Background: Electronic portal imaging device(EPID)has different dosimetric characteristics than the ionization chamber, which is considered as the gold standard detector in radiation dosimetry. The main purpose of this study was to develop the applications of EPID. Dosimetric properties of amorphous silicon EPID (aS500) need to be investigated. Materials and methods: To verify linear response with dose, images of a 10×10 cm² open field were acquired. The EPID was positioned at a fixed detector distance of 150 cm, and varying doses were delivered with monitor unit settings of 1MU and 12MU. Results: The flatness should be less than 3%. The maximum flatness value was 2.7% for field size 10×10 cm² and 1.8% for field size 18×8 cm², which are within tolerance. EPID response was compared with the chamber dose. It was found that by increasing field size, both the EPID response and chamber dose were increased. The study showed that the EPID aSi500 has the potential to be used as a relative dosimeter, making it a very simple and efficient tool for daily QA. Conclusion: All EPID measurements were performed using the linear accelerator Varian DMX. The physical characteristics measured in this work suggest that the SLIC-EPID can be used be as a relative dosimeter.

Background: Electronic portal imaging device(EPID)has different dosimetric characteristics than the ionization chamber, which is considered as the gold standard detector in radiation dosimetry. The main purpose of this study was to develop the applications of EPID. Dosimetric properties of amorphous silicon EPID (aS500) need to be investigated. Materials and methods: To verify linear response with dose, images of a 10×10 cm² open field were acquired. The EPID was positioned at a fixed detector distance of 150 cm, and varying doses were delivered with monitor unit settings of 1MU and 12MU. Results: The flatness should be less than 3%. The maximum flatness value was 2.7% for field size 10×10 cm² and 1.8% for field size 18×8 cm², which are within tolerance. EPID response was compared with the chamber dose. It was found that by increasing field size, both the EPID response and chamber dose were increased. The study showed that the EPID aSi500 has the potential to be used as a relative dosimeter, making it a very simple and efficient tool for daily QA. Conclusion: All EPID measurements were performed using the linear accelerator Varian DMX. The physical characteristics measured in this work suggest that the SLIC-EPID can be used be as a relative dosimeter.

micro ribonucleic acid-21 (miRNA 21) is overexpressed in multiple solid tumors, indicating that its biology is relevant to different type of cancers, in colorectal cancer (CRC), a lot of studies suggested its use as a diagnostic marker. Others as a predictive for 5-flurouracil (5 FU) sensitivity. This study was conducted to verified the significance of miRNA 21 as a prognostic and predictive marker in CRC. Patients and methods: It is a prospective study included 45 patients with stage I - IV CRC who attended at South Egypt Cancer Institute (SECI) from May 2017 to September 2018. miRNA 21 was measured by Quantitative real time polymerase chain reaction (q PCR) from peripheral blood sample and its levels of expression was correlated to the clinco pathological features of the studied patients, response to 5FU containing regimen which was assessed by response evaluation criteria in solid tumors (RECIST criteria) and to the survival. Results: High expression of the miRNA21 was significantly associated with advanced stage of CRC p 0.001, lymph node (LN) invasion p 0.001, distant metastasis p 0.01, lymphovascular invasion (LVI) p 0.01 and pre treatment level of carcinoembryonic antigen (CEA) p 0.031. Also we found that high expression of miRNA21was significantly had a bad effect on the response to 5FU containing regimen p 0.001, disease free survival (DFS) p 0.01 and overall survival (OS) p 0.01. Conclusion: miRNA 21 could be used as a non invasive prognostic and predictive marker in CRC.

Background and Objectives: Risk-adapted therapy for children with HL is directed toward high survival, minimal toxicity and optimal quality of life, with long term follow up. We assess the impact of prognostic factors associated with local treatment failure of pediatric HL patients with unfavorable criteria treated with combined modality: Alternating ABVD (Doxorubicin, Bleomycin, Vinblastine and Decarbazine) and COEP (Cyclophosphamide, Oncovin, Etoposide and Prednisone) chemotherapy and response-based, involved- field radiation for newly diagnosed unfavorable pediatric HL patients, also will detect toxicities and long-term complications observed in the patients. Methods: This prospective study was carried out from January 2010 to January 2018, with a median follow up of 74 months (range 8 - 103 months). 54 patients were eligible for this study stratified into two groups: intermediate risk (IR) and high-risk group (HR). Patients were treated with (4 - 6 cycles) and (6 - 8 cycles) respectively of alternating ABVD/COEP chemotherapy followed by involved-field radiation therapy (IFRT): 15 Gy for patients achieved complete response, and 25.5 Gy for those achieved a partial response. Results: 27 patients were IR and 27 patients were HR. There were 16 treatment failures; 5 patients had progressive disease; and 11 patients had a relapse. 9 patients died from their disease progression. The 5-year overall survival (OS) and event-free survival (EFS) rates (±SE) were 81.8% ± 5.7% and 71.8% ± 6.2% respectively. Multivariate analysis revealed that the only independent factor for inferior OS was radiotherapy. Conclusion: Treatment results of unfavourable HL patients in our study are satisfactory for with IR group but not for HR group who needs intensification of therapy. Radiotherapy is considered as a cornerstone in the treatment of the patients with unfavourable criteria with better assessment of early responders needed by PET-CT to identify patients at risk for relapse.

