فهرست مطالب kambiz novin

Coronavirus disease 2019 (COVID-19) emerged in December 2019 in China and exhibited as a highly contagious viral infection which led to a high level of mortality and morbidity. It is followed by a great deal of complications, such as serious psychological disorders. There are a few studies evaluating the psychological status of COVID-19 on the patients with cancer in Iran. This was a cross-sectional study carried out on 94 patients with cancer who referred to Haft-e-Tir hospital for radiotherapy and chemotherapy from 20 April to 15 may, 2020. The data collection tool was the impact of events scale-revised (IES-R). The prevalence of anxiety disorders and obsessive compulsive disorder based on past psychiatric history in the patients was 11.7% and 2.1%, respectively. The results revealed that age was significantly related to avoidance dimension score (B = -0. 209, 95% CI: -0.084 to - 0.335). Regarding hyper arousal dimension score, the results were as follows: rural residency (B = 5.091, 95% CI: 0.610 to 9.573), past psychiatric history (PPH) (B = 8.312, 95% CI: 4.314 to 12.310), and radiotherapy (B = -2.976, 95% CI: -5.878 to -0.074) had a statistically significant relationship with the hyper arousal dimension score. The patients with cancer had a severe form of COVID-19. Individuals with cancer who had a previous psychiatric history are more vulnerable to post-traumatic stress disorder symptoms after trauma.

Sleep disorder is one of the main complaints of patients with cancer that could affect their quality of life and clinical outcomes. We aimed to investigate major contributors of poor quality sleep in patients with cancer that underwent treatment.  We performed a cross-sectional study on 250 patients with cancer referred to the oncology department of Shohaday-e-Haftome-Tir Hospital, Tehran, Iran. Sleep quality as the main outcome of the study was evaluated using the Persian version of the self-report PSQI questionnaire. Global PSQI score >5 was categorized as the poor quality sleep. We also collected demographic and clinical data and physical performance status based on ECOG scale which grading is from 0:Fully active to 12:Death. Collecting the data regarding each patient was performed through medical records and face-to-face interviews. Mean age (±SD) of the study participants was 52.8 (±11.9) and 177 (70.8%) patients were female. The overall proportion of poor quality sleep was 66.8%. Sleep disorders were observed more frequent in patients with partial (OR=2.0, 95% CI=1.0, 3.8) and complete (OR=7.4, 95% CI=1.5, 36.4) physical dysfunction (p-value<0.05). There was also a strong association between a history of sleep disorder and cancer-related insomnia (OR=4.4, 95% CI=1.9, 10.1). No association was found between age, marital status, metastasis status, and cancer location with poor quality sleep. Poor sleep quality had a high prevalence among our patients. Patients with physical functional impairment and those with psychiatric disorders (mood disorder) and pre-existing insomnia were the main groups of patients with a higher likelihood of cancer-related insomnia.

Soft tissue sarcoma (STS) is a rare tumor with mesodermal origin. There are more than 100 different types of histology in sarcoma, which present different clinical behaviors. Liposarcoma, leiomyosarcoma, and undifferentiated pleomorphic sarcoma are among the most common pathologies

The patient was a 46-year-old man with 2 masses. The pathology of chest-wall mass (250 × 187 mm) was compatible with undifferentiated pleomorphic sarcoma (UPS). Arm mass (42 × 29 mm) pathology was suggestive of low-grade epithelioid leiomyosarcoma with smooth muscle differentiation. He received two cycles of mesna and doxorubicin and ifosfamide (MAI) regimen chemotherapy due to large and multiple masses, but the tumor size did not change. After consultation with an orthopedic oncosurgeon, wide masses resection was done. Adjuvant chemotherapy with an MAI regimen was continued for a total of 6 courses and radiation with a 60 Gy total dose to the posterior aspect of the chest wall. No recurrence or complications was observed after 4 months of follow-up.

Multiple STS is rare; nevertheless, its probability, either synchronous or metachronous, should be considered during patient examine and follow-up. In the case of a secondary lesion, different histology is probable, and the patient should be biopsied and imaged.

