Background: Metastatic breast cancer (Stage IV) accounts for 3% of all newly diagnosed patients with breast cancer in Japan, which is not different from that of USA (6%) reported according to the Surveillance, Epidemiology and End Results data. The treatment of Stage IV breast cancer has traditionally been palliative care with chemotherapy, hormonal therapy and/or radiation therapy. Young patients with limited metastatic (oligometastatic) disease and an excellent performance status tend to be long-term survivors. Combined treatment for such patients including surgery, provide better chance for longterm progression-free survival than systemic therapy alone. Objective: Evaluating overall survival and progression free survival for metastatic breast cancer patients underwent mastectomy plus systemic therapy versus that on systemic therapy alone.
Patients and methods: This randomized study was conducted in surgical oncology department, medical oncology department, South Egypt Cancer Institute, Assiut University. We prospectively review and compare women presented with metastatic breast cancer between from January 2014 and December 2020, who received primary tumor resection (group A) and women treated non-operatively (group B).
Results: This study was conducted in surgical oncology department, medical oncology department-South Egypt Cancer Institute, Assiut University. we retrospectively and prospectively review and compare women (200 patients) presented with metastatic breast cancer between January 2014 and December 2019, who received surgery to the breast and women treated non-operatively. The study includes …
Objective: The present study aimed to compare intraoperative and postoperative outcomes of laparoscopic-assisted distal gastrectomy versus totally laparoscopic distal gastrectomy (TLDG) Billroth I (BI) for gastric cancer and to assess the impact of the initial introduction phase of TLDG BI anastomosis.
Patients and methods: The study analyzed the prospectively collected data of patients who underwent laparoscopic distal gastrectomy BI from 2014 to 2021 at Seoul National University Hospital.
Results: Among 1116 patients, laparoscopic-assisted distal gastrectomy BI was performed in 566 patients and TLDG BI was performed in 550 patients. The total laparoscopic arm had a faster mean operative time (190 vs 208 min; P < 0.001) and a shorter postoperative hospital stay (7.4 vs 7.9 d; P < 0.001). Local complications were higher in the total laparoscopic group (17.6% vs 9.9%; P = 0.008) during the early introduction phase.
Conclusion: The total laparoscopic approach for BI reconstruction is safe and effective with faster operative time, shorter hospital stays, and less wound infection, but it may be associated with an increase in postoperative surgical complications and hospital stay in the early introduction phase.
Background: In breast cancer, painful bone metastases are common. Local radiotherapy is the standard treatment of painful bone metastases. Pain control and overall response rateswere low in radiotherapy alone.
The objectives of this study were to compare the safety and efficacy of external beam radiotherapy with concurrent capecitabine vs. external beam radiotherapy alone in pain control of painful bone metastases in breast cancer patients.
Materials and methods: Eighty-four patients with painful bone metastases from breast cancer participated in this prospective study. We randomized the patients into two groups: group A treated with radiotherapy 30 Gy in 10 fractions and group B treated with capecitabine 825 mg/m2 every 12 hrs. concurrently with the same radiotherapy dose.
Results: There was no statistically significant difference between the two groups regarding early treatment toxicity. Most of the toxicity was gastrointestinal (diarrhea and nausea) and mild (grade I or II). The median pain score decreased from week one, and there was a marked response at week4. The difference in median pain score between both groups was statistically significant with p-value = 0.045. The median analgesic score in both groups was statistically significant with a p-value = 0.032 at week 12. A complete response to pain at week 4 was 19% and 42.9% in groups A and B, respectively. Conclusion: Concurrent chemoradiation in painful bone metastases from breast cancer origin was tolerable and safe; it had a higher overall response rate and pain palliation than radiotherapy alone.
