Concomitant chemotherapy and radiotherary in locally advanced cervical cancer

Radiotherapy has been the standard therapy for locally advanced cervical cancer for decades. Neoadjuvant chemotherapy had failed to improve survival in these patients. Concomitant combination of chemotherapy and radiotherapy is promising in improving survival in many clinical trials with risk of increasing radiation reactions. We report a study comparing the combination of weekly cisplatin concomitant with irradiation versus irradiation alone in the same dose and technique. Sixty patients with cervical cancer [stage JIB-I VA] were randomized into two arms; either weekly cisplatin 40 mg/m2 plus radiotherapy [group A] or radiotherapy 45 Gy whole pelvis followed by intracavitary irradiation [to raise the dose to point A to 80 Gy] then parametrial irradiation with central shield for another 15 Gy [group B]. There was a significant difference in response to treatment in both arms [90% Vs. 69% respectively F<0.05]. Also, there was a statistically superior progression free and overall survival in the concomitant group [P<0.043 and p<0.0336]. The toxicity reported was generally limited in both groups and of lower grade despite being significantly higher in patients who received combination treatment. We conclude that combined modality is feasible and could be well tolerated in our patients population

study of hepatocellular carcinoma in relation to different occupational exposures

This study was conducted to determine the probable occupational exposures and to estimate the risk of occupational exposure in hepatocellular carcinoma [HCC]. The index group included 53 patients of HCC, while, the control group included 53 patients matched for age and sex. All individuals were subjected to a questionnaire [sociodemographic characteristics, medical and occupational history] and medical examination. The results revealed the following: Past history of either schistosomiasis or jaundice was a significant risk factor for HCC in the univariate analysis [OR= 2.35 and 3.45, respectively] but not in the multivariate analysis; the presence of occupational exposures in general and exposure to pesticides in particular was a risk factor for the development of HCC [OR= 3.48 and 5.53, respectively, in the univariate analysis as well as 1.87 and 2.55, respectively, in the multivariate analysis]; also, the risk for HCC increased for persons with both exposure to pesticides and history of jaundice [OR= 8.88 in the univariate analysis and 3.34 in the multivariate analysis] compared to persons with either of them alone. It was concluded that the exposure to pesticides is a risk factor for HCC and this risk increases with the concomitant presence of history of jaundice. Furthermore, schistosomiasis may have an association with HCC. It was recommended that the use of pesticides should be restricted to the minimal possible extent and further studies were advised to explore the effect of pesticides and serologically diagnosed viral hepatitis on the occurrence of HM

Macop-B [with or without molgramostim support] versus chop in intermediate and high grade non-hodgkin's lymphoma

The study included 40 patients with intermediate and high-grade non-Hodgkin's lymphoma, randomly divided into: group 1: [20 patients] received combination of MACOP-B without [group IA, 9 patients] and with GM-CSF, Molgramostim [group IB, 11 patients] group II: [20 patients] received CHOP regimen. CR was higher in group I compared to group II [70% vs 30%], and in subgroup IB compared to subgroup IA [81.8% vs 55.5%], with no statistically significant difference. The average percentage projected dose intensity was 0.75 in Group IA, and 0.6 in Group II Group IA had treatment delays and received a lower dose intensity than group IB [relative DI = 0.8]. The overall actuarial survival rates in groups IA, IB and II patients were 58%, 72% and 68.8%, respectively. Myelosuppression was higher in group IA than in group IB. Leucopenia < 2000/c.mm was encountered in four occasions in group IA, while none of the patients in group IB developed leucopenia < 2000/c.mm. A trend towards improved CR rate, disease-free and overall survival with increasing dose intensity was observed. MACOP-B seems to be an effective regimen in intermediate and high grade NHL. The use of GM-CSF produced improvement in the hematological toxicity of MACOP-B and better adherence to treatment schedule with improvement of dose intensity. Dose intensity had a potential prognostic impact on response and survival

