Cosmetic outcome of hypofractionated whole-breast irradiation with concomitant boost in breast cancer

Background: Breast cancer is the most common cancer in women worldwide, second most common malignancy in Egypt.Methods: 60 early-stage breast cancer patients who underwent breast-conserving surgery were clusterized into 2 groups: Arm A hypofractionation with concomitant boost and Arm B conventional fractionation, each compromising 30 early stage breast cancer patients. Assessment of cosmetic outcome after breast irradiation was recorded in both groups in 4 intervals to correlate cosmesis in relation to different irradiation schedules and boost dosage and timing. The study was conducted from April 2016 till December 2018, 32 months were obtained to assure that all patients completed their irradiation schedule and 12 months follow-up period.Results: Lowest cosmetic outcome was recorded immediately after completion of breast irradiation with excellent/good in 66.7% and 73.3% of patients and fair/poor in 33.3% and 26.7% in Arm A and B, respectively. Improvement in cosmesis after 12 months of breast irradiation reaching excellent/good in 83.4% and fair/poor in 16.7% in both Arm A and B.Conclusion: An abbreviated 4-week hypofractionated schedule with a concomitant boost is as effective as conventional irradiation with comparable cosmesis and may be a reasonable alternative following breast conserving surgery

Laser versus radiotherapy in the treatment of early glottic carcinoma

Background: Laryngeal cancer is one of the most common types of head and neck malignancy, although its optimal primary treatment is still a matter of debate. Methods: Typical patients with laryngeal SCC (90% at least) are males, over 45 years and heavy smokers. Hoarseness, voice changes, dysphagia, odynophagia, neck mass, dyspnea, referred otalgia and aspiration are the symptoms seen in laryngeal carcinoma. Glottic carcinomas are usually diagnosed earlier and hoarseness is the most common typical symptom. Results: All patients had completed the study. After comparison of the result between the 2 treatment groups, transoral laser excision shows better results than radiotherapy. There is significant difference between laser and radiotherapy in post-operative complications regarding granuloma tissue formation, tumor recurrence and web formation. In laser excision of laryngeal carcinoma, 10% of cases have post-operative granuloma while in radiotherapy, 66.6% of them have post-operative granuloma, but no cases has tumor recurrence while in radiotherapy, 33.3% of them have tumor recurrence. In laser excision of laryngeal carcinoma, 10% of cases have post-operative web formation while in radiotherapy, 22.3% of them have post-operative web formation. There is statistically significant difference between laser and radiotherapy in post-operative satisfaction about the voice (voice quality). Radiotherapy shows better results than laser in voice satisfaction. Conclusions: As regard the study, transoral laser excision of early glottic carcinoma shows better control rate and decrease recurrence and complications than radiotherapy. Keywords