Abstract: Purpose: The aim of this prospective study was to compare the efficacy and toxicities of gemcitabine to cisplatin as a radio sensitizer in trimodality treatment of bladder transitional cell carcinoma. Methods: It was a prospective study on100 patients with bladder TCC, clinical stage T2 or T3 N0 M0 who underwent concurrent radio chemotherapy after maximum safe trans-urethral resection. Patients were divided into 2 groups: gemcitabine group, received weekly doses of gemcitabine 125mg/m2 , and cisplatin group, received weekly doses of cisplatin 40mg/m2 concurrently with 66 Gy of conventional radiation therapy. Results: Disease free survival in gemcitabine group was 79.4%, while in cisplatin group was 77.6% with insignificant differences. All patients in cisplatin group tolerated treatment protocol completely, while six patients in gemcitabine group could not completed their weekly gemcitabine doses because of grade III gastrointestinal toxicity. Conclusions: Gemcitabine is a reasonable option in trimodality treatments in urinary bladder preservative strategies. [
Abstract Introduction: Skin sparing mastectomy with immediate autologous breast reconstruction has a positive psycho-social and sexual effect, however postoperative radiotherapy could adversely affect its cosmetic results. Patients and methods: This study included 24 female breast cancer patients underwent skin sparing mastectomy with or without scarifying NAC and immediate reconstruction by autologous TRAM and latissimus dorsi myocutaneous flap. They received adjuvant chemotherapy followed by 3DCRT, we evaluated them for skin complications and cosmoses. Results: Faint erythema or dry desquamation detected in 16 patients (66.6%), while 8 patients (29.2%) had moderate to brisk erythema. Two patients (8.3%) had skin edema and one patient (4.2%) had telangiectasia. Two patients complained from moderate pain Fat necrosis within the flap detected only in one patient (4.2%). Twentytwo patients (83.3%) had acceptable cosmoses while 2 patients had unsatisfactory cosmetic results. Conclusion: Postoperative radiotherapy is safe with acceptable rate of complications and very good patients satisfactions after skin sparing mastectomy and immediate autologous breast reconstruction. Keywords: Skin sparing; Immediate autologous reconstruction; Post-operative; Radiotherapy; Breast cancer
Oxaliplatin and infusional fluorouracil/leucovorin or capecitabine has emerged as important options in the adjuvant and palliative treatment of colorectal cancer. Severe Oxaliplatin induced neurotoxicity may require chemotherapy dose reduction or cessation. The incidence of oxaliplatin-induced neurotoxicity has varied from 12% - 18%. Several attempts have been proposed to prevent or treat oxaliplatin-induced neurotoxicity, but treatment of established chronic Oxaliplatin induced neurotoxicity is limited. Purpose: To assess the efficacy of parenteral Glutamine dipeptide (N2-L-Alanyl-L-Glutamine Dipeptide, 20 g·m/100ml, IV) for preventing of oxaliplatin induced neurotoxicity. Patients and Methods: A pilot study was performed. 120 patients with metastatic colorectal cancer (mCRC) entered into the study. 60 patients randomly assigned to receive IV glutamine dipeptide (20 g·m IV) day 1-2 with FOLFOX-4 to be repeated every 15 days as a first line of treatment of metastatic colorectal cancer and 60 patients assigned to receive only FOLFOX-4 (control group). Neurotoxicity symptoms and signs were evaluated before each cycle. Results: There were significantly fewer neurological symptoms in patients receiving glutamine dipeptide than in those who did not. A decreased percentage of grade 1-2 peripheral neuropathy was observed in the glutamine dipeptide group after two cycles (8.3% versus 20%; P = 0.04) and 4 cycles (13.3% vs 26.7%; P = 0.02). A significantly lower incidence of grade 3-4 neuropathy was noted in the glutamine dipeptide group after four and six cycles (6.7% versus 15%, P = 0.02 and 13.3% versus 33.3%. P = 0.04, respectively). The need for oxaliplatin dose reduction was significantly lower in the glutamine dipeptide (Dipeptiven) group (10% vs 26.7%; P = 0.02) and there were no significant differences between two groups in response to chemotherapy among patient with mCRC (48.3% vs 50%). Conclusion: These data concluded that IV dipeptide glutamine significantly decreases the incidence and severity of oxaliplatin induced neurotoxicity of mCRC without any attendant side effects.
Keywords
Colorectal Cancer, Oxaliplatin, FOLFOX-4, Alanylglutamine, Neuropathy
