ORIGINAL_ARTICLE
Simultaneous Bilateral Chest Wall Irradiation, Can Helical Tomotherapy Improve Dose Distribution?
Background: Radiotherapy to bilateral breast cancer (BBC) is technically challenging because of the proximity to organs as the heart and lungs. Aim: We conducted this study tocompare helical tomotherapy (HT) to 3-dimensional conformal radiation therapy (3D-CRT) technique in bilateral chest wall irradiation regarding the coverage of target volume and the doses recorded at adjacent organs at risk. Methods: Ten patients with synchronous BBC who underwent bilateral mastectomy were included. Two plans were performed for each patient using HT and 3D-CRT. Results: Target volume included bilateral chest wall, bilateral supraclavicular and level III axillary lymph nodes. Prescription dose was 50 Gy/25 fractions in 5 weeks. The mean chest wall planning target volume (PTV) homogeneity index and conformality index were 0.15 and 1.09 in HT versus 0.37 and 1.43 in 3D-CRT plans (p= 0.012 and 0.031). At least 95% of the prescribed dose was covering 96% and 92% of the chest wall PTV for HT and 3D-CRT plans (p= 0.026). Helical tomotherapy plans achieved significant decrease in all cardiac parameters compared to 3D-CRT plans. Helical tomotherapy also achieved reduction in mean dose and V20 for both lungs in expense of higher low dose to normal healthy tissue and longer treatment time in comparison to 3D-CRT. Conclusion: For BBC patients treated with bilateral chest wall and supraclavicular lymph nodes irradiation, HT provides more conformal and homogenous plan than conventional 3D-CRT plans. Helical tomotherapy improves chest wall PTV coverage and decreases the dose to the heart and lungs in expense of more volume of normal tissues exposure to low doses of radiation and longer treatment time.
https://resoncol.journals.ekb.eg/article_18503_55d5222e3b5fd40ec18ae784168753f3.pdf
2019-06-01
1
8
10.21608/resoncol.2018.5667.1066
Bilateral breast cancer
Chest wall irradiation
Helical tomotherapy
Dose distribution
Ahmed
Elashwah
ashwah_a80@yahoo.com
1
Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
LEAD_AUTHOR
Amr
Mousa
amrgabermousa@yahoo.com
2
Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
AUTHOR
Ghadeer
Nazer
gnazer@kfshrc.edu.sa
3
Biomedical Physics Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Outcome of Treatment of Giant-Cell Tumor of Bone: A Single-Institutional Retrospective Study
Background: Giant-cell tumor of bone (GCTB) is a locally aggressive tumor which metastasizes infrequently to the lungs. The standard treatment of GCTB was surgery until the approval of denosumab. Aim: To describe the outcome of treatment of this rare tumor and to determine factors that influence survival. Methods: Retrospective review of the medical records of GCTB patients treated at our institution. Collected data includes: clinicopathological data, treatment modalities and possible prognostic factors. Results: Forty-two patients were identified between May 2008 and November 2017. Their median age was 31 years, and the majority (62%) were females. The commonest primary sites were the upper and lower limbs (50% and 43%, respectively). Eight (19%) patients initially presented with lung metastases. Thirteen (31%) patients received denosumab as first line treatment before surgery and 12 of them underwent surgery post-denosumab. Denosumab was given after recurrence in 12 (29%) patients [8 (19%) with lung metastasis and 4 (10%) with localized disease]. The objective response rate to denosumab after recurrence was 50%. Four (10%) patients achieved complete response and 2 (5%) partial response. After a median follow up of 4.7 years, 6 (14%) patients had local recurrence and 8 (19%) had lung metastasis with no recorded deaths. The 5-year progression-free survival rate was 61%. Conclusion: Denosumab is effective and tolerable in the management of GCTB preoperatively in localized disease to facilitate surgery and in the management of metastatic disease. Multi-institutional prospective studies are needed for further assessment.
