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Beam Focal Spot Offset Determination for Linear Accelerators: A Phantom less Method. 线性加速器光束焦斑偏移的测定:一种无幻影的方法。
Q3 Medicine Pub Date : 2023-09-01
Silpa AjayKumar, Arathi C, Resmi K B, Suja C A, Lisha Jose, Vinin N V, Geetha Muttath, M M Musthafa

The effectiveness of radiotherapy treatment is influenced by the position of beam focal spot; therefore, it is important to verify the beam focal spot periodically. In this study the beam focal spot offset is measured using an electronic portal imaging (EPID) based technique and co- rotational penumbra modulation technique(CPM).

Materials and methods: This method utilizes one set of jaws and the multileaf collimator (MLC) to form a symmetric field and then a 180o collimator rotation was utilized to determine the radiation isocenter defined by the jaws and the MLC, respectively. The difference between these two isocentres is then directly correlated with the beam focal spot offset of the linear accelerator. In the current study, the method has been used for Varian ClinaciX and Elekta Versa HD linear accelerators. Since an Elektalinac with the Agility® head does not have two set of jaws, a modified method that making use of one set of diaphragms, the MLC and a full 360o collimator rotation is implemented.

Result: The method is validated against CPM and found to be in agreement within 0.00923± 0.009360 mm ( SD) also the method has been found to be reproducible to within 0.0365 mm (SD).

Conclusion: The method could be used for routine quality assurance (QA) to ensure that the beam focal spot offset is in tolerance.

放射治疗的有效性受束焦点位置的影响;因此,周期性地验证光束焦斑是很重要的。在本研究中,使用基于电子门成像(EPID)的技术和共旋转半影调制技术(CPM)测量光束焦斑偏移。材料和方法:该方法利用一组钳口和多叶准直器(MLC)形成对称场,然后利用180°准直器旋转来确定钳口和MLC。然后,这两个等中心之间的差与线性加速器的光束焦斑偏移直接相关。在目前的研究中,该方法已用于Varian ClinaciX和Elekta Versa HD线性加速器。由于带有Agility®头部的Elektalinac没有两套钳口,因此采用了一种改进的方法,即使用一套隔膜、MLC和360°准直器全旋转。结果:该方法经CPM验证,在0.00923±0.009360mm(SD)范围内一致,在0.0365mm(SD)内可重复使用。结论:该方法可用于常规质量保证(QA),以确保光束焦斑偏移在公差范围内。
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引用次数: 0
The External Jugular Vein Cut-Down Method for Chemoport Insertion from a Tertiary Cancer Treatment Center in Central India: A Prospective Study. 印度中部一家三级癌症治疗中心颈外静脉切开法插入化学端口:一项前瞻性研究。
Q3 Medicine Pub Date : 2023-09-01
Sandeep Ghosh, Bonny Joseph, Amar Jain, Sanjay M Desai, Vinod Dhakad, Soumya Singh

Introduction: In the realm of oncology, the development of TIVAD (chemoport) has been a blessing for cancer patients, freeing them from having to undergo numerous recurrent venepunctures throughout their treatment. The External Jugular Vein cut-down has been the standard procedure for administering chemotherapy to cancer patients at our institution. Here, we discuss our experience with the External Jugular Vein cut-down Chemoport Insertion Technique and the outcomes it produced.

Materials and methods: We performed a prospective observational study and included all patients who underwent the open External Jugular Vein cut-down technique of Chemoport Insertion from January 2019 to January 2022 in the Department of Surgical Oncology at our hospital.

Results: Out of 136 patients, 3 (2.2%) had failed external jugular vein (EJV) cannulation, and alternative access (Internal Jugular Vein) was chosen for cannulation. The most common indication for chemoport insertion in our study was carcinoma of the breast, around 72.93% (97/133), and hence the majority of patients were females, about 84.21% (112/133). Only 18.04% (24/133) were male patients. The age distribution ranged from 2 years to 84 years. Out of 133 patients, complications were observed in 14 patients (10.52%). Around 6 patients (4.5%) had problems with catheter blockage after one cycle of chemotherapy. 4 patients (3%) had port infections at the chamber region (pectoral region). 3 patients (2.2%) had catheter tip displacement into the brachiocephalic vein. 1 patient (0.75%) had extravasation of chemotherapy.

Conclusion: In conclusion, our study demonstrates that the External Jugular Vein cut-down technique offers several advantages in the realm of oncology, as it is a safe, efficient, and straightforward technique for chemoport insertion. With its minimal learning curve and simplicity, this technique represents a favorable initial option for successfully implanting chemoports in cancer patients. Further research and comparative studies are needed to validate and further explore the benefits of this technique in diverse patient populations and healthcare settings.