Histological study of the effect of methotrexate on rat teeth development

Fifty rats aged four days were divided into five groups: Group I was the control group, groups II-V animals were given intraperitoneal methotrexate injection with escalating doses [2.1, 3.5, 8.4 and 14 mug/g body weight]. The animals were observed for gross changes and were decapitated at two weeks after injection. Skull radiographs were taken and tooth germs were dissected and submitted for histological study. All rats of groups IV and V died in less than one week with growth arrest. 40% of group III died within two weeks. The LD50 = 4.9 mug/g body weight and LD10 = 1.9 mug/g body weight. Reduction in the average weight of groups II and III rats compared with the control group was observed, which was dose dependent [F = 112.6882, P <0.0001]. Radiographically and histologically, there was delay in dental eruption with disturbances of odontogenesis that were dose related. Methotrexate in non-lethal doses causes a dose-related reduction in growth and dental development. The proliferating undifferentiated mesenchymal cells are more sensitive to methotrexate than odontogenic epithelium

Reirradiation in the management of locally recurrent breast cancer

Thirty one female patients with breast cancer recurring in previously irradiated fields were reirrdiated. The fields were previously treated by 45 Gy/4 1/2 weeks of elective postoperative irradiation, eight to 34 months before recurrence. Reirradiation was given on a daily fractionation basis, with a dose per fraction of 2-3 Gy, to a total dose of 30-40 Gy, using megavoltage irradiation or electron beam therapy. Systemic treatment was used in 19 cases due to the presence of metastatic disease. Six patients showed complete regression and 14 cases showed partial regression. The median duration of response was 5 months. Acute skin reactions in the form of moderate to severe erythema and/or moist desquamation were seen in 12 patients. Late radiation effects seen before reirradiation did not show any increase during the follow up period of 2 to 9 months. A higher radiation dose was associated with a higher probability of complete response and acute skin reactions [P<0.05]. Reirradiation is tolerable and offers a good means of palliation in recurrent breast cancer, in previously irradiated fields

Electron beam therapy shielding material and clinical applications

The relative percent dose reduction of different electron energies [5, 9 and 13 Mev] were measured using Mevatron 74 Linear accelerator and different shielding materials [lead, aluminium, copper and stainless steel]. A step wedge of each was used during this wrk, the steps thickness ranged between 2 mm and 20 mm. It was found that 95% attenuation for energies [5, 9 and 13 Mev] were obtained by 2, 4 and 6 mm thickness of lead respectively compared to the attenuation obtained by other materials of the same tickness

role of postoperative irradiation in intracranial menlngloma

Ninety five patients with intracranial meningioims were included in this study. Total surgical removal was done in 51 patients and partial removal was done in 44 oases. Postoperative radiotherapy was applied in 63 oases depending on the extent of surgery and/or histologioal findings. Objective complete response was achieved in 67/95 of the cases. The 5 year actuarial survival rate was 93.8% in -cases with limited disease treated by complete removal alone, 89.5% in malignant types treated by complete removal and postoperative radiotherapy and 87.5% in patients whose tumours were incompletely removed and treated by radiotherapy

Risk factors of cancer bladder: a case-control study

Cancer epidemiology is one of the recent and most rapidIy developing fields of cancer research. The aim of the present work was to investigate further the effects of residence, education, occupation, smoking and some selected urinary tract diseases on occurrence of cancer bladder among cases attending radiotherapy clinic in the Alexandria Main University Hospital. A case-control study was done to determine the estimated relative risk [Odds ratio]. The results of the work showed that residing or previously residing rural areas, farming as a main occupation or even as a second job, as well as educational status are risk factors for cancer bladder. Urinary tract diseases as urinary schistosomiasis and cystitis may predispose to cancer bladder. From the previous results, it is recommended that intensive health education activities should be directed to rural areas and stressing on remote complications of schistosomiasis. Also, training courses for physicians working at primary health care level especially for those in rural areas for early detection and proper management of cancer bladder cases