Breast cancer is one of the most common cancers. Researchers are trying to diagnose the disease through easier and safer methods. Serum markers such as ferritin and vitamin D level would be very helpful. This research could pave the way for more comprehensive studies on how to use this serum factor in breast cancer screening, as well as early detection of the disease in its early stages.

This study consisted of two groups, the first group comprising patients diagnosed with breast cancer before undergoing any treatment and the second group as control were healthy people. Serum ferritin and vitamin D levels were measured. Pathological information of the patientchr('39')s tumor, including ER, HER2, KI67, lymphovascular invasion, and disease stage, were collected as well. Data were analyzed by IBM SPSS advanced statistics version 23.0 (SPSS Inc., Chicago, IL). P-value of ≤0.05 was considered significant.

Eighty-eight subjects were enrolled in this study, 29 (33%) breast cancer patients and 59 (67%) healthy women. In breast cancer patients, serum ferritin levels were 106.55±111.25, which were higher than healthy women’s serum ferritin 52.71±36.95 (p=0.083). Furthermore, 18 (66.7%) of breast cancer patients and 55 (93.2%) of healthy women had low serum ferritin levels (p=0.001). 3 (11.1%) patients in the cancer group had serum vitamin D deficiency, while all subjects in the control group had serum vitamin D higher than 10 ng/dl (p =0.009).

The results of this study showed a correlation between breast cancer and vitamin D deficiency, and elevated ferritin. Perhaps with further studies, there could be a role in predicting the prognosis and screening of breast cancer for these associations.

Primary breast lymphoma (PBL) is a rare form of extranodal lymphoma. The most common pathology is diffuse large B cell lymphoma and most patients are diagnosed at stages 1 and 2. The therapeutic options available so far include surgery, radiotherapy, and chemotherapy

The patient was a 54-year old woman with localized primary breast diffuse large B-cell lymphoma (DLBCL). The patient underwent 6 courses of chemotherapy with an R-CHOP regimen followed by radiotherapy of the breast and regional lymph nodes with a dose of 40 Gy. In PET scan done three months later, the patient was in complete remission. Around one year later, the patient experienced relapse in the contralateral breast.

In the pattern of lapse of patients, there is a tendency for extranodal relapse. In some studies it has been speculated that there is a high probability of relapse in central nervous system (CNS) and some authorities advocate CNS prophylaxis in these patients. The best outcome would be for patients treated with chemotherapy including rituximab followed by radiation. We reviewed some studies regarding treatment modalities and site of relapse.

 Colorectal cancers are the third common malignancies after lung and breast neoplasms. Some contributing factors for pathological complete response (pCR) to neoadjuvant therapy of rectal cancer have been defined. Despite various studies in this era, there are few studies on the location of tumors.

 Regarding the high prevalence of colorectal cancer in Iran and the importance of neoadjuvant chemoradiation for survival and morbidity, this study was carried out to determine the association between pathologic complete response and tumor location in patients with rectal cancer after neoadjuvant chemoradiotherapy.

 In this prospective cohort, 100 cases with rectal adenocarcinoma from 2017 to 2019 were enrolled. Distance between anal verge and tumor was measured by clinical examination, colonoscopy, endo-sonography, and MRI. Tumors were defined as distal (less than 5 cm from the anal verge) and none distal (more than 5 cm from the anal verge). Another subdivision was inferior (0 - 4.99 cm), middle (5 - 9.99 cm), and superior (10 - 15 cm). The pathological response was compared across the groups.

 In this study, the pCR was seen in 30%. In univariate analysis body mass index (BMI), grade, N-stage, and distance from anal verge were related to pCR. In cases with BMI over 25 kg/m2 and in tumors with low to medium grade N0/N1, and distance less than 5 cm from the anal verge (low lying tumors) the pCR to neoadjuvant treatment was higher. In multivariate analysis tumor grade, N stage, and distance from anal verge were still related to pCR.

 According to the obtained results in this study, there may be some association between rectal tumor location and pathologic complete response.

