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Treatment Efficiency and Problems of Local Control in Localized Bladder/Prostate Rhabdomyosarcoma
Hanafy Hafez,
Enas El Nadi,
Alaa Younes,
Gehad Ahmed,
Mohamed Saad Zaghloul,
Hala Taha,
Rania Labib,
Sayed Abdelhamid Fadel,
Soha Ahmed
Issue:
Volume 7, Issue 2, June 2019
Pages:
33-38
Received:
19 February 2019
Accepted:
22 March 2019
Published:
18 April 2019
Abstract: Objectives: To assess the treatment efficiency, outcome and factors affecting the local control of localized bladder/prostate RMS. Patients and methods: Retrospective analysis of 54 patients with localized bladder/prostate RMS treated at Children Cancer Hospital, Egypt between August 2007 and Jan 2017. All patients were treated according to Intergroup Rhabdomyosarcoma Study (IRS -V) and subsequent Children’s Oncology Group COG guidelines. Results: The median age at diagnosis was 3.28 years (range 0.4–13.6). Fifty-one patients (94%) underwent initial biopsy. Complete surgical resection (primary or delayed) was performed in 7 patients (13%). Local control started before/at week 12 in 29 patients (61.7%). Local control methods were: Radiotherapy in 43 patients (79.2%), radiotherapy with surgery in 4 patients (9%), surgery in 1 patient and four patients did not receive local control. With a median follow up of 38.12 months, the 5-year failure-free survival (FFS) and overall (OS) of the whole patients were 60.4 ± 14.5% and 75.4 ± 14.1% respectively. A better 5-year FFS was experienced by those who had early local control (79.2 ± 17% vs. 43.8 ± 25% p= 0.005). Conclusions: Timing of local control and local radiotherapy is crucial and shouldn’t be delayed waiting for further response to the systemic chemotherapy.
Abstract: Objectives: To assess the treatment efficiency, outcome and factors affecting the local control of localized bladder/prostate RMS. Patients and methods: Retrospective analysis of 54 patients with localized bladder/prostate RMS treated at Children Cancer Hospital, Egypt between August 2007 and Jan 2017. All patients were treated according to Intergr...
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New Targets in Advanced Thyroid Cancer Refractory Iodine
Lynda Marianela Vásconez Proaño
Issue:
Volume 7, Issue 2, June 2019
Pages:
39-44
Received:
24 September 2018
Accepted:
12 October 2018
Published:
22 April 2019
Abstract: The majority of deaths due to thyroid cancer occur in patients with advanced DTC refractory to radioactive iodine. The spectacular advances in molecular medicine of recent years have opened new therapeutic possibilities. Currently, there is general agreement that treatment with Tyrosine Kinase Inhibitors (TKI) should only be considered in patients with differentiated thyroid carcinoma refractory to radioactive iodine, with progressive and / or symptomatic metastatic disease that can not otherwise be treated locally. Most of these "new molecules" are multichannel inhibitors with varied action, which interact on different proteins such as RET, BRAF, cKIT, MET, EGFR, MAPK, PDGFR, etc. In addition, they have the additional advantage that they markedly prevent angiogenesis by acting on VEGFR 1, 2, and 3. TKI are associated with progression-free survival but not curative. Also, causes adverse effects that can affect the quality of life.The prolongation of progression-free survival has been demonstrated with sorafenib and lenvatinib compared with placebo in two phase III trials. These two drugs have been approved by the FDA and the European Medicines Agency for use in patients refractory to radioactive iodine with metastatic disease. Based on the Phase II Trials there are other Tyrosine Kinase Inhibitors (TKI) available such as sunitinib, axitinib or pazopanib that can produce some kind of clinical benefit and therefore need further investigation.
Abstract: The majority of deaths due to thyroid cancer occur in patients with advanced DTC refractory to radioactive iodine. The spectacular advances in molecular medicine of recent years have opened new therapeutic possibilities. Currently, there is general agreement that treatment with Tyrosine Kinase Inhibitors (TKI) should only be considered in patients ...
