Background and aim: The prognostic role of neutrophil to lymphocyte ratio (NLR) has been shown in many solid tumors included in a recent meta-analysis of one hundred studies. We aimed to evaluate the prognostic value ...Background and aim: The prognostic role of neutrophil to lymphocyte ratio (NLR) has been shown in many solid tumors included in a recent meta-analysis of one hundred studies. We aimed to evaluate the prognostic value of neutrophil to lymphocyte ratio in treatment outcomes;response and survival of patients with different stages of rectal cancers. Patients and methods: All patients with pathologically confirmed cancer rectum presented to our department during the period from January 2012 to the end of 2014 were included in this retrospective study, these recruited patients were evaluated through their files to determine different objectives of our study. Results: The median overall survival was 31 ± 4.676 months while disease free survival was 40 ± 2.346 for the whole study group;neutrophil to lymphocyte ratio was negatively correlated with overall survival with r = –0.743, P disease free survival with r = –0.717, P total number of lymph nodes dissected ratio with r = +0.254, P = 0.028. Roc curve was used to find the accurate cut point of NLR for these patients and was found to be of 4.5. Conclusion: Elevated pre-treatment NLR is an independent predictor of shorter survival in patients with rectal cancer. This parameter is a simple, easily accessible laboratory test for identifying patients with poorer prognosis.展开更多
Aim of work: This study aimed to evaluate the resectability rate, rate of conservative surgery, toxicity, local control, and disease free survival for oxaliplatin and capecitabine based chemoradiation compared to stan...Aim of work: This study aimed to evaluate the resectability rate, rate of conservative surgery, toxicity, local control, and disease free survival for oxaliplatin and capecitabine based chemoradiation compared to standard 5-FU based chemoradiation in locally advanced cancer rectum. Patients and methods: 65 patients were eligible;33 patients received oxaliplatin and capecitabine based chemoradiation (arm I) and 32 patients received 5-FU based chemoradiation (arm II). Results: The overall response rate in arms I and II were 78.7% and 87.5% respectively. Conservative surgery was done in 81.81% and 53.13% of patients with arms I and II, pathologic complete response (pCR) rate was significantly better in arm I than arm II (30.3% vs. 21.9%, P < 0.01). 3-year recurrence rates were 54.5% and 56.2% in arms I, II respectively;the median disease free survival (DFS) were 30 months and 15 months in arms I and II respectively. Grade III anemia, grade IV diarrhea and severe proctitis were developed in a significantly large number of patients with arm I;in addition deep venous thrombosis (DVT) was developed in 15.15% of patients with arm I but none in arm II. Conclusion: The addition of oxaliplatin to the preoperative chemo radiation increased the response rate mainly pCR rate which was considered a target goal in the neoadjuvant treatment, but it was not recommended because of higher toxicity and no significant effect on DFS in different response groups of arm I when compared to arm II, but longer follow up may be needed to evaluate the overall survival.展开更多
Background and aim of work: We aimed from this study to determine the response and local relapse free survival (RFS) of pediatric patients with localized Ewing’s sarcoma treated with accelerated hyper-fractionated RT...Background and aim of work: We aimed from this study to determine the response and local relapse free survival (RFS) of pediatric patients with localized Ewing’s sarcoma treated with accelerated hyper-fractionated RT. Patient and methods: This study was a nonrandomized uncontrolled phase II study and was conducted at clinical oncology department and south Egypt cancer institute;it involved 28 patients with histologically confirmed Ewing’s sarcoma;all of them were subjected to PET/CT whenever possible or MRI with contrast of the primary site, MSCT chest, bone scan, and LDH to ensure absence of metastasis followed by the protocol of accelerated hyper fractionated RT. Results: The overall response rate (ORR) was 92.9% by MRI with significant effect of the type of response on local RFS (P 0.002). The median local RFS of 28 patients with localized Ewing’s sarcoma was 30 ± 8.599 months with 95% CI = 13.147 - 46.853;the 3-year local control was 35%. Conclusion: Accelerated hyper fractionated RT didn’t achieve better results than standard fractionation RT, but it is recommended to be done on a large sample size, and multiple centers, and continued follow up is also recommended to evaluate 5-year LRFS, 5-year OS.展开更多
Double primary malignancies could be divided into two categories, depending on the interval between tumor diagnoses. A secondary malignancy could be defined as a new cancer that has occurred as a result of previous tr...Double primary malignancies could be divided into two categories, depending on the interval between tumor diagnoses. A secondary malignancy could be defined as a new cancer that has occurred as a result of previous treatment with radiation or chemotherapy. Second primary malignancy can occur at any age but it’s commonly at old age. A 46 premenopausal female patient presented to our outpatient clinic complaining from a mass in her right breast, routine metastatic work-up for distant metastasis declared multiple hepatic metastases, RT renal mass, and bone metastases. Palliative radiotherapy to tender and weight bearing sites followed by 4 cycles of systemic chemotherapy FEC regimen were received. Tru-cut needle biopsy from renal mass detected renal cell carcinoma of clear cell type, the patient started sunitinib and tamoxifen with bisphosphonate (Zoledronic acid), assessment of the response revealed reduction of the size and number of HFLs, and the size of renal mass, so the patient was decided to do cytoreductive nephrectomy and then continued on TAM and sunitinib. Collectively, due to the rising incidence of multiple primary malignancies, further studies should be done not only for better clinical evaluation and treatments but also for accurate determination of possible causes, pathogenesis, effective managements and screening programs.展开更多
文摘Background and aim: The prognostic role of neutrophil to lymphocyte ratio (NLR) has been shown in many solid tumors included in a recent meta-analysis of one hundred studies. We aimed to evaluate the prognostic value of neutrophil to lymphocyte ratio in treatment outcomes;response and survival of patients with different stages of rectal cancers. Patients and methods: All patients with pathologically confirmed cancer rectum presented to our department during the period from January 2012 to the end of 2014 were included in this retrospective study, these recruited patients were evaluated through their files to determine different objectives of our study. Results: The median overall survival was 31 ± 4.676 months while disease free survival was 40 ± 2.346 for the whole study group;neutrophil to lymphocyte ratio was negatively correlated with overall survival with r = –0.743, P disease free survival with r = –0.717, P total number of lymph nodes dissected ratio with r = +0.254, P = 0.028. Roc curve was used to find the accurate cut point of NLR for these patients and was found to be of 4.5. Conclusion: Elevated pre-treatment NLR is an independent predictor of shorter survival in patients with rectal cancer. This parameter is a simple, easily accessible laboratory test for identifying patients with poorer prognosis.
