@article { author = {}, title = {Thank you “Research in Oncology” Reviewers: 2016-2017}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {1-1}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2018.3099.1050}, abstract = {}, keywords = {}, url = {https://resoncol.journals.ekb.eg/article_5609.html}, eprint = {https://resoncol.journals.ekb.eg/article_5609_1ece0aafc16269ec2ff5d2bbcb35aebb.pdf} } @article { author = {Sinzabakira, Felix and Alsirafy, Samy}, title = {The Obesity Epidemic and Cancer in Africa}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {2-5}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2017.2010.1040}, abstract = {Overweight and obesity have increased since the 1980s. It reached 37% for men and 38% for women in 2013. The situation worsened for children and adolescents in developed countries. Recent reports showed that African and other developing nations are not immune from the devastating obesity epidemic.Many studies revealed a relevant strong relationship between obesity and cancers such as esophageal, postmenopausal breast, colorectal and endometrial cancers. Obesity-related cancers have increased exceptionally in adolescents and young adults but decreased in more advanced ages.Currently, cancer care services in Africa are still limited despite the rising demand; therefore, access to them is relativelydifficult for many cancer patients with low income. Considering the fact that some cancers may be preventable, we reviewed articles about obesity and cancer to highlight the magnitude of the problem and raise awareness among African leadership on the importance of cancer prevention measures targeting obesity.}, keywords = {Obesity,Cancer,prevention,Africa}, url = {https://resoncol.journals.ekb.eg/article_4893.html}, eprint = {https://resoncol.journals.ekb.eg/article_4893_e1de8710b5825bd4f95491c1efa31535.pdf} } @article { author = {Ellithy, Mahmoud and Ashoush, Nermeen and El Shahat, Khalid and Ahmed, Emad and Abdelsalam, Mahmoud}, title = {Intensity Modulated Radiation Therapy versus Supportive Care in Malignant Pleural Mesothelioma: A Pilot Study for Treatment Outcomes and Cost-Effective Expectations}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {6-11}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2018.2409.1042}, abstract = {Background: Malignant pleural mesothelioma (MPM) is an aggressive tumor. The outcome of treatment of EgyptianMPM patients is not satisfactory and its cost-effectiveness is questionable.Aim: The study aimed to test the treatment outcome and cost-effectiveness of intensity modulated radiation therapy(IMRT) in unresectable MPM patients who exhausted the standard treatment modalities.Methods: Twenty-four eligible patients were randomized (1:1) to either a control group receiving best supportive care(BSC) or an intervention group receiving IMRT to the tumor volume. Quality of life (QoL) was assessed by the EuropeanOrganization for Research and Treatment of Cancer QoL questionnaires QLQ-C30 and QLQ-LC13 (lung cancer module).Tumor progression was monitored by serial computerized tomography scans. Assessment was done at enrollment and after4 months. Incremental cost-effectiveness ratio (ICER) was calculated for BSC vs. IMRT. The output data of the ICERwere total costs, overall survival (OS), progression-free survival (PFS) for each treatment modality.Results: The median OS did not differ significantly between IMRT and BSC (13 versus 11 months, respectively; p=0.117)while the median PFS was significantly longer with IMRT (6 versus 4 months, respectively; p=0.009). The IMRT group < br />demonstrated a significant deterioration in their final QoL scores compared to baseline. IMRT had an incremental cost of5912 USD per patient with an incremental effectiveness of 4 months of PFS, providing an ICER of 6.260.Conclusion: Although it may be associated with longer PFS, IMRT in MPM with intact lung is likely detrimental and notcost-effective.