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Bowel Obstruction and Perforation in Pediatric Intestinal Mature B Cell Lymphoma: Incidence, Clinical Features, and Outcome in CCHE
Samah Fathy Semary,
Hany Abdel Rahman,
Gehad Ahmed,
Naglaa El Kenaie,
Marwa Romeih,
Rana Mohy,
Nouran Nagi
Issue:
Volume 7, Issue 2, June 2019
Pages:
45-52
Received:
19 March 2019
Accepted:
17 April 2019
Published:
26 May 2019
Abstract: Bowel perforation or obstruction is life-threatening complications of intestinal lymphoma. Our aim was to define incidence, clinical features, and outcome associated with bowel perforation or obstruction in pediatric intestinal lymphoma. A retrospective, non-randomized study was included all newly diagnosed pediatric intestinal mature B cell lymphoma patients who were operated out of intestinal obstruction or perforation from July 2007 till July 2017 in CCHE. The results showed that, intestinal obstruction or perforation developed in 34 patients (7.5%) out of 456 patients with intestinal mature B cell lymphoma. Median age is 4.85 years. All of them were treated accordingly to NHL LMB 96 protocol [1]. The 5 years OS among patients were operated out of intestinal obstruction, and who were operated out of perforation were 87.7%, 62.9% respectively with no significant statistical differences. Five years OS among patients with viable malignant cell versus no malignant cell was 65.2%, 90.9% respectively with significant P value. The five years OS for patients didn’t have surgery, and who had surgery was 87.9%, 78.6%, respectively, with no significant statistical differences. Multivariate analysis on EFS and OS was done for the overall group and the subgroup. Including age, sex, pathology, clinical stage, elevated LDH, presence of ATLS, showed statically no significance. In Conclusion, Intestinal complication in the form of obstruction with or without intussusception, or obstruction perforation followed by exploration is not adverse prognostic factor for survival in pediatric patients with intestinal mature B cell lymphoma. Operation with viable malignant cell was associated with significant lower outcome.
Abstract: Bowel perforation or obstruction is life-threatening complications of intestinal lymphoma. Our aim was to define incidence, clinical features, and outcome associated with bowel perforation or obstruction in pediatric intestinal lymphoma. A retrospective, non-randomized study was included all newly diagnosed pediatric intestinal mature B cell lympho...
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Clinico-Epidemiological Features and Survival Outcome in Patients with NSCLC: Ain Shams Clinical Oncology Department 5-Year Data
Ahmed Nagy,
Mohamed Kelney
Issue:
Volume 7, Issue 2, June 2019
Pages:
53-57
Received:
28 April 2019
Accepted:
10 June 2019
Published:
24 June 2019
Abstract: Background: Primary lung cancer is the most common malignant neoplasm worldwide with various prognostic factors. Methods: Data was analysed retrospectively from the medical records of 504 patients diagnosed with NSCLC and treated at Department of Clinical Oncology and Nuclear Medicine, Ain Shams University, Cairo-Egypt in the period from 1-1-2008 till 31-12- 2012. Results: The Median PFS after first, second and third lines was 3, 4 and 2 months respectively and the median OS was 8 months. Factors which were associated with a statistically significant difference in median OS were: age<60 years versus≥60 years (10 and 7 months respectively, p<0.001), female versus male gender (10 and 8 months respectively, p<0.001), urban versus rural residence (9 and 8 months respectively, p=0.03), smokers versus non-smokers (8 and 10 months respectively, p<0.001), patients presenting with non-neurological symptoms and those presenting with neurological symptoms (9 and 6 months respectively, p<0.001) and the receiving treatment versus no treatment (10 and 5 months respectively, p<0.001). Conclusion: This study shows that the active treatment of patients with NSCLC continues to have an important impact on survival. The fact that rural residence could be associated with worse OS warrants further investigation.
Abstract: Background: Primary lung cancer is the most common malignant neoplasm worldwide with various prognostic factors. Methods: Data was analysed retrospectively from the medical records of 504 patients diagnosed with NSCLC and treated at Department of Clinical Oncology and Nuclear Medicine, Ain Shams University, Cairo-Egypt in the period from 1-1-2008 t...
