Open Access Case Report

Hybrid Lesion of Ameloblastoma and Adenomatoid Odontogenic Tumour (AOT): Report of Two Cases from a Tertiary Referral Hospital in Sub-Saharan Africa

Olufunlola Motunrayo Adesina, Olawunmi Adedoyin Fatusi, Ramat Oyebunmi Braimah, Francis Adewale Adejobi

Journal of Cancer and Tumor International, Page 31-38
DOI: 10.9734/jcti/2020/v10i230124

Introduction: Hybrid lesions are lesions showing the combined histopathological characteristics of two or more previously recognized odontogenic tumours and /cysts of different categories. Hybrid lesions do exist because of close interrelationship of several odontogenic lesions and also because odontogenic tumors and cysts can arise at any stage of odontogenesis. The objective of this study was to present 2 cases of hybrid odontogenic tumour that is composed of adenomatoid odontogenic tumour (AOT) and ameloblastoma.

Case Reports:

Case 1: A 33year old female patient with a bucco-lingual swelling in the left mandibular premolar-molar-ramus regions of 13years duration. The lesion measured about 15x5x3cm, it is non tender. Surgical specimen revealed hybrid lesion of granular cell type ameloblastoma and AOT.

Case 2: An 18year old female patient with a painless right mandibular molar-ramus swelling of 10years duration. Mandibulectomy specimen measured about 11 cm x 8.5 cm x 5 cm and was found to be hybrid lesion of acanthomatous ameloblastoma and AOT.

Conclusion: Both cases had a very long clinical duration and showed more buccal bone expansion with barely noticeable lingual bone expansion. With such clinical scenarios, a suspicion of hybrid tumour should be made.

Open Access Original Research Article

In Pursuance of Differentiation Inducers to Combat Cancer via Targeting of Abnormal Methylation Enzymes

Ming C. Liau, Jai-Hyun Kim, John P. Fruehauf

Journal of Cancer and Tumor International, Page 39-47
DOI: 10.9734/jcti/2020/v10i230125

Cell differentiation agent-2 (CDA-2) was a promising hypomethylating agent approved by the Chinese FDA for the therapy of MDS in China. The active components of CDA-2 are differentiation inducers (DIs) and differentiation helper inducers (DHIs). DIs are chemicals capable of eliminating telomerase from abnormal MEs commonly found in human cancers. The major DI of CDA-2 is an organic acid without UV absorption. Without UV absorption as a guide, it was difficult to purify the DI of CDA-2 for identification. Thus, we pursued possible candidates to function as DIs in this study.

Cancer MEs become abnormal due to association with telomerase. Naturally we sought telomerase inhibitors as possible candidates of DIs. Prostaglandin E2 (PGE2) attracted our attention because it was implicated to involve in wound healing, which is a major biological mission of progenitor stem cells (PSCs) and cancer stem cells (CSCs). Eradication of CSCs has been a major focus of our studies. Besides, PGE2 fits the description of the major DI of CDA-2.

Induction of terminal differentiation (TD) of HL-60 cells by NBT assay was employed to evaluate the activity of chemicals as DIs. Cell growth was based on cell numbers. All-trans retinoic acid (ATRA) and 12-O-tetradecanoylphorbol-13-acetate (TPA) are two well known DIs. ATRA displayed a wide active dosage range from 0.2 to 4.5 µM with a maximum of inducing 89% NBT+ cells at 3 µM. TPA displayed a narrow active dosage range from 0.2 to 0.6 nM with a maximum of inducing 84% NBT+ cells at 0.4 nM. BIBR1532 and bodine were the two telomerase inhibitors studied. Both were found active as DIs. BIBR1532 was active in the dosage range from 30 to 75 µM with a maximum of inducing 86% at 63 µM. Bodine was active in the dosage range from 60 to 98 µM with a maximum of inducing 80% at 98 µM. PGE2 was active in the dosage range from 20 to 70 µM with a maximum of inducing 80% at 56 µM.

DIs at dosages not active as DIs could function as effective DHIs to other DIs. RI0.5 of BIBR1532, boldine and PGE2 as DHIs were 2.02 µM, 3.11 µM, and 0.92 µM, respectively.

