Preoperative chemo-radiotherapy in rectal cancer effect on down staging and possibility of sphincter sparing surgery

This study included 30 patients with rectal carcinoma with either border line respectability or not suitable for primary sphincter sparing surgery. Performance status >/60, adequate bone marrow reserve and adequate hepatic and renal functions. All patients had been staged by radiological studies and endoscopies. All patients were treated by combined chemo-radiation; radiotherapy with dose of 45 Gy in 25 fractions over 5 weeks, chemotherapy with 5-flurouracil 500 mg/m2 i.v. infusion over 2 hours and leucovorin immediately before radiation setting for first 5 days of the first week and the first 5 days of the last week of radiation. Patients were evaluated 4-6 weeks after treatment. Operable patients were subjected to abdominoperineal resection [APR] or low anterior resection [AR]. Toxicity was evaluated using WHO Common Toxicity Criteria. In conclusion, preoperative chemo-radiotherapy is an effective treatment in inducing down-staging of locally advanced rectal cancer patients and enhances curative resection and sphincter preserving procedures

Hypofractionanted radiotherapy as a convenient treatment in high grade astrocytomas

In the present study 61 patients with grade III and IV malignant astrocytoma and glioblastoma multiform were randomized into two groups of radiation treatment schedules. Conventional treatment [6000 cGy/30 tt/6 weeks] and hypofractionation treatment [3000 cGy/6tt /3weeks] i.e. 500 cGy per fraction twice weekly by Cobalt 60 machine. Overall response 3 months after treatment were 48.1% in hypofractionation group and 40.7% in conventional group. After 6 months responders were 35.4% versus 36.6% respectively. Early treatment reactions were moderate more in hypofractionation group. Mean time of progression were 10.1 months in hypofractionation versus 9.8 months in conventional treatment. Median survival time were 12 months in hypofractionation versus 9 months in conventional group. Cost of treatment including hospitalization were 690 EP for hypofractionation arm and 1560 E.P for conventional arm. It was concluded that hypofractionation is a simple palliative treatment with comparable results to conventional radiation treatment, save more time [work load], less cost. So, it is a convenient treatment in high grade glioma, where palliation is considered, for patients and physicians as well as treatment place