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IMRT, VMAT and Proton Therapy for Prostate Cancer Treatment
Get PDFDear Editor,Recently, I read an article entitled "Literature Review on IMRT and VMAT for Prostate Cancer" published by American Journal of Cancer Review in its Volume 2, Issue 1[1]. Authors have done excellent work in reviewing two radiation treatment techniques for prostate cancer, and the article also highlights various factors which can have direct or indirect impact on the dosimetric results. Prostate cancer is the most frequently diagnosed cancer among men in the world. Different types of treatment options are currently available to manage the prostate cancer, and radiation therapy is one of them. Due to advancement in computing power and technology, it is now possible to generate very conformal dose plans for the prostate cancer. Although VMAT provides slight advantage over the IMRT, the superiority of the VMAT over the IMRT is still a debating topic due to lack of clinical evidence [1].In the review article [1], authors have focused solely on the IMRT and VMAT, which use photon radiation beams to deliver the radiation dose. However, there are other radiotherapy techniques, which can produce comparable results to that of IMRT and VMAT. The primary purpose of this letter is to provide brief update on the most advanced radiotherapy technique in the form of proton therapy for the prostate cancer. Proton therapy can produce excellent dose distribution because protons have finite range and sharp distal fall-off at the end of proton beam path [2]. Several studies [3-10] have shown that proton therapy is capable of producing excellent dosimetric results in terms of rectal and bladder sparing. For example, Vargas et al. [3] demonstrated that proton therapy is better at sparing rectum and bladder when compared to photon therapy. Trofimov et al. [4] showed that the angled lateral proton fields can further reduce the rectal dose. Rana et al. [5] showed that the combination of lateral and oblique fields in proton therapy provides dosimetric advantage over the VMAT for prostate cancer involving a metallic hip prosthesis. Chera et al.[6] showed that proton therapy reduced the dose to the bladder, rectum, small bowel, and pelvis when compared to the IMRT. In another study by Rana et al. [7], it was shown that the proton therapy produced lower values for the rectum and bladder doses for the similar target volume coverage when compared to the VMAT. Hence, literature review indicates that the advanced proton therapy technique has the potential of lowering rectal and bladder toxicities in prostate cancer patients when compared to the photon therapy such as IMRT and VMAT
Rare Mucinous Colorectal Adenocarcinoma: Analysis of the Epidemiological Factors in Relation to Survival in Egyptian Patients
Get PDFColorectal carcinoma (CRC) is one of the leading causes of cancer related deaths; in Egypt it constitutes 6.5% of all cancers. Previous studies have shown conflicting results on clinicohistopathological features and survival of patients with colorectal mucinous (MA) and non-mucinous adenocarcinoma (NMA). To the best of our knowledge, this study is the first to investigate these features in Egypt. In this work, we studied tumor tissue specimens from 150 patients with colorectal MA and NMA who underwent radical surgery from Jan 2007 to Jan 2012 at Gastroenterology Centre, Mansoura University, Egypt. Their clinicohistopathological parameters and survival were analyzed using established statistical methodologies. Incidence of MA and its subtypes was much higher in Egypt than worldwide incidence. MA was significantly associated with younger age, more depth of invasion, lymph node metastasis, less microscopic abscess formation and less peri-tumoral lymphocytic response (Crohn-like response) than NMA. Both groups were not significantly different "among others" in other clinicopathological parameters including lymphovascular and perineural invasion, association with adenoma and schistosomiasis. Multivariate analyses for disease free and overall survival revealed that mucinous histology is an independent prognostic factor. Among several factors, only distant metastasis and presentation with recurrent disease were independent prognostic factors within MA patients. In conclusion, MA represents a distinct clinicopathological entity with worse survival than NMA. Distant metastasis and presentation with recurrent disease are independent prognostic factors. Further molecular investigations considering genetic features of MA will lead to drug development and better management
Determination of the Primary Organ is Difficult for Poorly Differentiated Adenocarcinoma with Signet-Ring Cells of the Esophagus and Urinary Bladder
Get PDFIntroduction: Diagnosis of poorly differentiated adenocarcinoma with signet-ring cells of the esophagus and urinary bladder is very difficult.Presentation of Cases: We report 2 cases of poorly differentiated adenocarcinoma with signet-ring cells, 1 in the esophagus and 1 in the urinary bladder.Conclusion: Infiltration of cells of poorly differentiated adenocarcinoma with signet-ring cells occurs in early stage of the cancer development. Therefore, complete removal is difficult for these cancers of the esophagus and urinary bladder
Improving Printability of Silk and Polyamide Substrates with Madder Nano-Sized Particles
Get PDFThe possibility of using madder nanoscaled particles, as a natural dye for printing silk and polyamide 6 fabrics, has been investigated. The dried plant is both milled and exposed to ultrasound waves (for a specific period of time), incorporated with urea in the printing paste at an acidic pH value, printed on the pretreated fabrics and eventually the prints are steamed and washed off. The influence of several parameters and measurements affecting K/S values as well as fastness levels of the prints are studied in detail i.e. mordant and urea concentrations, printing paste pH, SEM, TEM and FT-IR analysis and fastness properties. Results show that, printing using nano-scaled particles of the natural dye greatly enhances both: K/S values and fastness levels of the prints. SEM, FT-IR and UV visible spectroscopes are employed to show particle changes after milling as well as sonication
Duodenal Duplication Cyst with Recurrent Acute Pancreatitis: Report of a Case
Get PDFIntroduction:Duplication cyst can be occurred in any level of GI tract but the duodenal cysts are extremely rare. Most of the duplication cysts are detected in children. Duodenum duplication cysts are difficult to diagnose, as the presenting symptoms are nonspecific and are closely related to the type, size and location of the lesion. Both CT imaging and MRI can adequately identify a duodenal duplication cyst.Presentation of the case: We report an adult with recurrent episodes of acute pancreatitis who was diagnosed with ERCP. With the diagnosis of duodenal duplication cyst, we planned to perform surgical resection of the cyst.Conclusions: The surgical intervention for duodenal duplication cyst includes complete or partial surgical resection of the cyst. The location of the cysts in relation to the duodenum, especially to the ampulla, is important to determine the treatment strategy. Alternatively, duodenum duplication can be safely and effectively treated by different endoscopic interventions