https://resoncol.journals.ekb.eg/article_26360_7a78e3e3ea68c4b5671451b678ea3de5.pdf
2019-06-01
9
14
10.21608/resoncol.2019.7254.1072
Denosumab. Giant
cell tumor of bone. Prognosis. Metastatic
Mahmoud
Elshenawy
mahmoudelshenawy78@gmail.com
1
Medical Oncology Section, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
LEAD_AUTHOR
Ahmed
Badran
asobh@kfshrc.edu.sa
2
Medical Oncology Section, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
AUTHOR
Ayman
Elshentenawy
aelshentenawy@kfshrc.edu.sa
3
Medical Oncology Section, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
AUTHOR
Abdelmonem
Eldali
aeldali@hotmail.com
4
Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
AUTHOR
Muhammad
Memon
memon61@hotmail.com
5
Medical Oncology Section, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Low-dose versus Standard-Dose Leucovorin in the Treatment of Colon Cancer: Mansoura University Clinical Experience in Facing the Problem of Leucovorin Shortage
Background: Drug shortages have become a health care problem worldwide. One of the important drugs that are affected by shortage is leucovorin. It is used with 5-fluorouracil in many protocols for gastro-intestinal tumors and its shortage would have a negative impact on the treatment outcome. Aim: To compare the effect of low-dose leucovorin versus the standard-dose in the treatment of stage II and III colon cancer. Methods: The study included 100 patients with stage II or III adenocarcinoma of the colon who presented to the Clinical Oncology Department at Mansoura University Hospital from January 2011 till December 2012 after curative resection and were scheduled to receive adjuvant FOLFOX6 regimen. Patients were randomly allocated to receive standard-dose leucovorin (200 mg/m2, group 1) or low-dose leucovorin (125 mg/m2, group 2), both administered on days 1 and 2 over 2 hours infusion before 5-fluoruracil. The end points were toxicity, disease free survival (DFS) and overall survival (OS). Results: The two study groups were matched regarding age, sex, and tumor stage. The mean DFS was 48.36 months for group 1 and 49.12 for group 2 with no significant difference (p=0.866). The mean OS was 65.07 months for group 1 and 62.45 for group 2 with no significant difference (p=0.544). Similarly, there was no significant difference between the two groups regarding hematosuppression, diarrhea, mucositis, neurotoxicity and the need for hospitalization. Conclusion: Both protocols were well tolerated by all patients with no significant difference in the treatment outcome. The use of low-dose leucovorin protocol can help in solving the leucovorin shortage problem.
https://resoncol.journals.ekb.eg/article_23375_0e61827a84bb34690a147de15e832d94.pdf
2019-06-01
15
19
10.21608/resoncol.2018.6256.1069
Leucovorin
Drug shortage
Colon cancer
FOLFOX
Hend
Elkalla
dr.hend1113@gmail.com
1
Clinical Oncology and Nuclear Medicine Department, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Mansoura, Egypt
LEAD_AUTHOR
Mohamed
Zahi
saadmohamed2611@yahoo.com
2
Clinical Oncology and Nuclear Medicine Department, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Mansoura, Egypt
AUTHOR
Osama
Eldamshety
dr_osama_82@mans.edu.eg
3
Surgical Oncology, Oncology Center of Mansoura University (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
AUTHOR
ORIGINAL_ARTICLE
Retrospective Analysis of Prognostic Factors in Adult Glioblastoma Multiforme: A Single Institution Experience
Background: Primary brain tumors represent 2% of cancers in adults. Glioblastoma Multiforme (GBM) is the most frequent among these tumors. Different prognostic factors have been identified including age, performance status, extent of surgery and genetic factors. Aim: To analyze treatment outcome and prognostic factors in adult patients with GBM treated at a single institution. Methods: We retrospectively collected the data of patients treated for GBM form January 2012 till December 2016. During this 5-years period, 111 patients were identified and the data of 93(84%) of them was complete and included in the analysis. Results: Males represented 67% of patients, their median age was 52 years and the Eastern Cooperative Oncology Group (ECOG) performance status was 1, 2 and 3 in 48%, 40% and 12% respectively. Only 4.3% of patients underwent complete surgical resection, 38% underwent partial resection and 58% underwent biopsy. Post-operative treatment was radiotherapy alone in 30% of patients and chemo-radiotherapy in 70%. The median progression-free survival (PFS) and overall survival (OS) were 8 months (95% Confidence Interval: 6.678-9.322) and 10 months (95% Confidence Interval: 7.522-12.487), respectively. Longer PFS was associated with age Conclusion: Glioblastoma Multiforme remains an aggressive disease with high mortality rate and poor outcome. Complete resection and adjuvant chemo-radiotherapy improve PFS and OS.
