جستجوی مقالات مرتبط با کلیدواژه « neoadjuvant chemotherapy » در نشریات گروه « پزشکی »

Upper tract urothelial carcinoma (UTUC) can be divided into renal pelvis tumor (RPT) and ureteral tumor (UT) based on the tumor origin. This study aimed to evaluate the efficacy of neoadjuvant chemotherapy with gemcitabine and cisplatin (NAC-GC) in terms of the pathological outcomes and oncological prognoses in patients with UTUC. We also compared its efficacy between RPT and UT.

Patients who underwent radical nephroureterectomy for clinical T (cT)3N0M0 UTUC between 1999 and 2021 were included. Patients who underwent NAC-GC and those who did not were included in the NAC-GC and non-NAC-GC groups, respectively. Based on the tumor origin, we divided patients with UTUC into RPT and UT groups. Oncological prognosis was assessed using progression-free survival (PFS) and overall survival.

Of 44 patients, 20 (45.5%) and 24 (54.5%) patients were in the NAC-GC and non-NAC-GC groups, respectively. The NAC-GC group had significantly lower pathological T stage and negative lymphovascular invasion (LVI), and a better PFS (p < .05) compared to those in the non-NAC-GC group. Among patients with RPT, the NAC-GC group had significantly negative LVI and better PFS than the non-NAC-GC group (p < .05). In contrast, in patients with UT, the NAC-GC group had no significant difference in pathological outcomes, and no significant difference in oncological prognosis was observed between the NAC-GC and non-NAC-GC groups.

NAC-GC improves both pathological outcomes and oncological prognosis in patients with cT3N0M0 UTUC. With regard to tumor location, RPT has better pathological outcomes and oncological prognoses than UT.

Penile cancer is a rare malignancy, where extranodal extension in inguinal or pelvic lymph nodes is associated with decreased 5-year cancer-survival rate in this study, we try to assess survival and quality of life in a penile cancer patient with bulky lymph node.

We retrospectively reviewed data from penile cancer patients with bulky lymph nodes who underwent treatment between July 2016 and July 2021 at tertiary referral hospital care. The inclusion criteria (age >18 yr, histologically proven penile cancer, and completion of last treatment 6 months prior to this study) yielded a cohort of 20 eligible penile cancer patients with bulky lymph nodes (> 4 cm/bilateral mobile/unilateral fixed). Only patients who had completed therapy at least 6 months prior to the study were included. After obtaining consent, they were asked to complete the EORTC QLQ-C30 questionnaire to evaluate the patient's quality of life.

Out of 20 patients, 5 patients underwent direct ILND and 15 patients underwent chemotherapy. Median follow-up after primary diagnosis was 114+32 months in patients with early ILND and 52+11 months in patients who underwent delayed lymph node dissection. Out of 5 patients who underwent early ILND, all of them survived during follow-up, and achieved cancer-free status without residual tumor and with excellent functional outcomes (Karnofsky 90). There was no significant difference in social function (p-value = 0.551), physical function (p-value = 0.272), role function (p-value = 0.546), emotional function (p-value = 0.551), cognitive function (p-value = 0.453), and global health status (p-value = 0.893) between patient which treated with early ILND and Neoadjuvant Chemotherapy. However, patients who underwent early ILND showed a relatively better clinical outcome.

Early ILND followed by adjuvant chemotherapy for penile cancer with palpable lymph nodes is more favourable than neoadjuvant TIP chemotherapy.

Mature teratoma is a benign neoplasm, mostly composed of welldifferentiated derivations of almost two or three germ cell layers, while immature teratoma is a malignant neoplasm composed of immature neural and embryonic tissue. Immature teratoma in the context of ovarian endometrioma has not been reported yet.

A 34-year-old woman with primary infertility is reported in this study who suffered from immature teratoma associated with ovarian endometrioma. After several rounds of fertility treatment, the patient was referred for severe abdominal pain and underwent emergency surgery for the rupture of ovarian endometrioma. To preserve the ovary, the cyst was not resected in areas attached to the ovary. Some months later, the patient noticed a progressive abdominal enlargement. The sonographic evaluation revealed multiple solid-cystic lobulated masses on the abdominal wall and throughout the pelvic cavity. The histologic diagnosis was consistent with immature teratoma. The patient was treated with high-dose neoadjuvant chemotherapy and fertility-sparing surgery (FSS). The histologic evaluation of the extracted masses revealed teratoma maturation.