简介:在肿瘤学领域,TIVAD(化学端口)的发展对癌症患者来说是一件幸事,使他们在整个治疗过程中不必接受多次反复静脉穿刺。颈外静脉切开术是我院癌症患者化疗的标准程序。在这里,我们讨论了颈外静脉切开化学端口插入技术的经验及其产生的结果。材料和方法:我们进行了一项前瞻性观察性研究,纳入了2019年1月至2022年1月在我院肿瘤外科接受颈外静脉切开化疗的所有患者。结果:136例患者中,3例(2.2%)颈外静脉(EJV)插管失败,选择了替代途径(颈内静脉)进行插管。在我们的研究中,化疗端口插入最常见的适应症是乳腺癌,约72.93%(97/133),因此大多数患者是女性,约84.21%(112/133)。男性患者仅占18.04%(24/133)。年龄分布在2~84岁之间。在133名患者中,有14名患者(10.52%)出现并发症。大约6名患者(4.5%)在一个周期的化疗后出现导管堵塞问题。4名患者(3%)在腔区(胸区)有端口感染。3例(2.2%)导管尖端移位进入头臂静脉。1例(0.75%)化疗药物外渗。结论:总之,我们的研究表明,颈外静脉切断技术在肿瘤学领域具有几个优势,因为它是一种安全、有效和直接的化学端口插入技术。凭借其最小的学习曲线和简单性,这项技术为癌症患者成功植入化学端口提供了一个有利的初始选择。需要进一步的研究和比较研究来验证和进一步探索这项技术在不同患者群体和医疗环境中的益处。
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引用次数: 0
An Unusual Cause of Recurrent Visible Hematuria; Posterior Urethral Hemangioma: A Case Report and Review of Literature. 复发性可见血尿的一个不寻常的原因;后尿道血管瘤:一例报告并文献复习。
Q3 Medicine Pub Date : 2023-09-01
Moath K Alfentoukh, Abdullah H Alghamdi, Ahmed Allohidan, Ahmed Alzahrani, Saeed Abdullah Alzahrani, Rami M Hasan

Urinary tract hemangiomas are uncommon entity to urologists, despite their benign nature and course; they can cause significant patient's hemodynamic instability or distress if not recognized and managed properly. Here, we present a case of urethral hemangioma with its treatment, follow-up course and review of literature of similar cases. Introduction: Bloody urine or urethral bleeding can be the initial presentation of a number of different medical and surgical conditions, some of which are benign and others are malignant, when encountered, they are alarming and must be evaluated thoroughly. As a cause, urethral hematomas are faced rarely, among all urinary tract sites; they are the second least common(1). Due to their paucity in clinical practice, there is no agreed approach on their management and each case has to be individualized. In the literature, different assessment and treatment methods were tried with satisfactory outcomes in each one. Here we report a case with detailed, concise explanation of such pathology and a comprehensive comparison in light of previous literature. Keywords: Urethral hemangioma, urethral bleeding, benign urinary tract tumors.

尿路血管瘤对泌尿科医生来说并不常见,尽管其性质和病程都是良性的;如果不正确识别和管理,它们可能会导致患者严重的血液动力学不稳定或痛苦。在此,我们报告一例尿道血管瘤的治疗、随访过程及文献复习。引言:血尿或尿道出血可能是多种不同医疗和外科疾病的最初表现,其中一些是良性的,另一些是恶性的,当遇到时,它们是令人担忧的,必须彻底评估。作为一种病因,尿道血肿在所有尿路部位中很少出现;它们是第二不常见的(1)。由于他们在临床实践中的匮乏,对他们的管理没有达成一致的方法,每个病例都必须个性化。在文献中,尝试了不同的评估和治疗方法,每种方法都取得了令人满意的结果。在这里,我们报告了一个病例,对这种病理学进行了详细、简洁的解释,并根据以前的文献进行了全面的比较。关键词:尿道血管瘤,尿道出血,良性尿路肿瘤。
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引用次数: 0
Neoadjuvant Chemotherapy for Muscle-invasive Bladder Cancer in a Lebanese experience: in all aspects. 新辅助化疗治疗肌肉浸润性膀胱癌症的黎巴嫩经验:各方面。
Q3 Medicine Pub Date : 2023-09-01
Nizar Ahmadieh, Toufic Zeidan, Josselin Abi Chebel, Fady Gh Haddad, Elie Nemr

Background: Bladder cancer (BC) is the most common malignant tumor of the urinary tract and the 11th most frequent cancer worldwide. BC is the 2nd most common cancer in Lebanon in men and women.

Materials and methods: After searching for patients records in the pathology and oncology database, we identified those who underwent a cystectomy between 2017 and 2019 in our hospital, Hotel Dieu de France - Beirut. We selected for the study the patients who have undergone a cystectomy for MIBC. We excluded patients who initially had a pelvic tumor, or a prostate cancer invading the bladder, and patients with absent medical record from the study. We also noted the gender of the patients, if they are smokers and the number of pack years at the time of diagnosis, as well as their age, the histological type of the tumor, its stage according to the TNM classification and its grade. We also noted whether neoadjuvant chemotherapy was taken by the study 's subjects.

Results: The total number of patients who met the inclusion and exclusion criteria was 38. The median age of the population was 66 (± 10) years and the median number of pack years at diagnosis was 60 (± 36). 79% of study 's patients were males and 21% were females. Regarding the tumor 's histological type, the urothelial type predominated with 92% while the remaining 8% were of the squamous type. Regarding treatment modalities, only 20% of patients in the study received neoadjuvant chemotherapy before cystectomy. 80% of patients underwent a cystectomy directly without neoadjuvant and/or adjuvant chemotherapy. No patient received adjuvant chemotherapy. Among the 7 patients, 2 patients (29%) presented a pathological complete response (pCR; equivalent to pT0N0M0). 14% had a pT3 stage post-neoadjuvant chemotherapy and 43% had a pT4 stage.