https://resoncol.journals.ekb.eg/article_26418_b6edb4b504dfa42bf841c62a5d6d5ab1.pdf
2019-06-01
20
25
10.21608/resoncol.2019.6360.1071
Glioblastoma Multiforme
prognosis
Egypt
Mohamed
Abd El Moumen
hammylomy@gmail.com
1
Oncology Department, Galaa Military Hospital, Cairo, Egypt
AUTHOR
Lobna
Ezz El Arab
ezzlobna@yahoo.com
2
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Nesreen
Mosalam
dr.nesreen2000@gmail.com
3
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Ahmed
Gaballah
drgaballah@gmail.com
4
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Cross-Sectional Study of Burnout among a Group of Egyptian Oncologists at Ain Shams University
Background: Oncologists are at risk of developing burn out syndrome due to many stressors they may face. Aim: To determine the level of burnout in a cohort of clinical oncologists working in an Egyptian university hospital. Methods: Fifty-two clinical oncologists were invited to participate in the study. Burnout was assessed using the Arabic version of Maslach Burnout Inventory Human Services Survey (MBI-HSS).Results: The response rate was 90% (47/52). The majority (70%) of responders were young oncologists and 62% had >10 years experience in the oncology field. Females represented 52% of them and 62% were married. The MBI-HSS scores indicated that 72% of participants had burnout on the emotional exhaustion (EE) scale, 49% on the depersonalization (DP) scale and 38% on the personal accomplishment (PA) scale. A significantly lower PA score was associated with female gender, being single, viewing vacation time as insufficient, and an experience duration <10 years in oncology (p = 0.01, 0.01, 0.03, and 0.02; respectively). The preference not to choose again oncology as a career was also associated with significantly lower PA score and higher EE score (p=0.02 and 0.001; respectively). Conclusion: The surveyed oncologists experienced high burnout. Larger studies are needed in order to assess the burden of the problem and to develop evidence-based interventions to reduce it.
https://resoncol.journals.ekb.eg/article_19556_192c378f8c01123a9e1a57f4f56b3c4a.pdf
2019-06-01
26
30
10.21608/resoncol.2018.3478.1056
Burnout
Oncologists
Egypt
Ramy
Ghali
ramyghali@hotmail.com
1
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
LEAD_AUTHOR
Dina
Boulos
dnkamel@med.asu.edu.eg
2
Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Mohamed
Alorabi
mohamed_alorabi@med.asu.edu.eg
3
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Clinicopathological Characteristics and Survival of Triple-Negative Breast Cancer Patients: A single Institution Study from Egypt
Background: Triple-negative breast cancer (TNBC) is a subtype of breast cancer that is characterized by being more aggressive, presentation in younger age, and higher response rate to chemotherapy. It is more likely to recur and to metastasize early. Methods: Retrospective review of the medical records of TNBC patients treated in a single Egyptian cancer center during a 4-year period. Results: Sixty-five patients were included. Forty-six percent of patients were < 50 years old and 22% had a positive family history. Ten (15%) patients were metastatic at presentation. Modified radical mastectomy was performed in 42% of patients and adjuvant chemotherapy was administered in 55% of them. Relapse occurred in 12 (22%) out of 55 patients who had no distant metastasis at presentation (M0). The overall survival rate of M0 patients at 12, 24 and 36 months was 96%, 91% and 88%; respectively. The disease-free survival rate of M0 patients at 12, 24 and 36 months was 90%, 81% and 71%; respectively. Conclusion: In Egyptian female patients,TNBC is an aggressive subtype of breast cancer that occurs at younger age. Frequently, it is of high grade and presents in an advanced stage.
