فهرست مطالب

Reports of Radiotherapy and Oncology - Volume:4 Issue: 1, 2017 Jun

Reports of Radiotherapy and Oncology
Volume:4 Issue: 1, 2017 Jun

  • تاریخ انتشار: 1396/11/30
  • تعداد عناوین: 3
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  • Abolghasem Allahyari , Maryam Sheikhvanloo , Mahdi Jannati , Fatemeh Kalalinia , Amir Hoooshang Mohamadpoor , , Sepideh Elyasi * Page 1
    Background
    Capecitabine is widely used to treat patients with gastrointestinal and breast cancers. However, its narrow therapeutic index is a limitation and prevents the achievement of a good therapeutic response. Dihydropyrimidine dehydrogenase (DPD) is the main enzyme in the metabolism of capecitabine. Previous studies show that deficiency in the activity of this enzyme can lead to incomplete metabolism of fluoroprimidine derivatives and severe complications. However, in the case of capecitabine, limited information based on case reports and small population surveys are available. There is also scarce evidence of a relationship between serum concentrations of DPD and the prevalence of capecitabine adverse reactions.
    Objectives
    The current study aimed at investigating the relationship between DPD serum concentrations and capecitabine adverse reactions in patients with gastrointestinal tract cancer receiving capecitabine.
    Methods
    The current cohort study was conducted on 30 patients referred to Isar Clinic affiliated to Mashhad University of Medical Sciences, Iran, diagnosed with gastric or colorectal cancer; treatment with capecitabine-containing regimens including XELOX (capecitabine + oxaliplatin) Or EOX (epirubicin + oxaliplatin + capecitabine) was performed from November 2016 to July 2017. At the beginning of the study, the patients’ demographic and laboratory data and information about the type of malignancy and chemotherapy regimen were recorded. Then, on the day before the first chemotherapy course administration until the end of the third cycle of chemotherapy, the side effects of the drug were investigated by interview, clinical examination, and laboratory findings. The occurrence of adverse reactions was assessed based on NCI-CTCAE V4 criteria. The serum concentration of DPD enzyme was measured by the enzyme-linked immunosorbent assay (ELISA) kit and its relationship with incidence of capecitabine induced side effects was evaluated.
    Results
    A significant relationship was observed between DPD serum concentration and neuropathy (P < 0.001), thrombocytopenia (P = 0.017), neutropenia (P = 0.004), and weakness (P = 0.014). However, there was no significant relationship between DPD and other complications. No significant relationship was observed between age and gender of patients and DPD concentration (P > 0.05).
    Conclusions
    According to the data obtained from the current study, the incidence of some of the capectiabine induced complications can be influenced by the serum concentration of DPD.
    Keywords: Dihydropyrimidine Dehydrogenase, Capectiabine, Adverse Reaction
  • Hamid Nasrollahi*, Behnam Kadkhodaei , Seyed Hassan Hamedi , Mansour Ansari , Niloofar Ahmadloo , Ahmad Mosalaei , Shapour Omidvari , Mohammad Mohammadianpanah Page 2
    The pineal region is a rare site for primary tumors of the central nervous system. Papillary tumor of the pineal region (PTPR) is a relatively new phenomenon in this region. Considering the rarity of this tumor, the clinical course, treatment, and outcomes are not well studied. In the present study, we searched PubMed for relevant articles. A total of 72 articles were retrieved from PubMed. The exclusion criteria were autopsy and archive series, animal studies, and reports without clinical data. We had no access to the full - text of some articles; accordingly, 19 articles were excluded from the analysis. Data from 53 reports, including 50 case reports and three case series (a total of 73 patients), were collected and analyzed. The patients’ mean age was 33.5 (± 15.4) years. Forty - two cases were male and 31 were female. The most common symptom was headache in patients (80%). Other common symptoms included visual complaints (40%), nausea (31%), memory loss (7%), Parinaud’s syndrome (4%), and impaired gait (2%). Among 73 patients, 32 had undergone complete tumor resection. Twenty - nine patients had received conventional external beam radiotherapy, stereotactic radiosurgery (n, 10), brachytherapy (n, 5), and proton therapy (n, 1). Eight patients received no adjuvant therapy, and data presented in other reports were incomplete. Among the patients (n, 73), 11 received chemotherapy. Fifty patients had no evidence of recurrence at the time of report, while three patients had died. Local recurrence was the most common pattern of relapse (28%); nonetheless, parenchymal and meningeal involvement was also observed. The median disease - free survival (DFS) was 24 months, while five- and ten - year DFS rates were 50.1% and 25.0%, respectively. The median overall survival was 24 months. Generally, PTPR has an indolent course with a tendency towards local recurrence; nonetheless, an aggressive clinical course, associated with parenchymal and meningeal metastases, is well established.
    Keywords: Papillary Tumor, Treatment, Prognosis
  • Masomeh Gharib , Fatemeh Homaee Shandiz , Oldoz Bizhani , Mohammad Naser Forghani Torghaban , Donia Farrokh Tehrani , Mohammed Keshtgar , Seyed Ali Alamdaran * Page 3
    Objectives
    Neoadjuvant chemotherapy in locally advanced breast cancer is associated with a volume decrease of the tumor and needs tumor bed localization. We evaluated the accuracy of the radio-opaque surgical clip marker/wire localization in 35 patients.
    Methods
    Patients who were candidates for breast-conserving surgery after neoadjuvant chemotherapy were enrolled at Omid Hospital, Mashhad University of Medical Sciences, Iran in 2015 - 2017. The lesion localization was performed before the start of chemotherapy. A radio-opaque manually straightened surgical clip was inserted into the mass center by a coaxial needle. After the completion of the neoadjuvant chemotherapy, a localization wire was introduced adjacent to the clip and the surgeon removed the tumor bed. The resected mass was assessed for marginal involvement and location of the clip by the pathologist. Data analysis was performed by SPSS and P values of less than 0.05 were considered significant.
    Results
    The mean maximum diameter of the mass before neoadjuvant chemotherapy was 3.8 ± 1.1 cm. The marker was seen at the center of the lesion in 32 (91.4%) patients and at the para-central part in three patients. All patients had a response to chemotherapy as a decrease in size in 22 patients (63%), and complete effacement of the mass in 13 patients (37%). After chemotherapy, the marker was localized in the peripheral part of the residual mass in six patients. Intra-tumoral clip displacement was detected in 3 patients (8.6%). The clip migration out of the lesion was not seen in any patient. In all of the patients, the tumor bed was resected in the pathology examination and marginal involvement was not seen in any of the cases.
    Conclusions
    In the absence of seed localization, the combination of a surgical clip and wire localization is an easy, safe, available, and accurate choice for localizing the tumor bed in advanced breast cancer patients that are candidates for neoadjuvant chemotherapy.
    Keywords: Advanced Breast Cancer, Neoadjuvant Chemotherapy, Marker Localization