This study reveals the importance of complete removal of endometrioma and highlights the role of neoadjuvant chemotherapy in fertility-sparing surgery and potentiating teratoma maturation.

Neoadjuvant chemotherapy (NAC) grants a modest survival benefit in localized muscle-invasive bladder cancer (MIBC). We evaluated the pathological response and survival outcome after NAC in stage II and IIIA MIBC and their correlation with body mass index (BMI). Our retrospective study included stage II (T2 N0) and IIIA (T3 N0, T4 N0, T1-4 N1) MIBC. They received NAC followed by radical cystectomy. The patients were categorized into level I: a BMI of 18.5 – 24.9 kg/m2, level II: a BMI of 25-29.9 kg/m2, and level III: a BMI of ≥ 30 kg/m2. 103 patients with localized MIBC were included. The median age was 63 years; 35 patients (34.0%) belonged to level I, 40 patients (38.8%) belonged to level II, and 28 patients (27.2%) belonged to level III. Smoking status was more common in level II (51.0%) and level III (36.7%) (P < 0.001). Only 18 patients had ECOG PS 2, all belonging to level III (P < 0.001). After NAC, the pCR was 34.3%, 25%, and 10.7% of level I, level II, and level III (P = 0.03), respectively. Of 19 patients who passed away, 10 patients belonged to level III and 6 patients belonged to level II (P = 0.007). For level I, level II, and level III, the disease-free survival was 23.2 months, 12.7 months, and 10.7 months and the overall survival was 61.9, 52.3, and 28.7 months, respectively. Obesity and overweight could be predictive and prognostic markers in localized MIBC. These factors are associated with low pCR after NAC, poor disease-free survival, and overall survival.

More than 75% of epithelial ovarian cancer (EOC) cases are diagnosed in advanced stages, which is associated with tumor recurrence and chemotherapy resistance. So far, to the best of our knowledge, a similar study has not been conducted in Iran to investigate the clinical characteristics and survival rate of these patients treated with neoadjuvant chemotherapy (NACT).

This study aimed to evaluate the clinical characteristics and survival of patients treated with NACT followed by cytoreductive surgery and the factors affecting survival.

This retrospective cohort study was conducted on 147 advanced ovarian cancer cases who were treated with NACT referring to the Gynecology Oncology Department of Imam Khomeini Hospital in Tehran, Iran, between 2011 and 2021 and met the inclusion criteria for this study. The survival curve and Cox regression method were used to analyze the data.

The results revealed that 8.9% of advancedEOC (147/1,650) were treated with NACT and the average number of NACT courses was 4.12 periods. The survival rates of 1, 3, 5, and 8 years were 85.31%, 44.05%, 18.35%, and 13.77%, respectively. The mean and median of survival time were 47.7 and 36 months,respectively. Nearly 80% of the patients had stages 3C and 4A before receiving NACT. Based on the results of the adjusted Cox regression model, tumor marker level showed a significant relationship with survivalrate (P=0.008), and also peritoneum involvement had a clinically significant impact on survival with a hazard ratio of 2.88.

The results suggested that8.9% of ovarian cancer cases were treated with NACT. It was also revealed that the average number of NACT courses was 4.12 periods and the 8-year survival rate was 13.77%. CA125 tumor marker level showed a significant relationship with survival rate, and peritoneum involvement had a clinically significant impact on survival.

Cisplatin-based neoadjuvant chemotherapy (NAC) is the standard of care in non-metastatic muscle-in-vasive bladder cancer (MIBC). There are limited data regarding the alternative choices for cisplatin-ineligible patients. This study has investigated the oncological outcomes of gemcitabine plus cisplatin (Gem/Cis) and gem-citabine plus carboplatin (Gem/Carbo) in this setting.

One hundred forty consecutive patients with MIBC (cT2–T4a) receiving neoadjuvant Gem/Cis or Gem/Carbo before chemoradiation (CRT) or radical cystectomy (RC) were retrospectively evaluated between April 2009 and April 2019. Patients with ECOG performance status 2, creatinine clearance < 60 mL/min, hydronephrosis, ejection fraction < 50%, or single kidney received Gem/Carbo. The complete clinical response (cCR) and overall survival (OS) of NAC regimens were compared. Prognostic significance was assessed with Cox proportional hazards model.