}, keywords = {Malignant Pleural Mesothelioma,intensity modulated radiation therapy,quality of life,Cost-effectiveness,Egypt}, url = {https://resoncol.journals.ekb.eg/article_5878.html}, eprint = {https://resoncol.journals.ekb.eg/article_5878_c2e70a2e9bad7137b14b176584c07768.pdf} } @article { author = {Zawam, Hamdy and Edesa, Wael and Alrefai, Sherif and Salama, Rasha and Abdelhafeez, Ahmed}, title = {ESHAP versus GEMOX in Management of Relapsed or Refractory Lymphoma: A Prospective Randomized Study}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {12-16}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2018.3040.1048}, abstract = {Background: There is lack of evidence about the best chemotherapy regimen in treatment of relapsed/refractory Hodgkin'slymphoma (HL) and aggressive non-Hodgkin’s lymphoma (NHL) lymphoma.Aim: To compare GEMOX (gemcitabine, oxaliplatin) with ESHAP (etoposide, methylprednisolone, cytarabine arbinoside,cisplatin) regimes as 2nd line in lymphomas.Methods: This was a prospective randomized study that included relapsed/refractory HL and aggressive NHL patientswho failed 1st line chemotherapy. After assessment for eligibility, patients were randomized to receive GEMOX orESHAP.Results: The study included 41 patients, 21 of them received GEMOX and 20 received ESHAP. The response rate did notdiffer significantly between the GEMOX and ESHAP arms (28.6% vs. 35%, p=0.793) as well as progression free survival(8.7 months vs. 6.6 months, p=0.711). By univariate analysis for the whole group, the response rate differed significantlyaccording to disease status at relapse, time to relapse, lactate dehydrogenase, International Prognostic Index (IPI) andsecondary age-adjusted IPI (2ry aa-IPI). Hematological toxicity was not statistically different between the two treatmentarms. GEMOX was associated with significantly less vomiting of any grade (p=0.013). Acute renal toxicity of any gradewas significantly lower in GEMOX compared to ESHAP (p=0.003). In terms of peripheral neuropathy, GEMOX wasassociated with significantly higher all grades (p=0.0001).Conclusion: The current study results suggest that the response rate and progression free survival of GEMOX and ESHAPare comparable with different toxicity profile.}, keywords = {Relapsed/refractory lymphoma,GEMOX,ESHAP}, url = {https://resoncol.journals.ekb.eg/article_5723.html}, eprint = {https://resoncol.journals.ekb.eg/article_5723_86a56012e17afb7b8d2cfdeb24680218.pdf} } @article { author = {Zawam, Hamdy and Edesa, Wael and Alrefai, Sherif and Abdelhafeez, Ahmed}, title = {Third line Treatment in Relapsed/Refractory Hodgkin's Lymphoma and Aggressive non-Hodgkin Lymphoma after 2nd line ESHAP or GEMOX}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {17-20}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2018.2479.1043}, abstract = {Background: Treatment after failure of 2nd line chemotherapy in patients with Hodgkin's lymphoma (HL) or aggressive non-Hodgkin’s lymphoma (NHL) is not well studied. Aim: To assess the value of 3rd line treatment in a cohort of HL and aggressive NHL patients. Methods: This was a retrospective study of patients with relapsed/refractory HL or aggressive NHL treated with 3rd line treatment based on physician choice. Response rate as well as overall survival (OS) and factors affecting it were assessed. Results: Fifteen (41%) out of 37 patients who failed 2nd line received 3rd line. The remaining 22 received single-agent palliative chemotherapy or best supportive care only. Third line treatment was IGEV (ifosfamide, gemcitabine, navelbine) in 7 (47%) patients, lenalidomide in 4 (26%), ESHAP (etoposide, methylprednisolone, cytosine arabinoside, cisplatin) in 2 (13%) and GEMOX (gemcitabine, oxaliplatin) in 2 (l3%). Four (27%) patients achieved complete remission (2 with IGEV and 2 with lenalidomide) and 3 of them underwent autologous stem cell transplantation. One (7%) patient achieved partial response and another one (7%) had stable disease. The median OS for the whole group was 4.7 months. For patients who received 3rd line the OS was significantly longer than those who didn’t (13.4 vs. 3.4 months, p=0.001). Among the whole set of patients, performance status, lactate dehydrogenase, tertiary age-adjusted International Prognostic Index, 3rd line treatment, response to 3rd line and transplantation had significant impact on OS.Conclusion: Third line treatment may be feasible in selected HL and aggressive NHL patients who failed 2nd line.