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

Lots of people are struggling with Kidney disease or cancer around the world. Chronic kidney disease (CKD) and renal cell carcinoma (RCC) are associated directionally and share risk factors. Because of the role of kidneys in detoxification, studying the relationship between cancer chemotherapy and kidney disorders is significant. This investigation fills the current gap between cancer occurrence and kidney problems. CKD can induce RCC through a cystic disorder or oxidative stress. RCC also promotes CKD due to the tumor interactions, physical removal of kidney mass, and perioperative acute renal disease. Kidney failure also leads to renal cancer-specific pathways. For example, renal progenitors are converted to tumor-initiating cells through HIF, Notch, mTOR, and Hippo pathways. Furthermore, progress in cancer treatment during recent years has increased the overall survival of patients with advanced malignancies faced with early and late adverse effects from therapeutics. There are conflicting findings about the dosing of typical chemotherapeutics because of loss of kidney function. Recommended doses are usually according to expert opinion, not scientific evidence. This investigation has evaluated issues in cancer patients with kidney problems that can help patients by informing physicians about GFR loss and its effect on chemotherapy.Keywords: kidney diseases, cancer, chemotherapy, CKD, AKI

In cancer treatment, anesthesia is commonly used during surgery to remove tumors, as well as for other procedures like biopsies, radiation therapy, and chemotherapy administration. Some research suggests that the choice of specific anesthetic drugs and nerve-sparing techniques can have a significant impact on cancer recurrence rates and overall patient survival. It is well-established that a patient's immune system plays a direct role in postoperative complications and long-term outcomes, highlighting the importance of optimizing anesthesia to minimize potential immune system suppression and improve immune function during cancer surgery. Recent studies have revealed a strong connection between the type of anesthesia used during surgery and the likelihood of cancer relapse and related mortality. Therefore, it is crucial to select the appropriate anesthesia technique for cancer resection, focusing on reversible effects, rapid recovery, and resistance to feedback. The specific anesthetic agents used during surgery have a significant impact on survival rates and the risk of cancer-related mortality. Genetic influences on anesthesia response are significant for improving patient care and achieving better results. Additionally, personalized medicine, which combines diagnostic testing and treatment, is now a clinical reality. Anesthesia's effects on depth, pain signals, vital signs, and the motor system are complex and not fully understood, and many researchers believe that anesthesia is regulated by multiple genes, although further research is needed to identify them and understand how they are regulated. The relationship between anesthesia and cancer is complex and evolving with implications for medical treatment. Limited evidence suggests that anesthesia and surgery-related factors can affect cancer biology and outcomes. Further research is needed to understand these interactions and develop strategies for improving cancer care during surgery. Better understanding can lead to safer and more effective cancer treatment, benefitting patients.

Statement of the Problem:

 Chemotherapy-induced mucositis is the most common complication during cancer treatment. This complication can lead to pain, increased risk of infection and malnutrition. Therefore, it is important to find a solution to reduce the severity and duration of side effects.

This study aimed to assess the efficacy of Mucosamin spray as an adjunct for prevention of oral mucositis in children under chemotherapy.

This parallel-design clinical trial evaluated 48 patients aged 5 to 15 years with leukemia and lymphoma presenting to the Hematology Department of Mofid and Mahak Hospitals. The patients were randomly divided into two groups (n=24). Before starting chemotherapy, all patients received oral hygiene instructions (toothbrushing without flossing). Patients in both groups were requested to use a mouthwash composed of nystatin, aluminum-magnesium hydroxide suspension (aluminum MgS), and diphenhydramine for 1 min every morning on a daily basis starting the day before treatment. Patients in the intervention group were also requested to spray their entire oral mucosa with Mucosamin spray 3 times a day in addition to using the mouthwash. Patients were requested to refrain from eating and drinking for 1h after spraying. The patients were clinically examined by a senior dental student once every other day for 20 days regarding the occurrence, severity, and duration of oral mucositis. Data were analyzed using the Chi-square and Mann-Whitney tests, Kaplan-Meier survival analysis, and log rank test.

