Pub Date : 2024-05-30eCollection Date: 2024-01-01DOI: 10.3332/ecancer.2024.1706
Angelo Borsarelli Carvalho Brito, Tiago Cordeiro Felismino, Diego Rodrigues Mendonca E Silva, Maria Paula Curado, Lais Corsino Durant, Rodrigo Gomes Taboada, Adriane Graicer Pelosof, Alessandro Landskron Diniz, Felipe Jose Fernandez Coimbra
Background: Gastric cancer (GC) is the fourth leading cause of cancer deaths globally. There is a paucity of real-life data on GC in Brazil. Our study aimed to evaluate survival trends in gastric adenocarcinoma (GA) in a large cancer center in Brazil during 2000-2017.
Methods: Based on our Hospital Cancer Registry Database, all individuals diagnosed with GA between 2000 and 2017, and treated at A.C. Camargo Cancer Center, were retrospectively included. The primary objectives were to describe the patient demographics, clinicopathological characteristics, treatment modalities and survival trends during four separate periods of diagnosis (2000-2004; 2005-2009; 2010-2014 and 2015-2017). χ2 test was performed between two specified periods (2000-2004 and 2015-2017) to compare categorical variables. Overall survival (OS) curves were stratified by four separate periods and compared with log-rank tests.
Results: This analysis included 1,406 individuals. Across all periods, most patients were men aged 50-69 and presented with Lauren's intestinal subtype. The frequency of stage IV disease significantly decreased between 2000-2004 and 2015-2017 (43.6% to 32.8%, p < 0.001). In contrast, we observed a rise in stage II (9.4% to 24.8%, p < 0.001) in the same comparison. We noticed an increased utilization of a combined approach involving chemotherapy and surgery (12% in 2000-2004 and 36.3% in 2015-2017, p < 0.001). The predicted 5-year OS of patients with GA in 2000-2004 was 27.8%, which increased to 53.9% in 2015-2017 (p < 0.001).
Conclusion: Our retrospective cohort showed an upward trend in survival rates during the period. We observed that 5-year OS almost doubled among men and women during 2000-2017.
Mini abstract: The present retrospective cohort showed an upward trend in survival rates during the period from 2000 to 2017, in which the OS almost doubled among men and women.
{"title":"Survival trends in gastric cancer in Brazil: real-life data from a large cancer center.","authors":"Angelo Borsarelli Carvalho Brito, Tiago Cordeiro Felismino, Diego Rodrigues Mendonca E Silva, Maria Paula Curado, Lais Corsino Durant, Rodrigo Gomes Taboada, Adriane Graicer Pelosof, Alessandro Landskron Diniz, Felipe Jose Fernandez Coimbra","doi":"10.3332/ecancer.2024.1706","DOIUrl":"10.3332/ecancer.2024.1706","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) is the fourth leading cause of cancer deaths globally. There is a paucity of real-life data on GC in Brazil. Our study aimed to evaluate survival trends in gastric adenocarcinoma (GA) in a large cancer center in Brazil during 2000-2017.</p><p><strong>Methods: </strong>Based on our Hospital Cancer Registry Database, all individuals diagnosed with GA between 2000 and 2017, and treated at A.C. Camargo Cancer Center, were retrospectively included. The primary objectives were to describe the patient demographics, clinicopathological characteristics, treatment modalities and survival trends during four separate periods of diagnosis (2000-2004; 2005-2009; 2010-2014 and 2015-2017). <i>χ</i>2 test was performed between two specified periods (2000-2004 and 2015-2017) to compare categorical variables. Overall survival (OS) curves were stratified by four separate periods and compared with log-rank tests.