International Journal of Cancer Therapy and Oncology
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Measurement of radium isotope activities in reservoir and spring water in the Cameroon Central Region
Get PDFPurpose: To determine the activities of 226Ra and 228Ra in the reservoir and spring water samples respectively during the dry and the rainy seasons; and to calculate the annual intake Ii (Bq/y) for each type of water samples. Methods: Using both well calibrated Canberra NaI(Tl) and HPGe detector systems, it was possible to determine the average specific activity of those radium’s isotopes in water samples which were collected in 2010, from Reservoirs and springs in Cameroon central region including Ngoaekelle, Minboman, Etoudi and Njoungolo. Results: The average specific activity values obtained for 226Ra and 228Ra in reservoir water samples were 8.76 ± 3.50 BqL-1 and 0.64 ± 0.28 BqL-1 during the dry season and, 8.24 ±3.48 BqL-1 and 0.58 ± 0.24 BqL-1 during the rainy season respectively. For spring water, the average values were 3.50 ± 0.63 BqL-1 and below 0.0002 BqL-1 (detection limit of 228Ra in water) during the dry season; 3.20 ± 0.60 BqL-1 and below 0.0002 BqL-1 (detection limit of 228Ra in water) during the rainy season respectively. Assuming that the volume of drinking water for adult is 2.5 litres per day, the average annual intakes of 226Ra and 228Ra through ingestion in these water samples were 7702 Bq/y and 575 Bq/y for reservoir water; 2993 Bq/y and < 0.25 for spring water respectively. Conclusion: The results have indicated that the annual intake by the population of sampling region as a result of 226Ra in these drinking waters is 7.7 × 103Bq/y more than the maximum limit fixed by ICRP which is 7 × 103 Bq/y. There is a need for regular monitoring the radiological water quality aspect in this region
Intensity modulated radiotherapy versus volumetric modulated arc therapy in breast cancer: A comparative dosimetric analysis
Get PDFPurpose: Intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) has the capacity to optimize the dose distribution. We analyzed the dosimetric differences of plans in treatment planning system (TPS) between VMAT and IMRT in treating breast cancer. Methods: Fourteen patients were simulated, planned, and treated with VMAT using single, double or partial arcs. IMRT treatments were generated using 4 to 5 tangential IMRT fields for the same patients. All treatment plans were planned for 50 Gy in 25 fractions. The VMAT and IMRT plans were compared using the planning target volume (PTV) dose and doses to the other organs at risk (OARs). Results: For the PTV, comparable minimum, mean, maximum, median, and modal dose as well equivalent sphere diameter of the structure (Equis) were observed between VMAT and IMRT plans and found that these values were significantly equal in both techniques. The right lung mean and modal doses were considerably higher in VMAT plans while maximum value was considerably lower when compared with IMRT plans. The left lung mean and modal doses were higher with VMAT while maximum doses were higher in IMRT plans. The mean dose to the heart and maximum dose to the spinal cord was lower with IMRT. The mean dose to the body was higher in VMAT plans while the maximum dose was higher in IMRT plans. Conclusion: Four field tangential IMRT delivered comparable PTV dose with generally less dose to normal tissues in our breast cancer treatment study. The IMRT plans typically had more favourable dose characteristics to the lung, heart, and spinal cord and body dose when compared with VMAT. The only minor advantage of VMAT for breast cases was slightly better PTV coverage
The use of TiNi-based endografts in larynx cancer patients
No full textPurpose: Laryngeal cancer constitutes 26-30% of all head and neck malignant tumors. It is remarkably common in men and it is primarily distributed between ages 40 and 70 years old, but the frequency rate is the highest between ages 50 and 60. Well-known etiologic factors of laryngeal cancer include smoking, alcohol, human papilloma virus and radiation. It has been reported that the occurrence rate is up to 20 times higher in smokers compared to non-smokers, but the exact pathogenesis of the disease is still unknown.Despite an increasing role of non-adjuvant radiotherapy and/or chemotherapy in treatment of larynx cancer, the surgical technique is still a basic one both in combined treatment of patients with locally advanced stages of primary larynx cancer and in the cases when recurrence is treated after radiotherapy or chemoradiotherapy. Leading position in the combined treatment of locally advanced carcinoma of the larynx belongs to surgical treatment. Published reports of salvage treatment for larynx reconstruction after partial laryngectomy are available, some of them using structures of the larynx itself, but few aimed on a search of new materials and techniques for sparing laryngeal surgery.Possibility to perform a sparing surgery depends on several factors, including, the possibility of adequate laryngeal replacement after an extensive resection. Meanwhile, surgery improvement goes along with differentiated choice of an adequate