No significant difference was noted between the two groups in the incidence, severity, or time of development of mucositis (p> 0.05). The 7-day non-recovery percentage was 72.7% (SE= 13.4) and 25.0% (SE= 15.3) in the control and test groups, respectively, indicating shorter duration (faster healing) of mucositis in the intervention group (p= 0.01).

Within the limitations of this study, it seems that prophylactic application of Mucosamin spray can shorten the course of oral mucositis, in case of its occurrence.

To investigate the efficacy and safety of autologous Cytokine-induced killer (CIK) cellular immunotherapy combined with chemotherapy for non-small-cell carcinoma (NSCLC).

The literature related to the efficacy and safety of autologous CIK cellular immunotherapy combined with chemotherapy in NSCLC were collected. The Chinese literature databases were collected from CNKI, Wanfang and Weipu, and the English literature were retrieved from Cochrane Library and PubMed. All literature were retrieved until the year of 2022, and evaluated by its method quality and analyzed by RevMan5.3 software.

A Meta-analysis on the 11 included literature showed that the treatment efficacy and disease control rate (DCR) of patients in the observation group were significantly higher than those in the control group (P＜0.05), and significantly increased the levels of CD3+, CD4+, CD4+/CD8+ indexes than the control group (P＜0.05), and the incidence of bone marrow suppression, liver injury and gastrointestinal symptoms were significantly lower than those of the control group (P＜0.05).

Compared with single chemotherapy, CIK combined with chemotherapy in the treatment of patients with NSCLC can improve the efficacy of treatment and DCR, significantly improve their immune function, reduce the incidence of adverse reactions, and is beneficial to the recovery of prognosis.

Although the effect of adriamycin, a chemical drug used to treat cancer, is known to affect gametogenesis and ovarian function, the drug’s effect on endometrial receptivity and expression of integrin genes is unclear. To fill this gap, we aimed to investigate the effect of adriamycin on the expression of integrin genes that play a role in endometrial receptivity.

A total of 32 female rats weighing about 200 g were tested in the present study. The rats were divided into 4 groups: Healthy (sham), control, and experimental, with adriamycin at 4 mg/kg and 8 mg/kg doses for 6 weeks. Two weeks after the injection of adriamycin at an 8 mg/kg dose in the treatment group, all rats were sacrificed, but the treatment group with a 4 mg/kg dose of adriamycin continued the treatment. Then, the estrus phase was determined in the three groups using vaginal smears. The endometrial tissue was removed, and gene expression levels of α1β1, α1β4, and ανβ3 genes were evaluated using Real-time PCR methods in the three groups.

The rats’ weight decreased significantly in the treatment group with adriamycin. The process of weight loss was found to be dose-dependent. Integrin gene expression in the adriamycin group in the estrus phase had no significant difference compared with that in the control and sham groups (P>0.05). In the adriamycin group, the expression of integrin α1 increased significantly (P<0.05; P=0.013).

The expression of integrin genes did not change, except for integrin alpha1 (intgα1), during the estrus phase in the endometrium treated with adriamycin drug. Probably, adriamycin did not have any effect on the expression of integrin genes.

This study aimed to investigate the pulmonary side effects of chemotherapy drugs in children with Acute Lymphocytic Leukemia (ALL) three years after treatment. The results could be of great help in managing lung complications in pediatric oncology patients.

This cross-sectional descriptive study included 50 patients (22 males and 28 females) with ALL. Data were collected from patients' files, including age, sex, duration of illness, last dose of chemotherapy, and medications such as PEG.Asparginas, Cyclophosphamid, thioguanine, Dexamethason, cytarabin, cytosin.arabinosid, vincristine, mercaptopurine, and methotrexate. Pulmonary function tests (Forced Vital Capacity (FVC), FEV1 (Forced Expiratory Volume in the first second)) were assessed by spirometry.

Out of 50 patients, 47 (94%) did not have pulmonary disorders, while 3 (6%) had pulmonary dysfunction. Forty-seven patients (94%) did not have respiratory symptoms. FVC results showed that 45 patients were normal, and 5 were abnormal. Similarly, 45 patients had normal FEV1, and 5 had abnormal results. Spirometry results were normal in 45 patients and abnormal in 5. A significant relationship was found between the use of these drugs in different doses and spirometry results, recurrence rate, and pulmonary complications (P <0.05). No significant relationship was observed between pulmonary dysfunction and other drugs (P> 0.05). No correlation was found between pulmonary complications due to chemotherapy with duration of chemotherapy, patient age, and patient gender (P> 0.05).

