[ preventative role of sesame oil on phlebitis induced by anti-neoplastic agents]

Phlebitis is an inflammatory response to intravenously injected chemotherapy drugs and the reported incidences about 70% among colorectal cancer patients. The purpose of this study was to determine the effect of external use of Sesame Oil [SO] in prevention of chemotherapy-induced phlebitis. This randomized controlled clinical trial was performed on 60 patients with colon or rectum cancer, who randomly divided in two equal, control and intervention groups. This protocol was used 10 drops of SO every 12 hours, two times a day, from the first day of chemotherapy up to the four tenth day, whereas control group received nothing. Data tools included a bipartite questionnaire [demographic Q, clinical Q and Infusion Therapy scale] for measurement of phlebitis. The incidence of phlebitis in intervention group were significantly lower than that in control group [p<0.05]. Kaplan-Meier survival analysis showed that the median survival was Less than 4 days in the intervention and 8 days more in the control. In addition, there was statistically significant difference between grade and incidence of chemotherapy-induced phlebitis with SO and control group [p<0.05]. This study shows that external use of SO is effective and well tolerated for prophylaxis from chemotherapy- induced phlebitis. Therefore, it can be suggest as a selected Prevention method for reducing the complication

Clinical manifestations and treatment results of patients with cervical cancer: a report from Iran

Cervical cancer is one of the major causes of cancer and death among women aged 40 to 60 in developing countries. There is some difference, however, in the incidence of this cancer in Iranian women compared to women living in western and south-east Asian countries. We aimed at investigating the epidemiologic aspects and treatment results of cervical cancer among Iranian patients. Medical records of patients with cervical cancer who were referred to Mortazavi Radiation Oncology Center [Imam Hossein Hospital] between 2000 and 2004 were evaluated retrospectively. Clinical data such as stage of the disease, type pf chemotherapy, radiation technique and sequence of treatment was recorded. A total of 220 patients with a median age of 55 years [range: 28 to 89] were studied. The majority of them [37.3%] were referred with stage IIB of the disease. Other stages, in order of frequency, were IIA, IIIA and IB. Most of the patients [74%] were treated with two opposed field radiotherapy with a dose of 50 Gy or less [64%]. Disease recurred in 46 patients [21%], 153 patients [74%] received two opposed field radiotherapy and 54 [36%] patients were treated with four fields. On the other hand, 113 patients [55%] did not receive brachytherapy, 36 [18%] only received ovoid brachytherapy and 56 [27%] were treated with ovoid and tandem brachytherapy. Recurrence was more prevalent if the radiotherapy dose was less than 50 Gy and also in patients treated with four-field box technique. The most frequent site of recurrence was pelvic area [71%]. Our report revealed that most of the patients in Iran are diagnosed in advanced stages, a finding that can influence treatment results. Also, using external beam radiotherapy techniques, accessibility to brachytherapy devices and better patient support may improve treatment results

Adding liver window setting to the standard abdominal CT scan protocol: is it useful?

Hepatic lesions may be missed in the routine abdominal computed tomography [CT] scan protocol using soft tissue window setting. The ability to find these lesions is very important in the assessment of metastasis and follow-up of patients. Patients and Methods: In this study, 411 patients who underwent abdominal CT for various causes were evaluated separately by two radiologists blindly. All liver images were viewed in two different window settings, soft tissue window setting: window width [WW] of 350-400 Hounsfield unit [HU], window level [WL] of 35-50 HU, and liver window setting: WW of 150 HU, WL of 50-100 HU, at the workstation. Out of 411 patients, 181 [44%] were referred for cancer follow-up and 230 [56%] for evaluation of abdominal discomfort. Soft tissue window setting revealed no lesion in 334 [81.26%] patients, single lesion in 30 [7.31%], and multiple lesions in 47 [11.43%] patients. Liver window setting revealed no lesion in 313 [76.2%] patients, single lesion in 35 [8.5%], and multiple liver lesions in 63 [15.3%] patients. Compared to liver window, soft tissue window setting revealed 77.77% of all detectable liver lesions. Liver window showed new lesions in 22 [6.6%] of patients in whom no lesion had been found in soft tissue window setting. Therefore, liver window setting brought 5.3% increase in the diagnostic yield of CT in our series, and changed the decision for treatment in 2.4% of patients studied. Liver window setting added to the standard soft tissue setting protocol of abdominal CT at the workstation can improve the diagnosis and follow-up of patients, especially for those who have known cancer. Image review with this new setting takes a few minutes and the cost is also low; there is no added radiation exposure to patients

Sphincter preservation and pathologic response in rectal cancer undergoing neoadjuvant chemoradiation with and without oxaliplatin according to thymidilate synthase [TS] expression

Oxaliplatin [OX] significantly enhanced the antitumor activity of 5-FU in patients with advanced colorectal cancer and recently some phase II trials have evaluated the feasibility and efficacy of oxaliplatin in neoadjuvant setting for treatment of locally advanced rectal cancer. On the other hand various studies have demonstrated that the overexpression of thymidylate synthase [TS] can induce resistance to 5-FU in colorectal carcinoma. The aim of this study was to assess the value of TS expression as a predictive factor in the efficacy of neoadjuvant chemoradiation with and without oxaliplatin in rectal cancer. This study was performed in 61 patients [that ultimately 50 patients had including criteria] with locally advanced rectal adenocarcinoma that inferior margin of the tumor had to be located no farther than 6 cm from the anal verge. Preoperative radiotherapy was delivered to the pelvis with CO 60 to 50/4 Gy. All patients received simultaneous chemotherapy: 5-fluorouracil [5-FU], 300 mg/square meter i.v. 24 h infusion during radiotherapy on days 1-5 every week. Thirty patients received oxaliplatin 50-60 mg /square meter weekly during radiotherapy.TS expression was assessed by immunohistochemical staining technique in pretreatment specimen, and the patients were categorized into TS [+] and TS [-] groups. A total of 23 of 50 tumors showed TS positive status at biopsy [46%] . Overall 36 patients [72%] achieved pathologic response [40% complete and 32% partial] that was significantly better in the TS [-] group than in the TS [+] group [85.1 vs 56.5%, p=0.024] and in the OX [+] group than in the OX [-] group [86.6 vs 50%, p=0.005]. Among TS [-] patients there was no difference in pathologic response [88.2 vs 80%, p=0.561] or sphincter preservation [76.4 vs 80%, p= 0.831] as a result of whether oxaliplatin therapy was carried out or not. But among the TS [+] patients there was a significant gain in pathologic response [84.6 vs 20 %, p=0.002] and sphincter preservation [84.6 vs 40 %, p= 0.026] in favor of oxaliplatin group. Our study indicate that oxaliplatin can improves poor outcome of TS positive rectal cancer and TS expression may be used for selecting patients for oxaliplatin containing neoadjuvant chemoradiation protocols that can have major role in the tumor down staging and preservation of sphincter and ultimately better quality of life