degree of surgical intervention. However, the functional results of such surgeries do not always satisfy both patients and professionals, if we consider that large fragments of the organ have to be resected in locally advanced larynx cancers.The larynx reconstruction is a complex goal, it can be explained by several factors. First of all, this is topographic and anatomical feature of the larynx since it is located next to the digestive tract. Fixation and immobilization of the larynx is hard to perform as it is a mobile organ when swallowing, speaking etc. Secondly, there are no commercially produced endografts for wide clinical practice. Thirdly, there are high demands regarding the material selection for the replacement. This study aimed to present the new technique of sparing surgery in patients with laryngeal cancer.Methods: Totally 120 patients with laryngeal cancer were observed with stage grouping T2-3N0-1M0 (Т1N0M0 – 14, Т2N0M0 – 40, T3N0M0 – 58, T2N1M0 – 8). Most of them (118, 98.3%) were males where patients’ age ranged from 32 to 70 years (Tab. 1). The maximum number of patients (78%) was in 40–60 years group. Not all of those in the laryngeal cancer group were newly diagnosed and they received previous treatment. Informed consent was obtained from each patient. The subsites of laryngeal cancer were the glottis in 17 cases, the supraglottic-glottis in 45 cases and the transglottic in 58 cases.The intervention depended on the location and extent of the tumor process. Standard volume of resection, extended resection, combined resection, subtotal resection were basic types of surgery. Most of laryngeal resections were front-lateral (117, 98%) and there were only three (2%) subtotal ones. Surgeries on the primary focus were combined with cervical lymph node dissection in eight patients (6.6%). The essence of the resection is to remove larynx structures which are affected by neoplastic process as a single unit including mucosa, submucosa layer, muscles, thyroid cartilage with the inner perichondrium into the volume of cut out tissue.Both the creation of laryngeal frame using the endograft made of superelastic TiNi-based alloy mesh and the providing of the inner lining of the recovered larynx is the basis of sparing technique regarding the larynx prosthetics.Producing of original design endograft made of superelastic TiNi-based alloy mesh was performed individually for each patient using the data acquired by helical CT of the larynx, laryngoscopy and volume of upcoming surgery. The endograft is a framework made of two twisted superelastic TiNi-based wires (TN-10 brand alloy) having 0.4 mm dia provided by Kang&Park Medical Co. (S. Korea). It is further covered with superelastic TiNi-based alloy mesh. The mesh is constructed of knitted filaments made of the same TN-10 brand alloy wire, which stress-strain behavior is identical to human body tissues. This mesh is thin, flexible and laminate designed for the repair of hernias, ruptured tendons, and other fascial deficiencies. This material, when used in vivo, has been reported to be non-reactive and to retain its properties indefinitely in wide clinical use. The mesh 0.1-0.15 mm thick is knitted by a process which interlinks each fiber junction and provides for superelasticity in any direction. Such design enables the mesh to be cut off into any desired shape or size without unraveling. The fiber junctions are not subject to the same work fatigue showing by more rigid polypropylene or metal-based meshes. This any-directional superelastic property allows the mesh to be easily adapted to various stresses appeared in the human body. The mesh mentioned has been also commercially produced by Kang&Park Medical Co. (S. Korea).This endograft design shows the superelastic behavior (at the time of physiological movements of the larynx during swallowing, breath and speech) recovering the shape of frame. The endograft described is radio-opacifying, unlike other endografts e.g. polymer-based endografts. This property makes it possible to control the position over time.We used local muscle tissues (platysma) or muscle-flap prefabrication technique (flap of the rectus abdominis) for formation of the inner lining. 15 patients with laryngeal cancer (stage Т2-3N0M0) have been treated by using the technique.All patients underwent different types of sparing surgeries (front-lateral laryngectomy – 3 cases, frontal laryngectomy – 6 cases, subtotal laryngectomy – 6 cases) with simultaneous replacement with the endograft described. These surgeries were performed in 5 patients (Т2N0M0 - 2 and Т3N0M0 - 3 cases) in terms of combined treatment (with preoperative radiotherapy dose 40 Gy). 