</p><p><strong>Results: </strong>This analysis included 1,406 individuals. Across all periods, most patients were men aged 50-69 and presented with Lauren's intestinal subtype. The frequency of stage IV disease significantly decreased between 2000-2004 and 2015-2017 (43.6% to 32.8%, <i>p</i> < 0.001). In contrast, we observed a rise in stage II (9.4% to 24.8%, <i>p</i> < 0.001) in the same comparison. We noticed an increased utilization of a combined approach involving chemotherapy and surgery (12% in 2000-2004 and 36.3% in 2015-2017, <i>p</i> < 0.001). The predicted 5-year OS of patients with GA in 2000-2004 was 27.8%, which increased to 53.9% in 2015-2017 (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Our retrospective cohort showed an upward trend in survival rates during the period. We observed that 5-year OS almost doubled among men and women during 2000-2017.</p><p><strong>Mini abstract: </strong>The present retrospective cohort showed an upward trend in survival rates during the period from 2000 to 2017, in which the OS almost doubled among men and women.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-21DOI: 10.3332/ecancer.2024.1705
Tasneem Dawood, Yasmin Abdul Rashid, S. R. Khan, Adnan Abdul Jabbar, M. Zahir, M. Moosajee
Background and aim: Docetaxel, oxaliplatin, leucovorin and 5-fluorouracil (FLOT) may improve overall survival (OS) in patients with locally advanced gastric and gastroesophageal cancer. Our study aims to determine the pathological response in these patients with the FLOT chemotherapy in the Neoadjuvant setting. This is the first study conducted in our country. Methods: We conducted a retrospective cross-sectional study from March 2018 to December 2020. After ethical review committee approval, all patients who fulfilled the inclusion criteria and received treatment at our tertiary care center were included in the study. SPSS version 22 was used for data analysis. Frequencies and percentages were calculated for categorical. Values were presented as mean ± standard deviation (SD) for continuous variables. The chi-square test was used to determine the difference between categorical variables. A p -value of ≤0.05 was considered the level of significance. Kaplan-Meier curves were used to calculate survival analysis. Results: Out of 41, 35 patients with locally advanced resectable gastric or gastroesophageal adenocarcinoma were included in our study analysis. The entire cohort had a male predominance, with a mean age of 59. All patients received neoadjuvant FLOT. Pathological treatment response achieved was 77%, of which 66% had partial and 11% had complete response. There is a significant association of pathological response with age, gender, stage, grade, co-morbid and number of chemotherapy cycles received ( p -value =<0.05). The OS was 80% with the mean OS was 2.6 years (31 months). Conclusion: Our study shows comparable response rates to other studies conducted internationally. Our findings confirm that FLOT is an effective and well-tolerated peri-operative regimen with reasonable response rates in the Pakistani population. A more extensive longitudinal study would ensure these preliminary results in the local patient population.
{"title":"Outcomes of locally advanced gastric and gastroesophageal adenocarcinoma cancers treated with neoadjuvant FLOT in a tertiary care hospital in Pakistan","authors":"Tasneem Dawood, Yasmin Abdul Rashid, S. R. Khan, Adnan Abdul Jabbar, M. Zahir, M. Moosajee","doi":"10.3332/ecancer.2024.1705","DOIUrl":"https://doi.org/10.3332/ecancer.2024.1705","url":null,"abstract":"Background and aim: Docetaxel, oxaliplatin, leucovorin and 5-fluorouracil (FLOT) may improve overall survival (OS) in patients with locally advanced gastric and gastroesophageal cancer. Our study aims to determine the pathological response in these patients with the FLOT chemotherapy in the Neoadjuvant setting. This is the first study conducted in our country. Methods: We conducted a retrospective cross-sectional study from March 2018 to December 2020. After ethical review committee approval, all patients who fulfilled the inclusion criteria and received treatment at our tertiary care center were included in the study. SPSS version 22 was used for data analysis. Frequencies and percentages were calculated for categorical. Values were presented as mean ± standard deviation (SD) for continuous variables. The chi-square test was used to determine