文摘Aim of work: This study aimed to evaluate the resectability rate, rate of conservative surgery, toxicity, local control, and disease free survival for oxaliplatin and capecitabine based chemoradiation compared to standard 5-FU based chemoradiation in locally advanced cancer rectum. Patients and methods: 65 patients were eligible;33 patients received oxaliplatin and capecitabine based chemoradiation (arm I) and 32 patients received 5-FU based chemoradiation (arm II). Results: The overall response rate in arms I and II were 78.7% and 87.5% respectively. Conservative surgery was done in 81.81% and 53.13% of patients with arms I and II, pathologic complete response (pCR) rate was significantly better in arm I than arm II (30.3% vs. 21.9%, P < 0.01). 3-year recurrence rates were 54.5% and 56.2% in arms I, II respectively;the median disease free survival (DFS) were 30 months and 15 months in arms I and II respectively. Grade III anemia, grade IV diarrhea and severe proctitis were developed in a significantly large number of patients with arm I;in addition deep venous thrombosis (DVT) was developed in 15.15% of patients with arm I but none in arm II. Conclusion: The addition of oxaliplatin to the preoperative chemo radiation increased the response rate mainly pCR rate which was considered a target goal in the neoadjuvant treatment, but it was not recommended because of higher toxicity and no significant effect on DFS in different response groups of arm I when compared to arm II, but longer follow up may be needed to evaluate the overall survival.
文摘Background and aim of work: We aimed from this study to determine the response and local relapse free survival (RFS) of pediatric patients with localized Ewing’s sarcoma treated with accelerated hyper-fractionated RT. Patient and methods: This study was a nonrandomized uncontrolled phase II study and was conducted at clinical oncology department and south Egypt cancer institute;it involved 28 patients with histologically confirmed Ewing’s sarcoma;all of them were subjected to PET/CT whenever possible or MRI with contrast of the primary site, MSCT chest, bone scan, and LDH to ensure absence of metastasis followed by the protocol of accelerated hyper fractionated RT. Results: The overall response rate (ORR) was 92.9% by MRI with significant effect of the type of response on local RFS (P 0.002). The median local RFS of 28 patients with localized Ewing’s sarcoma was 30 ± 8.599 months with 95% CI = 13.147 - 46.853;the 3-year local control was 35%. Conclusion: Accelerated hyper fractionated RT didn’t achieve better results than standard fractionation RT, but it is recommended to be done on a large sample size, and multiple centers, and continued follow up is also recommended to evaluate 5-year LRFS, 5-year OS.
文摘Double primary malignancies could be divided into two categories, depending on the interval between tumor diagnoses. A secondary malignancy could be defined as a new cancer that has occurred as a result of previous treatment with radiation or chemotherapy. Second primary malignancy can occur at any age but it’s commonly at old age. A 46 premenopausal female patient presented to our outpatient clinic complaining from a mass in her right breast, routine metastatic work-up for distant metastasis declared multiple hepatic metastases, RT renal mass, and bone metastases. Palliative radiotherapy to tender and weight bearing sites followed by 4 cycles of systemic chemotherapy FEC regimen were received. Tru-cut needle biopsy from renal mass detected renal cell carcinoma of clear cell type, the patient started sunitinib and tamoxifen with bisphosphonate (Zoledronic acid), assessment of the response revealed reduction of the size and number of HFLs, and the size of renal mass, so the patient was decided to do cytoreductive nephrectomy and then continued on TAM and sunitinib. Collectively, due to the rising incidence of multiple primary malignancies, further studies should be done not only for better clinical evaluation and treatments but also for accurate determination of possible causes, pathogenesis, effective managements and screening programs.
