39 percent with RIS and [28 percent] by US. Also RIS and US can differentiate effectively between thyroid and extrathyroid swellings which clinically resemble thyroid. So, the use of RIS and US alter the primary evaluation of thyroid nodularity based on palpation. In spite of the high sensitivity of thyroid US in detection of multinodular goitre [MNG], however, this can not determine the function of the nodules and so, can not exclude neoplasia. Three cases of MNG by US were found by RIS to be as following: one case with solitary cold nodule, another case showed MNG with dominant cold nodule, both proved to be follicular adenomas after operation. The third case showed 2 cold nodules the largest of them was found to be follicular carcinoma. Malignancy was detected In [16 percent] of patients with solitary cold or hypofunctioning nodules, nil in patients with solitary cold pure cystic nodules, [14 percent] of cases with solitary cold mixed nodules and [25 percent] in cold solid nodules. In the later group no malignancy was detected in cold hyperechoic solid nodules, [20 percent] malignancy was found in isoechoic solid cold nodules and [43 percent] in hypoechoic solid cold nodules. So, we recommend to begin with RIS in thyroid diseases. If MNG, hot nodules or residual or recurrence was detected US can not add new informations. If absent thyroid tissue [without thyroidectomy], US helps in differentiation between true absence and failure of uptake e.g. in thyroiditis or suppression by hot nodule or malignancy. Also in solitary cold or hypofunctioning nodules malignancy is more predicted if by US the nodule was mixed or solid [isoechoic or hypoechoic]. Thus the combination of RIS and US in solitary cold nodule and absent RIS can lead to a very high accuracy in the preoperative diagnosis of thyroid pathology and making surgery unnecessary in many cases and improving the cost benefit ratio

Correlaton between estrogen receptors and histo-pathological parameters in human breast cancer

A monoclonal antibodies immunoassay technique was used to demonstrate oestrogen receptors in 50 in freshly excised human breast tumours. 48 cases were infiltrating duct carcinoma and 2 cases were infiltrating lobular carcinoma. The relationship between oestrogen receptors, histopathological type, histopathologicalIy and nuclear grades, fibrosis, elastosis and necrosis was evaluated. Oestrogen receptors positivity was demonstrated in 44 out of 50 cases. A significant positive correlation was found between histopathological and nuclear grades and oestrogen receptors content, well differentiated tumours rarely lacked oestrogen receptors. Tumours with marked fibrosis showed less oestrogen receptors content than tumours with mild fibrosis, Elastotic tumours were more oestrogen receptors positive than non elastotic tumours. Those with marked elastosis showed higher oestrogen receptors content than tumours with moderate and mild elastosis. A significant correlation was found between oestrogen receptors content and necrosis, tumours without necrosis showed higher oestrogen content than those with necrosis. The previous results may explain significant higher 2 year recurrent survival in cases with well differentiated tumours, little fibrosis and absent necrosis found in the present study

Evaluation of nucleolar organizer regions in Non-hodgkin's Lymphoma

46 lymph nodes specimens of N.H.L were included in the present study. Paraffin processed sections were prepared and stained with the following: 1. Hx. and E. for histopathological typing of N.H.L. according to the working formulation classification. 2-Argyrophil silver staining for analysis of NORs. Our results demonstrated there is well defined difference: between low, intermediate and 5 of grade lymphomas on the basis of NORs count of their cells.Also, NORs count increased in patient living than 2 years. Our findings documented the considerable value of the Ag-NORs for both grading and prognosis in NHL

Treatment failure of cervical cancer after radiotherapy

Forty-five patients with histologically proven carcinoma of the cervix uteri were treated with radiotherapy. Seventeen patients showed persistent or recurrent disease. There was a statistical significant correlation between treatment failure and stage of the disease, accuracy of intracavitary application and dose of radiation therapy. In conclusion, more than one clinical and geometrical factor were present individually or in combinations in patients with treatment failure, including massive central disease, advanced stage, low haemoglobin level, marked deviation of the application from the st and ard position, suboptimal doses due to discontinuation of treatment by the patients or wrong calculation. This emphasized the importance of early detection of cancer cervix and accurate delivering and calculation of adequate radiation doses to the tumor volume in decreasing the risk of treatment failure