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Efficacy of Voriconazole Prophylaxis in Pediatric Patients with Acute Myeloid Leukemia, Single Center Experience, Egypt
Youssef Madney,
Omar Arafah,
Hader Elmahalawy,
Lobna Shalby
Issue:
Volume 7, Issue 2, June 2019
Pages:
58-65
Received:
2 May 2019
Accepted:
11 June 2019
Published:
24 June 2019
Abstract: Patients with hematologic malignancies are at higher risk for invasive fungal infections (IFI) mainly patients with acute myeloid leukemia. Antifungal prophylaxis can help to decrease the incidence of these infections and their related complications. Prospective study compared to historical control data included 136 newly diagnosed Acute Myeloid Leukemia patients treated at the National Cancer Institute, Cairo University from 2011 to 2014. The prospective group received primary Voriconazole compared to retrospective control regarding the infectious complications and incidence of fungal infection. Results showed that one hundred thirty-six (136) newly diagnosed pediatric AML patients were included in the study, 61 patients didn't receive antifungal prophylaxis (Non- prophylactic arm) while 75 patients received voriconazole prophylaxis (prophylactic arm). The median age among both groups was 5.5 years old. Thirty-one (50%) of the 61 patients in (non - prophylactic arm) and five (6.6%) of the 75 patients enrolled in group B (prophylactic arm) developed an invasive fungal infection. The most commonly affected sites were pulmonary (34/ 36) while fungal sinus infection was reported in 2 patients. Most patients develop an invasive fungal infection during the induction treatment phase. Primary prophylaxis with voriconazole had a highly statistically significant impact on the reduction of incidence of invasive fungal infection between 2 groups (p value.001). Fungal attributable mortality was reported in 8 patients (13%) in the historical group (no antifungal prophylaxis) in comparison to 2 patients (2.6%) in group patients received voriconazole antifungal prophylaxis. Three Overall and Event-free survival were comparable between both groups. In conclusion, Prophylactic Voriconazole significantly decreased the incidence of fungal infections but it had no impact on diseases or overall survival outcome. Bacterial sepsis and disease-related mortality was the main cause of deaths among our group patients.
Abstract: Patients with hematologic malignancies are at higher risk for invasive fungal infections (IFI) mainly patients with acute myeloid leukemia. Antifungal prophylaxis can help to decrease the incidence of these infections and their related complications. Prospective study compared to historical control data included 136 newly diagnosed Acute Myeloid Le...
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Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group
Mohamed Reda,
Mohamed Elbeltagy,
Mohamed Kamal,
Mahmoud Hammad
Issue:
Volume 7, Issue 2, June 2019
Pages:
66-72
Received:
14 May 2019
Accepted:
12 June 2019
Published:
24 June 2019
Abstract: Introduction: Primary intracranial germ cell tumors (ICGCTs) are rare, histologically diverse, and diagnostically challenging tumors that are usually localized in the pineal and suprasellar regions of the brain. Advanced neurosurgical techniques such as neuroendoscopy and frameless stereotactic biopsy have made diagnosis of newly discovered cases of ICGCTs easier and safer. Material and methods: Seventeen patients with intracranial germ cell tumors operated upon between 2008 to 2012 at the Children's Cancer Hospital Egypt, were retrospectively reviewed and analyzed regarding the surgical decision, clinical outcome and surgical complications. Results: There were 9 cases of germinoma (53%), and 8 cases of non-germinomatous germ cell tumors (47%). Nine cases were in the pineal region, six in the suprasellar, and two in the thalamic region. Ten cases were operated upon initially by open surgery and frozen section with subtotal resection and seven cases were biopsied either endoscopically (3 cases) or by frameless guided stereotaxic (4 cases). Accurate pathology was achieved in all biopsied cases without major complications. In the germinoma group, the 4-year overall survival and progression free survival rate were 75% for both at a median follow up period of 26 (range 1 -50) months. For the non-germinomatous germ cell tumors group, the 4-year OS and PFS rates were 36.5% and 31.2% at a median follow up period of 11 (range 2-54) months, respectively. Conclusion: In cases of intracranial germ cell tumors with negative tumor markers the role of surgery is important in the establishment of proper histopathological diagnosis. However, in Non Germinomatous Germ Cell Tumors, further investigations should be done regarding the extent of resection owing to the poor long-term outcome.
Abstract: Introduction: Primary intracranial germ cell tumors (ICGCTs) are rare, histologically diverse, and diagnostically challenging tumors that are usually localized in the pineal and suprasellar regions of the brain. Advanced neurosurgical techniques such as neuroendoscopy and frameless stereotactic biopsy have made diagnosis of newly discovered cases o...
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