ABSTRACT
Introduction: Upper limbs lymphedema is one of the rather common and debilitating sequels of breast cancer treatment. The incidence of this sequel has been reported in different sources to be from 25% to 38%. The purpose of this study was to evaluate the incidence and the risk factors of lymphedema following invasive breast carcinoma treatment
Materials and Methods: Recorded data of breast cancer patients referred to Mashhad Omid Hospital between 1997 and 2005 were evaluated for the incidence and risk factors of lymphedema. Univariate and multivariate analysis were performed to evaluate the risk factors using a logistic regression model
Results: Out of 312 patients entering the study 101 patients [32.4%, 95% CI: 27.2-37.6] developed lymphedema. Univariate analysis did not show a statistically significant difference between the rates of lymphedema in radical mastectomy when compared to other types of surgery such as lumpectomy with axillary dissection. Obesity according to body mass index significantly affected the development of lymphedema [p=0.03]. The average number of metastatic nodes was 4.56 +/- 4.05 in patients who had and 2.48 +/- 3.19 in patients who did not have lymphedema [p<0.01]. The average percentage of metastatic to excised nodes was%54.59 +/- 37.48 in patients who had and%34.67 +/- 34.84 in patients who did not have lymphedema [p<0.01]. Age, the number of excised nodes, the stage of disease, hormonal therapy, adjuvant radiation therapy and chemotherapy had no correlations with lymphedema
Conclusion: According to our findings, body mass index, the number of metastatic nodes and the percentage of metastatic to excised nodes were correlated with the development of lymphedema
ABSTRACT
Introduction: We conducted a multi-centric phase II study to evaluate the tumor response and safety of the combination of vinorelbin and docetaxel in treatment of metastatic breast cancer patients
Patients and methods: Forty one metastatic breast cancer patients, who had at least one measurable lesion and had not been treated for metastasis before, were enrolled from March 2006 to June 2009. Treatment contained vinorelbine 25mg/m2 IV and docetaxel 30mg/m2 at day 1 and 8. Cycles were repeated every 21 days for 6 cycles. We evaluated response to chemotherapy every three weeks and toxicity every week
Results: The mean age of patients was 50.4 years [range 30-81]. Twenty eight patients [68.2%] had received prior neoadjuvant anthracycline based chemotherapy. No patient had received adjuvant chemotherapy within the last 3 months. Twenty four patients [58.3%] had two or more metastatic sites. Thirty six patients were evaluable for their response. An objective tumor response [either complete response or partial response] was achieved in 32 [88.8%] and complete response was seen in 9 [25%] patients. Thirteen patients [31.6%] developed grade 3-4 neutropenia and neutropenic fever was reported in 11 [26.8%]. Grade 3 anemia was observed in 1 patient [2.4%]. No grade 4 non-hematological toxicity was noted and the most frequent grade 3 non-hematological toxicities were hair loss [39%], stomatitis [7.3%] and diarrhea [4.8%]. Median time to progression was 7 months and median overall survival was 11 months
Conclusion: Vinorelbine-docetaxel combination shows a considerable tumor response and manageable toxicity as the first line treatment for metastatic breast cancer. It seems logical to conduct phase III trials to further evaluate this regimen
ABSTRACT
Introduction: Cancer is the 3rd cause of death after heart disease and injuries in Iran. Radiotherapy is one of the most effective procedures in cancer therapy, but in spite of widespread usage, its nature and side effects are still unknown for many patients. The main goal of this survey was studying various educational needs among cancer patients with specific emphasis on radiation therapy and its side effects
Patients and methods: This study was a descriptive-analytical research based on the information extracted from personal interviews and files in order to determinate patients' educational needs and their relationship with different variables such as demographic characteristics and the kind of disease among those referred to radiation therapy department in Mashhad Omid Hospital during a 6 months period
Results: Our findings show that age and marital status have a statistically significant association with educational needs [P<0.01]. Also patients in early stage of their disease had higher educational requirements. Most of the patients had limited or moderate information about their disease and treatment effects [88%]. In addition 46% of patients mentioned the physician as their preferred source of information
Conclusion: Findings indicate lack of training about radiotherapy and its side effects among our cancer patients, and emphasizes the need for a structured program to alleviate this problem. It seems that the role of physicians in this field is more significant than other health care staff
ABSTRACT
Introduction: Human papilloma virus prevalence data is scarce in Iran. This study was performed to evaluate type-specific human papilloma virus prevalence and to compare it with Pap smear results among Iranian women attending regular gynecological visits
Patients and methods: A total of 851 women aged 18-65 years, attending regular gynecological visits were retrospectively evaluated. Human papilloma virus detection and genotyping was performed using polymerase chain reaction technique. Cytological evaluation was performed by Papanicolaou method and the association between cytological results and human papilloma virus profile was analyzed
Results: Nineteen different types of human papilloma virus were detected in 265 of 851 patients [31.1%]. Overall infection as well as infection with high risk human papilloma virus types; were highest in women aged 18-25 years and decreased with age. Type-specific prevalence of human papilloma virus -16 and 18 was 7.3% and 2.8% respectively. There was also an upward trend in the prevalence of high risk human papilloma virus infection as the abnormality in cytology increased. The prevalence of human papilloma virus related events was 29.1% among virus positive patients and declined from low grade squamous intraepithelial lesion [18.2%] to high grade squamous intraepithelial lesion [3.9%]
Conclusion: Our study indicated that the burden of human papilloma virus infection among Iranian females was higher in comparison with previous estimates reported from Iran. Furthermore, higher prevalence of premalignant changes in Iranian women infected with high risk human papilloma virus types other than vaccine types should be considered in immunization programs and development of population-specific human papilloma virus vaccines
ABSTRACT
Introduction: Adjuvant Online! [AOL] is used extensively by oncologists in Iran to treat patients with breast cancer; however, it has never been validated for use in Iran, and its predictions might not be applicable to Iranian patients. The aim of this study was to evaluate the usefulness of this program in predicting the outcomes of Iranian patients with breast cancer
Patients and methods: 368 patients who were treated between 1997 and 2010 at Jorjani Cancer Center entered the study. Data for each patient, including tumor size, number of positive nodes, tumor grade, ER status, and adjuvant systemic therapy, were entered into the AOL program [version 8.0], and the calculated disease free survival [DFS] was compared with the observed one. Analyses were performed using Cox regression modeling and SPSS 17.0 software, and P values < 0.05 were considered significant
Results: Observed disease free survival [DFS] in our study was 72 months, while the calculated DFS by AOL was 68 months. In all subgroups of AOL, calculated DFS was less than observed DFS except for patients receiving Tamoxifen + Aromatase Inhibitors + Ovarian Ablation hormone therapy, for whom the calculated DFS was 2 percent more than the observed one
Conclusion: AOL underestimated overall survival and disease free survival rates in Iranian patients with breast cancer, which in our opinion was mainly due to the shorter period of follow-up in our study. Although AOL is widely used by Iranian oncologists, we believe that developing an Iranian version of a prediction tool would better predict the prognosis of our patients