Discussion and conclusions: We can note a reluctance of urologists at our institution to prescribe neoadjuvant chemotherapy. It would therefore be interesting to extend the study to the national level with a larger number of patients, as well as to evaluate survival in patients who received neoadjuvant chemotherapy, especially in those presenting a pCR. Our study can serve as a point of change in the practice of urologists in Lebanon regarding BC.

背景:癌症(BC)是泌尿系最常见的恶性肿瘤,也是世界上第11常见的癌症。BC是黎巴嫩男性和女性第二常见的癌症。材料和方法:在病理学和肿瘤学数据库中搜索患者记录后,我们确定了2017年至2019年间在我们位于贝鲁特的法国迪厄酒店接受膀胱切除术的患者。我们选择了接受过MIBC膀胱切除术的患者进行研究。我们排除了最初患有盆腔肿瘤或侵犯膀胱的癌症的患者,以及没有医疗记录的患者。我们还注意到了患者的性别,如果他们是吸烟者,在诊断时的包年数,以及他们的年龄,肿瘤的组织学类型,根据TNM分类的分期和分级。我们还注意到研究对象是否接受了新辅助化疗。结果:符合纳入和排除标准的患者总数为38人。人群的中位年龄为66(±10)岁,诊断时的中位包年数为60(±36)。79%的研究患者为男性,21%为女性。就肿瘤的组织学类型而言,尿路上皮型占92%,其余8%为鳞状细胞型。关于治疗方式,研究中只有20%的患者在膀胱切除术前接受了新辅助化疗。80%的患者在没有新辅助和/或辅助化疗的情况下直接接受了膀胱切除术。无患者接受辅助化疗。在7名患者中,2名患者(29%)出现病理学完全反应(pCR;相当于pT0N0M0)。14%的患者在新辅助化疗后有pT3期,43%的患者有pT4期。讨论和结论:我们可以注意到我们机构的泌尿科医生不愿意开新辅助化疗处方。因此,将这项研究扩展到国家层面,让更多的患者参与,并评估接受新辅助化疗的患者的生存率,尤其是那些出现pCR的患者,将是一件有趣的事情。我们的研究可以作为黎巴嫩泌尿科医生关于BC实践的一个改变点。
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引用次数: 0
Survival Outcomes of Post-mastectomy Breast Cancer Patients Treated with Hypofractionated Radiation Treatment Compared to Conventional Fractionation -a Retrospective Cohort Study. 与传统分次放射治疗相比,乳腺癌切除术后采用低分次放射治疗的患者的生存结果--一项回顾性队列研究。
Q3 Medicine Pub Date : 2023-05-01
Ciniraj Raveendran, Suma Susan Meloot, I Yadev

Introduction: For post-mastectomy patients, radiation treatment with conventional fractionation with a treatment duration of five weeks was the frequently used regimen, whereas hypofractionated regimens are recently used in the adjuvant treatment, which has a shorter treatment time over three weeks. We determined to estimate the treatment outcome by survival analysis between these two fractionation schedules to determine if any difference exists between these two groups.

Methods: We retrospectively reviewed the data of 348 breast cancer patients who had received adjuvant radiation treatment to the breast from January 2010 to December 2013. After assessing the eligibility criteria, 317 patients had received post-mastectomy radiation treatment to the chest wall and axilla and followed up till December 2018. The conventional fractionation schedule consisted of 50 Gy in 25 fractions, 2 Gy per fraction over five weeks, whereas the hypofractionated schedule was 42.6 Gy in 16 fractions with 2.66 Gy per fraction, over 3.2 weeks. Survival outcomes using 5- year Overall survival and 5-year Disease-free survival between these two fractionations were estimated and compared between the conventional and hypofractionated radiation treatment.

Results: All patients were females with a median age of 50 [IQR 45 to 58] and a median follow-up of 60 months. Of the 317 patients, 194 (61%) received hypofractionated radiation and 123(39%) conventional fractionation. The Kaplan-Meier estimates of the 5- year survival rate were 81% (95% CI = 74.9 to 87.6%) for the hypofractionated group (n = 194) and 87.8% (95% CI = 81.5 to 94.6%) for the conventional fractionation group (n = 123). The log-rank test revealed no evidence of a difference between the survival rates over time (p= 0.1 ). Restricted mean survival time in the hypofractionated group was 54.5 months, and in the conventional fractionation group was 57 months. Further investigation with cox proportional hazards regression analysis, which controlled for age, N stage, and T stage, showed that patients with conventional fractionation radiotherapy were 0.6 times less likely to die than those with hypofractionated radiation (95% CI for the hazard or risk ratio = 0.31 to 1.21; P = 0.2). However, there is no statistical evidence to say the reduction in mortality is different from null. 5-year disease-free survival for the hypofractionated group (n= 194) was 62.6% (55.7-70.2) whereas that for the conventional fractionation group (n=123) was 67.8% (59.8-76.8). However, there was no evidence to say any difference between the disease-free survival rates on the log-rank test (p=0.39). Restricted mean diseasefree survival time in the hypofractionated group was 45.1 months compared to 46.9 months for the conventional fractionation group.