Background and Objectives: Risk-adapted therapy for children with HL is directed toward high survival, minimal toxicity and optimal quality of life, with long term follow up. We assess the impact of prognostic factors associated with local treatment failure of pediatric HL patients with unfavorable criteria treated with combined modality: Alternating ABVD (Doxorubicin, Bleomycin, Vinblastine and Decarbazine) and COEP (Cyclophosphamide, Oncovin, Etoposide and Prednisone) chemotherapy and response-based, involved- field radiation for newly diagnosed unfavorable pediatric HL patients, also will detect toxicities and long-term complications observed in the patients. Methods: This prospective study was carried out from January 2010 to January 2018, with a median follow up of 74 months (range 8 - 103 months). 54 patients were eligible for this study stratified into two groups: intermediate risk (IR) and high-risk group (HR). Patients were treated with (4 - 6 cycles) and (6 - 8 cycles) respectively of alternating ABVD/COEP chemotherapy followed by involved-field radiation therapy (IFRT): 15 Gy for patients achieved complete response, and 25.5 Gy for those achieved a partial response. Results: 27 patients were IR and 27 patients were HR. There were 16 treatment failures; 5 patients had progressive disease; and 11 patients had a relapse. 9 patients died from their disease progression. The 5-year overall survival (OS) and event-free survival (EFS) rates (±SE) were 81.8% ± 5.7% and 71.8% ± 6.2% respectively. Multivariate analysis revealed that the only independent factor for inferior OS was radiotherapy. Conclusion: Treatment results of unfavourable HL patients in our study are satisfactory for with IR group but not for HR group who needs intensification of therapy. Radiotherapy is considered as a cornerstone in the treatment of the patients with unfavourable criteria with better assessment of early responders needed by PET-CT to identify patients at risk for relapse.

Background and Objectives: Risk-adapted therapy for children with HL is directed toward high survival, minimal toxicity and optimal quality of life, with long term follow up. We assess the impact of prognostic factors associated with local treatment failure of pediatric HL patients with unfavorable criteria treated with combined modality: Alternating ABVD (Doxorubicin, Bleomycin, Vinblastine and Decarbazine) and COEP (Cyclophosphamide, Oncovin, Etoposide and Prednisone) chemotherapy and response-based, involved- field radiation for newly diagnosed unfavorable pediatric HL patients, also will detect toxicities and long-term complications observed in the patients. Methods: This prospective study was carried out from January 2010 to January 2018, with a median follow up of 74 months (range 8 - 103 months). 54 patients were eligible for this study stratified into two groups: intermediate risk (IR) and high-risk group (HR). Patients were treated with (4 - 6 cycles) and (6 - 8 cycles) respectively of alternating ABVD/COEP chemotherapy followed by involved-field radiation therapy (IFRT): 15 Gy for patients achieved complete response, and 25.5 Gy for those achieved a partial response. Results: 27 patients were IR and 27 patients were HR. There were 16 treatment failures; 5 patients had progressive disease; and 11 patients had a relapse. 9 patients died from their disease progression. The 5-year overall survival (OS) and event-free survival (EFS) rates (±SE) were 81.8% ± 5.7% and 71.8% ± 6.2% respectively. Multivariate analysis revealed that the only independent factor for inferior OS was radiotherapy. Conclusion: Treatment results of unfavourable HL patients in our study are satisfactory for with IR group but not for HR group who needs intensification of therapy. Radiotherapy is considered as a cornerstone in the treatment of the patients with unfavourable criteria with better assessment of early responders needed by PET-CT to identify patients at risk for relapse.