Pulmonary dysfunction and respiratory syndrome were observed in 6% of patients receiving chemotherapy. A significant relationship was found between the frequency of pulmonary and respiratory complications with some chemotherapy drugs in children with ALL. Further research is needed to optimize treatment strategies and minimize lung complications in pediatric oncology patients.

Cervical cancer stands out as one of the most prevalent gynecological cancers. Cervical cancer’s link to human papillomavirus (HPV) testing and recurrence is unclear despite previous studies. Investigating this relationship in Iranian patients is a pivotal aspect of this research.

This study encompassed all cervical cancer patients referred to Firoozgar Hospital, Tehran, Iran, between 2016 and 2018. Utilizing a census method, the patients’ data, including their demographics and treatment details, were extracted from records. Follow-up samples were collected after vaginal cuff or cervix treatment (surgical or radiotherapy). A total of 124 patients were included in the study and categorized into two groups: Patients with recurrence and those without. INNO-LiPA standard test was employed to detect HPV presence. Comparative analysis of various variables, such as age at diagnosis, smoking history, multiple partners, sexually transmitted diseases history, body mass index, abnormal cervix, vaginal fornix involvement, cervical parameters involvement, tumor size, The International Federation of Gynaecology and Obstetrics (FIGO) staging, MRI staging, pathology, and treatment, was conducted between the recurrence and non-recurrence groups.

A total of 124 patients were included in the study, with an average age of 45.95±7.45 years. Most patients had an 18-25 kg/m2 body mass index. Based on MRI findings, the most common stage of cervical cancer was stage III, IIB. Squamous cell carcinoma pathology was the most prevalent, observed in 47 patients (37.9%). The most frequently performed treatment modality was radical trachelectomy and adjuvant chemoradiotherapy, accounting for 20 cases (16.1%). There were no significant differences in terms of age at disease diagnosis, smoking history, body mass index, histological type, and treatment type between patients with recurrent disease and those without recurrence. However, a significant difference was observed in terms of lymph node involvement. In addition, the HPV test was positive in 3 cases (2.4%) with recurrence and 11(8.9%) without. These results suggest no relationship between hrHPV (high-risk human papillomavirus) status and disease recurrence (P=0.196).

The result of our study showed no correlation between positive HPV test and cervical cancer recurrence. Consequently, HPV testing is not suitable as a reliable predictor for the recurrence of cervical cancer.

While virtual reality holds promise for enhancing patientmanagement and experience during chemotherapy, its use remains limited. The present study aimed to test the feasibility, acceptability, and preliminary efficacy of smartphone-based virtual reality relaxation (SVR) in chemotherapy patients.

Methods & Materials:

 In this pilot study, 29 participants were divided into two groups. The SVR group (n=14) experienced a 10-minute virtual reality intervention, while the control group (n=15) received standard care and guided imagery leaflets. Outcomes such as comfort, anxiety, pain, systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate were evaluated at baseline and post-chemotherapy. The Technology Acceptance Model (TAM) questionnaire and open-ended questions evaluated SVR’s acceptability. Data was analyzed using descriptive statistics, non-parametric t-tests, and thematic analysis.

The SVR intervention appears feasible, as evidenced by a high recruitment rate of 93.75% (30 out of 32 eligible patients) and a retention rate of 96.67% (29 out of 30 participants), despite one withdrawal. The SVR group showed significant comfort improvement (P=0.002), significant changes in pulse rate (P=0.047), and SBP (P=0.023) compared to the control group. Anxiety, pain, pulse rate, and DBP showed no significant differences.Asignificant TAMvariable (P<0.001) confirmed the intervention's acceptability. Qualitative feedback showed no serious side effects and patients reported positive experiences.