}, keywords = {Hodgkin’s lymphoma,Non-Hodgkin’s lymphoma,Relapsed,Refractory,3rd line treatment}, url = {https://resoncol.journals.ekb.eg/article_5591.html}, eprint = {https://resoncol.journals.ekb.eg/article_5591_2a302b942c4664bdf382e83864d6cbe8.pdf} } @article { author = {Ibrahim, Dina and Askoura, Anas}, title = {Treatment Outcome and Prognostic Factors of Anaplastic Thyroid Carcinoma: A Single Institution Experience in Egypt}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {21-28}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2017.1934.1039}, abstract = {Introduction: Anaplastic thyroid carcinoma (ATC) is a rare lethal malignancy. It is one of the most aggressivehuman malignancies with limited progress in finding effective therapies.Aim: We aimed to study the treatment outcome and prognostic factors of ATC patients treated at our institution.Methods: We retrospectively analyzed charts of 30 ATC patients, treated at the Clinical Oncology Department,Ain-Shams University from 2006 to 2017. The clinical characteristics and factors affecting survival were studied.Kaplan-Meier survival curve was used to analyze the overall survival (OS) of the patients.Results: The median age of patients was 60 years and males represented 63% of them. Almost half of patients(47%) had stage IVA disease. Equal number of patients received combined modality treatment versus singlemodality treatment (37% each). The median OS was 3 months (95% Confidence interval: 1.429-4.571). Variablesassociated with significantly better OS in univariate analysis included male sex (p=0.04), stage IVA disease(p=0.012), surgical treatment (p=0.034), radiotherapy (p=0.003), and combined modality treatment (p=0.005).However, only female sex was identified as significant poor prognostic variable of OS (p=0.043) by multivariateanalysis.Conclusion: Our results of treatment outcome and prognosis of ATC agree with most of the literature.Multimodality treatment is currently the standard of care. While still there is no successful treatment of this rapidlyfatal disease, exploration of novel therapies and approaches are warranted to help improve the outcome.}, keywords = {Anaplastic thyroid carcinoma,treatment outcome,multimodal treatment,prognosis}, url = {https://resoncol.journals.ekb.eg/article_4884.html}, eprint = {https://resoncol.journals.ekb.eg/article_4884_8c7a73ab8f8b9d8363b870133b8d46d4.pdf} } @article { author = {Salem, Dina and El Sayed, Somaia and Amin, Amin}, title = {Effective Adaptive Radiotherapy for Locally Advanced Lung Cancer Treated with 3D Conformal Technique}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {29-33}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2017.1625.1035}, abstract = {Background: The reduction in tumor volume during the treatment of locally advanced non-small cell lung cancer (NSCLC)with chemoradiotherapy allows the application of adaptive radiotherapy strategy. Adaptive planning has the potential forimproving radiotherapy planning indices and dose escalation while respecting the dose to the organs at risk (OARs).Aim: To evaluate the benefit of adaptive radiotherapy in patients with advanced NSCLC treated with conformal technique.Methods: In this dosimetric planning study, we included computerized tomography data-sets from 10 patients with locallyadvanced NSCLC who responded to the first 22 fractions (44 Gy) and achieved ˃ 20% regression in gross tumor volume. We designed for each patient two plans. Plan 1 (conventional planning) in which the whole prescribed dose (64 Gy) was delivered to the planning target volume 1 (PTV1). Plan 2 (adaptive planning) was divided into plan 2A delivering 44 Gy to PTV1 and plan 2B delivering 20 Gy to PTV2. In plan 2B we re-delineated the PTV and all the target volumes on the repeated CT images to deliver the rest of the prescribed dose (20 Gy). Plan 2A and Plan 2B were summed to measure the accumulated dose delivered to OARs.Results: The mean PTV2 was significantly smaller than the mean PTV1 (p < 0.001) with 53% reduction. Adaptive planningresulted in 13.2% mean reduction in the maximum dose to the spinal cord (p < 0.001), 10.4% in esophagus V35 (p < 0.001), 11.4% in esophagus V50 (p < 0.001), 24.3% in mean lung dose (p=0.001) and 19.7% in lung V20 (p < 0.001). The reduction in heart d-max and heart mean dose was not significant.Conclusion: The adaptive radiotherapy technique used in our study can reduce the irradiated volume and minimize the dose delivered to OARs. This simple applicable technique can be easily implemented in limited resources centers.