Conclusion: In post-mastectomy breast cancer patients receiving radiation treatment, the survival outcome w

简介对于乳房切除术后的患者,常用的放射治疗方案是治疗时间为五周的常规分次疗法,而最近在辅助治疗中使用的是治疗时间较短的三周以上的低分次疗法。我们决定通过生存分析来估算这两种分次方案的治疗效果,以确定这两组之间是否存在差异:我们回顾性审查了 2010 年 1 月至 2013 年 12 月期间接受乳腺辅助放射治疗的 348 名乳腺癌患者的数据。在对资格标准进行评估后,有317名患者接受了乳房切除术后胸壁和腋窝的放射治疗,并随访至2018年12月。常规分次治疗计划包括25次分次,每次50Gy,每次2Gy,疗程5周;低分次治疗计划包括16次分次,每次42.6Gy,每次2.66Gy,疗程3.2周。对这两种分次放疗的 5 年总生存率和 5 年无病生存率进行了估算,并对传统放疗和低分次放疗的生存率进行了比较:所有患者均为女性,中位年龄为 50 岁[IQR 45 至 58],中位随访时间为 60 个月。在317名患者中,194人(61%)接受了低分次放射治疗,123人(39%)接受了常规分次放射治疗。根据 Kaplan-Meier 估计,低分次照射组(194 人)的 5 年生存率为 81%(95% CI = 74.9 至 87.6%),常规分次照射组(123 人)的 5 年生存率为 87.8%(95% CI = 81.5 至 94.6%)。对数秩检验显示,随着时间的推移,存活率之间没有差异(P= 0.1)。低分次治疗组的限制性平均存活时间为54.5个月,常规分次治疗组为57个月。通过控制年龄、N分期和T分期的cox比例危险回归分析进行的进一步调查显示,接受常规分次放疗的患者的死亡几率是接受低分次放疗患者的0.6倍(危险或风险比的95% CI = 0.31至1.21;P = 0.2)。不过,没有统计证据表明死亡率的降低与零有差异。低分次治疗组(194人)的5年无病生存率为62.6%(55.7-70.2),而常规分次治疗组(123人)的5年无病生存率为67.8%(59.8-76.8)。不过,没有证据表明无病生存率之间存在对数秩检验差异(P=0.39)。低分化组的限制性平均无病生存期为45.1个月,而传统分化组为46.9个月:结论:对于乳房切除术后接受放射治疗的乳腺癌患者,常规分次放射治疗和低分次放射治疗的生存期相当。
{"title":"Survival Outcomes of Post-mastectomy Breast Cancer Patients Treated with Hypofractionated Radiation Treatment Compared to Conventional Fractionation -a Retrospective Cohort Study.","authors":"Ciniraj Raveendran, Suma Susan Meloot, I Yadev","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>For post-mastectomy patients, radiation treatment with conventional fractionation with a treatment duration of five weeks was the frequently used regimen, whereas hypofractionated regimens are recently used in the adjuvant treatment, which has a shorter treatment time over three weeks. We determined to estimate the treatment outcome by survival analysis between these two fractionation schedules to determine if any difference exists between these two groups.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of 348 breast cancer patients who had received adjuvant radiation treatment to the breast from January 2010 to December 2013. After assessing the eligibility criteria, 317 patients had received post-mastectomy radiation treatment to the chest wall and axilla and followed up till December 2018. The conventional fractionation schedule consisted of 50 Gy in 25 fractions, 2 Gy per fraction over five weeks, whereas the hypofractionated schedule was 42.6 Gy in 16 fractions with 2.66 Gy per fraction, over 3.2 weeks. Survival outcomes using 5- year Overall survival and 5-year Disease-free survival between these two fractionations were estimated and compared between the conventional and hypofractionated radiation treatment.</p><p><strong>Results: </strong>All patients were females with a median age of 50 [IQR 45 to 58] and a median follow-up of 60 months. Of the 317 patients, 194 (61%) received hypofractionated radiation and 123(39%) conventional fractionation. The Kaplan-Meier estimates of the 5- year survival rate were 81% (95% CI = 74.9 to 87.6%) for the hypofractionated group (n = 194) and 87.8% (95% CI = 81.5 to 94.6%) for the conventional fractionation group (n = 123). The log-rank test revealed no evidence of a difference between the survival rates over time (p= 0.1 ). Restricted mean survival time in the hypofractionated group was 54.5 months, and in the conventional fractionation group was 57 months. Further investigation with cox proportional hazards regression analysis, which controlled for age, N stage, and T stage, showed that patients with conventional fractionation radiotherapy were 0.6 times less likely to die than those with hypofractionated radiation (95% CI for the hazard or risk ratio = 0.31 to 1.21; P = 0.2). However, there is no statistical evidence to say the reduction in mortality is different from null. 5-year disease-free survival for the hypofractionated group (n= 194) was 62.6% (55.7-70.2) whereas that for the conventional fractionation group (n=123) was 67.8% (59.8-76.8). However, there was no evidence to say any difference between the disease-free survival rates on the log-rank test (p=0.39). Restricted mean diseasefree survival time in the hypofractionated group was 45.1 months compared to 46.9 months for the conventional fractionation group.</p><p><strong>Conclusion: </strong>In post-mastectomy breast cancer patients receiving radiation treatment, the survival outcome w","PeriodicalId":53633,"journal":{"name":"The gulf journal of oncology","volume":"1 42","pages":"26-34"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9594764","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}
引用次数: 0
Variants of Human Mucin Genes in Clear Cell Renal Cell Carcinoma and their Potential Prognostic and Predictive Values. 透明细胞肾细胞癌中人粘蛋白基因的变异及其潜在的预后和预测价值。
Q3 Medicine Pub Date : 2023-05-01
Jamal Zekri, Mohammed A Baghdadi, Abdelrazak Meliti, Turki M Sobahy, Saba Imtiaz

Background: There is no reliable prognostic and predictive biomarkers for clear cell renal cell carcinoma (cc-RCC).

