Open Access Original Research Article
Background: Medulloblastomas are the most common infratentorial malignant brain tumors with an incidence rate of 0.5 in 100.000 typically arising in childhood at age 5-9 years.
Aim of Work: Exploring the epidemiological characteristics, treatment outcome and prognostic factors of medulloblastoma patients whom were referred to Mansoura Clinical Oncology &Nuclear Medicine Department for adjuvant treatment through the period from Jan. 1997 to Dec. 2011 inclusive.
Patients and Methods: Sixty-Two patients records were in harmony with the eligibility criteria . Males were slightly larger in number [33 cases (53%)]. The majority of the cases were of pediatric age (42 patient representing 68%). Complete resection was possible in only 31 cases (50%).The classic type was the commonest [36 cases (58%)]. The majority were of the of M0 stage [52 cases (84%)] and of high risk category [37 cases (60%)]. Median dose to posterior fossa was 52.5 Gray (range, 43-56 Gray). The Chemotherapy was administrated in forty-seven patients (75.8%). The toxicity of treatment were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 3.0).
Results: Adjuvant Radiotherapy was generally well tolerated. The median overall survival time and median progression – free survival were 90 & 72 months respectively. Relapse was reported in 28 patients (45.16%).M staging, extensiveness of resection, hydrocephalus at presentation and time elapsed till radiotherapy all affected significantly the prognosis.
Conclusion: In conclusion, this study highlights the effect of stage, completeness of surgery, and early initiation of adjuvant radiotherapy on the outcome.
Open Access Original Research Article
Background: Renewed interest in induction chemotherapy for treatment of locally advanced nasopharyngeal carcinoma has been made recently. Multiple phase III trials were going aiming to define the best candidate, and the best regimen for induction chemotherapy. We conducted this phase II study to evaluate the efficacy and safety of induction chemotherapeutic (TPF) regimen before CCRT with cisplatin weekly in locally advanced non metastatic NPC.
Methods: 36 patients diagnosed with stage III, IVA & IVB, poorly differentiated or undifferentiated carcinoma in the period between August 2014 and August 2016 were included in the study, all of them received induction chemotherapy with TPF regimen followed by cisplatin (40 mg/m2) weekly concurrent with RT. Radiotherapy was given by 3D conformal modality where, high-risk GTVP, GTVLN & CTV was given a dose of 60 Gray / 30 fractions followed by 10-14 gray/5-7 fractions to GTVP and 6-10 Gray /3-5 fractions to GTVLN.
Results: The objective response rate was 86% (CR 12%) in the primary tumor and, 100% (CR 62%) in the cervical LN after induction chemotherapy and the corresponding rate was 100% (CR 91%), 45-60 days after the completion of RT. No local recurrence or distant metastasis was seen during the follow-up period. The two-year DFS was 85% and the estimated two-year OS was 95%. The rate of grade 3 /4 neutropenic fever was encountered in 6% of cases during induction chemotherapy. Grade 3/4 mucositis was seen in 9 % of patients while no grade 3 or 4 skin desquamation or xerostomia were seen. There was no treatment-related death. Field in field technique gave the best coverage of the PTV without exceeding the tolerance dose of other OAR. Conclusion: The TPF regimen was well tolerated and had a manageable toxicity profile. 3DCRT can be tailored to reach the target of Intensity modulation modalities.
Open Access Review Article
The article relates in general to intralipid and its use in cancer therapy. Specifically, it relates to the combined intralipid-urotherapy for treating cancer, and methods of such treatment.
Cancer cells release various antigens, some of which appear in the urine. Combined oral Intralipid and auto-urotherapy is suggested as a new treatment modality for cancer patients. It will provide the intestinal lymphatic system the many tumor antigens against which antibodies may be produced. These antibodies may be transpierced through the blood stream and attack the tumor and its cells.
Intralipid can increase the response to the cancer antigens in the intestinal lymphatic system against which antibodies may be produced.