Assessment of Thyroid Lobe Dose in Breast Cancer Intraoperative Radiotherapy.

BACKGROUND: Breast cancer is the most common cancer among women. Considering the fact that a high dose is delivered in a single fraction of IORT, the evaluation of the dose at sensitive organs like thyroid is necessary. OBJECTIVE: The current study has aimed to evaluate the received dose to thyroid lobes in the breast IORT technique. MATERIAL AND METHODS: A total of 49 women with breast cancer undergoing IORT were enrolled in this cross-sectional study with census sampling. Immediately after tumor resection, a single dose of 20 Gray at the applicator surface was delivered using 50KV X-ray by an Intrabeam machine. The thyroid dose was detected using thermoluminescent detectors (TLD) 100 at the mid-thyroid line, left and right lobes. RESULTS: The dose at the right and left lobes of the thyroid gland as well as the mid-thyroid line was found to be 40.18±35.44 mGy, 35.50±27.32 mGy, and 40.61±32.47 mGy, respectively. The right lobe received a significantly higher absorbed dose compared to the left lobe when the right breast was under IORT treatment. The same trend was seen with the left lobe and left breast under IORT treatment (P=0.0001 and P=0.018, respectively). The applicator size showed non-significant effects on the absorbed dose at the thyroid gland. Also, the applicator depth had a non-significant inverse effect on thyroid dose. CONCLUSION: According to our findings, the absorbed dose at each thyroid lobe depends on the under-treatment side as well as the applicator size and depth (applicator upper surface distance from the skin).

Intelligent modelling of oesophageal cancer treatment and its use to determine the dose of chemotherapy drug.

In this paper, the behaviour of oesophageal cancer has been modelled to provide treatment for patients with oesophageal squamous carcinoma. In this method, the dose of chemotherapy drugs is calculated using a combination of neural networks. Implementation shows that the proposed method is able to effectively treat oesophageal cancer. The results of the proposed method for determining chemotherapy drug dose are in most cases consistent with expert medical opinion.

Esophageal Cancer in Northeast of Iran.

BACKGROUND: Esophageal cancer is the 7th most common cancer in Iran. The northern part of the country shows the highest incidence for this malignancy. In this study we present some epidemiological and clinicopathological characteristics of patients with esophageal carcinoma in this region. METHODS: In a cross sectional study, 238 Esophageal cancer patients were enrolled in a prospective study of neoadjuvant chemo-radiation treatment in a 4-year period (2006- 2009). In an oncology clinic their epidemiologic characteristics and clinicopathological findings were registered in a preplanned file. Data consisted of age, sex, race, occupation, residential location, smoking, addiction history, signs and symptoms, blood biochemistry profile, imaging and endoscopic findings. The data were analyzed with the SPSS software. RESULTS: The mean age of the patients was (55% female) 59 years. They were mostly Fars (63%) and Turkmen (13%). Seventy two percent were residents of rural area, 20% were smokers and 22.3% were opium addict and its analogues. Only 1.3% of patients consumed alcohol. The most common presenting symptom was dysphagia (93.7%), mainly grade III dysphagia (53%). Location of tumor in esophagus was in the middle third in 53.4% and lower segment in 44.5%.Sixty five percent of the patients had an abnormal esophagogram. On endoscopic evaluation the most common types of tumors were polypoid, vegetative and fungoid, respectively. Mean tumor length was 5.7 cm. The most common histology type was squamus cell carcinoma (99.1%) which was moderately differentiated in 51.3% of these patients. No significant relationship was found between the grade of dysphagia with the macroscopic type and the pathologic grade of the tumor in this study. CONCLUSION: Squamous cell carcinoma comprised more than 99% of all esophageal cancers in our patients and this histological type is the prominent type in the Northeast of Iran. Middle esophageal segment is the major site for this type of cancer which unfortunately most patients present with grade III. Dysphasia reflects the advanced stage of the disease.

The Faces Symbol Test, a newly developed screening instrument to assess cognitive decline related to multiple sclerosis: first results of the Berlin Multi-Centre FST Validation Study.

Reliable, language-independent, short screening instruments to test for cognitive function in patients with multiple sclerosis (MS) remain rare, despite the high number of patients affected by cognitive decline. We developed a new, short screening instrument, the Faces Symbol Test (FST), and compared its diagnostic test characteristics with a composite of the Digit Symbol Substitution Test (DSST) and the Paced Auditory Serial Addition Test (PASAT), in 108 MS patients and 33 healthy controls. An Informant-Report Questionnaire, a Self-Report Questionnaire, and a neurologist's estimation of the Every Day Life Cognitive Status were also applied to the MS patients. The statistical analyses comprised of a receiver operating characteristic analysis for test accuracy and for confounding variables. The PASAT and DSST composite score estimated that 36.5% of the MS patients had cognitive impairment. The FST estimated that 40.7% of the MS patients were cognitively impaired (sensitivity 84%; specificity 85%). The FST, DSST and PASAT results were significantly correlated with the patients' physical impairment, as measured by the Expanded Disability Status Scale (EDSS). The results suggest that the FST might be a culture-free, sensitive, and practical short screening instrument for the detection of cognitive decline in patients with MS, including those in the early stages.