In total, 79 patients (56.4%) received Gem/Cis. The cCR was not significantly different between Gem/Cis and Gem/Carbo regimens (38.7% vs. 36.2%, P = .771). After NAC, 79 patients (56.4%) received CRT, and other cases underwent RC. After a median follow-up of 43 months, patients in the Gem/Cis group had significantly better OS than Gem/Carbo (median OS: 41.0 vs. 26.0 months, P = .008). Multivariable Cox proportional hazards models identified cT4a stage (95% confidence interval [95% CI]: 1.001–4.85, hazard ratio [HR] = 2.08, P = .03) and cCR (95% CI: 0.26–0.99, HR = 0.51, P = .04) as the only independent prognostic factors of OS, and ruled out the type of NAC regimen.

The choice of NAC (between Gem/Cis and Gem/Carbo) is not the predictor of survival and both regimens had similar cCR.

Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.

This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated with Isfahan University of Medical Sciences (IUMS) during 2020 and 2021. The laparoscopic predictive index value (PIV) score (range: 0-14) was calculated for all patients. In patients with PIV scores <8, primary cytoreductive surgery (PCS) was performed, and patients with scores ≥8 were candidates for neoadjuvant chemotherapy (NACT). In the PCS group, laparotomy scoring and surgical findings for each anatomical area were registered for all patients, and concordance between laparoscopy and laparotomy findings was compared. Residual disease following PCS was documented for all patients.

A total of 27 patients underwent laparoscopic scoring surgery; 25 patients (92/5%) had a PIV score <8, and two patients (7/5%) had a PIV score ≥8. There was 92% agreement between PIV scores at laparoscopy and laparotomy. Agreements in different anatomical regions in laparoscopy and laparotomy were as follows: involvement of the bowel 76%, mesenteric 92%, liver 96%, omental 92%, diaphragm 96%, stomach 100%, peritoneal carcinomatosis 96%. A laparoscopic PIV score of <8 had a PPV of 84% at predicting R0 at PCS.

Laparoscopic scoring is a precise approach in the management of patients with advanced ovarian cancer. Laparoscopic scoring is a screening method of selecting patients for primary surgery or NACT and improved R0 resection at PCS. The present study was designed to assess patients who would gain the maximum benefits from primary surgery.

Neoadjuvant chemotherapy (NAC) is an integral part of breast cancer treatment. Determination of the factors that can distinguish patients who will have best response to NAC is invaluable. In this study, we aimed to elucidate the factors influencing patient response to NAC.

We retrospectively collected data of female patients with non-metastatic breast cancer that had received NAC followed by surgery, admitted to Imam Khomeini hospital between 2015–2019. We investigated the association between various tumor and patients’ characteristics with pathologic complete response (PCR).

Overall data of 205 female patients were collected. PCR was observed in 27.6% of cases. PCR rate in luminal A, luminal B, HER2 enriched, and TNB tumors was reported in 11.1%, 30.2%, 35.7%, and 36.4% of patients respectively ( P = 0.27). In patients with luminal B tumors, PCR was more prevalent in patients with positive HER2 only (P = 0.006). In our study factors which was significantly associated with PCR were: tumor grade, progesterone receptor (PR) status, and HER2 status. In the multiple regression model, positive PR in the tumor lowered the odds of pathologic response 3.6 times (P = 0.004).

In our study, tumor grade, PR status, and HER2 status was associated with response to NAC. PCR was more prevalent in non-luminal tumors; however, PCR rate in luminal B patients-especially those with HER2 positive status- was slightly less than non-luminals.

Ovarian yolk sac tumor in pregnancy is a very rare case (<5%). The management could be very challenging since studies regarding the disease are very limited. This case report is written in order to report a rare case of yolk sac tumor in pregnancy and its management.A 29-year-old woman with a 16 weeks gestational age (WGA) in her first pregnancy presented in the emergency room with severe lower abdominal pain. Next, she underwent exploratory laparotomy, and a biopsy was performed, which indicated an ovarian yolk sac tumor. The patient was then given neoadjuvant chemotherapy with carboplatin and paclitaxel. The pregnancy resulted in an intrauterine growth restriction (IUGR) baby, delivered on 33 WGA. The baby was delivered through C-section and the mother continued to undergo optimally debulked laparotomy, total hysterectomy, bilateral salphingo-oophorectomy, omentectomy, and rectosigmoid tumor resection.In dealing with a rare case with limited resources, tailor-made management is required. The most ideal treatment may not be performed, but the clinician should be more adaptive for the patient to have a better outcome.