the difference between categorical variables. A p -value of ≤0.05 was considered the level of significance. Kaplan-Meier curves were used to calculate survival analysis. Results: Out of 41, 35 patients with locally advanced resectable gastric or gastroesophageal adenocarcinoma were included in our study analysis. The entire cohort had a male predominance, with a mean age of 59. All patients received neoadjuvant FLOT. Pathological treatment response achieved was 77%, of which 66% had partial and 11% had complete response. There is a significant association of pathological response with age, gender, stage, grade, co-morbid and number of chemotherapy cycles received ( p -value =<0.05). The OS was 80% with the mean OS was 2.6 years (31 months). Conclusion: Our study shows comparable response rates to other studies conducted internationally. Our findings confirm that FLOT is an effective and well-tolerated peri-operative regimen with reasonable response rates in the Pakistani population. A more extensive longitudinal study would ensure these preliminary results in the local patient population.","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141116575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-21DOI: 10.3332/ecancer.2024.1704
Ahmed Balla M Ahmed, Salma S. Alrawa, Ahmed A Yeddi, Esraa S A Alfadul, Hind Mohi Aldin Abd Allah, Muhannad Bushra Masaad Ahmed
Background: Breast cancer (BC) is prevalent in Sudan, yet data on its epidemiology in Eastern Sudan is limited. This study aims to provide insights into the demographic and clinicopathologic features of BC patients treated at the East Oncology Centre (EOC) in Gadarif State, Eastern Sudan. Furthermore, we aim to identify the factors that contribute to a late-stage diagnosis. Methods: This cross-sectional study included patients diagnosed with BC and treated in the EOC between 2016 and 2022. Data obtained from medical records were analysed using R software, with descriptive statistics and multiple logistic regressions applied to determine determinants of advanced-stage presentation. A p -value < 0.05 was considered statistically significant. Results: Among the 394 patients studied, the majority were women (96%), married (66%) and from rural areas (43%). The peak years for BC diagnoses were 2018 and 2022, with a median age at diagnosis of 48 years. A family history of cancer was reported by 20% of patients. Clinical stages were distributed as follows: I (1.6%), II (17%), III (50%) and IV (32%). Twenty-five percent tested positive for human epidermal growth factor receptor 2, while 73% tested negative and 43% had triple-negative BC. Modified radical mastectomy was performed in 47% of patients, with 21% undergoing breast-conserving surgery. Treatment rates were 38% for radiotherapy, 84% for chemotherapy and 46% for hormonal therapy. Higher grade BC and lower education levels were associated with advanced-stage presentation, while a family history of cancer reduced the risk of advanced-stage disease (OR: 0.38, 95% CI: 0.18–0.78). Conclusion: The study found that females in East Sudan often present at a young age and advanced stage, with a significant prevalence of triple-negative BC. Notably, family cancer history exhibited a protective effect against advanced-stage presentation, while grade 3 cancer was positively associated with advanced disease.
背景：乳腺癌（BC）在苏丹很普遍，但有关其在苏丹东部流行病学的数据却很有限。本研究旨在深入了解在苏丹东部加达里夫州东部肿瘤中心（EOC）接受治疗的乳腺癌患者的人口统计学和临床病理学特征。此外，我们还旨在确定导致晚期诊断的因素。研究方法这项横断面研究包括 2016 年至 2022 年期间在 EOC 诊断并接受治疗的 BC 患者。我们使用 R 软件分析了从病历中获取的数据，并应用描述性统计和多元逻辑回归确定晚期诊断的决定因素。P值小于0.05被认为具有统计学意义。研究结果在研究的 394 名患者中，大多数为女性（96%）、已婚（66%）和来自农村地区（43%）。确诊 BC 的高峰年份为 2018 年和 2022 年，确诊年龄中位数为 48 岁。20%的患者有癌症家族史。临床分期分布如下：I期（1.6%）、II期（17%）、III期（50%）和IV期（32%）。25%的患者人表皮生长因子受体2检测呈阳性，73%呈阴性，43%为三阴性BC。47%的患者接受了改良根治性乳房切除术，21%的患者接受了保乳手术。放疗率为38%，化疗率为84%，激素治疗率为46%。乳腺癌等级越高、受教育程度越低与晚期发病率越高有关，而癌症家族史会降低晚期发病风险（OR：0.38，95% CI：0.18-0.78）。结论研究发现，苏丹东部的女性通常发病年龄较轻且处于晚期，三阴性 BC 的发病率较高。值得注意的是，家族癌症史对晚期发病有保护作用，而三级癌症与晚期发病呈正相关。