}, keywords = {Adaptive radiotherapy,non small cell lung cancer,Chemoradiotherapy}, url = {https://resoncol.journals.ekb.eg/article_4780.html}, eprint = {https://resoncol.journals.ekb.eg/article_4780_e40a8363f8215ee6b438c01509f2f823.pdf} } @article { author = {Elsherbini, Nader and Ahmed, Wafaa and Elwakeel, Sherifa}, title = {Verification of performance of Acuros XB Algorithm (AXB) Implemented on Eclipse Planning System}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {34-38}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2018.3026.1047}, abstract = {Background: Verification of dose calculation algorithms is important in the radiotherapy process. Aim: The aim of this work is to verify the dose calculation accuracy of Acuros XB version 10 algorithm (AXB10) in homogenous and heterogeneous media. Methods: We compared AXB10 calculated doses with the measured doses using thermo-luminescent dosimeters (TLD) for 6 MV photon beam. Two clinical cases, nasopharynx and lung tumors, were studied to evaluate the ability of the AXB10 to deal with tissue heterogeneity. Selected field sizes were measured in water phantom then compared with that calculated with the Eclipse treatment planning system (TPS) - based on AXB10 algorithm. Rando humanoid phantom was computerized tomography scanned and the images were transferred to the TPS system where a set of similar plans of a single direct field were calculated with AXB10, then the dose was measured within  the phantom using the TLD in the brain and lung regions. Lastly the measured and calculated data were compared. Results: There was a good agreement between the measured fields in the water phantom and that calculated with the AXB10 (± 2%). The percentage difference between full Monte Carlo algorithm and AXB10 were 3% for the phantoms with lung. Conclusion: Acuros XB algorithm (version 10) results are in agreement with the International Commission for Units and Measurements recommendations.}, keywords = {Acuros XB algorithm,Treatment Planning System,Thermo-luminescent dosimeters}, url = {https://resoncol.journals.ekb.eg/article_6041.html}, eprint = {https://resoncol.journals.ekb.eg/article_6041_5777bc751f32dd5a200412d60838dd1c.pdf} } @article { author = {Kandeel, Ahmed and Abdel Meguid, Rehab and Nasr, Ahmed and Abdel Samiea, Medhat and Kassem, Khalid}, title = {The Association between Degenerative Spine Disease and Obesity in Cancer Patients: An Evaluation by Bone Scintigraphy}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {39-42}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2017.1800.1038}, abstract = {Introduction: Degenerative changes of the spine are common in obese cancer patients and are frequently confusing duringthe interpretation of bone scan of those patients. Aim: To investigate the influence of body weight on the frequency of degenerative spine disease in a cohort of cancer patients using technetium-99m methylene diphosphonate (Tc-99m MDP) bone scan. Methods: A prospective study of 100 cancer patients with or without back pain referred for bone scanning. Their mean age was 58.5±10.2 years and 46% were males. Tc-99m MDP bone scan was done followed by spinal magneticresonance imaging (MRI) examination. Patients were divided into two groups according to the body mass index (BMI) intogroup 1 including 60 overweight and obese (BMI ≥ 25) patients and group 2 including 40 non-obese (BMI < 25) patientsserving as a control group. Any spot of enhanced radiotracer uptake at any part of the vertebrae was considered abnormaland correlated with MRI findings. Results: A total of 168 vertebral lesions were detected by bone scan (150 in group 1 and 18 in group 2) with significant difference between both groups and between different grades of obesity in group 1. All lesions were accurately localized and proved to be of degenerative nature by MRI. The percentage of patients with back pain in group 1 was significantly higher than in group 2 (65% vs. 35%, respectively). Conclusion: Bone scintigraphy is a good technique to detect degenerative spinal disease in obese cancer patients. }, keywords = {Degenerative spine disease,Bone