Comparison of Capecitabine (Xeloda) vs. Combination of Capecitabine and Oxaliplatin (XELOX) as Neoadjuvant CRT for Locally Advanced Rectal Cancer.

We decided to compare pathologic complete response (pCR) and disease-free survival (DFS) in rectal adenocarcinoma patients who received neoadjuvant chemoradiotherapy (CRT) with capecitabine plus oxaliplatin (XELOX) or capecitabine (Xeloda). In this study, patients with non-metastatic locally advanced rectal cancer (tumor stages of T2, T3, or T4) with or without lymph node involvement were retrospectively included. Patients received concomitant radiation (50.4-54 Gy external beam radiation in 28 to 30 fractions) and neoadjuvant therapy as either Xeloda (capecitabine, 2500 mg/m2 concomitantly with radiation therapy) (42patients) or XELOX [(oxaliplatin (50 mg/m2 intravenously once a week for five weeks) and capecitabine)] (72 patients). Surgery was done eight weeks after CRT. The endpoints were pCR (defined as no evidence of viable tumoral cells) and DFS (the interval from the initial treatment to the first tumor recurrence). Rectal sphincter preservation via low-anterior resection (LAR) was achieved in 73.8% of Xeloda group which was similar to XELOX group (70.8%), P = 0.61. pCR was documented in 11 (26.9%) of Xeloda group and 26 patients (36.1%) of XELOX group (P = 0.27). Tumor recurrence was recorded in 97 patients (85.1%). Mean (±SD) DFS was 52.13 (±31.92) months (median = 48 months). Mean (95% CI) DFS was 129.42 (110.19 to 148.64) in Xeloda group vs. 122.77 (110.72 to 134.83) in XELOX group (P = 0.74). Addition of oxaliplatin to capecitabine as neoadjuvant CRT for locally advanced rectal cancer did not result in improved pCR or better DFS.

Developing a WebGIS for Geo-Visualization of Cancer.

BACKGROUND: Considering the hygiene facilities and sharing the data of diseases, considerable attempts to promote the public awareness have been made by various media; however, most of the provided information is based on numerical and verbal statistics, and may not provide suitable understanding for people in regard with the situation of diseases. OBJECTIVES: The main aim of this study is to design an interactive WebGIS system in which people could simply produce and observe their favorite maps of different cancers and environmental parameters. They can use this tools to produce their personalized maps and explore various aspects of the cancer. MATERIALS AND METHODS: A system has been developed by using WebGIS for convenience of ordinary users without any knowledge about geospatial information system (GIS) to observe the situation of the diseases and environmental conditions in terms of static and user-produced interactive maps. It has also provided the possibility of spatial comparison of the arbitrary parameters in the framework of bar and pie diagrams. This system has been designed and launched on cancer database of Iran where information of meteorological stations has been embedded as environmental parameters. RESULTS: The innovative idea in this study has received less attention in previous works including possibility of producing web-based Choropleth map so that users could easily select the parameters and algorithms for classification and interactive coloring in the system to produce their personalized maps. CONCLUSIONS: Development of WebGIS tools and increased cooperation of people in terms of inserting the spatial labels on the map to report a disease or using their views about reasons of occurring a specific cancer in a specific region may cause turning the process of mono-direction flow of information to users to a bi-directional flow of information. As a result, cancer specialists could use the knowledge of local people and residents of different regions of the country to better analyze the situation of various kinds of cancers.

Cetuximab Plus Various Chemotherapy Regimens for Patients with KRAS Wild-Type Metastatic Colorectal Cancer.

BACKGROUND: The aim of this study was to compare the efficacy and hematologic toxicity of cetuximab combined with various types of chemotherapy regimens in patients with KRAS wild-type metastatic colorectal cancer (mCRC). METHODS: The response rate, progression-free survival (PFS) and overall survival of the patients were analyzed. RESULTS: In total, 45 patients were included in the study. The overall response rate for the combination of cetuximab and FOLFOX, FOLFIRI and CAPOX was 20, 46 and 30%, respectively, but the differences were not statistically significant. The median PFS for the three groups were 8, 6 and 3.5 months, respectively, but again these differences were not significant. All-grade leukopenia and anemia for the cetuximab plus FOLFOX group were significantly higher than for the other chemotherapy regimens. CONCLUSION: Our findings suggest that the combination of cetuximab and the three standard chemotherapy regimens resulted in the same outcomes in our patient population of mCRC, with higher hematologic toxicities among the FOLFOX subgroup.

Attitude of cancer patients toward diagnosis disclosure and their preference for clinical decision-making: a national survey.

OBJECTIVES: There is still contradictory evidence on disclosure preferences regarding cancer diagnosis. The aim of this study was to evaluate the preference of cancer patients for knowing the truth about their disease, as well as the factors that might have an impact on these preferences. METHOD: This study was conducted in 11 cancer centers in Iran. A questionnaire was used to collect data, and all patients above 15 years of age who were willing to participate were included in the study. The patients were asked if they were aware of the malignant nature of their disease, and if they came to know about their disease at the time of initial diagnosis, or later. The patients were then asked about the way they looked upon their disease. In the final part of the questionnaire, the participants were asked the level of involvement they prefer to have in making treatment decisions. RESULTS: In total, 1226 patients were enrolled in this study, only 565 (46.7%) of whom were aware of their disease at the time of diagnosis, and 878 (72.7%) at the time of interview, while 980 (85.2%) were willing to receive information about their disease. Patients' awareness was significantly associated with age under 50 years, female gender, having breast, skin or head and neck cancer, and having medical care in Shiraz or Hamadan while it was not associated with the stage or accompanying illness. CONCLUSION: While the majority of Iranian cancer patients prefer to be aware of the nature of their disease and have an active role in treatment decision making, they do not receive this information.