{"title":"Breast cancer burden in eastern Sudan: seven-year retrospective study","authors":"Ahmed Balla M Ahmed, Salma S. Alrawa, Ahmed A Yeddi, Esraa S A Alfadul, Hind Mohi Aldin Abd Allah, Muhannad Bushra Masaad Ahmed","doi":"10.3332/ecancer.2024.1704","DOIUrl":"https://doi.org/10.3332/ecancer.2024.1704","url":null,"abstract":"Background: Breast cancer (BC) is prevalent in Sudan, yet data on its epidemiology in Eastern Sudan is limited. This study aims to provide insights into the demographic and clinicopathologic features of BC patients treated at the East Oncology Centre (EOC) in Gadarif State, Eastern Sudan. Furthermore, we aim to identify the factors that contribute to a late-stage diagnosis. Methods: This cross-sectional study included patients diagnosed with BC and treated in the EOC between 2016 and 2022. Data obtained from medical records were analysed using R software, with descriptive statistics and multiple logistic regressions applied to determine determinants of advanced-stage presentation. A p -value < 0.05 was considered statistically significant. Results: Among the 394 patients studied, the majority were women (96%), married (66%) and from rural areas (43%). The peak years for BC diagnoses were 2018 and 2022, with a median age at diagnosis of 48 years. A family history of cancer was reported by 20% of patients. Clinical stages were distributed as follows: I (1.6%), II (17%), III (50%) and IV (32%). Twenty-five percent tested positive for human epidermal growth factor receptor 2, while 73% tested negative and 43% had triple-negative BC. Modified radical mastectomy was performed in 47% of patients, with 21% undergoing breast-conserving surgery. Treatment rates were 38% for radiotherapy, 84% for chemotherapy and 46% for hormonal therapy. Higher grade BC and lower education levels were associated with advanced-stage presentation, while a family history of cancer reduced the risk of advanced-stage disease (OR: 0.38, 95% CI: 0.18–0.78). Conclusion: The study found that females in East Sudan often present at a young age and advanced stage, with a significant prevalence of triple-negative BC. Notably, family cancer history exhibited a protective effect against advanced-stage presentation, while grade 3 cancer was positively associated with advanced disease.","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141116458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.3332/ecancer.2024.1703
Summera Fatima, Asia Bibi, Sara Samad Qureshi, Suman Khan
{"title":"Analysis of mutational variations in TP53 tumour suppressor gene among Pakistani head and neck cancer patients","authors":"Summera Fatima, Asia Bibi, Sara Samad Qureshi, Suman Khan","doi":"10.3332/ecancer.2024.1703","DOIUrl":"https://doi.org/10.3332/ecancer.2024.1703","url":null,"abstract":"","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140970344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.3332/ecancer.2024.1701
Ricardo Ubilla, Michelle Zeppelin, Fernanda Martin
Background: Multilocus inherited neoplasia allelic syndrome (MINAS) is a recently coined term that describes the coexistence of two or more pathogenic variants (PVs) in cancer susceptibility genes (CSGs) in a single individual. Case presentation: This article presents two cases of MINAS due to rare CSG combinations. The first was a 37-year-old woman carrying PVs in the mutated ataxia telangiec-tasia ( ATM ) and CHEK2 genes, with HER-2 positive unilateral breast cancer at 29. The second was a 53-year-old woman carrying PVs in the BRCA1 and CDKN2A genes, who presented with triple-negative breast cancer at 51. We describe their family history and treatment, where the lack of evidence for personalised management becomes evident. Conclusion: Predicting the phenotypic effect of harbouring two variants in CSG is challenging. It is essential to encourage the notification of other cases and carry out functional studies to establish specific risks for affected individuals to develop personalised follow-up guidelines to reduce the associated morbimortality.