Establishing an Anal Neoplasia Screening Service for a Unique HIV Positive Patient Population in a Small City: Lessons Learned
Get PDFMortality from human papillomavirus (HPV) mediated squamous carcinoma of the uterine cervix has dramatically decreased in recent decades as a result of broad scale population screening for early detection of cervical cancer precursors. Concomitantly, deaths associated with HPV related carcinomas of the anus have oppositely trended upward. At this time, there are no national guidelines for anal screening. We herein report our experience with establishing an anal cytology screening program for HIV infected patients in a small city. The HIV positive population studied is unique in that 75% of patients had undetectable viral loads by PCR with average CD4+ cell/uL counts of 550. In addition 40% are adult females. 45% of patients in this relatively healthy HIV+ population were discovered to have atypical squamous cells or worse on entry into screening, and 20% of patients were ultimately shown on high resolution anoscopic biopsy histology to harbor high grade squamous intraepithelial lesions (AIN 2/3). Meaningful small scale anal cytology screening programs are possible with clinical and anoscopic collaborations. It seems possible that this simple and inexpensive test may prevent morbidity and mortality from HPV mediated anal carcinoma
A Wavelet based Method for QRS Complex Detection
Get PDFECG signal plays an important role in the diagnosis and analysis of heart diseases and allows the assessment of cardiac muscle functionality. The main and most obvious part of electrocardiography tracing is its QRS complex which corresponds to the ventricular depolarization. The morphology of QRS complex and its repetition are important issues in the analysis of heart diseases so its detection is important for such analysis. In this paper an algorithm based on the multiplication of wavelet coefficients is presented to find out the R peak in ECG for QRS complex detection. The proposed method is based on the band-limited properties of QRS waveform. The ability of proposed method has been evaluated through the comparison with traditional Pan-Tompkins algorithm by standard datasets. The results show that the proposed method besides having lower complexity is comparable with Pan-Tompkins method.
The Effect of DNA Methylation Modification Polymorphism of Corn Seeds on Their Germination Rate, Seedling Resistance and Adaptive Capacity under UV-C Exposure
Get PDFRelations between epigenetic polymorphism of corn seeds, their germination rate, resistance and adaptation under UV-C exposure have been investigated. Association of various seed germination rate with the original differences in chromosome aberration yield and methylation patterns of transcribed and satellite DNA have been shown. In two series of experiments involving а аcute single and repetitive UV-C exposure according to the scheme «adaptive - challenging», the investigation of possible biological importance of epigenetic polymorphism has been performed. Significant differences have been established in chromosome aberration yield and methylation pattern changes in satellite and transcribed DNA of seedlings from fast- and slowly-growing seeds under UV-C exposure. This data indicate existence of various resistances to UV-C exposure and adaptive capacity of seedlings from seeds with different epigenomes
Protein Acetylation as an Integral Part of Metabolism in Cancer Development and Progression
Get PDFAcetylation of lysine is one of the major post-translational modifications of histone and non-histone proteins of eukaryotic cells. Acetylation has been indicated as an avenue for cellular response to environmental, nutritional and behavioral factors. At the same time, aberrant protein acetylation has been related to cancer as well as many other diseases. Abnormal expression of some classes of histone deacetylases and histone acetyl transferases has been documented for the majority of cancers. These observations have led to extensive efforts in the development of inhibitors for these enzymes for the treatment of cancer as well as other diseases as well as pathogen control.Regulation of protein activities and gene expression by acetylation influences many processes relevant for cancer development, including metabolism. At the same time acetylation depends on a number of metabolic co-factors and a variety of metabolites act as inhibitors of acetylation proteins making acetylation enzymes an integral part of metabolism. Cancer metabolic phenotype is generally understood as one of the major hallmarks of cancer and thus the interplay between acetylation, anabolism and catabolism provides a very interesting forum for exploration of cancer development and for novel treatments. An ever increasing pool of publications shows relationships between the acetylation process and related enzymes with metabolites in cancerous and non-cancerous systems. In this review we are presenting previously established relationships between acetylation/deacetylation, metabolites and enzyme regulation particularly in relation to cancer development, progression and treatment
The Cosmetic Effect of Intra Cavity Injection of Saline in Patients with Breast Conserving Therapy
Get PDFIntroduction: For many women with breast cancer, breast conserving therapy (BCT) is preferable to total mastectomy because BCT produces survival rates equivalent to those after total mastectomy while preserving the breast. However the effect of breast conservation therapy on aesthetic outcome is not minimal and those patients may benefit from reconstructive consultation. Here, we present a simple and safe procedure with shortened hospital stay for centers where plastic specialty services are not available.Methods: It was a prospective study. Twenty one women with breast cancer underwent breast-conserving surgery followed by injection of 200-400 cc of normal saline into the cavity. At 6 months follow up, all patients were evaluated of asymmetry, deformities, satisfying with the end result and requesting or requiring further cosmetic surgery.Results: Twenty one patients were enrolled, aged 23-59 years. All margins were negative on post operative pathologic study. At 6 months follow up, all patients had some degree of asymmetry, but were satisfied with the result; none requested plastic surgery.Conclusion: Saline injection into the cavity is a safe and quick technique to preserve breast contour for patients who do not access onco-plastic surgery