https://resoncol.journals.ekb.eg/article_31029_0f58d81b5bcea4bf48b0c50df40df6ac.pdf
2019-06-01
31
34
10.21608/resoncol.2019.11625.1076
Triple-negative breast cancer
Clinicopathological characteristics
treatment outcome
Egypt
Wael
Makar
wael_makar@yahoo.com
1
Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Pharmacokinetic-Based Chemotherapy Dosing in Advanced Head and Neck Cancer: A Mini Review
Despite the continuous evolution in different treatment modalities for head and neck cancer (HNC), severe side effects of medications remain a challenge. Chemotherapy (CTH)-induced toxicities may lead to alterations in the treatment plan in the form of dose reduction, treatment delay or even discontinuation of treatment. Many efforts were done to overcome the impact of CTH-induced toxicity on HNC treatment. One of the explored strategies is the pharmacokinetic (PK)-based dosing of CTH. A literature search for trials investigating PK-based CTH dosing in HNC from 1988 to 2018 was performed. Few clinical studies including one randomized clinical trial were identified. The limited evidence obtained from these studies shows that PK-based CTH dosing in HNC results in significantly less toxicities with no detrimental impact on treatment outcome. The current evidence is not enough to recommend the routine use of PK-based CTH dosing in HNC. However, the promising results call for future studies.
https://resoncol.journals.ekb.eg/article_30980_99362e2df33c362b13c37d39245f1e9d.pdf
2019-06-01
35
37
10.21608/resoncol.2019.10154.1074
Pharmacokinetics
Chemotherapy
toxicity
head and neck cancer
Body surface area
Abdelhamid
Fouad
abdelhamid.fouad@nci.cu.edu.eg
1
Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
LEAD_AUTHOR
Ahmed
Abo Gabal
ahmed.abogabal@nci.cu.edu.eg
2
Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
AUTHOR
Mariam
Elhaddad
mariameelhaddad@gmail.com
3
Department of Clinical and Chemical Pathology, National Cancer Institute, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Corrigendum: Abd El Bary et al. Cost Effectiveness Analysis of Letrozole Compared with Tamoxifen as Initial Adjuvant Therapy for Postmenopausal Women with Endocrine Responsive Breast Cancer. Kasr El-Aini J Clin Oncol Nucl Med. 2009; 5(3-4): 11-17.
This corrigendum corrects the author list and affiliations of the article: Abd El Bary et al. Cost Effectiveness Analysis of Letrozole Compared with Tamoxifen as Initial Adjuvant Therapy for Postmenopausal Women with Endocrine Responsive Breast Cancer. Kasr El-Aini J Clin Oncol Nucl Med. 2009; 5(3-4): 11-17.In response to a request supported by documents from the corresponding author, the name Dr. Mohamed Elsherbini was added to the list of authors and the affiliation of Dr. Mohamed Abdeen was mentioned.The corrected version of this article replaces the primarily published one.
https://resoncol.journals.ekb.eg/article_18648_8a94e7c0057feb90656cfc2b4d5c731c.pdf
2019-06-01
38
38
10.21608/resoncol.2018.6131.1067
Corrigendum
Abd El Bary et al
Kasr El-Aini J Clin Oncol Nucl Med 2009
Naser
Abd El Bary
nbary11@yahoo.com
1
Clinical Oncology Department, Faculty of Medicine, Menoufia University, Shibin El-Kom, Egypt
LEAD_AUTHOR
Mina
Maher
maher111mina@yahoo.com
2
Clinical Oncology Department, Faculty of Medicine, Menoufia University, Shibin El-Kom, Egypt
AUTHOR
Mohamed
Elsherbini
dr_sherbini61@yahoo.com
3
Clinical Oncology Department, Faculty of Medicine, Menoufia University, Shibin El-Kom, Egypt
AUTHOR
Mohamed
Abdeen
abdeennemor@yahoo.com
4
Clinical Oncology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
AUTHOR
Tarek
Hashem
tarekhashem79789@hotmail.com
5
Clinical Oncology Department, Faculty of Medicine, Menoufia University, Shibin El-Kom, Egypt
AUTHOR