Teleoncology refers to the use of telemedicine for remotely providing multiple specialized services in clinical oncology processes, including screening, diagnosis, treatment planning, consultation, supportive care, pathology, surgery, and follow-up services.

The aim of this study was to identify the required data elements and elicitation of requirements for developing a telemedicine system that aims at providing treatment plans for patients with breast cancer.

In this study, the required data elements for the teleoncology system were identified through both the investigation of clinical guidelines and review of patients’ medical records. Identified data elements were determined by breast cancer specialists through the questionnaire. Besides, an interview method was applied to elicit the requirements of this system.

The identified data elements were categorized into 20 groups (e.g., clinical data, breast physical examinations, pathological results, tests, imaging results, etc.). From the 182 data elements included within the questionnaire, 125 were recognized to be necessary (n = 32, 100%). The lowest mean percentage were observed in magnesium blood test (Mg) (n = 21, 65.63%) and protein test (Pr) (n = 21, 65.63%). Other data elements with a minimum mean of 71.87% and a maximum mean of 100% were recognized necessary. In general, 2 major themes, 9 categories, and 45 related sub-categories were extracted from analyzing the findings of the interviews related to the system requirements.

The findings of the present study can be used as a basis for developing teleoncology systems that aim at providing treatment plans for patients with breast cancer.

Quality of life in head and neck cancer patients

We present a rare case of breast papillary carcinoma associated with intracystic component in a woman with a long history of autoimmune hypothyroidism and multiple sclerosis.
The patient was a 59-year-old woman presented with complaints of pain and swelling in her right breast. She was a known case of autoimmune hypothyroidism since 20 years and secondary progressive multiple sclerosis since 13 years ago. She had received frequent interferon, corticosteroid and cytotoxic therapy for her multiple sclerosis. On imaging studies, there were multiple large cystic-solid lesions in the right breast and with presumptive diagnosis of infectious collection or phyllodes tumor, she finally underwent simple mastectomy. On gross pathological evaluation, a large multi-loculated cyst filled with blood clots and necrotic debris was identified. In serial sections, a 7 cm solid tumoral mass with papillary projections protruding into the cyst cavity was seen. Although the gross appearance of the lesion resembled an angiosarcoma accompanied by cystic hemorrhagic necrosis, after the microscopic evaluation of the specimen, papillary breast carcinoma associated with intracyctic component was finally diagnosed.
The aim of this study was to describe a rare variant of invasive breast cancer presenting with a large solid-cyctic mass in a woman with long standing autoimmune disorders.

Evidence about survival of the patients with nasopharyngeal cancer is scant in our region and the aim of the current study was to determine clinico-pathological factors influencing outcome of these patients.
We reviewed all patients with a new diagnosis of nasopharyngeal carcinoma admitted between 2008 and 2014 to Jorjani cancer center, Tehran, Iran. Overall survival (OS) of the patients and their relation with demographic and clinico-pathological factors were analyzed.
Of 88 included patients, 56 were male and 32 were female with mean age of 46 years. With a median follow-up period of 31 months (range: 3 to 86 months), the overall survival of the whole patients and those without distant metastasis were 64% and 67% respectively. Tumor stage and presence or absence of distant metastasis at presentation were the only parameters that significantly influenced the patients’ OS.
Our study provides some evidence on the outcome of Iranian patients with nasopharyngeal cancer and factors influencing it.

In this research, we analyzed the EEG signals of patients with brain tumor and healthy participants in order to study the effects of brain tumor on brain signals and also the feasibility of brain tumor detection using EEG signals. For this reason, EEG signals of four channel F3, F4, T3 and T4 from 5 patients with brain tumor and 4 healthy participants were recorded. After preprocessing, linear features in time and frequency domains and nonlinear ones such as fractal dimensions and entropies were extracted. Afterwards, the differentiation between2 groups was analyzed using Davies-Bouldin Index, LDA, KNN and SVM classifiers. According to the results of Davies-Bouldin Index, RMS, Theta Absolute Power, Approximate Entropy and Sample Entropy features in resting state with eyes closed and RMS and Theta Absolute Power features in resting state with eyes opened, had the most distinction between the two groups. In this stage classification of two groups using single features was done and the most accuracy of 88.89% was obtained for RMS feature in resting state with eyes closed. At the end, classification of two groups using all selected features was conducted and the maximum accuracy of 82.54% was obtained for RMS, Theta Absolute Power, Approximate Entropy and Sample Entropy features in resting state with eyes closed. According to the results, EEG linear features have a good capability of detecting brain tumor. As these features are simple and have low computational complexity, they can be used in online applications especially for periodic screening tests.

