Open Access Original Research Article

Timing of Daily Radiotherapy for Cases of Head and Neck Cancer: Does It Make Difference?

Mohamed Saad Eldeen Elzahi, Shimaa E. Attia, Skoukri H. Elazab

Journal of Cancer and Tumor International, Page 12-16
DOI: 10.9734/jcti/2020/v10i130118

Background: Oral mucositis is a major problem affecting all head and neck cancer (HNC) patients received radiotherapy. Till now, available treatment is just symptomatic with limited effects. Preventive strategies may be better to avoid this complication. Animal models studies have illustrated that anti-cancer treatment toxicity display prominent daily variations; therefore, undesirable side effects could be significantly reduced by administration of radiotherapy at specific times when they are better tolerated.

Aim: To compare “soreness quality score” (SQS) between 2 groups of head and neck cancer patients received radiotherapy at different daily time.

Methods: 2 groups of head neck cancer patients treated at Mansoura university hospital; each group included 80 cases. Group A received radiotherapy at early morning between 6 and 8 am, while Group B received radiotherapy in the afternoon between 1 and 3 pm. Oral mucositis survey was self-reported weekly during and at the end of treatment by using “soreness quality score” (SQS).

Results: For group A, mild mucositis (score 1 and 2) was recorded in 53 cases (66%) and severe mucositis was recorded in 27 cases (34%). For group B, mild mucositis was recorded in 29 cases (36%) and severe mucositis was recorded in 51 cases (64%). There was statistically significant difference (0.003) between both groups as regards development of severe oral mucositis.

Conclusion: Better toxicity profile as regards oral mucositis could be obtained by giving radiotherapy for (HNC) patients at early morning compared to late afternoon. Further studies are worthwhile to confirm our findings.

Open Access Original Research Article

Value of Strain Elastography Ultrasound in Differentiation of Benign and Malignant Breast Masses with Histopathological Correlation

Mahbuba Azim Moonmoon, M. N. Rubaia Islam Bony, Md. Ubaidul Islam, Parbati Devnath, Nahid Safrin

Journal of Cancer and Tumor International, Page 17-25
DOI: 10.9734/jcti/2020/v10i130119

Introduction: Breast cancer is currently one of the leading causes of cancer deaths in women. Early detection and accurate classification of suspicious masses as benign or malignant is important for arriving at an appropriate treatment plan. Elastography has shown potential in differentiating benign from malignant breast tumors.

Objective: To evaluate the usefulness of Strain Elastography ultrasound in differentiation of benign and malignant breast masses taken histopathology as Gold Standard.

Methods: This cross-sectional study was carried out in the Department of Radiology and Imaging, BIRDEM, Dhaka, from July 2017 to June 2019. A total of 92 female patients with breast masses were enrolled in this study. Strain Elastography Ultrasound and histopathology were done in all these patients. Statistical analyses of the results were obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22).

Results: The validity test of B-mode ultrasonography for differentiation of benign and malignant breast mass has sensitivity 95.0%, specificity 71.2%, accuracy 81.5% and positive predictive value 71.7% and negative predictive value 94.9%. Strain Score has sensitivity 85.0%, specificity 92.3%, accuracy 89.1%, positive predictive value 89.5% and negative predictive value 88.9%. Strain ratio has sensitivity 87.5%, specificity 94.2%, accuracy 91.3%, positive predictive value 92.1% and negative predictive value 90.7%. The validity test of Combined (B-mode sonography and Elastography) has sensitivity 97.5%, specificity 96.2%, accuracy 96.7%, positive predictive value 95.1% and negative predictive value 98.0%. The areas under the curve (AUCs) from the receiver operating characteristic (ROC) curves were 0.948 for ACR-BIRADS classification, 0.986 for Strain Score, 0.956 for Strain Ratio and 0.990 for combination.

Conclusion: The combination of strain elastography with B-mode ultrasonography has the potential to improve the differentiation of benign and malignant breast masses.

Open Access Original Research Article

Awareness of Cervical Cancer Screening and Prevention among Students of a Tertiary Institution in Southern Nigeria

I. L. Oboro, B. P. Athanasius

Journal of Cancer and Tumor International, Page 26-32
DOI: 10.9734/jcti/2020/v10i130120

Aim: To access the level of awareness of cervical cancer screening tools and preventive measures amongst students of a tertiary institution.

Methodology: This was a questionnaire-based cross-sectional study. Pre-tested self-administered Questionnaires were distributed to students who were above the age of 18 years in the University of Port Harcourt, Rivers State, Nigeria, to obtain information on their socio-demographics and awareness of cervical cancer, its prevention, risk factors and association with Human Papilloma Virus infection. Information acquired from the questionnaires were presented using descriptive statistics. Chi-Square analysis was used to compare differences between knowledge and practice among the respondents. P-value < 0.05 was considered significant. All tests were carried out with the Epi Info v7 software.

