The gulf journal of oncology最新文献

Background: Brain metastases pose a significant challenge in oncology, contributing to morbidity and mortality rates. These metastases originates from primary tumors in the breast, lung, and melanoma tumors and has promoted the exploration of several treatment modalities, including stereotactic radiosurgery (SRS). SRS is considered to be one of the most effective treatments for brain metastases due to its precision in delivering high doses of radiation with low damage to the surrounding tissues.

Method: A search of Scopus database was conducted using key terms like "stereotactic," "radiosurgery," "brain metastasis," and "SRS". Relevant articles were screened based on title, abstract, and full text. The top 100 articles, ranked by citation frequency, were included, and analysed for various details including title, first author, publication year, journal name, journal impact factor, country of first author, country of study, first author institution, corresponding author institution, study design, patient involvement, number of patients studied, primary aim, source of metastasis, and study conclusion.

Results: The top 100 cited articles on SRS for brain metastases were identified, with an average citation of 149 citations per article. The study found that the USA, followed by Japan and Switzerland, produced the highest number of publications on stereotactic radiosurgery for brain metastasis. The University of Pittsburgh was the leading institution in the USA. The analysis showed an increasing trend in publications from 2007 to 2017, with a peak in 2010, followed by a decline, potentially influenced by the COVID-19 pandemic.

Conclusion: Stereotactic radiosurgery (SRS) is an effective treatment for brain metastases, delivering precise high-dose radiation with rapid dose fall-off. This study revealed that the USA, particularly the University of Pittsburgh, has produced the most publications on this topic. This information can help clinicians and researchers identify valuable articles and journals related to SRS.

Aim & Objectives: Although NCRT (Neoadjuvant Chemo Radiation Therapy) followed by surgery demonstrates an increase in overall survival (OS) in locally advanced operable esophageal cancer, there is a lack of a reliable predictive factor to identify patients who are more likely to be affected by treatment toxicities or natural history of the disease. In this study, we have studied various indices like pre-treatment serum albumin, hemoglobin, Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), Platelet to Albumin Ratio (PAR), Systemic Immune Index (SII) as independent prognostic factors in esophageal cancer, with respect to the outcomes and tumor response. Material & Methods: A total of 83 patients of esophageal cancer who were treated with Neoadjuvant Chemoradiation from 2016-2021 were evaluated in this study. All the patients were treated with 41.4 Gy / 23 # External Beam Radiation Therapy with concurrent weekly Paclitaxel & Carboplatin (CROSS Protocol). Baseline hematological parameters like PLR, NLR, PAR, SII, Serum Albumin and Hemoglobin were obtained from laboratory records. Survival outcomes were analyzed using the Kaplan-Meier method and log rank test. Chi square test was used to analyze the association with pathological complete response after NCRT. Results: The median follow-up time of the study was 42.50 months, and the median age of patients was 55 years (IQR - 45-63). The majority of the patients were squamous cell carcinoma (92.8%), and 7.2% of the patients were adenocarcinoma of the esophagus. Amongst this study group, 41 patients (49.4%) underwent surgery following chemoradiation, the rest of the patients couldn't undergo surgery. Amongst the 41 operated patients, 21 (51.2%) had pathological complete response, 13 (31.7%) had partial response, 7 (17.1%) had poor/no response to neoadjuvant chemoradiation. The median OS of a group of patients who underwent surgery (44.7 Months) was found to be significantly higher (p<0.001) than that of patients who were not operated (17.8 Months). Kaplan Meir analysis and log-rank test revealed that high pretreatment albumin and hemoglobin had statistically significant association with better OS. High PLR, low NLR, low PAR and high SII had a correlation trend with better OS. However, statistical significance couldn't be demonstrated owing to our smaller sample size. Patients with high PLR (> 180) were found to have a higher rate of pathologic complete response compared to the patients with low PLR (< 180). Conclusion: NCRT when offered to a selected subgroup of patients having operable carcinoma esophagus can give excellent survival outcomes. Patient selection should incorporate factors that look into the biology, systemic inflammatory response and baseline status of these patients. The evaluation of these factors on a larger scale prospective multicentric trials is warranted.

Introduction: The relationship between social support, coping strategies, spirituality, and psychological well-being in breast cancer survivors is crucial in psycho-oncology. Survivors face complex challenges, and the interplay of these factors affects their recovery. Social support, encompassing emotional, informational, and practical assistance, is pivotal, offering belonging and resilience. Coping strategies, whether adaptive (like problemsolving) or maladaptive (like denial), significantly impact psychological outcomes. Spirituality, irrespective of ties to organized religion, significantly impacts the psychological well-being of breast cancer survivors. It provides a framework for understanding and coping, offering hope and meaning. Psychological status encompasses emotional well-being, mental health, and quality of life, influenced by cancer severity, personality traits, social support, coping strategies, and fear of recurrence. Methodology for literature review: The literature review employed a systematic approach, utilizing various databases and search terms to identify recent research on the relationship between social support, coping strategies, spirituality, and psychological status among breast cancer survivors. Inclusion criteria focused on relevance and rigor, with a thematic emphasis on the interplay between these factors. Both qualitative and quantitative studies from peer-reviewed journals were considered within a specific time frame (2010-2023) to capture recent advancements. The screening process involved two independent reviewers, with disagreements resolved through discussion. Data extraction and synthesis involved carefully analyzing study characteristics, key findings, and implications for survivorship. The analysis aimed to provide a comprehensive overview and identify future research directions.

Conclusion: Understanding the dynamics of social support, coping strategies, spirituality and psychological status among breast cancer survivors is essential for developing effective interventions and support systems. By addressing and challenging societal attitudes, promoting awareness and education, and fostering supportive environments, Healthcare professionals can help breast cancer survivors overcome they face, enhance their coping mechanisms, bolster their social support networks, and ultimately improve their psychological status.