{"title":"Multilocus inherited neoplasia allele syndrome: report of uncommon combinations between CHEK2/ATM and BRCA1/CDKN2A genes","authors":"Ricardo Ubilla, Michelle Zeppelin, Fernanda Martin","doi":"10.3332/ecancer.2024.1701","DOIUrl":"https://doi.org/10.3332/ecancer.2024.1701","url":null,"abstract":"Background: Multilocus inherited neoplasia allelic syndrome (MINAS) is a recently coined term that describes the coexistence of two or more pathogenic variants (PVs) in cancer susceptibility genes (CSGs) in a single individual. Case presentation: This article presents two cases of MINAS due to rare CSG combinations. The first was a 37-year-old woman carrying PVs in the mutated ataxia telangiec-tasia ( ATM ) and CHEK2 genes, with HER-2 positive unilateral breast cancer at 29. The second was a 53-year-old woman carrying PVs in the BRCA1 and CDKN2A genes, who presented with triple-negative breast cancer at 51. We describe their family history and treatment, where the lack of evidence for personalised management becomes evident. Conclusion: Predicting the phenotypic effect of harbouring two variants in CSG is challenging. It is essential to encourage the notification of other cases and carry out functional studies to establish specific risks for affected individuals to develop personalised follow-up guidelines to reduce the associated morbimortality.","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Discordant lymphoma (DL) is an uncommon condition in which two or more histologically different types of lymphomas are present at distinct anatomical sites in the same patient. Here, we report a case of a pediatric patient under 10 years old presenting with symptoms of general sickness with cervical lymphadenopathy, abdominal distension and an abdominal mass. Upon conducting investigations, classic Hodgkin lymphoma (CHL) was detected in the cervical lymph nodes, and high-grade B-cell non-Hodgkin lymphoma was detected in the bone marrow and abdominal mass. The patient was therefore diagnosed with DL. The boy was initially diagnosed with CHL but proceeded to have aggressive disease progression, due to which further workup was done. In the past, literature reports have been published for adult cases of DL, and currently, research is being conducted to formulate treatment protocols for it. However pediatric cases of DL remain widely undis-cussed. Since we are dealing with a rare or widely underreported condition, we found it significant to elaborate on its clinical presentation, treatment plan, complications and prognosis.
{"title":"Pediatric discordant lymphoma with classic Hodgkin lymphoma in cervical lymph nodes and high-grade B-cell non-Hodgkin lymphoma in bone marrow: a case report from Pakistan","authors":"Namrita Rai, Zeenat Amna Azhar, Neelum Tahir Kheli, Fozia Lateef, Omer Javed, Muhammad Rafie Raza","doi":"10.3332/ecancer.2024.1702","DOIUrl":"https://doi.org/10.3332/ecancer.2024.1702","url":null,"abstract":"Discordant lymphoma (DL) is an uncommon condition in which two or more histologically different types of lymphomas are present at distinct anatomical sites in the same patient. Here, we report a case of a pediatric patient under 10 years old presenting with symptoms of general sickness with cervical lymphadenopathy, abdominal distension and an abdominal mass. Upon conducting investigations, classic Hodgkin lymphoma (CHL) was detected in the cervical lymph nodes, and high-grade B-cell non-Hodgkin lymphoma was detected in the bone marrow and abdominal mass. The patient was therefore diagnosed with DL. The boy was initially diagnosed with CHL but proceeded to have aggressive disease progression, due to which further workup was done. In the past, literature reports have been published for adult cases of DL, and currently, research is being conducted to formulate treatment protocols for it. However