Methods: DNA from 47 cc-RCC tissue samples were sequenced using next generation sequencing and a customized gene panel testing for tumor-driver genes including 19 Mucin genes.

Results: Distinctive variants in 12 Mucin genes were present in all samples. These genes are: MUC2, MUC3A, MUC4, MUC5AC, MUC5B, MUC6, MUC7, MUC12, MUC16, MUC17, MUC19, and MUC22. The numbers of distinctive and non-distinctive variants were counted for each sample. The median number of variants was 455. High variant number (HVN) (>455) was associated with shorter overall survival compared to low variant number (≤455) [Median 50 months vs. not reached; P=0.041]. In the 11 patients who received anti-angiogenic tyrosine kinase inhibitors (TKIs), HVN was associated with a trend of shorter progression free survival.

Conclusion: Alterations in Mucin family genes are common in ccRCC. HVN is associated with worse prognosis and may predict decreased benefit from anti-angiogenic TKIs.

Key words: Mucin; Variants; Renal cell carcinoma; Biomarker; Tyrosine kinase inhibitors.

背景:透明细胞肾细胞癌(cc-RCC)没有可靠的预后和预测性生物标志物。方法:对47例cc-RCC组织样本的DNA进行测序,采用下一代测序和包括19个粘蛋白基因在内的肿瘤驱动基因定制基因面板检测。结果:在所有样本中均存在12个粘蛋白基因的显著变异。这些基因分别是:MUC2、MUC3A、MUC4、MUC5AC、MUC5B、MUC6、MUC7、MUC12、MUC16、MUC17、MUC19和MUC22。对每个样本的显著和非显著变异数进行计数。变异的中位数是455。与低变异数(≤455)相比,高变异数(HVN)(>455)与较短的总生存期相关[中位50个月vs.未达到;P = 0.041)。在接受抗血管生成酪氨酸激酶抑制剂(TKIs)治疗的11例患者中,HVN与无进展生存期缩短的趋势相关。结论:黏素家族基因的改变在ccRCC中是常见的。HVN与较差的预后相关,并可能预示抗血管生成TKIs的获益降低。关键词:粘蛋白;变异;肾细胞癌;生物标志物;酪氨酸激酶抑制剂。
{"title":"Variants of Human Mucin Genes in Clear Cell Renal Cell Carcinoma and their Potential Prognostic and Predictive Values.","authors":"Jamal Zekri,&nbsp;Mohammed A Baghdadi,&nbsp;Abdelrazak Meliti,&nbsp;Turki M Sobahy,&nbsp;Saba Imtiaz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There is no reliable prognostic and predictive biomarkers for clear cell renal cell carcinoma (cc-RCC).</p><p><strong>Methods: </strong>DNA from 47 cc-RCC tissue samples were sequenced using next generation sequencing and a customized gene panel testing for tumor-driver genes including 19 Mucin genes.</p><p><strong>Results: </strong>Distinctive variants in 12 Mucin genes were present in all samples. These genes are: MUC2, MUC3A, MUC4, MUC5AC, MUC5B, MUC6, MUC7, MUC12, MUC16, MUC17, MUC19, and MUC22. The numbers of distinctive and non-distinctive variants were counted for each sample. The median number of variants was 455. High variant number (HVN) (>455) was associated with shorter overall survival compared to low variant number (≤455) [Median 50 months vs. not reached; P=0.041]. In the 11 patients who received anti-angiogenic tyrosine kinase inhibitors (TKIs), HVN was associated with a trend of shorter progression free survival.</p><p><strong>Conclusion: </strong>Alterations in Mucin family genes are common in ccRCC. HVN is associated with worse prognosis and may predict decreased benefit from anti-angiogenic TKIs.</p><p><strong>Key words: </strong>Mucin; Variants; Renal cell carcinoma; Biomarker; Tyrosine kinase inhibitors.</p>","PeriodicalId":53633,"journal":{"name":"The gulf journal of oncology","volume":"1 42","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9582609","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}
引用次数: 0
A Rare Tumor in Adulthood: Extrapancreatic Pancreatoblastoma. 一种罕见的成年肿瘤:胰腺外胰腺母细胞瘤。
Q3 Medicine Pub Date : 2023-05-01
Ugur Topal, Begüm Çalım Gürbüz, Hasan Bektaş

Pancreatoblastoma is a rare malignant epithelial neoplasm of the pancreas. It primarily occurs in the pediatric population and is extremely uncommon in adults. A 64-year-old male patient with no known systemic disease presented to our clinic with abdominal pain and dyspeptic complaints. On physical examination, a tender epigastric mass was palpated. The patient was operated on with a preliminary diagnosis of gastrointestinal stromal tumor. Enbloc resection of the mass was performed. The transverse colon was segmentally resected with wedge resection of the gastric corpus. A stapled side-to-side anastomosis was performed. The macroscopic examination of the case revealed a tumoral lesion of approximately 16x13.5x10m, located in the submucosal area between the gastric corpus and the transverse colon. The microscopic examination showed acini, which have a highly cellular appearance, contain areas of necrosis, and form nested structures in places, stratification in places. The immunohistochemical examination demonstrated positive Trypsin expression, while focal positive expression of neuroendocrine markers such as Synaptophysin, Chromogranin, and Insulinomaassociated protein 1 (INSM-1) was observed. In betacatenin staining, aberrant nuclear and cytoplasmic positive expression was observed, and this staining pattern and morphology confirmed the diagnosis of pancreatoblastoma. Pathological Stage:pT3,N0,Mx the patient had an uneventful postoperative period and was referred to the oncology department for adjuvant chemotherapy. Pancreatoblastoma is an extremely rare type of pancreatic cancer and there are no established guidelines for the treatment of this aggressive disease. Surgical resection is recommended if anatomically possible. Pancreatoblastoma should be considered in the differential diagnosis of asymptomatic masses containing cystic-solid components and reaching very large sizes. Key words: Pancreas,Rare tumor, Pancreatoblastoma.