Treatment of gestational trophoblastic disease (GTD) with chemotherapy is a success story for medical oncology; a combination of chemosensitive disease with a sensitive tumour marker makes GTD an eminently curable disease. However, 0·5-5·0% of women with this cancer continue to die as a result of multidrug resistance. PD-L1 is strongly expressed in these tumours, making them a target for immune therapy with immune checkpoint inhibitors such as pembrolizumab.

Case presentation: We present two challenging cases of gestational choriocarcinomas, resistant to multiple interventions including multiple lines of chemotherapy, surgery and radiation, who are in long term remission after pembrolizumab immunotherapy.

Discussion and conclusion: Immunotherapy is a potent weapon in the treatment of GTD and should be considered earlier option as it has the potential to alter the natural history of refractory choriocarcinoma with possible cure.

Skin and brain metastasis in head and neck carcinoma (SCC) is extremely rare and contribute to less than 5% of cases. Cutaneous metastases of head and neck cancer usually manifests as papulonodular lesions and brain metastases presents with features of raised intracranial tension. We present a case report of 49- year male diagnosed with synchronous cutaneous and brain metastasis. Intent is usually palliative & prognosis remains poor in these cases marked by poorer outcomes. Keywords : Head and neck cancer, Brain metastases, Cutaneous metastases.

Background: Brain metastasis is the most frequent brain tumor associated with poor survival. Solitary metastasis can be treated with excision or stereotactic radiosurgery. Systemic therapy remains challenging & is evolving for different types of primary cancers.

Patient and method: This study was conducted to evaluate the most common types of primary tumors that can spread to the brain, methods of diagnosis, treatments, and survival outcomes in 72 patients with brain metastasis from primary solid tumors who were presented and treated in the Mosul oncology hospital between Jan 2018 to 2020 in Nineveh province.

Results: Breast and lung primary tumors are the most frequent primaries causing brain metastasis. Imaging studies using MRI & CT scans are more available and accessible for most of the patients. We found that WBRT is the main treatment used.

Discussion and conclusion: Stereotactic radiotherapy was not available at the time of performing this study. Surgical resections are limited to a minority of our patients. We recommend more studies for each primary tumor focusing on its pathologic and molecular characteristics and its relation to brain metastasis.

Key words: Brain metastasis, breast cancer, lung cancer.

Hairy cell leukemia (HCL) presenting as extramedullary disease without bone marrow infiltration is extremely rare. We report a 42-year-old male diagnosed as extramedullary HCL in right parotid gland without cytopenia, bone marrow infiltration, and splenic involvement. Immunohistochemistry of core biopsy of was positive for LCA, CD 10, CD20, CD25, BCL2, BCL6, and cyclin D1, negative for CD3, and CD5 with Ki 67 of 10-15%. Molecular analysis showed BRAF V600E mutation. He was treated with Cladribine and 8 doses of weekly Rituximab without any local radiation. Post therapy, he had very good clinical and radiological improvement with complete resolution of parotid gland lesions with mild uptake in left scapula and right femoral epicondyle in PET CT scan. Key Words: hairy cell leukemia, parotid gland, extramedullary, without marrow involvement.

Background: Breast cancer is the most common among women, which affects their fertility, so that patients feel a loss of femininity and identity after being infected. This research was conducted with the aim of investigating the experiences of pregnancy, childbirth and breastfeeding after recovery from breast cancer.

Methods: In this qualitative case report study, 4 participants based on the objective and available were selected. After conducting an interview and asking questions about their experiences in pregnancy after recovery from the disease, as well as the experiences of breastfeeding and caring for the child, their statements were analyzed.

Results: The data were divided into the period of pregnancy-delivery and breastfeeding. The main dimensions extracted during pregnancy and childbirth include: physical conflict,Stop tracking cancer, Support failure, physical conflict, Stop tracking cancer. The main dimensions extracted breastfeeding include: Support failure, Inability to care for a child, Changes in the lives of couples, Get support.

Conclusion: Based on the results of this study, breast cancer survivors have problems in taking care of their children if they have children, and they need all-round support from the family and the government.

Introduction: Breast cancer (BC) is the most common cancer and foremost cause of death in women.

Aim: This study was conducted to study the calretinin expression in BC and its correlation with other clinicopathological parameters such as tumor size, histological grade, lymph node status, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2/neu), Ki67 status and molecular subtypes in Indian setting.

Materials and methods: Fifty cases of BC diagnosed between 2017 and 2019 were included in the study. A technique of manual tissue microarray was employed for the analysis of expression of IHC markers such as calretinin, ER, PR, Her2/neu, Ki67, CK5/6 and EGFR in all cases. Results were subjected to statistical analysis.

Results: Calretinin positivity was seen in 66% (33/50) cases of BC of which 45.45% (19/33) were triple negative BC (TNBC) and 21.21% (7/33) were of basal like BC (BLBC) molecular subtype. Calretinin expression was significantly associated with higher grade and negative ER and PR expression. Maximum cases expressing calretinin showed lymphovascular invasion (LVI), positive lymph node status, higher stage, Ki67 and HER2/neu positivity. 38% cases were TNBC. Calretinin was found positive in 78.95% of TNBC cases. Calretinin expression was seen in TNBC cases of higher grade and stage with positive lymph node status, presence of LVI and Ki67 positivity.14% cases were BLBC. Calretinin was found positive in 77.78% of BLBC cases. Calretinin expression was seen in BLBC cases of higher grade and stage with positive lymph node status, Ki67 positivity and presence of LVI.

Conclusion: Calretinin can be potentially used as a prognostic marker and could be included in routine IHC workup of BC cases which could aid in development of tailored therapy.