Background and Objectives: Risk-adapted therapy for children with HL is directed toward high survival, minimal toxicity and optimal quality of life, with long term follow up. We assess the impact of prognostic factors associated with local treatment failure of pediatric HL patients with unfavorable criteria treated with combined modality: Alternating ABVD (Doxorubicin, Bleomycin, Vinblastine and Decarbazine) and COEP (Cyclophosphamide, Oncovin, Etoposide and Prednisone) chemotherapy and response-based, involved- field radiation for newly diagnosed unfavorable pediatric HL patients, also will detect toxicities and long-term complications observed in the patients. Methods: This prospective study was carried out from January 2010 to January 2018, with a median follow up of 74 months (range 8 - 103 months). 54 patients were eligible for this study stratified into two groups: intermediate risk (IR) and high-risk group (HR). Patients were treated with (4 - 6 cycles) and (6 - 8 cycles) respectively of alternating ABVD/COEP chemotherapy followed by involved-field radiation therapy (IFRT): 15 Gy for patients achieved complete response, and 25.5 Gy for those achieved a partial response. Results: 27 patients were IR and 27 patients were HR. There were 16 treatment failures; 5 patients had progressive disease; and 11 patients had a relapse. 9 patients died from their disease progression. The 5-year overall survival (OS) and event-free survival (EFS) rates (±SE) were 81.8% ± 5.7% and 71.8% ± 6.2% respectively. Multivariate analysis revealed that the only independent factor for inferior OS was radiotherapy. Conclusion: Treatment results of unfavourable HL patients in our study are satisfactory for with IR group but not for HR group who needs intensification of therapy. Radiotherapy is considered as a cornerstone in the treatment of the patients with unfavourable criteria with better assessment of early responders needed by PET-CT to identify patients at risk for relapse.

Aim: To assess the outcome and determine predictors of survival in pediatric patients with osteosarcoma of the extremities treated with a unified chemotherapy protocol at a single institution over a fifteen-year period. Methods: We performed a retrospective analysis of medical records of 48 pediatric patients with histologically-verified osteosarcoma of the extremities diagnosed at South Egypt Cancer Institute and received treatment between January 2001 and December 2015. Results: With a median follow-up of 61 months for the entire cohort, estimates of Overall Survival (OS) for 3 and 5-year were 50.9% & 42.1%, respectively. While the estimates of OS for 3 and 5-year in the non-metastatic group were 79% & 65.2%, respectively. In the multivariable analysis, both metastatic disease at diagnosis and poor response to chemotherapy retained their statistical significance as independent predictors for Event Free Survival (EFS). Whereas for OS, a metastatic disease at diagnosis remained as the lone predictor of a dismal outcome, whilst a poor response to chemotherapy became marginally associated with an inferior outcome. Conclusion: In Upper Egypt, whereas slightly less than two-thirds of children with localized osteosarcoma of extremities survives their disease, metastasis at presentation remains the key predictor of dismal survival outcomes.

Aim: To assess the outcome and determine predictors of survival in pediatric patients with osteosarcoma of the extremities treated with a unified chemotherapy protocol at a single institution over a fifteen-year period. Methods: We performed a retrospective analysis of medical records of 48 pediatric patients with histologically-verified osteosarcoma of the extremities diagnosed at South Egypt Cancer Institute and received treatment between January 2001 and December 2015. Results: With a median follow-up of 61 months for the entire cohort, estimates of Overall Survival (OS) for 3 and 5-year were 50.9% & 42.1%, respectively. While the estimates of OS for 3 and 5-year in the non-metastatic group were 79% & 65.2%, respectively. In the multivariable analysis, both metastatic disease at diagnosis and poor response to chemotherapy retained their statistical significance as independent predictors for Event Free Survival (EFS). Whereas for OS, a metastatic disease at diagnosis remained as the lone predictor of a dismal outcome, whilst a poor response to chemotherapy became marginally associated with an inferior outcome. Conclusion: In Upper Egypt, whereas slightly less than two-thirds of children with localized osteosarcoma of extremities survives their disease, metastasis at presentation remains the key predictor of dismal survival outcomes.

Aim: To assess the outcome and determine predictors of survival in pediatric patients with osteosarcoma of the extremities treated with a unified chemotherapy protocol at a single institution over a fifteen-year period. Methods: We performed a retrospective analysis of medical records of 48 pediatric patients with histologically-verified osteosarcoma of the extremities diagnosed at South Egypt Cancer Institute and received treatment between January 2001 and December 2015. Results: With a median follow-up of 61 months for the entire cohort, estimates of Overall Survival (OS) for 3 and 5-year were 50.9% & 42.1%, respectively. While the estimates of OS for 3 and 5-year in the non-metastatic group were 79% & 65.2%, respectively. In the multivariable analysis, both metastatic disease at diagnosis and poor response to chemotherapy retained their statistical significance as independent predictors for Event Free Survival (EFS). Whereas for OS, a metastatic disease at diagnosis remained as the lone predictor of a dismal outcome, whilst a poor response to chemotherapy became marginally associated with an inferior outcome. Conclusion: In Upper Egypt, whereas slightly less than two-thirds of children with localized osteosarcoma of extremities survives their disease, metastasis at presentation remains the key predictor of dismal survival outcomes.