10 patients (rT2N0M0 – 3 and rT3N0M0 - 7 cases) had recurrent laryngeal cancer after radical radiotherapy. In 9 cases we used the platysma flap and in 6 cases we did muscle-flap prefabrication technique (flap of the rectus abdominis) with inclusion of the endograft for formation of the inner lining of the larynx wall. Muscle-flap prefabrication technique consists of an implantation of pre-created superelastic TiNi mesh into the rectus abdominis muscle. When the time of prefabrication (about 3–4 weeks) was over we performed reconstructive surgery using this prepared muscle flap with inclusion of the endograft. Such autograft was included in the blood flow by means of microvascular anastomosis applied between the recipient and donor vessels (as a rule - superior thyroid artery and vein).Results: Analyzing sparing operations using endografts described we achieved the following functional results. Voice function was completely saved in 112 (93.3%) cases and partially in 8 ones (6.7%). Respiratory function was fully restored in 106 (88.3%) patients, in 14 cases (11.7%) the cannula was not taken out from patients due to scar changes. The protective function of the larynx was saved in 116 (96.6%) patients. There was a temporary partial impairment of larynx protective function in four patients (3.4%).Monitoring of the reconstructed larynx was traditionally based on laryngeal endoscopy, spiral CT study and scintigraphy. Laryngoscopy in 14 days after the operation showed the endograft coated with fibrin plaque with isolated islets of pink granulation tissue "approaching" from the periphery. Almost the entire surface of the endograft was coated with an even layer of tender granulation tissue in 30 days after the surgery. Mucous membrane on endograft edges is bright pink and shiny without signs of inflammation. In 3 months after the surgery - glottic chink lumen was not deformed, it was free, and endograft surface was covered with a tender pale pink mucous membrane. Entire endograft was coated with thin even layer. Morphological study of mucosa fragments taken from the surface of endografts in 12 months after surgery revealed the following: layered non-squamous flat epithelium with proper stratification; poorly expressed hyperplasia of basal cells. Such condition of epithelium proves complete reparative regeneration of mucosa without any signs of pathology. Impairment of epithelial differentiation was not detected in any site of mucosa studied.Analysis of complications allowed to define that aftereffects as local inflammatory reactions nearby prosthetics region (perichondritis of larynx cartilages, mucosal edema of the larynx) were observed in 16 cases (13.3%) in postoperative period. These complications required additional medical treatment (antibiotics, photoradiotherapy, etc.). In particular, laryngectomy was performed in one case due to intractable laryngeal chondroperichondritis, severe pain and persistent impairment of swallowing function. In our study, laryngectomy was performed in 14 cases (11.7%) due to the continued growth of tumor during the first year after surgery according to the technique offered. Three (2.5%) patients died because of cancer progression. The 5-year and overall recurrence-free survival rates of all 120 patients were 83% and 76%, respectively.Evaluation of results when we used sparing surgery applying modified approaches and endografts has shown that there was an exact match of endograft topology and larynx defects appeared. Helical computed tomography of the larynx has proven the correct state of the endograft and no migration in all the cases.Conclusion: The developed sparing surgical treatment using TiNi-based endografts has shown the efficiency of laryngeal reconstruction in adverse conditions (trophic-inflammatory changes of the larynx after radiotherapy). Given the nature of techniques and postoperative course, we have formulated our indications for each method of reconstruction.Using the flap of the platysma is more preferable in small reconstructions (after anterolateral laryngectomy). This method has the advantage of simplicity and one-stage reconstruction. Prefabrication method allows to get a prototype of the layerwise wall of the laryngeal cavity having the mucosal lining and vascular continuity. This method is preferable in reconstructing the large defect (subtotal laryngectomy) in patients with severe post-radiation changes in the larynx and the neck, as well as in case of postpone reconstruction.The offered method of sparing treatment was finally turned out to be economically justified regarding treatment cost minimization. The results of functional rehabilitation of patients after surgical treatment using TiNi-based endografts permit to show preference for such surgery despite the fact that cannula was not taken out from a certain number of patients and there was a continued growth of tumor and recurrence. Compliance with the paradigm of malignant tumor metastasis and ablastics enables to hope that the number of complications will be reduced. Endografts made of TiNi-based mesh can adequately restore the frame function of the larynx, without postoperative aggravation. Both the local and displaced (prefabrication technique) tissues can be used in reconstruction of the inner lining of the larynx. Careful selection of patients, indications and replacement technique is necessary for such sparing surgery to be performed.-----------------------------------------Cite this article as: Denis K, Marat M, Timofey C, Ji-Hoon K, Georgiy C, Valentina H, Victor G. The use of TiNi-based endografts in larynx cancer patients. Int J Cancer Ther Oncol 2015; 3(4):3404.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.
