Mapping Palliative Care in the Arab World
Samy
Alsirafy
Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
author
text
article
2017
eng
Research in Oncology
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
2357-0687
13
v.
1
no.
2017
1
1
https://resoncol.journals.ekb.eg/article_3515_f0e1a22f53969601e1378c438a79bd2e.pdf
dx.doi.org/10.21608/resoncol.2017.1318.1030
Adjuvant Chemo-Radiotherapy versus Chemotherapy in Pancreatic Carcinoma
Shimaa
Attia
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
Ibrahim
Awad
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
Nawal
Elkholy
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
Ghada
Eladawei
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
text
article
2017
eng
Background: Pancreatic carcinoma has the worst prognosis of all gastrointestinal solid tumors. Only 15-20% of cases present at a resectable stage and the rate of local recurrence is high.Aim: To assess tolerability and efficacy of adjuvant chemo-radiotherapy (CRT) for pancreatic carcinoma compared to chemotherapy (CTH) alone.Methods: This was a prospective study with historical control group. The intervention group involved patients who underwent a 3-phases protocol following Whipple surgery. In the first phase, weekly gemcitabine was administered at a dose of 1 gm/m2 for 3 weeks. The second was a CRT phase whereas capecitabine (800 mg/m2) used twice daily for 5-6 weeks concurrent with 3 dimensional conformal radiotherapy. Finally, the maintenance phase in which gemcitabine administered at a dose of 1 gm/m2 weekly for 3 weeks with 1 week rest for 3 cycles. The historical group included patients who received gemcitabine only within the preceding 2 years.Results: From 50 patients with pancreatic cancer in the intervention group, 41 completed the treatment protocol versus 40 patients in the control group. The estimated median disease-free survival was 15 months in the CRT group versus 10 months in the CTH group, and the estimated mean was 19.4 versus 13.2 (p = 0.041). The estimated median overall survival was not reached in both treatment arms. The estimated mean overall survival was 27.9 months in the CRT group compared to 19.2 months in the CTH group (p = 0.023). The relapse rate was 29% in the CRT group versus 65% in the CTH group (p= 0.001). CRT was associated with more toxicity which was tolerated with no interruption of treatment. Conclusions: Adjuvant gemcitabine before and after capecitabine concurrent with 3D conformal radiotherapy was tolerated with better survival and local control in pancreatic cancer patients.
Research in Oncology
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
2357-0687
13
v.
1
no.
2017
2
7
https://resoncol.journals.ekb.eg/article_3517_76deab11be553286f0baa427cc471159.pdf
dx.doi.org/10.21608/resoncol.2017.1093.1027
Dosimetric Comparative Study of Static Gantry IMRT and 3D Conformal Radiotherapy for Organ at Risk in Adjuvant Therapy of Gastric Cancer
Hanan
Darwish
Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine; Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
author
text
article
2017
eng
Background: Despite the benefits of postoperative radiotherapy for gastric cancer patients after publishing the results of the Intergroup 0116 (INT-0116) study, there are still the concerns of radiation-induced toxicity.Aim: To determine the radiation technique that can eliminate the dose of radiation to the organ at risk (OAR) in patients postoperatively treated for gastric cancer with three-dimensional conformal radiotherapy (3D-CRT) or intensity- modulated radiotherapy (IMRT) using dosimetric analysis.Methods: A total of 22 computerized radiation plans were reviewed. Dosimetric values for 3DCRT and IMRT technique were calculated. The following dosimetric parameters were compared for the planned target volume (PTV); the homogeneity index, maximal and minimal doses, the volumes of PTV received 95 % and 107 % of the prescribed dose. In addition, the mean dose and dose volume histogram (DVH) for the OAR as, V20 for each kidney, V30 for the liver, maximum dose (Dmax) for D1% of the spinal cord and V40 to the heart .Results: The 3D-CRT and IMRT achieved comparable PTV coverage. However, IMRT was associated with a highly significant decrease in the mean V20 value of the right kidney by 15% (P=0.001) and left kidney by 9% (P=0.01). The IMRT significantly improved sparing of the mean irradiated volume and the V30 of the liver by 12% (P=0.01) and by 10% (P=0.02) respectively compared with 3D-CRT. On the other hand, the dosimetric parameters for the spinal cord and heart were comparable for the IMRT and 3D-CRT plans.Conclusion: In gastric cancer patients receiving postoperative radiotherapy, IMRT provided better protection for the liver and kidneys when compared to 3D-CRT.
Research in Oncology
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
2357-0687
13
v.
1
no.
2017
8
13
https://resoncol.journals.ekb.eg/article_3518_e68b8f262419c8c5d3cce919473865d6.pdf
dx.doi.org/10.21608/resoncol.2017.933.102
Pathological Pattern of Urinary Bladder Cancer: Data from a Single Egyptian Institute
Sabri
Moussa
Urology Department, Al-Azhar University Hospitals, Cairo, Egypt
author
Wael
El-Sheshtawy
Clinical Oncology Department, Al-Azhar University Hospitals, Cairo, Egypt
author
text
article
2017
eng
Background: The control of schistosomiasis in Egypt was associated with changes in the prevalence and histopathology of urinary bladder cancer.Aim: To investigate the histological pattern among patients treated for bladder cancer at our institution over a 5-year period.Methods: This retrospective study was conducted by reviewing the medical records of 632 patients treated for urinary bladder cancer at the departments of Urology and Clinical Oncology, Al Azhar Faculty of Medicine, between January 2011 and December 2015.Results: The study included 632 patients. Their age ranged from 27-87 years old with a median of 62 years. Male to female ratio was about 6:1. Fifty-nine percent of the patients had Non-Muscle Invasive Bladder Cancer (NMIBC) versus 41% had Muscle Invasive Bladder Cancer (MIBC). Patients with history of schistosomiasis were 46.5%; besides, 67.9% of the patients were smokers. Transitional Cell Carcinoma (TCC) was the predominant histological type (87.5%), followed by Squamous Cell Carcinoma (SCC) 9.1%, mixed SCC and TCC (2.8%), and other subtypes 0.6%.Conclusion: Our study confirms that the histopathological pattern of urinary bladder cancer in Egypt is still changing. Over the last decades, the incidence of bladder SCC is declining and bladder TCC is rising. Yet the incidence of bladder SCC is the lowest compared to previous reports.