Results: A total of 227 students were interviewed.82.8% were female and 22.9% indicated being sexually active. About two-thirds of respondents had some knowledge (heard) of cervical cancer and Pap smear, majority of whom indicated they did so from health care personnel followed closely by the media houses and social media. Only 12.1% were aware of sexual intercourse as a risk factor for Human Papilloma virus infection and about one-fifth knew the currently recommended age for vaccination against the virus.

Conclusion: The degree of awareness of cervical cancer in a key population such as the undergraduates sampled in this study is unacceptably low. Increased efforts must therefore be put into public enlightenment as primary prevention of cervical cancer

Aim: To access the level of awareness of cervical cancer screening tools and preventive measures amongst students of a tertiary institution.

Methodology: This was a questionnaire-based cross-sectional study. Pre-tested self-administered Questionnaires were distributed to students who were above the age of 18 years in the University of Port Harcourt, Rivers State, Nigeria, to obtain information on their socio-demographics and awareness of cervical cancer, its prevention, risk factors and association with Human Papilloma Virus infection. Information acquired from the questionnaires were presented using descriptive statistics. Chi-Square analysis was used to compare differences between knowledge and practice among the respondents. P-value < 0.05 was considered significant. All tests were carried out with the Epi Info v7 software.

Results: A total of 227 students were interviewed.82.8% were female and 22.9% indicated being sexually active. About two-thirds of respondents had some knowledge (heard) of cervical cancer and Pap smear, majority of whom indicated they did so from health care personnel followed closely by the media houses and social media. Only 12.1% were aware of sexual intercourse as a risk factor for Human Papilloma virus infection and about one-fifth knew the currently recommended age for vaccination against the virus.

Conclusion: The degree of awareness of cervical cancer in a key population such as the undergraduates sampled in this study is unacceptably low. Increased efforts must therefore be put into public enlightenment as primary prevention of cervical cancer

Open Access Original Research Article

Adult Granulosa Cell Tumor of the Ovary: A Retrospective Study of 40 Cases

Waleed N. Abozeed, Skoukri H. Elazab, Mohamed S. Zahi

Journal of Cancer and Tumor International, Page 33-42
DOI: 10.9734/jcti/2020/v10i130121

Background: Granulosa cell tumors (GCTs) are rare ovarian tumors represent only 5% of all ovarian cancers. GCTs are divided into an adult (AGCT) and juvenile (JGCT) types. The prognosis of these tumors is good when compared with other epithelial tumors. Radical surgery and adjuvant chemotherapy according to the presence of risk factors still the main line of treatment. Many Prognostic factors are suggested to affect the course of the disease like tumor stage and extend of surgery. But due to the small number of cases and indolent course of the disease, clinical characteristics and prognostic factors for this type of tumours still unclear.

Aim: To determine the clinical characteristics of cases with AGCT and the prognostic factors for disease relapse and survival.

Methods: This is a retrospective descriptive study. 40 patients with (AGCT) were recruited. Patient characteristics were collected. The disease-free interval and overall survival were determined.

Results: At the end of the study, the median disease-free survival DFS was 101.215 months (93.2-109.3) with statistically significant difference regarding the stage of the disease, extent of surgery, rupture of the tumor and presence of residual disease. The median overall survival OAS was 106.38 months (100.3-112.5) with statistically significant difference regarding stage of the disease, parity and presence of residual disease.

Conclusion: (AGCT) are rare tumors with excellent survival. Stage of the disease and extent of surgery were significant prognostic factors affecting the course of the disease. Prospective studies are needed for better understanding of this disease.

Open Access Review Article

Preoperative Radiosurgery in Management of Brain Metastases

Erkan Topkan, Ahmet Kucuk, Sukran Senyurek, Duygu Sezen, Nulifer Kilic Durankus, Eyub Yasar Akdemir, Esma Didem Ikiz, Yasemin Bolukbasi, Berrin Pehlivan, Ugur Selek

Journal of Cancer and Tumor International, Page 1-11
DOI: 10.9734/jcti/2020/v10i130117

Brain metastases (BMs), the most frequent intracranial tumors, are diagnosed in approximately 30% of all adult patients over the span of planned treatment against a broad spectrum of solid cancers. The prognosis of patients presenting with BM is bleak with an expected median OS of only 4-7 months. However, some particular patients’ groups may enjoy longer survival durations with effective systemic and local therapies. At present, the feasible alternatives for active management of BMs typically include the whole-brain radiotherapy (WBRT), surgery, definitive SRS, postoperative SRS, systemic chemotherapy, targeted therapies, and their combination variants. Considering the local treatment, the severe neurotoxic effects of WBRT, and the increased risk for radionecrosis and leptomeningeal dissemination after postoperative SRS and together with the ineligibility of certain patients during the postoperative period prompted the energetic quest of alternative treatment strategies for such patients. In this respect, the novel preoperative SRS (PO-SRS) was proposed to provide at least equivalent local control rates with lesser radionecrosis and leptomeningeal dissemination risk. Respecting the scarcity of related literature, the present review aimed to meticulously detail theplausible rationale and accessible evidence for the novel PO-SRS in the management of patients presenting with BMs.