Dose variation due to change in planned position for patients with carcinoma of the cervix undergoing high-dose-rate brachytherapy- 2D dose analysis
Get PDFPurpose: To assess the dosimetry to organs at risk (OARs) in lithotomy position with a planned time-dose pattern obtained from supine position. Methods: The sample consists of thirty patients with carcinoma of the uterine cervix, Stage II and III. Patients often feel discomfort in supine position (S position) when compared to lithotomy position (M position) due to relaxation of pelvic floor muscles after the insertion of applicator (tandem and ovoids) or before delivery of the treatment. Each patient was imaged with orthogonal X- ray radiographs simultaneously in two positions, i.e. S position and M position. Dwell time and dwell position pattern obtained from the optimized plan in S position was used to generate plan in M position. Following dose reference points (point A, pelvic wall points, bladder points, rectal, anorectum (AR point) and rectosigmoid (RS point) points) were identified for analysis in S and M positions. The dosimetric data for reference points generated by the Brachyvision TPS was analyzed.Results: Pelvic wall points registered lower doses in M position when compared to S position. Mean doses for right pelvic wall point (RPW) and left pelvic wall point (LPW) were reduced by -10.02 % and -11.5% in M position, respectively. International Commission on Radiation Units and Measurements (ICRU) bladder point also registered lower doses in M position with a mean dose of -6.8%. Rectal point showed dose reduction by mean of -6.4%. AR and RS points showed an increased dose in M position by a mean of 16.5% and 10%, respectively. Conclusion: Current dosimetry procedure serves as a model with time-dose pattern planned for S position, but delivered in M position, without dose optimization. Prioritization of comfort and position can be considered in conjunction with optimization of dose.
Solitary pulmonary metastasis of pancreatic cancer presenting a thin-walled cavity
Get PDFBecause the prognosis of the patients with pancreatic cancer is very poor, there are few opportunities to perform surgery for pulmonary metastasis. Here we report the resection of a solitary pulmonary metastasis from pancreatic cancer, appearing as thin-walled cavity, which appeared 5 years after pancreaticoduodenectomy. Although the present patient underwent incomplete resection because of malignant pleural effusion and pleural dissemination, he is currently still alive without evident recurrence at 18 months after surgery
Co-expression of CXCR4 and CD133 in gastric neoplastic tissue and their correlation with clinicopathological factors and prognosis in gastric cancer
Get PDFPurpose: Worldwide Gastric carcinoma considered as the second most common cause of cancer related death. Cancer stem cell plays significant role in prognosis and invasion of gastric cancer. CXCR4 is a chemokine receptor and plays an important role in self renewal, differentiation potential, and cell adhesion of cancer stem cell (CSC). On the other hand CD133 is a cell surface glycoprotein and could serve as a prognostic indicator for tumor re-growth, malignant progression, and patient survival. The aim of this study was to establish the expression pattern of CXCR4 and CD133 in gastric cancer tissues; and their correlation with clinicopathological factors like age and gender of patients, position, size and depth of tumor, lymphatic invasion and node metastasis.Methods: Expression of CXCR4 and CD133 proteins were assessed by immunohistochemical and immunofluorescence staining of paraffin–embedded tissues, and followed by RT-PCR in 90 tumors (observed group) and 30 normal gastric samples. The clinical pathological data was statistically analyzed by chi-square methods. Results: The positive rate of CXCR4 and CD133 expression in the observed group was 94.44 (85/90) and 95.55 (86/90) respectively. The expression of CXCR4 and CD133 were correlated with age and gender of patients, and position, size, & depth of the tumor, lymphatic invasion and node metastasis (p < 0.05). While CXCR4 was positive, CD133 had a positive rate of 92.22% but the positive rate was 2.22% when CXCR4 expression was negative (χ2 = 58.657; p < 0.001). Conclusion: Overall this data suggests that increased expression of CXCR4 and CD133 might be attributed with disease progression and malignant transformation of gastric epithelium cells. A significant correlation was found in between CXCR4 and CD133 expression and their co-expression may play significant role in invasiveness of gastric cancer
The AMPK-related Kinase HUNK: Potential Target for HER2-positive Breast Cancer