 We analyzed different methods used to assess the radiological responses of patients undergoing neoadjuvant chemotherapy and metastasectomy treatment for liver metastases associated with colorectal cancer (CRC) by comparing the response evaluation criteria in solid tumors (RECIST) 1.1, the modified RECIST, and the criteria of the European Association for the Study of the Liver (EASL) methods and the histological response obtained after metastasectomy.

 We aimed to determine the optimal radiological method to assess the response of colorectal liver metastases to neoadjuvant chemotherapy.

 We conducted a retrospective study of CRC patients treated for liver metastases who had received neoadjuvant chemotherapy in our hospital between January 2000 and December 2017. We analyzed the agreement between the methods for analyzing the radiological response using the quadratic weighted kappa coefficient (κ). We studied the overall survival and analyzed factors related to survival using the Kaplan-Meier method. We performed multivariate analysis to study the prognostic factors of survival. We analyzed the relationship between the radiological and histological responses using Goodman and Kruskal's gamma (γ).

 A significant agreement was observed between the modified RECIST and EASL methods (κ = 0.841, P < 0.001). Cox regression multivariate analysis indicated the RECIST 1.1 criteria as an independent prognostic factor (P = 0.03).
The γ value showed a significant relationship between the three radiological response methods and histological response.

 In our study, we showed that using RECIST 1.1 criteria is the ideal radiological analysis method for studying CRC liver metastases treated with neoadjuvant chemotherapy when compared to other methods that are based on functional imaging markers.

In this study, radical hysterectomy, followed by neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer (LACC) was compared with radical hysterectomy in patients with early-stage cervical cancer.

This retrospective comparative observational study was performed on 13 patients with LACC International Federation of Gynecology and Obstetrics (FIGO) stage IB2-IIB who underwent a radical hysterectomy after NACT between March 2014 and November 2018. This group was compared with 18 patients undergoing radical hysterectomy with cervical cancer FIGO stage IIA-IB1 in the same period of time.

In the NACT group, 8 (61.5%) and 5 (38.4%) patients were in stages IIB and IB2, respectively, and 13 (72.2%) cases were in the IB1 stage in the non-NACT group. Post-operative blood transfusion in the NACT group was significantly higher compared to the non-NACT group [5 (38.4%) patients versus 0, P = 0.008]. The estimated blood loss (EBL) and operative time were similar between the groups. Finally, there were no significant differences in terms of intra-operative and other post-operative complications.

Radical hysterectomy after NACT in women with LACC seems to be safe and reduces the need for radiation in patients with NACT who are at stage IIB. These results need to be confirmed in studies with a larger patient sample.

Breast-conserving therapy (BCT) with partial-breast irradiation (PBI) has become a standard alternative to whole-breast irradiation. Recently, neoadjuvant chemotherapy (NACT) has been widely performed for early breast cancer. Although BCT using perioperative PBI decreased invasiveness and geographic miss, risks of adverse events and local recurrence remain a concern for patients receiving NACT. Thus, a prospectively registered study, the Clinical Outcome of Multicatheter BrAchyTherapy after NEOadjuvant chemotherapy (COMBAT-NEO), was conducted.

Patients who underwent BCT using multicatheter-interstitial brachytherapy (MIB) by intraoperative catheter implant were analyzed. Early and late adverse events (AEs) including higher grade skin toxicities and wound complications, and tumor control of patients receiving NACT were evaluated in comparison with adjuvant chemotherapy (ACT) and no chemotherapy (no-CT).

Between April 2017 and February 2020, 265 consecutive patients who received single-stage BCT were evaluated, including 13 NACT (4.9%), 68 ACT (25.7%), and 184 no-CT (69.4%). The median follow-up time and age were 30.0 months and 59.0 years, respectively. All patients were followed up for at least 12 months. Although AEs in NACT, ACT, and no-CT were observed in 1 (7.7%), 5 (7.4%), and 11 (6.0%) patients, respectively (p = 0.91) and there was no acute AE in NACT patients. Overall, 3 (1.1%) ipsilateral and 1 (0.4%) contralateral breast tumor recurrences were observed in no-CT patients. There were no regional and distant recurrences.

