Radiation treatment planning for prostate cancer: a new dosimetric comparison of five and seven fields IMRT plans

Background: To compare the dosimetric coverage of the planning target volume [PTV] and the dose delivered to the main Organs at Risk [OARs] in 5 and 7-field techniques of Intensity Modulated Radiation Therapy [IMRT] in patients with local prostate cancer

Materials and Methods: Twelve patients with local prostate cancer underwent 5 and 7-field IMRT planning. The delivery of IMRT was carried out using the sliding technique. The dose coverage for PTV was designated to >/= 98% of the PTV covered by 95% of the prescribed dose. Dose conformity was evaluated by comparing the volume of nontarget tissue receiving maximum, and average of the prescribed dose and the dose of 33%, 50%, and 66% of the volumes on both planning sets. For target, this evaluation was made with comparing the Conformity Index [CI] and Inhomogeneity Index [HI]. In addition, we compared the monitor units used for dose delivery in both planning techniques

Results: All the 5 and 7-field IMRT plans differed slightly in the measured parameters, and none of them have statistically significant differences with each other except for the monitor units where significant differences were observed in favor of the 5-field IMRT plans [p=0.000]. In all of the 5-field IMRT plans the mean dose delivered to OARs were very similar or less than that of the 7-field plans

Conclusion: In comparison to the 7-field technique, the 5-field IMRT technique has resulted in improved IMRT dose conformity, homogeneity, and lesser MUs used for radiation therapy. However, this difference was not significant

Long term survival in unresectable stage iv esophageal squamous cell carcinoma treated with chemoradiation: a case report

Introduction: Esophageal squamous cell carcinoma is one of the most common gastrointestinal cancers in Iran. Development of para-aortic lymphadenopathy is classified as stage IV and long term survival is rare. We report a case of esophageal squamous cell carcinoma with paraaortic lymphadenopathies, who was treated with systemic and nonsurgical locoregional therapy

Report of the case: A 39-year-old female with squamous cell carcinoma of the distal esophagus and proximal stomach, that was unresectable on laparatomy, was referred to our center for palliative treatment. She received six cycles of chemotherapy [Paclitaxel / Cisplatin], and then concurrent chemotherapy and radiotherapy to the primary tumor and paraaortic region with a total dose of 5220 centigray [cGy]. Six years later, she was still alive without any complaints or disease progression

Conclusion: It seems that patients with locally advanced unresectable esophageal squamous sell sarcinoma can be treated radically with systemic and nonsurgical locoregional therapy, to achieve long term survival

Megavoltage dose enhancement of gold nanoparticles for different geometric set-ups: Measurements and Monte Carlo simulation

Gold nanoparticles [GNPs] have been shown as a good radiosensitizer. In combination with radiotherapy, several studies with orthovoltage X-rays have shown considerable dose enhancement effects. This paper reports the dose enhancement factor [DEF] due to GNPs in 18 megavoltage [MV] beams. Different geometrical 50-nm GNPs configurations at a concentration of 5 mg/ml were used by both experimental and Monte Carlo [MC] simulation in a deep-seated tumor-like insertion within a phantom. Using MCNP repeated structure capability; a large number of gold nanospheres with a semi-random distribution were applied to simulate this phantom based study. Thermoluminescence dosimetries were used to verify the process of irradiation and MC simulation. Under geometries with different probable combinations of water and GNPs distribution in the tumor, the percentage depth dose and DEF were calculated. Incorporation of GNPs into the radiation field in our set-ups showed a 12% DEF. We show that the method of nanoparticles, distribution, and orientation can effectively change the DEF value

Epidermal growth factor receptor gene in prostate cancer after radical prostatectomy

The aim of this study was to evaluate over expression of epidermal growth factor receptor [EGFR] gene in localized prostate cancers and determine its relation with clinical and pathological factors affecting the progression of the disease. In the tissue samples of the patients with prostate cancer undergoing radical prostatectomy, EGFR expression was evaluated by immunohistochemistry technique. Those with scores 2 and 3 were considered to be positive for the expression. The relation between gene expression and grade was evaluated by chi-square test. Of 100 tissue samples evaluated, 80 and 20 had Gleason score [GS] < 7 and >/= 7, respectively. Also, 68 and 32 had PSA level 10, respectively. A total of 59 samples were positive for EGFR expression, of whom, 46 had GS < 7 and 13 had GS > 7 [P-value = 0.39]. Forty patients had PSA < 10 and 19 had PSA > 10 [P-value = 0.5]. Fifty-nine percent of the patients with localized prostate cancer undergoing radical prostatectomy were EGFR positive. No significant relation was found between EGFR and grading [GS] or PSA

Colorectal cancer prevalence according to survival data in Iran 2007

Colorectal cancer is a common [5000 new cases per year in Iran] and lethal disease. Regarding the high incidence [7 cases per 100000] and survival rate of colorectal cancer and the priority of prevalence index in cancer management, in this study, 1, 2-3 and 4-5 year point prevalence were determined according to survival data. In this study, survival and incidence data were used for the determination of cancer prevalence. Incidence data were extracted from cancer registry in Iran and survival data were determined during a descriptive study through the follow up of 2342 colorectal cancer patients. 1, 2-3 and 4-5 year point prevalence were estimated from incidence rates in different years and the proportion of patients surviving 0.5, 1.5, 2.5, 3.5 and 4.5 year[s] from diagnosis. Proportion of cases surviving 0.5, 1.5, 2.5, 3.5 and 4.5 year[s] from diagnosis were 79.2%, 65.08%, 57.36%, 51.76% and 48.87%, respectively. Estimates of 1, 2-3 and 4-5 year prevalence were 4156, 5715 and 4283, respectively. The cumulative 5 year prevalence was 13954 cases. These estimates of 1, 2-3 and 4-5 year prevalence are applicable to the evaluation of initial treatment, clinical follow-up and point of cure, respectively. Therefore, 1, 2-3 and 4-5 year point prevalence estimates are necessary in health service planning for cancer management