胰腺母细胞瘤是一种罕见的胰腺恶性上皮肿瘤。它主要发生在儿科人群中,在成人中极为罕见。一名64岁男性患者,无已知全身性疾病,以腹痛和消化不良主诉来到我们诊所。体格检查时,触诊到一压痛的上腹部肿块。初步诊断为胃肠道间质瘤,接受手术治疗。行肿块整体切除。横结肠部分切除,胃体楔形切除。行侧对侧吻合术。病例的宏观检查显示肿瘤病变约16 × 13.5 × 10m,位于胃主体和横结肠之间的粘膜下区域。显微镜检查显示腺泡具有高度细胞化的外观,包含坏死区域,局部形成巢状结构,局部分层。免疫组化检查显示胰蛋白酶阳性表达,神经内分泌标志物如Synaptophysin、Chromogranin和胰岛素瘤相关蛋白1 (INSM-1)局灶性阳性表达。betacatenin染色显示细胞核和细胞质异常阳性表达,这种染色模式和形态证实了胰腺母细胞瘤的诊断。病理分期:pT3、N0、Mx。术后平稳,转肿瘤科辅助化疗。胰腺母细胞瘤是一种极其罕见的胰腺癌,目前还没有针对这种侵袭性疾病的治疗指南。如果解剖条件允许,建议手术切除。胰腺母细胞瘤应考虑在鉴别诊断无症状肿块包含囊实性成分,并达到非常大。关键词:胰腺,罕见肿瘤,胰腺母细胞瘤。
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引用次数: 0
Metastatic Small Cell Carcinoma of a Male Breast: A Case Report and Review of the Literature. 男性乳房转移性小细胞癌1例报告及文献复习。
Q3 Medicine Pub Date : 2023-05-01
Nadin Shawar Al Tamimi, Yousra Bennouna, Mohammed El Fadli, Rhizlane Belbaraka

Neuroendocrine breast cancers are rare tumors that were recognized as a distinct entity by WHO classification in 2003. It is much rarer in male breast cancer. Diagnosis is based on immunochemical analysis in which the expression of at least one neuroendocrine marker is required, associated with the exclusion of another primary site of the tumor. These tumors have a worse long-term outcome compared to other breast cancers. Small cell carcinoma of the breast is a high-grade subtype, presents with more advanced disease, and has a poorer prognosis compared with other neuroendocrine breast subtypes. A proper therapeutic strategy is still not well established. In the herein reported case, a 62-year-old male patient was diagnosed with small cell neuroendocrine carcinoma of the breast, metastatic to the liver, lung, bone and lymph node, and was treated with a first-line Platinum-Etoposide chemotherapy combination with a good clinical and radiological response. Only four previous cases of male small cell breast carcinoma were reported. Keywords: Neuroendocrine Breast Carcinoma, Small Cell Carcinoma, Diagnosis, Prognosis, Treatment.

神经内分泌乳腺癌是一种罕见的肿瘤,在2003年被世卫组织分类认定为一个独特的实体。这种情况在男性乳腺癌中更为罕见。诊断基于免疫化学分析,其中至少需要一种神经内分泌标志物的表达,并排除肿瘤的另一个原发部位。与其他乳腺癌相比,这些肿瘤的长期预后更差。乳腺小细胞癌是一种高级别亚型,病程较晚,与其他神经内分泌乳腺亚型相比预后较差。适当的治疗策略仍然没有很好地确立。在本文报道的病例中,62岁男性患者被诊断为乳腺小细胞神经内分泌癌,转移到肝、肺、骨和淋巴结,并接受一线铂-依托泊苷联合化疗治疗,临床和放射学反应良好。既往仅报道4例男性小细胞乳腺癌。关键词:神经内分泌乳腺癌,小细胞癌,诊断,预后,治疗
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引用次数: 0
EGFR Expression in Gallbladder Carcinoma in North Indian Population. 北印度人群胆囊癌中EGFR的表达。
Q3 Medicine Pub Date : 2023-05-01
Vikash, Vikas Kailashiya, Mohan Kumar, Puneet

Objective: Gallbladder carcinoma is the most frequent biliary tract carcinoma with over all very poor prognosis. Epidermal growth factor receptor (EGFR) is known to be involved in carcinogenesis and overexpressed in various malignancies including head and neck, breast, lung and colon carcinomas. This study was done to explore the expression of EGFR in gallbladder carcinoma cases in the north Indian population so that it may be used as a therapeutic target in these patients.

Materials and methods: 59 cases of gallbladder carcinoma diagnosed by histopathological examination were included in study. Expression of EGFR was seen by immunohistochemistry method on histopathology slides.