pediatric cases of DL remain widely undis-cussed. Since we are dealing with a rare or widely underreported condition, we found it significant to elaborate on its clinical presentation, treatment plan, complications and prognosis.","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140990504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Craniospinal irradiation (CSI) poses a challenging planning process because of the complex target volume. Traditional 3D conformal CSI does not spare any critical organs, resulting in toxicity in patients. Here the dosimetric advantages of volumetric-modulated arc therapy (VMAT) using partial arc and avoidance sectors are compared with each other in planning in adult patients undergoing CSI to develop a clinically feasible technique that is both effective and efficient. Patient and methods: Eight adult patients treated with CSI were retrospectively identified. In total 16 plans were made. We generated two plans for each patient: 1. VMAT plan using partial arc, namely VMAT_pa. 2. VMAT plan using avoidance sectors, namely VMAT_as. The dose prescribed was 36 Gy in 20 fractions. The dose-volume histogram for planning target volume (PTV) and organs at risk (OAR) (lens, eye, heart, thyroid, lungs, liver, gonads and kidneys) were analysed and compared. Dose parameters of mean dose, V 95% , and V 107% for the PTV were evaluated. Results: The median length of PTV is 65.58 cm (45.8–79.5). The volume of PTV receiving 95% of the dose (V95%) in both the plans are 97.51% (VMAT_as) and 97.99% (VMAT_pa) ( p = 0.121) while V107% are 0.733 and 0.742 for VMAT_as and VMAT_pa, respectively ( p = 0.969). The doses of OARs such as lens, eye, liver and gonads were comparable. The mean heart dose was 10.4 and 9.0 Gy in VMAT_as and VMAT_pa plans, respectively ( p = 0.005). Significant lower doses to the thyroid, kidneys and lungs were seen in VMAT plans using avoidance sectors. Conclusion: This study provides a practically useful VMAT planning method for the treat-ment of CSI and illustrates the ability of VMAT using avoidance sectors to generate highly conformal and homogeneous treatment plans for CSI, while limiting the dose to the relevant OARs.
{"title":"Optimising craniospinal irradiation for medulloblastoma: a dosimetric comparison of two VMAT planning methods","authors":"Niketa Thakur, Nancy Bansal, Meena Sudan, Abhishek Sharma","doi":"10.3332/ecancer.2024.1700","DOIUrl":"https://doi.org/10.3332/ecancer.2024.1700","url":null,"abstract":"Background: Craniospinal irradiation (CSI) poses a challenging planning process because of the complex target volume. Traditional 3D conformal CSI does not spare any critical organs, resulting in toxicity in patients. Here the dosimetric advantages of volumetric-modulated arc therapy (VMAT) using partial arc and avoidance sectors are compared with each other in planning in adult patients undergoing CSI to develop a clinically feasible technique that is both effective and efficient. Patient and methods: Eight adult patients treated with CSI were retrospectively identified. In total 16 plans were made. We generated two plans for each patient: 1. VMAT plan using partial arc, namely VMAT_pa. 2. VMAT plan using avoidance sectors, namely VMAT_as. The dose prescribed was 36 Gy in 20 fractions. The dose-volume histogram for planning target volume (PTV) and organs at risk (OAR) (lens, eye, heart, thyroid, lungs, liver, gonads and kidneys) were analysed and compared. Dose parameters of mean dose, V 95% , and V 107% for the PTV were evaluated. Results: The median length of PTV is 65.58 cm (45.8–79.5). The volume of PTV receiving 95% of the dose (V95%) in both the plans are 97.51% (VMAT_as) and 97.99% (VMAT_pa) ( p = 0.121) while V107% are 0.733 and 0.742 for VMAT_as and VMAT_pa, respectively ( p = 0.969). The doses of OARs such as lens, eye, liver