Changes in thyroid functional tests in breast Cancer patients under Tamoxifen therapy

Tamoxifen, a synthetic anti-estrogen agent, is administered as an adjuvant treatment in breast cancer. Since various studies have indicated that Tamoxifen can change some hormones and bound globolines, controversial results have been achieved using this medicine on Thyroid Functional Tests [TFT]. The present study was conducted to investigate the effects of Tamoxifen on TFT in women with breast cancer referred to oncology clinic in Imam Hossein hospital between 2001 and 2002. A quasi-experimental clinical trial study was performed on 23 women with breast cancer in a single blind basis [with no control group]. Patients were under Tamoxifen 20 mg P.O. daily and their serum TSH, free T4 and three Iodothyronine [T3] were assessed before treatment with Tamoxifen and after 3 months. Paired T test was used for statistical analysis. There was a significant difference in T3 before and after the treatment with Tamoxifen [p = 0.02], whereas no significant differences were seen in TSH [p = 0.095] and FT4 [p = 0.13]. This study showed that treatment with Tamoxifen in women suffering from breast cancer results in an increase in serum T3 but has no effect on serum TSH and FT4, therefore women under treatment with Tamoxifen remain euthyroid

Stage I seminoma recurrences in patients admitted to radiotherapy clinic of Shohada hospital between 1991 and 2002

Currently, cancers are among the important and main problems of health system in Iran and around the world. In young men under 20 to 35 years of age, malignant masses of testis are the most common tumours. The main pathologic feature of these masses is germ cell tumour and about half of them are seminoma. Since seminoma is very prevalent in the forth decade, being affected with this tumour leads to losing many years of healthy life. In a cross sectional study, investigating 139 records of patients with testis tumour revealed 61 patients with stage-1 seminoma. Thirty three patients underwent para-aortic and unilateral pelvic irradiation [54%] while 28 patients only underwent para-aortic irradiation [46%]. The administered radiotherapy dosage varied between 25-40 Gy Mean age of the patients was 37.8 of whom the youngest was 15 and the oldest was 64 years of age. Only one recurrent patient was seen in this cohort who was in para-aortic group. There was no significant difference in recurrence rate between the two radiotherapy methods. [p= 0.7]. Considering fewer complications of para-aortic irradiation and the insignificant difference in the recurrence rate between the two methods of radiotherapy, para-aortic method could be more appropriate and acceptable in the treatment of testicular cancer

Response to chemoradiation in patients with squamous cell carcinoma of esophagus treated at Shohada-e-Tajrish hospital

Esophageal carcinoma is among the first ten common malignancies worldwide, with a high prevalence in Iran. Previously, surgery or radiotherapy were the only modalities of therapy; however, due to unsatisfactory outcomes, other therapeutic approaches such as chemoradiation are now under assessment as the first line treatment. Preliminary results have shown reduced local recurrence and better survival. It was a quasi experimental study. Patients with squamous cell carcinoma of esophagus who had the following criteria were enrolled: lack of previous therapy, no metastasis, performance status of 0-2, and normal liver, kidney and bone marrow function tests. Chemoradiation was carried out through one of the following regimens: 1- Cisplatin 40mg/m2/weekly + 50-60Gy radiation; or, 2- Cisplatin 75mg/m2 for the first day + 5-FU 1000mg/m2 for the first 4 days of weeks 1, 5, 9, and 13 + 50Gy radiation. Following the therapy, biopsies of suspected lesions and CT scan of local lymph nodes were obtained to evaluate the response rate. Of 39 patients with non-metastatic squamous cell carcinoma of esophagus who had been referred to our unit during a 5-year period [1998-2003], 30 met the inclusion criteria. The study population included 23 males and 7 females with a mean age of 65 years [35-77 years]. Tumor location was as follows: upper third of esophagus in 6, middle third in 12, and lower third in 12 patients. Twenty-one patients were put on the first protocol and the remaining nine patients on the second regimen. There were 2 deaths, one due to fever and neutropenia, and the other of uncertain cause. Clinical response to therapy was reported in 23 [76.6%] patients. Chemoradiation showed a low complication rate and high efficacy. It can be safely recommended for inoperable patients. Further clinical trials are necessary before definite recommendations can be made

Association of her[2] with prognostic factors of breast cancer

Breast cancer is the most common female malignancy world wide and in Iran as well and is the second cause of death due to malignancy after lung cancer. Varieties of factors such as estrogen and progesterone receptors, and axillary lymph node involvement may influence the prognosis and therapeutic approach. However, mutation in HER[2] gene may also affect the prognosis. In this study, we evaluate the relation between HER[2], estrogen and progesterone receptors and axillary lymph node involvement, in primary breast carcinoma.For this cross-sectional study, 102 patents with primary breast cancer were enrolled. Having prepared the sections, they were stained by H and E. Then, the size and type of tumor, severity, and number of involved lymph nodes were determined. On the other hand, we have identified the estrogen, progesterone and HER[2] according to the immunohistochemiostry staining.Of 102 subjects, 65 [73.7%] were HER[2] positive. We have found a significant association between the HER[2] and number of involved lymph nodes [p < 0.007], however, our results failed to show any significant association between estrogen and progesterone receptors and severity of diseases.The high frequency of HER[2] gene mutation draws our attention towards the importance of this marker among Iranians, however, to confirm the role of HER[2] in breast cancer prognosis, we must conduct further studies