Results: Out of 59 gallbladder carcinoma cases 46 (78%) were female and 13 (22%) were male with female to male ratio of 3.54:1. Mean age was 51.71±11.32 years. On histopathological examination 51 (86.4%) cases were conventional adenocarcinoma, 2 (3.4%) adenosquamous carcinoma, 2 (3.4%) mucinous adenocarcinoma, 2 (3.4%) papillary adenocarcinoma, 1 (1.7%) signet ring cell carcinoma and 1 (1.7%) squamous cell carcinoma histological subtypes. EGFR expression was present in 31 (52.5%) of gallbladder carcinoma cases and strong EGFR expression was significantly associated with poor differentiation of tumour.

Conclusion: In our study EGFR was positive in the majority of gallbladder carcinoma cases. There was inverse correlation between differentiation of tumor and EGFR expression. Strong EGFR expression was significantly higher in poorly differentiated tumors compared to well differentiated tumors suggesting its role in prognosis. This also suggest that EGFR might have a role in tumor progression and aggressiveness. Therefore, EGFR have potential to be used as therapeutic target in significant number of patients. More larger sample studies are required to confirm our findings. EGFR may be further studied as therapeutic target in clinical trials in the Indian population to improve morbidity and mortality of gallbladder carcinoma patients.

Key words: EGFR Expression, Gallbladder Carcinoma, Immunohistochemistry, Targeted Therapy.

目的:胆囊癌是最常见的胆道肿瘤,预后极差。表皮生长因子受体(Epidermal growth factor receptor, EGFR)参与肿瘤的发生,在头颈癌、乳腺癌、肺癌和结肠癌等多种恶性肿瘤中过度表达。本研究旨在探讨EGFR在印度北部人群胆囊癌病例中的表达情况,以便将其作为这些患者的治疗靶点。材料与方法:选取经组织病理学检查诊断为胆囊癌的59例进行研究。免疫组化法观察组织病理切片上EGFR的表达。结果:59例胆囊癌患者中,女性46例(78%),男性13例(22%),男女比例为3.54:1。平均年龄51.71±11.32岁。组织病理学检查:常规腺癌51例(86.4%),腺鳞癌2例(3.4%),粘液腺癌2例(3.4%),乳头状腺癌2例(3.4%),印戒细胞癌1例(1.7%),鳞状细胞癌1例(1.7%)。31例(52.5%)胆囊癌中存在EGFR表达,EGFR高表达与肿瘤分化程度低有显著相关性。结论:在我们的研究中,EGFR在大多数胆囊癌中呈阳性。肿瘤分化程度与EGFR表达呈负相关。EGFR在低分化肿瘤中的表达明显高于高分化肿瘤,提示其在预后中的作用。这也表明EGFR可能在肿瘤进展和侵袭性中起作用。因此,EGFR有潜力在相当数量的患者中作为治疗靶点。需要更多的大样本研究来证实我们的发现。EGFR可作为治疗靶点在印度人群的临床试验中进一步研究,以改善胆囊癌患者的发病率和死亡率。关键词:EGFR表达,胆囊癌,免疫组化,靶向治疗
{"title":"EGFR Expression in Gallbladder Carcinoma in North Indian Population.","authors":"Vikash,&nbsp;Vikas Kailashiya,&nbsp;Mohan Kumar,&nbsp;Puneet","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Gallbladder carcinoma is the most frequent biliary tract carcinoma with over all very poor prognosis. Epidermal growth factor receptor (EGFR) is known to be involved in carcinogenesis and overexpressed in various malignancies including head and neck, breast, lung and colon carcinomas. This study was done to explore the expression of EGFR in gallbladder carcinoma cases in the north Indian population so that it may be used as a therapeutic target in these patients.</p><p><strong>Materials and methods: </strong>59 cases of gallbladder carcinoma diagnosed by histopathological examination were included in study. Expression of EGFR was seen by immunohistochemistry method on histopathology slides.</p><p><strong>Results: </strong>Out of 59 gallbladder carcinoma cases 46 (78%) were female and 13 (22%) were male with female to male ratio of 3.54:1. Mean age was 51.71±11.32 years. On histopathological examination 51 (86.4%) cases were conventional adenocarcinoma, 2 (3.4%) adenosquamous carcinoma, 2 (3.4%) mucinous adenocarcinoma, 2 (3.4%) papillary adenocarcinoma, 1 (1.7%) signet ring cell carcinoma and 1 (1.7%) squamous cell carcinoma histological subtypes. EGFR expression was present in 31 (52.5%) of gallbladder carcinoma cases and strong EGFR expression was significantly associated with poor differentiation of tumour.</p><p><strong>Conclusion: </strong>In our study EGFR was positive in the majority of gallbladder carcinoma cases. There was inverse correlation between differentiation of tumor and EGFR expression. Strong EGFR expression was significantly higher in poorly differentiated tumors compared to well differentiated tumors suggesting its role in prognosis. This also suggest that EGFR might have a role in tumor progression and aggressiveness. Therefore, EGFR have potential to be used as therapeutic target in significant number of patients. More larger sample studies are required to confirm our findings. EGFR may be further studied as therapeutic target in clinical trials in the Indian population to improve morbidity and mortality of gallbladder carcinoma patients.</p><p><strong>Key words: </strong>EGFR Expression, Gallbladder Carcinoma, Immunohistochemistry, Targeted Therapy.</p>","PeriodicalId":53633,"journal":{"name":"The gulf journal of oncology","volume":"1 42","pages":"47-52"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9582605","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}
引用次数: 0
Study of Efficacy and Toxicity of Capecitabine Maintenance After Response to Docetaxel, Cisplatin, and 5-Fluracil-Based Chemotherapy in Advanced Carcinoma Stomach. 多西紫杉醇、顺铂、5-氟尿嘧啶化疗对晚期胃癌患者疗效及毒性的影响
Q3 Medicine Pub Date : 2023-05-01
Udip Maheshwari, Pankaj Goyal, Varun Goel, Nivedita Patnaik, Venkata Pradeep Babu Koyyala, Krushna Chaudhari, D C Doval, Vineet Talwar