Although this pilot study was based on a small sample size with short follow-up, these preliminary results support the study of a single-stage BCT with MIB-PBI following NACT.

This randomized clinical trial was aimed to assess the efficacy of neoadjuvant letrozole in combination with standard neoadjuvant chemotherapy regimen on clinical response rate of hormone receptor positive locally advanced breast cancer.In this randomized clinical study, 42 female patients, ≥ 18 years, with clinical stage IIB-IIIC (T1-4, N0-3, M0), pathologically proven hormone receptor positive and HER2 negative, invasive ductal carcinoma of breast, were randomly assigned to receive standard neoadjuvant chemotherapy alone (control group) or letrozole 2.5 mg/d (in association with goserlin in premenopausal patients) concurrent with standard neoadjuvant chemotherapy (study group). Standard neoadjuvant chemotherapy regimen has consisted of 4 cycles of doxorubicin (60mg/m2) and cyclophodphamide (600mg/m2), followed by 4 cycles of paclitaxel (175mg/m2) every two weeks.At the beginning of the study all patients underwent thorough exmination of breast mass and axillary lymph nudes by palpation and ultrasonography. At the end of the study response rates were also evaluated by palpation and ultrasonography and subsequently patients were referred for surgury. Pathologic response rates were also evaluated on surgical specimens. All of the clinical, ultrasonographic and pathologic examinations during the trial were performed by a single specialist. Finally all the data were analysed statistically.Overall clinical response rates in breast were 95.2%, in both study and control group. Overall clinical response rates in axilla were 80.9% and 76.2% in study and control group respectively. Similarly, overall radiologic complete response rates in breast and axilla were 95.2% and 76.2% respectively in both study and control group. Totally, the comparison of overall clinical and radiologic response rates in th breast and axilla, showed no significant difference between control and study group (p>0.05).The addition of letrozol to standard neoadjuvant chemotherapy regimen was not associated with higher clinical and radiologic response rates in patients with locally advanced hormon receptor positive breast cancer.Keywords: Neoadjuvant chemotherapy, Letrozole, Locally advanced breast cancer

In the large breast tumors or locally-advanced breast cancers, breast conserving surgery (BCS) after neoadjuvant chemotherapy (NACT) had an acceptable local control, but greater risk of recurrence. Adding boost dose radiation to whole breast radiotherapy is involved with a reduced risk of recurrence. Boost radiotherapy can be delivered in 3 methods, including (1) external beam radiotherapy (EBRT), (2) intraoperative radiotherapy with electron (IOERT), and (3) intraoperative radiotherapy with low-kV X-ray (IOXRT). This study compared the outcomes of these 3 methods with each other. Within 60 months, 217 unselected breast cancer patients in Cancer Research Center of Shahid Beheshti were under treatment with BCS after NACT. They received boost dose radiation in 3 groups; 115 patients in the EBRT group, 39 patients IOXRT group, and 63 patients in the IOERT group. All of them received WBRT after surgery. The patients had large tumors or stage 3 breast cancer. Local recurrences were 1 (2.5%) in IOXRT, 2 (3.2%) in IOERT, and 1 (0.9%) in EBRT groups. Systemic recurrences were 4 (10.3%) in IOXRT, 10 (15.9%) in IOERT, and 16 (13.9%) in EBRT groups. Deaths were 3 (7.7%) in IOXRT, 2 (3.2%) in IOERT, and 10 (6.9%) in EBRT groups. Patients with any events were 4 (10.3%) in IOXRT, 11 (17.5%) in IOERT, and 33 (15.2%) in the EBRT group. Death due to distant metastases was lower in IOERT group, but it was not significant. No significant difference was observed in disease-free survival (DFS) among 3 groups. IOXRT group had non-significant, lower events, and better DFS. Especially, in non-PCR (non-pathologic complete response) patients, multivariate COX analysis showed better outcome (DFS) in IOXRT group (HR = 0.50), although it was not significant (P = 0.53). Intraoperative radiotherapy (IORT or IOXRT) as tumor bed boost during BCS after NACT had at least non-inferiority compared with EBRT. In non-PCR patient, IOXRT group had non-significant better outcomes (DFS)

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. 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. 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. 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.