No full textPurpose: Approximately 25% of breast cancer patients are diagnosed with HER2-positive breast cancers. Although several targeted inhibitors to HER2 are approved for use in breast cancer, many patients either fail therapy or eventually become resistant to HER2 inhibitors. Therefore, understanding the molecular mechanisms that allow breast cancer cells to overcome treatment and become resistance is of critical importance.Methods: We have characterized an AMPK-related protein kinase called Hormonally Upregulated Neu-associated Kinase (HUNK) as a potential target for primary HER2-positive breast cancer using breast cancer cell and HER2/neu-induced mouse mammary tumor models. We have also investigated whether inhibiting HUNK impairs in vivo tumor growth that is initiated by primary (HER2 inhibitor sensitive) and HER2 inhibitor resistant breast cancer cells.Results: We found that HUNK supports the survival of primary HER2/neu-positive breast and mammary tumor cells as well as that of HER2 inhibitor resistant breast cancer cells. Therefore, targeting HUNK in primary HER2-positive breast cancers as well as those that are resistant to the HER2 inhibitor trastuzumab, inhibits tumorigenesis.Conclusions: We conclude from our findings that targeting HUNK is a potential therapeutic strategy for primary and resistant HER2-positive breast cancers.-----------------------------------------Cite this article as: Yeh ES, Hill EG. The AMPK-related Kinase HUNK: Potential Target for HER2-positive Breast Cancer. Int J Cancer Ther Oncol 2015; 3(4):3406.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.
Transition from Hospital to Community Care: The Experience of Cancer Patients
No full textPurpose: This study examines care transition experiences of cancer patients and assesses barriers to effective transitions.Methods: Participants were adult Hebrew, Arabic, or Russian speaking oncology patients and health care providers from hospital and community settings. Qualitative (n=77) and quantitative (n=422) methods such as focus groups, interviews and self-administered questionnaires were used. Qualitative analysis showed that patients faced difficulties navigating a complex and fragmented healthcare system.Results: Mechanisms to overcome barriers included informal routes such as personal relationships, coordinating roles by nurse coordinators and the patients' general practitioners (GPs). The most significant variable was GPs involvement, which affected transition process quality as rated on the CTM (p<0.001). Our findings point to the important interpersonal role of oncology nurses to coordinate and facilitate the care transition process.Conclusion: Interventions targeted towards supporting the care transition process should emphasize ongoing counseling throughout a patient’s care, during and after hospitalization.-----------------------------------------Cite this article as: Admi H, Muller E, Shadmi E. Transition from Hospital to Community Care: The Experience of Cancer Patients. Int J Cancer Ther Oncol 2015; 3(4):34011.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.
Antineoplastic mechanisms of Iodine in cancers that take up Iodine
No full textPurpose: In addition to being a component of thyroid hormone (TH), iodine can be an antioxidant as well as an antiproliferative and differentiation agent that helps to maintain the integrity of several organs with the ability to take up iodine.Methods and Results: Studies from our laboratory shown that in preclinical (cell culture, induced animal cancer and xenographs) and clinical studies (mammary cancer protocol), molecular iodine (I2) supplementation exerts suppressive effects on implantation, development, and progression of cancer neoplasias. These effects can be mediated by a variety of mechanisms and pathways, including direct actions, in which the oxidized iodine modulates the immune/tumor response and through iodolipid formation and the activation of peroxisome proliferator-activated receptors type gamma (PPARγ) triggering apoptotic and/or differentiation pathways.Conclusion: The absence of side effects and the easy availability and handling of I2 have allowed the establishment of clinical protocols to utilize I2 supplementation as an adjuvant in therapies against cancers that take up iodine.-----------------------------------------Cite this article as: Aceves C, Anguiano B. Antineoplastic mechanisms of Iodine in cancers that take up Iodine. Int J Cancer Ther Oncol 2015; 3(4):3401.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.
‘Inverted Y’ field radiotherapy planning with multi-leaf collimator: A single isocentric technique using multiple fields
Get PDFThe purpose of our study is to describe a planning technique using multi-leaf collimator and asymmetric fields for irradiating an ‘inverted Y’ shaped geometry in a patient with testicular seminoma. The entire target area covering the para-aortic, pelvic, and inguinal nodal regions was split into three fields. Single isocenter half-beam block technique was employed. The fields were planned with antero-posterior and postero-anterior portals with a differential weightage. The dose was prescribed at the respective reference points of the fields. A uniform dose distribution for the entire portal was achieved without any under- or over-dosing at the field junctions.