The SVR intervention, feasible and acceptable, significantly improved comfort and altered pulse rate and SBP in chemotherapy patients. It shows potential as an oncology care strategy. Further validation is needed through large-scale trials.

Small cell carcinoma of cervix (SCCC) is a rare disease. SCCC is highly invasive and prone to distant metastatic spread and lymph node involvement. Here we aim to present a patient and her treatment.

We report 47-year-old patient with history of breast cancer manifesting with abnormal vaginal bleeding diagnosed with SCCC. Patient underwent radical hysterectomy and bilateral salpingo-oophorectomy. Then, she received adjuvant chemoradiation postoperatively.

Small cell carcinoma of cervix is an aggressive form of cervical cancer with poor prognosis. Optimal treatment remains unsettled.

Cancer patients can experience different conditions depending on the quality of the treatment they receive. Chemotherapy is one of the most widely used treatments for cancer patients, leading to a wide range of consequences and outcomes. The present study aimed to investigate the lived experiences of cancer patients undergoing chemotherapy.

Using a phenomenological method, this qualitative study was conducted on 13 cancer patients undergoing chemotherapy in Rizgary Teaching Hospital, Erbil, Iraq, from September 2021 to July 2022. The participants were chosen using a purposive sampling method. The required data were collected using in-depth semi-structured interviews. The interviews were started by asking general questions (such as “Could you tell me about your chemotherapy experience?) and then analyzed by the Van Manen method (1990).

The results of data analysis showed that patients described their experience as “regaining hope in life,” which was drawn as the main theme that included 5 subthemes, namely, new lifestyle, new goals for life, optimism, value of life, and re-trust in God.

According to the results of the present study, since the recovery of patients and the effectiveness of treatments are greatly dependent on the patients’ psychological state, their lives improved, they took up new lifestyles and goals in their lives, became more optimistic, understood value of life, and regained their trust in God after they had received chemotherapy. Nurses working in chemotherapy wards are highly recommended to pay more attention to the psychological and spiritual state of cancer patients to promote hope in life among them and help them live normal lives with their families after undergoing chemotherapy

Traditional tumor markers such as cancer antigen 15.3 (CA15.3) and carcinoembryonic antigen (CEA) exhibit limited clinical utility in breast cancer due to their lack of sensitivity and specificity, particularly for detecting low-volume tumors. Other serum markers, such as nestin, may offer more promise. This study aimed to assess the clinical significance of serum nestin and CA15.3 in breast cancer patients. This case-control study enrolled 80 normal control females and 80 females with breast cancer. Serum samples were collected from both control and breast cancer groups. The serum nestin and CA15.3 levels were measured in all samples using enzyme-linked immunosorbent assay (ELISA) kits. The serum levels of nestin and CA15.3 were found to be significantly elevated in the breast cancer patient group compared with the control group. Preoperative serum nestin levels exceeding 9.9 ng/ml demonstrated a substantial odds ratio of 27 (confidence interval: 4.57-159.67; P = 0.0003). In receiver operating characteristic curve analysis, serum nestin exhibited the highest significant area under the curve at 85.2% (P < 0.001), followed by serum CA15.3 at 70% (P = 0.021). Post-surgery serum nestin levels significantly decreased compared with pre-surgery levels (P = 0.045). Serum nestin outperforms serum CA15.3 in diagnosing breast cancer patients. Elevated serum nestin levels may represent a significant risk factor for the development of breast cancer. Furthermore, serum nestin can monitor the effects of surgery, whereas none of the assessed biomarkers exhibit a significant role in monitoring the effects of chemotherapy on breast cancer patients.

Due to the toxicity of chemotherapy drugs in cancer patients, thrombocytopenia can lead to bleeding. Trifolium pratense L. is traditionally used as an anti-inflammatory compound for the treatment of various diseases. The aim of the present study was to evaluate the effect of T. pratense (red clover) extract (TPE) on thrombocytopenia and the related factors in a rat model of chemotherapy.