DIs alone, no matter how effective, could not induce NBT+ cells to reach 100%. 95% (89% plus 6% of blank) was the highest value achieved by ATRA. Incomplete induction of TD was the reason for frequent recurrence when ATRA was used alone in the therapy of acute promyelocytic leukemia (APL). A combination of ATRA and a DHI could induce NBT+ cells to reach 100% to avoid recurrence.

Open Access Original Research Article

Hemoglobin Level as a Prognostic Factor for Locally Advanced Bladder Cancer Patients Treated with Radical Radiotherapy

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

Journal of Cancer and Tumor International, Page 48-56
DOI: 10.9734/jcti/2020/v10i230126

Anemia is a common symptom in cancer patients and usually associated with poor prognosis. Urinary bladder cancer (BC) is the most common cancer in the urological tract with anemia being one the most common presenting symptom. Radical radiotherapy is the treatment of choice for advancer disease with many factors could influence the prognosis.

Aim: To identify pre-treatment hemoglobin level as prognostic factor for advanced bladder cancer treated with radiotherapy.

Materials and Methods: A retrospective study reviewed the data of 88 patients with advanced bladder cancer, treated with radical radiotherapy from 2013 to 2018.

Results: Median follow-up was 45 months. The median PFS was 26.87 months but when comparing anemic to non–anemic patient there was significant difference (17.25 and 40.02 months) respectively. Also as regards overall survival the median was 28.98 months but 20.24 and 40.47 months in anemic and non-anemic patients respectively with significant difference. Local or distant progression detected in 36 out of 50 anemic patients compared to only 4 out of 38 non-anemic patients. In multivariate analysis anemia was proved to be the strongest predictor of mortality.

Conclusion: Pre-treatment Hb level is an important factor affecting the prognosis of advanced bladder cancer patients treated with radical radiotherapy. Low HB level could be considered as a good biological marker for aggressive disease.

Open Access Review Article

Radiosurgery Techniques for Brain Metastases

Erkan Topkan, Ahmet Kucuk, Sukran Senyurek, Duygu Sezen, Nulifer Kılıc Durankus, Eyub Yasar Akdemir, Yucel Saglam, Yasemin Bolukbasi, Berrin Pehlivan, Ugur Selek

Journal of Cancer and Tumor International, Page 1-14
DOI: 10.9734/jcti/2020/v10i230122

As a notable cause of cancer-related morbidity and mortality, brain metastases (BMs) represent the most prevalent intracranial tumors arising in up to 40% of all adult solid tumors during the course of treatment. Intracranial stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) gained wide appreciation by the radiation oncology communities for the treatment of BM with regards to the grim prognosis of such patients after alternative therapies, including the whole brain radiotherapy (WBRT).  Additional concerns on the neurocognitive deterioration and comparably low tumor control rates offered by the conventional WBRT further quickened the implementation of SRS to the daily practice of radiation oncology clinics. However, the striking diversities among the treatment algorithms and the treatment planning systems of the gamma knife-, linear accelerator- (LINAC), tomotherapy-, robotic Cyberknife-, or the proton therapy-based SRS render the administration of SRS/FSRT challenging. Acknowledging these difficulties, the present review intended to offer a thorough outline of the main principals of the SRS/FSRT technique from the initial patient fixation to the final machine and dose delivery quality assurance treads.

Open Access Review Article

Tumor Cavity Stereotactic Radiosurgery for Resected Brain Metastases

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

Journal of Cancer and Tumor International, Page 15-30
DOI: 10.9734/jcti/2020/v10i230123

Stereotactic radiosurgery (SRS) has been utilized broadly for brain metastases not only for intact ones but as well as of late for the postoperative cavity of metastases after surgery, due to the advantages of SRS to preserve neurocognitive functions, maintain local control and prescribe the treatment in a short time frame. Randomized trials have proven the safety and efficacy of cavity SRS compared to observation. As WBRT offers no survival advantage in comparison to SRS and frequent monitorization with brain MRIs for early salvage upon failure, there has been a revolution in clinical approach for patients with limited intact brain metastases to treat with SRS only and omit WBRT. Likewise, the postoperative cavity SRS for brain metastases has gained a growing reputation. In this review, we summarize the proof for evidence-based optimization in the postoperative setting of the surgically removed brain metastases.