Breast cancer is the most prevalent site-specific cancer and one of the most frequent causes of cancer death in women worldwide. Neoadjuvant chemotherapy, along with surgical treatment—breast conserving surgery (BCS) or mastectomy—is an important part of treatment for locally advanced breast cancer. As BCS is preferred to mastectomy in terms of cosmetic, quality-of-life, and functional outcomes, it would be the preferred treatment for locally advanced breast cancer (LABC), if its oncological safety is confirmed.
In this study, we retrospectively compared the oncologic outcomes of post-neoadjuvant chemotherapy BCS with mastectomy in 202 patients with LABC.
There were no significant differences between BCS and mastectomy regarding overall survival, local recurrence, contralateral breast cancer, and distant metastasis.
Our study showed that post-neoadjuvant chemotherapy BCS is an oncologically safe surgical treatment in LABC and that BCS can be considered as an acceptable treatment in selected patients with LABC.

Nasopharyngeal carcinoma among the children has been rare accounting for only 1% of all pediatric malignancies. Both genetic and environmental factors have contributed to the development of nasopharyngeal carcinoma. Among the children there was a higher rate of undifferentiated histology. The mean age of nasopharyngeal carcinoma diagnosis has been 11 years old age; and the most common site was nasopharynx. Palpable lymphadenopathy, dysphasia and neural defect were common associated signs.
A 15-year-old boy has presented with a mass that located near by the heart in the left side of mediastinum with invasion to anterior mediastinum from two years ago. In biopsy, nasopharyngeal carcinoma, non-keratinizing type, has diagnosed while there was no involvement of nasopharyngeal region. Patient has treated by 70 Gy (2.0 Gy/fraction) radiotherapy plus concomitant chemotherapy with base of docetaxel. But the mass had no regression. Then, the patient has treated with Cisplatin 100 mg/m2 IV on days 1, 22, and 43 with radiation, then cisplatin 80 mg/m2 IV on day 1 plus fluorouracil (5-FU) 1000 mg/m2/day by continuous IV infusion on days 1 - 4 every 4wk for 3 cycles and after remission interferon beta has added to treatment for 6 months duration as a maintenance therapy. After 1 year follow up; the patient was in complete remission. In the course of therapy, only hypothyroidism has occurred.
Nasopharyngeal carcinoma in childhood, without nasopharyngeal involvement, initially could be detected in other sites such as pericardium. Also good results could be respected by cisplatin and 5-fluorouracil based neoadjuvant chemotherapy before radiotherapy plus interferon beta as a maintenance therapy in childhood aggressive nasopharyngeal carcinoma.

The mortality of patients with locally advanced triple-negative breast cancer (TNBC) is high, and pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) is associated with improved prognosis. This retrospective study was designed and powered to investigate the ability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) to predict pathological response to NAC and prognosis after NAC. The data of 32 consecutive women with clinical stage II or III TNBC from January 2006 to December 2013 in our institution who underwent FDG-PET/CT at baseline and after NAC were retrospectively analyzed. The maximum standardized uptake value (SUVmax) in the primary tumor at each examination and the change in SUVmax (ΔSUVmax) between the two scans were measured. Correlations between PET parameters and pathological response, and correlations between PET parameters and disease-free survival (DFS) were examined. At the completion of NAC, surgery showed pCR in 7 patients, while 25 had residual tumor, so-called non-pCR. Median follow-up was 39.0 months. Of the non-pCR patients, 9 relapsed at 3 years. Of all assessed clinical, biological, and PET parameters, N-stage, clinical stage, and ΔSUVmax were predictors of pathological response (p=0.0288, 0.0068, 0.0068; Fischer’s exact test). The cut-off value of ΔSUVmax to differentiate pCR evaluated by the receiver operating characteristic (ROC) curve analysis was 81.3%. Three-year disease-free survival (DFS) was lower in patients with non-pCR than in patients with pCR (p=0.328, log-rank test). The cut-off value of ΔSUVmax to differentiate 3-year DFS evaluated by the ROC analysis was 15.9%. In all cases, 3-year DFS was lower in patients with ΔSUVmax <15.9% than in patients with ΔSUVmax ≥15.9% (p=0.0078, log-rank test). In non-pCR patients, 3-year DFS was lower in patients with ΔSUVmax <15.9% than in patients with ΔSUVmax ≥15.9% (p=0.0238, log-rank test). FDG-PET/CT at baseline and after NAC could predict pathological response to NAC before surgery and the clinical outcome after surgery in locally advanced TNBC patients.