Accurate diagnosis and proper treatment of oncology patients presented to emergency department (ED) can dramatically enhance their quality of life and decrease their mortality rate. Therefore, the present study aimed to evaluate these patients from an epidemiologic point of view as well as identifying death-related factors.
In this retrospective cross-sectional study, all the oncology patients presented to ED during one year were evaluated using census sampling. A checklist that consisted of clinical and demographic data as well as patients outcome was filled for each patient. Using SPSS 21, multivariate stepwise logistic regression analysis was done to identify independent death-related factors.
568 patients with the mean age of 53.64§18.99 years were studied (56.5% male). The most common locations of tumor were brain (32.7%) and gastrointestinal tract (27.1%). Pain (32.5%) was the most frequent chief complaint on ED arrival. The overall mortality rate of studied patients was 154 (27.1%), 25 (16.2%) of them in ED. Among the evaluated factors, marital status, visiting on a weekday, arrival to ED via ambulance, type of cancer, stage of cancer, presence of metastasis, being under treatment with chemo-radiotherapy, chief complaint on arrival, tumor location, and admission to intensive care unit (ICU) correlated significantly with in-hospital mortality.
The most common type of cancer in the studied patients was solid, located in the brain or gastrointestinal tract, in stage III and IV, metastatic, and under chemo-radiotherapy. Independent death-related factors included ICU admission, presentation with loss of consciousness or bleeding, arrival via ambulance, cancer stage > II, neuroendocrine and genitourinary location of cancer, and being under chemo-radiotherapy.

We have presented a rare case of growth hormone (GH) producing pituitary adenoma with lymphocytic infiltration and brain parenchyma invasion. A 37-year-old woman has presented with complaints of headache, amenorrhea and acromegalic features. Her laboratory studies showed markedly elevated levels of Insulin-like Growth Factor 1 (IGF-1), and low levels of follicle stimulating hormone and luteinizing hormone. Computerized tomography has revealed a pituitary mass without extra-sellar extension. The tumor has completely excised via trans-nasal endoscopic approach. Histologically, the tumor has diagnosed as a pituitary adenoma with GH positive cells. The serum IGF1 levels have gradually decreased to the normal range and the patient was symptom free for three and a half years when she has returned with complaint of visual impairment. The brain MRI that time has shown a supra-sellar mass growing independently into the remaining sellar part. Subsequently, surgical operation has performed via trans-nasal endoscopic approach. Histopathological and immunohistochemistry examination have revealed a rare case of growth hormone producing pituitary adenoma with brain invasion and lymphocytic infiltration. The aim of this publication was to present a rare case of growth hormone producing pituitary adenoma with brain invasion and lymphocytic infiltration.

Evidences about survival of the patients with head and neck squamous cell carsinoma (HNSCC) have been scant in our region. The aim of current study was to determine clinico-pathological and treatment-related factors, influencing outcome of these patients.Patients and We have reviewed all patients with a new diagnosis of HNSCC admitted between 2008 and 2014 in “Jorjani Cancer Center”, Tehran, Iran. Overall survival (OS) and event free survival (EFS) of the patients, and their relation with demographic and clinico-pathological factors have been analyzed. Among 119 included patients, 90 were male and 29 were female with mean age of 58 years. Larynx was the most common primary tumor site (55% of all patients). With a median follow-up period of 28 months, OS and EFS of the study patients was 61.2% and 52.4%, respectively. Tumor stage was the only parameter has significantly influenced the patients’ OS. Patients with normal BMIs had significantly higher mean EFS compared with patients with bellow or above normal BMIs. Surgical treatment modalities have resulted in the same prognosis as non-surgical approaches. Our study seems to be the first that investigated outcome of Iranian patients with head and neck cancer and its influencing factors.