Background: Advanced gastric cancer is associated with poor survival despite chemotherapy. Maintenance chemotherapy has been successfully tried in lung cancer and colorectal cancers however there is scarce literature on maintenance therapy in advanced gastric cancer. We report a prospective non-randomized single-arm trial of capecitabine maintenance after response to docetaxel, cisplatin, and 5-Flurouracil-based chemotherapy.

Methods: 50 patients with advanced gastric cancer, who had achieved response or had stable disease after 6 cycles of Docetaxel, Cisplatin, and 5-Flurouracil (D 75 mg/m2, C 75 mg/m2, FU 750 mg/m2/d d1-d5, q3 weeks) chemotherapy were prospectively selected to receive maintenance chemotherapy with capecitabine (1000mg/ m2 bid d1-d14 q21 days) until progression.

Results: During the median follow-up period of 18 months all patients had progressed, however, there was no treatment-related death, the median time to tumor progression was 10.3 months, with grade 3 and 4 toxicities in 10-15% of patients, and treatment delays in 75% of patients.

Conclusions: Our study has shown that maintenance chemotherapy with capecitabine post-first-line docetaxel, cisplatin, and 5-FU-based chemotherapy is effective and delays tumor progression. However, toxicity was a concern in our study which led to treatment-related delays but without any treatment-related death. Most patients continued therapy till progression.

背景:晚期胃癌与化疗后生存率低相关。维持化疗在肺癌和结直肠癌中已成功尝试,但在晚期胃癌中维持治疗的文献很少。我们报告了一项前瞻性非随机单臂试验,在对多西他赛、顺铂和5-氟尿嘧啶化疗有反应后,卡培他滨维持治疗。方法:前瞻性选择多西他赛、顺铂、5-氟尿嘧啶化疗6个周期(D 75 mg/m2, C 75 mg/m2, FU 750 mg/m2/ D d1-d5, q3周)后达到缓解或病情稳定的晚期胃癌患者50例,接受卡培他滨维持化疗(1000mg/ m2 bid d1-d14 q21天),直至进展。结果:在18个月的中位随访期间,所有患者均出现进展,但无治疗相关死亡,肿瘤进展的中位时间为10.3个月,10-15%的患者出现3级和4级毒性,75%的患者出现治疗延迟。结论:我们的研究表明,一线多西他赛、顺铂和基于5- fu的化疗后卡培他滨维持化疗是有效的,并能延缓肿瘤进展。然而,在我们的研究中,毒性是一个值得关注的问题,它导致治疗相关的延迟,但没有任何治疗相关的死亡。大多数患者继续治疗直至病情恶化。
{"title":"Study of Efficacy and Toxicity of Capecitabine Maintenance After Response to Docetaxel, Cisplatin, and 5-Fluracil-Based Chemotherapy in Advanced Carcinoma Stomach.","authors":"Udip Maheshwari,&nbsp;Pankaj Goyal,&nbsp;Varun Goel,&nbsp;Nivedita Patnaik,&nbsp;Venkata Pradeep Babu Koyyala,&nbsp;Krushna Chaudhari,&nbsp;D C Doval,&nbsp;Vineet Talwar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Advanced gastric cancer is associated with poor survival despite chemotherapy. Maintenance chemotherapy has been successfully tried in lung cancer and colorectal cancers however there is scarce literature on maintenance therapy in advanced gastric cancer. We report a prospective non-randomized single-arm trial of capecitabine maintenance after response to docetaxel, cisplatin, and 5-Flurouracil-based chemotherapy.</p><p><strong>Methods: </strong>50 patients with advanced gastric cancer, who had achieved response or had stable disease after 6 cycles of Docetaxel, Cisplatin, and 5-Flurouracil (D 75 mg/m2, C 75 mg/m2, FU 750 mg/m2/d d1-d5, q3 weeks) chemotherapy were prospectively selected to receive maintenance chemotherapy with capecitabine (1000mg/ m2 bid d1-d14 q21 days) until progression.</p><p><strong>Results: </strong>During the median follow-up period of 18 months all patients had progressed, however, there was no treatment-related death, the median time to tumor progression was 10.3 months, with grade 3 and 4 toxicities in 10-15% of patients, and treatment delays in 75% of patients.</p><p><strong>Conclusions: </strong>Our study has shown that maintenance chemotherapy with capecitabine post-first-line docetaxel, cisplatin, and 5-FU-based chemotherapy is effective and delays tumor progression. However, toxicity was a concern in our study which led to treatment-related delays but without any treatment-related death. Most patients continued therapy till progression.</p>","PeriodicalId":53633,"journal":{"name":"The gulf journal of oncology","volume":"1 42","pages":"40-46"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9582608","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}
引用次数: 0
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The gulf journal of oncology
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