In this experimental in vivo study, 28 rats were randomly divided into four groups of seven members (four males and three females) including Group1 as the control subjects, Group2 as thrombocytopenia cases, and Groups 3 and 4 with thrombocytopenic animals receiving TPE (100 and 200 mg/kg). Thrombocytopenia was induced by intraperitoneal injection of cyclophosphamide (CP) on three consecutive days. Then, the TPE was fed to rats for 14 days. At the end of the study, the rats' weight was measured. Blood samples were collected, complete blood count (CBC) was performed, and PF4 and clotting time were measured. After the dissection of the animals, the bone marrow and spleen were separated, and hisopathological changes were determined. The data were analyzed by one-way ANOVA and a post-hoc Tukey test.

Cyclophosphamide decreased the platelets and the white blood cells (WBCs) and increased PF4 and the clotting time significantly (P < 0.05). Also, TPE significantly increased the platelets and the WBC counts but decreased the time of clotting and the PF4 factor (P < 0.05). TPE increased megakaryocyte (P < 0.001) and enhanced the bone marrow and spleen cellularity.

T. pratense can increase the number of platelets and WBCs and improve thrombocytopenia and bone marrow cellularity induced by chemotherapy.

Chemotherapy-induced peripheral neuropathy (CIPN) is a significant cancer treatment side effect that can influence both quality of life and treatment course. Melissa Officinalis (MO), due to its high content of flavonoids, has antioxidant, anti-inflammatory, and neuroprotective properties. 

The cancer patients diagnosed with CIPN attended a referral center in Sari (Iran). The hydroalcoholic extract of MO leaves was extracted by the maceration method. The control group received a placebo along with gabapentin as the standard treatment, and the intervention group received 500 mg Melissa officinalis 2 times daily for 3 months plus gabapentin. Patients were evaluated at the baseline and 3 months later, according to Common Terminology Criteria for Adverse Effects (CTCAE) and EORTC QLQ-C30 (Integrated System for Quality of Life Assessment). 

A total of 40 patients were considered as group D (intervention group), and 35 patients completed the study. Out of 40 subjects in the placebo group (P), 3 patients could not tolerate the drug due to gastrointestinal disturbances. The final values of CTCAE showed a statistically significant difference (p=0.010). Indicators related to the quality of life in both groups showed a significant improvement. In the intervention group, the pain perception and diarrhea experience were significantly reduced.

Quality of life indicators were improved by prescribing gabapentin with and without Melissa officinalis. The addition of Melissa officinalis to the chemotherapy regimen may improve diarrhea and pain perception.

This study aimed to assess the epidemiological, clinical, and therapeutic aspects and prognosis of juvenile nasopharyngeal carcinoma in Tunis country.

This study included 68 patients, younger than 18 years of age. All the patients had a clinical and para-clinical tumoral assessment. The study of survival and prognostic factors was done after a descriptive analysis. These prognostic factors were studied through uni and multivariate analysis.

The median age was 14.7 years and the sex ratio was 2 male to 1 female. The average time to first consultation was 4 months. Rhinological signs were the most frequent symptom for consultation (n= 41). The T3-T4 tumors accounted for 78% of patients and there was a lymph node invasion stage N2-N3 in 63% of cases. Non-metastatic patients had radiotherapy associated with chemotherapy in 97% of cases. Metastatic patients received hypofractionated radiotherapy on bone metastasis, and first-line chemotherapy followed by radiotherapy on the primitive tumor and lymph node areas in case of good response to chemotherapy ( n= 2). The mean follow-up was 94 months; 78% of these patients were alive and in complete remission, 19% were in therapeutic failure, and 16% of them had metachronous metastases. The five-year-overall survival was 95%. Hyposialia and skin dystrophy were the most frequent late complications.
In univariate analyses, significant prognostic factors were cranial nerve invasion, intracranial invasion, and infra-temporal fossa invasion. In multivariate analysis, the most parsimonious model associated extension to the infratemporal fossa, endo-cranial extension, and initial therapeutic modality (treatment failures were less frequent with neoadjuvant chemotherapy (p= 0.22)). 

Treatment of nasopharyngeal carcinoma in children consists of chemotherapy and radiotherapy. Synchronous or metachronous metastases are common in this patient population. Modern radiotherapy techniques, including conformal radiotherapy with intensity modulation, are promising and could overcome toxicities in long-term survivors.