Serum creatinine level is frequently used as a measure for renal function assessment. However, there are some situations in which patients may suffer significant renal impairment but serum creatinine levels remain within normal ranges. We conducted this study to evaluate the discrepancy between serum creatinine (SCr) level and glomerular filtration rate (GFR) in determining the eligibility for cisplatin-based chemotherapy among cancer patients. Patients and A total of 198 cancer patients had received cisplatin-based chemotherapy at Jorjani Cancer Center, Emam Hossein Hospital, Tehran, Iran were retrospectively investigated. The discordance between SCr level and calculated GFR by Cockcroft-Gault equation was analyzed. 130 patients (66%) were men and 68 (34%) were women with mean age of 54.5 years. Squamous cell carcinoma (SCC) and head and neck were the most common primary tumor histology and site respectively. Of 165 patients with available data to calculate eGFR, 45 (27.3%) had normal kidney function based solely on SCr levels, but their GFR was less than 60 mL/min (renal dysfunction). The discordance between SCr and GC calculated GFR values were most pronounced in the older age, transitional cell carcinoma histology and bladder primary site. This study shows that SCr level alone may not be a reliable measure of normal kidney function to determine eligibility for cisplatine-based chemotherapy.

Germ cell tumors are neoplasms that originate from multi potential germ cells and can be intra or extra gonadal. According to pathologic classification, they have different subtypes. They account for 3% of pediatric malignancies and most commonly happen in children before the age of 15 years old. Epidemiologic evidence about pediatric germ cell tumors is scant in our region. The aim of current study was to determine demographic characteristics, recurrence and survival rate of germ cell tumor patients under the age of 21 years. Patients and During a 10-year period (1996 - 2006), 106 patients under the age of 21 years suffering from germ cell tumor were admitted to our centers. We extracted the data needed for our study from patients’ medical records in the hospitals. Thirty seven boys and 69 girls with a mean age of 8.4 ± 7.8 years were included. Most tumors were diagnosed before the age of one year (37%). The most common pathologic subtype was mature teratoma (44%). Ovary (35%) was the most common primary site. Surgery plus chemotherapy were used to treat 54 patients and BEP was the most common chemotherapy regimen. Metastasis and recurrent tumor were seen in 22% and 8% of cases, respectively. Four-year overall survival was 89%. Our study showed that demographic characteristics of GCT patients in our population are similar to patients of other geographic regions in the world. Primary tumor site, histologic subtype and metastasis were significant prognostic factors for survival.

Adjuvant Online! (AOL) is used extensively by oncologists in Iran to treat patients with breast cancer; however, it has never been validated for use in Iran, and its predictions might not be applicable to Iranian patients. The aim of this study was to evaluate the usefulness of this program in predicting the outcomes of Iranian patients with breast cancer. Patients and 368 patients who were treated between 1997 and 2010 at Jorjani Cancer Center entered the study. Data for each patient, including tumor size, number of positive nodes, tumor grade, ER status, and adjuvant systemic therapy, were entered into the AOL program (version 8.0), and the calculated disease free survival (DFS) was compared with the observed one. Analyses were performed using Cox regression modeling and SPSS 17.0 software, and P values < 0.05 were considered significant. Observed disease free survival (DFS)in our study was 72 months, while the calculated DFS by AOL was 68 months. In all subgroups of AOL, calculated DFS was less than observed DFS except for patients receiving Tamoxifen + Aromatase Inhibitors + Ovarian Ablation hormone therapy, for whom the calculated DFS was 2 percent more than the observed one. AOL underestimated overall survival and disease free survival rates in Iranian patients with breast cancer, which in our opinion was mainly due to the shorter period of follow-up in our study. Although AOL is widely used by Iranian oncologists, we believe that developing an Iranian version of a prediction tool would better predict the prognosis of our patients.