and gonads were comparable. The mean heart dose was 10.4 and 9.0 Gy in VMAT_as and VMAT_pa plans, respectively ( p = 0.005). Significant lower doses to the thyroid, kidneys and lungs were seen in VMAT plans using avoidance sectors. Conclusion: This study provides a practically useful VMAT planning method for the treat-ment of CSI and illustrates the ability of VMAT using avoidance sectors to generate highly conformal and homogeneous treatment plans for CSI, while limiting the dose to the relevant OARs.","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141000736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-21DOI: 10.3332/ecancer.2024.1684
Salah Eddine El Herrag, Soraya Moulessehoul, Dounia zad EL MEHADJI, Djamila Djamila, M. Khaled
{"title":"Epidemiological insights into colorectal cancer in northwestern Algeria","authors":"Salah Eddine El Herrag, Soraya Moulessehoul, Dounia zad EL MEHADJI, Djamila Djamila, M. Khaled","doi":"10.3332/ecancer.2024.1684","DOIUrl":"https://doi.org/10.3332/ecancer.2024.1684","url":null,"abstract":"","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140222945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-19eCollection Date: 2024-01-01DOI: 10.3332/ecancer.2024.1682
Sheila W Muchiri, Elly O Ogutu, Peter O Oyiro, Lars Aabakken
The global incidence of pancreatic cancer (PC) continues to steadily increase whereas its prognosis remains poor. Previous studies have suggested worse outcomes among individuals of African descent. The characteristics of patients with PC in Kenya, and their contemporary management and survival outcomes remain largely unknown. This study aimed to describe the clinical and pathologic characteristics, management, and outcomes of patients diagnosed with PC at Kenyatta National Hospital (KNH), a tertiary referral hospital in Kenya. Records of 242 patients diagnosed with PC at KNH between 1st January 2014 and 30th September 2021 were assessed in this retrospective cohort study. Data on their clinical, histopathologic, and treatment characteristics was presented as mean (± standard deviation) and/or median (interquartile range) for continuous variables and frequency (percentage) for categorical variables. Kaplan-Meier and Cox proportional hazard ratios were used for survival analysis. PC occurred in a young population, the median age being 58.5 years (inter-quartile range 35-88). The majority of tumours (54%) were metastatic at diagnosis, while 28% and 14% were stage III and stage I/II, respectively. Surgical resections with curative intent were performed on 7% overall and 44% of stage I/II cases. The majority of patients with stage I/II disease (52.9%) received chemotherapy whereas the majority with stage III and IV disease received the best supportive care only (62.7% and 64.9%, respectively). Patients who underwent surgical resection (HR for mortality 0.20, 95% CI 0.05-0.83, p = 0.021) and chemotherapy (HR for mortality 0.15, 95% CI 0.08-0.29, p < 0.001) had significantly improved survival, reflecting a more favourable stage of the disease more amenable to aggressive therapies. The median survival time was 3 months and the 1-year survival rate was 32%.
胰腺癌（PC）的全球发病率持续稳步上升，但其预后仍然很差。以往的研究表明，非洲裔患者的预后较差。肯尼亚胰腺癌患者的特征以及他们的现代管理和生存结果在很大程度上仍不为人所知。本研究旨在描述肯尼亚三级转诊医院肯雅塔国立医院（KNH）确诊的 PC 患者的临床和病理特征、管理和预后情况。在这项回顾性队列研究中，对2014年1月1日至2021年9月30日期间在肯雅塔国立医院确诊的242名PC患者的记录进行了评估。连续变量的临床、组织病理学和治疗特征数据以均值（± 标准差）和/或中位数（四分位数间距）表示，分类变量的数据以频率（百分比）表示。生存分析采用卡普兰-梅耶尔和考克斯比例危险比。PC发生在年轻人群中，中位年龄为58.5岁（四分位数间距为35-88岁）。大多数肿瘤（54%）在确诊时已转移，28%和14%的肿瘤分别处于III期和I/II期。7%的患者接受了根治性手术切除，44%的I/II期患者接受了根治性手术切除。大多数 I/II 期患者（52.9%）接受了化疗，而大多数 III 期和 IV 期患者只接受了最佳支持治疗（分别为 62.7% 和 64.9%）。接受手术切除（死亡率HR为0.20，95% CI为0.05-0.83，p = 0.021）和化疗（死亡率HR为0.15，95% CI为0.08-0.29，p < 0.001）的患者生存率明显提高，这反映出患者的病情处于更有利的阶段，更适合接受积极的治疗。中位生存时间为3个月，1年生存率为32%。
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