scan,Obesity,Cancer}, url = {https://resoncol.journals.ekb.eg/article_4252.html}, eprint = {https://resoncol.journals.ekb.eg/article_4252_1fe8f0b7688f291b8d54a6ef6960eb19.pdf} } @article { author = {El-Sayed, Nehal and El-Sawy, Wael and El-Azony, Ahmed and Noshy, Enas and Alsirafy, Samy}, title = {The Relation between the Severity of Pain and Common Symptoms in Patients with Metastatic Cancer}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {43-46}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2017.1333.1033}, abstract = {Background: There is a relation between the severity of pain and common symptoms in patients with metastatic cancer.Aim: This study was done to explore this relation among Egyptian patients with advanced cancer.Methods: The study included 120 adult metastatic cancer patients with pain from two cancer centers in Cairo and Sharkia,Egypt. Pain and other common symptoms were assessed using the Arabic version of the Edmonton Symptom AssessmentSystem (ESAS). The Eastern Cooperative Oncology Group (ECOG) performance scale was used to assess performancestatus.Results: The prevalence of ESAS symptoms was high among patients with cancer pain (tiredness, 94%; drowsiness, 63%;nausea, 60%; lack of appetite, 77%; shortness of breath, 53%; depression, 88%; anxiety, 83%; poor wellbeing, 96%). TheECOG performance scale was 1 in 21 (17.5%) patients, 2 in 57 (47.5%), 3 in 38 (31.7%) and 4 in 4 (3.3%). The averageESAS score was 33.9 ± 13.8, 48.9 ± 14.7, 58 ± 15.4 and 70 ± 5.5 among patients with ECOG score 1, 2, 3 and 4;respectively (p < 0.001). There was no significant difference in the average score of any of the ESAS items according tothe site of metastases. There was a significant positive correlation between the pain score and the scores of tiredness(p < 0.001), nausea (p=0.037), lack of appetite (p < 0.001), shortness of breath (p=0.001), depression (p < 0.001), anxiety(p < 0.001) and poor wellbeing (p < 0.001).Conclusion: Egyptian patients with cancer pain experience high symptom burden. The severity of pain strongly correlateswith the presence and severity of other ESAS symptoms. Systematic assessment of other symptoms is indispensable inpatients with cancer pain for proper control of symptoms and improving quality of life.}, keywords = {Metastatic cancer,Pain,symptoms,Performance status}, url = {https://resoncol.journals.ekb.eg/article_4208.html}, eprint = {https://resoncol.journals.ekb.eg/article_4208_a32a1eb3ce051ca69d8fd0fdb9c56c60.pdf} } @article { author = {Abdel-Malek, Raafat and Sayed, Rehab and Anis, Shady}, title = {Isolated Extramedullary Relapse in a Case of Acute Myeloid Leukemia Following Allogeneic Stem Cell Transplantation}, journal = {Research in Oncology}, volume = {14}, number = {1}, pages = {47-49}, year = {2018}, publisher = {Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine}, issn = {2357-0687}, eissn = {2357-0695}, doi = {10.21608/resoncol.2018.2231.1041}, abstract = {Background: Acute myeloid leukemia (AML) is the commonest acute leukemia in adults. Allogeneic stem celltransplantation (ASCT) is a curative option for a subset of these patients.Case Presentation: We report the case of a 36 years old female patient who presented in April 2014 with pancytopenia.Investigations revealed that she had AML (M6). She achieved complete remission with induction chemotherapy which wasfollowed by four cycles of consolidation chemotherapy until a human leukocyte antigen-matched donor was available. Sheunderwent ASCT in January 2015. After 14 months, in March 2016, she presented with left breast and rightparapharyngeal masses. Histopathological examination of the excised mass showed infiltration with myeloid cells and thebone marrow was normocellular without leukemic infiltration. She received radiotherapy to the affected breast and thecervical region followed by chemotherapy with good response.Conclusion: AML relapse following ASCT may be in the form of isolated Extramedullary disease. Further research isneeded to optimize the management of these cases.}, keywords = {Acute Myeloid Leukemia,Allogeneic stem cell transplant,Extramedullary relapse}, url = {https://resoncol.journals.ekb.eg/article_6035.html}, eprint = {https://resoncol.journals.ekb.eg/article_6035_94dd0c0954266da74bd01781962349d0.pdf} }