Research in Oncology
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
2357-0687
13
v.
1
no.
2017
14
17
https://resoncol.journals.ekb.eg/article_3519_20d654a3d498e47aa00b72323d6b2eba.pdf
dx.doi.org/10.21608/resoncol.2017.869.1023
Survival of High Grade Glioma Patients Treated by Three Radiation Schedules with Chemotherapy: A Retrospective Comparative Study
Samir
S. Mohamed
Clinical Oncology Department, Faculty of Medicine, Assiut University, Egypt
author
Hamza
A. Hamza
Radiotherapy Department, South Egypt Cancer Institute, Faculty of Medicine, Assiut University, Egypt
author
Mohamed Alaa-Eldeen
Mohamed
Clinical Oncology Department, Faculty of Medicine, Assiut University, Egypt
author
Amany
G. Ali
Radiotherapy Department, South Egypt Cancer Institute, Faculty of Medicine, Assiut University, Egypt
author
text
article
2017
eng
Background: High grade glioma (HGG) is the most common primary malignant brain tumor. Radiotherapy (RT) plays an important role in the treatment of this tumor.Aim: To compare the survival rates of HGG patients treated by conventional RT and those treated by hypofractionated or hyperfractionated RT combined with chemotherapy in two centers in Upper Egypt.Methods: Data of HGG patients from two cancer care facilities in Upper Egypt who were treated by surgery followed by RT and temozolomide (TMZ) in the period between 2007 and 2012 were reviewed. Radiotherapy schedules were either conventional RT (60 Gy in 30 fractions over 6 weeks, group A) or hypofractionated RT (45 Gy in 15 fractions over 3 weeks, group B) or hyperfractionated RT (64.8 Gy in, 1.2 Gy/fraction, 2 fractions/day, group C) with ±concurrent TMZ and adjuvant TMZ. Progression-free survival (PFS) and overall survival (OS) of patients after receiving the different types of RT treatment were evaluated.Results: Forty-eight patients with grade III or IV HGG were identified. They were classified into 3 groups (A, B and C) that included 17, 16 and 15 patients, respectively. The median PFS were 6, 9 and 8 months (p= 0.354) and the median OS were 11, 12 and 14 (p= 0.760) for group A, B and C, respectively. Late RT toxicity was not different between the 3 groups.Conclusion: The three radiation schedules had a similar efficacy in adult HGG patients.
Research in Oncology
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
2357-0687
13
v.
1
no.
2017
18
22
https://resoncol.journals.ekb.eg/article_3520_c2fb776c4aec013caf80c55d3831279f.pdf
dx.doi.org/10.21608/resoncol.2017.552.1022
Second-Line Chemotherapy in Advanced Non-Small Cell Lung Cancer (NSCLC): Single Institution Experience
Hanaa
Attia
Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
author
Noha
Y. Ibrahim
Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
author
Soha
Talima
Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
author
Ibrahim
Elhassan
Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
author
text
article
2017
eng
Background: Lung cancer is the leading cause of cancer-related death worldwide. Non-small cell lung cancer (NSCLC) accounts for 80-85 %.Methods: In this retrospective hospital based study, 424 NSCLC patients "stage IIIb-IV" were enrolled to analyze the prognostic factors and survival after receiving second-line chemotherapy.Results: From 424 NSCLC patients, 236 (55.7%) had stage IIIb-IV disease. The majority (70%, 165/236) of these patients received best supportive care only and 30% (71/236) received first-line chemotherapy. Second-line chemotherapy was administered in 11.9% (28/236) patients after first-line chemotherapy. The median age of patients who received second-line was 58 years. The majority were males (64%). Sixty four percent had stage IV, 57% had an Eastern Cooperative Oncology Group (ECOG) performance status of 2-3, 72% had a body mass index of >18.5 kg/m2 and 57% had history of smoking. The median overall survival was 13 months (95% CI: 6.82-19.18). The first-line chemotherapy was platinum-based combination in all patients, and docetaxel was the second-line treatment in half of the patient. The most common side effects were hematological (93%) and gastrointestinal (78%). Higher risk of mortality was accompanied with age 40-60 years (HR: 5.53, 95% CI: 1.29-23.7, p = 0.022) and stage IV (HR: 3.65, 95% CI: 1.21-11.06, p = 0.022). Multivariate analysis revealed that stage IV had higher risk of mortality than stage IIIb (HR: 3.75, 95% CI 0.969-14.535, p = 0.056). The platinum-taxane combination added 3 months in the median survival (13 vs. 10 months, p = 0.4).Conclusion: Stage IV and age between 40-60 years had a higher risk of death in NSCLC.
Research in Oncology
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
2357-0687
13
v.
1
no.
2017
23
27
https://resoncol.journals.ekb.eg/article_3521_b4d593c592241c3df490a13acc832471.pdf
dx.doi.org/10.21608/resoncol.2017.490.1013