Abstract Purpose This phase III trial was designed to test trolamine emulsion compared with the usual supportive care for patients with head and neck cancer undergoing radiation therapy with concurrent chemotherapy. Patients and methods Patients with biopsy-proven head and neck squamous cell carcinoma (HNSCC) treated with radical radiotherapy and weekly concurrent cisplatin 40 mg/m2 at the South Egypt Cancer Institute (Assiut) were randomly assigned to one of the following groups: treatment group (prophylactic trolamine emulsion every 8 h, 4 h apart from the radiotherapy session) or control group (usual supportive care). The primary outcome was the reduction of grade III or higher skin toxicity, as per RTOG Acute Radiation Toxicity Criteria. Results From March 2008 to June 2009, 30 patients were entered onto the trial. The average age was 54.5 years. Patients were predominately male (83%) and most continued to use tobacco products (70%). The rate of skin-reaction was 100% in both groups. A mild radiation reaction (grades I and II) occurred as follows: 80% (12/15 cases) in the treatment group and 46.6% (7/15 cases) in the control group. A grade III skin reaction developed in 20% (3/15 cases) in the treatment group and 53.3% (8/15 cases) in the controls. There was a significant difference (P  0.01) between the two groups. Conclusion Our results confirm that trolamine emulsion significantly reduces the intensity of acute dermatitis following 3D-CRT with weekly cisplatin in HNSCC.

Background The optimal time sequences for chemotherapy and radiation therapy after breast surgery for patients with breast cancer remains unknown. Most of published studies were done for early breast cancer patients. However, in Egypt advanced stages were the common presentation. This retrospective analysis aimed to assess the optimum sequence for our population. Methods 267 eligible patients planned to receive adjuvant chemotherapy [FAC] and radiotherapy. Majority of patients (87.6%) underwent modified radical mastectomy while, 12.4% had conservative surgery. We divided the patients into 3 groups according to the sequence of chemotherapy and radiotherapy. Sixty-seven patients (25.1%) received postoperative radiotherapy before chemotherapy [group A]. One hundred and fifty patients (56.2%) were treated in a sandwich scheme (group B), which means that 3 chemotherapy cycles were given prior to radiotherapy followed by 3 further chemotherapy cycles. A group of 50 patients (18.7%) was treated sequentially (group C), which means that radiotherapy was supplied after finishing the last chemotherapy cycle. Patients' characteristics are balanced between different groups. Results Disease free survival was estimated at 2.5 years, and it was 83.5%, 82.3% and 80% for patient receiving radiation before chemotherapy [group A], sandwich [group B] and after finishing chemotherapy [group C] respectively (p > 0.5). Grade 2 pneumonitis, which necessitates treatment with steroid, was detected in 3.4% of our patients, while grade 2 radiation dermatitis was 17.6%. There are no clinical significant differences between different groups regarded pulmonary or skin toxicities. Conclusion Regarding disease free survival and treatment toxicities, in our study, we did not find any significant difference between the different radiotherapy and chemotherapy sequences.

Background The optimal time sequences for chemotherapy and radiation therapy after breast surgery for patients with breast cancer remains unknown. Most of published studies were done for early breast cancer patients. However, in Egypt advanced stages were the common presentation. This retrospective analysis aimed to assess the optimum sequence for our population. Methods 267 eligible patients planned to receive adjuvant chemotherapy [FAC] and radiotherapy. Majority of patients (87.6%) underwent modified radical mastectomy while, 12.4% had conservative surgery. We divided the patients into 3 groups according to the sequence of chemotherapy and radiotherapy. Sixty-seven patients (25.1%) received postoperative radiotherapy before chemotherapy [group A]. One hundred and fifty patients (56.2%) were treated in a sandwich scheme (group B), which means that 3 chemotherapy cycles were given prior to radiotherapy followed by 3 further chemotherapy cycles. A group of 50 patients (18.7%) was treated sequentially (group C), which means that radiotherapy was supplied after finishing the last chemotherapy cycle. Patients' characteristics are balanced between different groups. Results Disease free survival was estimated at 2.5 years, and it was 83.5%, 82.3% and 80% for patient receiving radiation before chemotherapy [group A], sandwich [group B] and after finishing chemotherapy [group C] respectively (p > 0.5). Grade 2 pneumonitis, which necessitates treatment with steroid, was detected in 3.4% of our patients, while grade 2 radiation dermatitis was 17.6%. There are no clinical significant differences between different groups regarded pulmonary or skin toxicities. Conclusion Regarding disease free survival and treatment toxicities, in our study, we did not find any significant difference between the different radiotherapy and chemotherapy sequences.

Background The optimal time sequences for chemotherapy and radiation therapy after breast surgery for patients with breast cancer remains unknown. Most of published studies were done for early breast cancer patients. However, in Egypt advanced stages were the common presentation. This retrospective analysis aimed to assess the optimum sequence for our population. Methods 267 eligible patients planned to receive adjuvant chemotherapy [FAC] and radiotherapy. Majority of patients (87.6%) underwent modified radical mastectomy while, 12.4% had conservative surgery. We divided the patients into 3 groups according to the sequence of chemotherapy and radiotherapy. Sixty-seven patients (25.1%) received postoperative radiotherapy before chemotherapy [group A]. One hundred and fifty patients (56.2%) were treated in a sandwich scheme (group B), which means that 3 chemotherapy cycles were given prior to radiotherapy followed by 3 further chemotherapy cycles. A group of 50 patients (18.7%) was treated sequentially (group C), which means that radiotherapy was supplied after finishing the last chemotherapy cycle. Patients' characteristics are balanced between different groups. Results Disease free survival was estimated at 2.5 years, and it was 83.5%, 82.3% and 80% for patient receiving radiation before chemotherapy [group A], sandwich [group B] and after finishing chemotherapy [group C] respectively (p > 0.5). Grade 2 pneumonitis, which necessitates treatment with steroid, was detected in 3.4% of our patients, while grade 2 radiation dermatitis was 17.6%. There are no clinical significant differences between different groups regarded pulmonary or skin toxicities. Conclusion Regarding disease free survival and treatment toxicities, in our study, we did not find any significant difference between the different radiotherapy and chemotherapy sequences.

الغرض: دراسه اكلينيكيه لتقيم فاعليه ومضاعفات العلاج الاشعاعي متازامنا مع عقاركابسيتابين كعلاج مساعد ما بعد الجراحه لسرطان المعده. طريقة البحث: سجلت الدراسه 30 مريض من مرضى سرطان المعده بعد الجراحه مع استئصال الغدداليمفاويه المقاربه تلقو المرضى جرعة علاج كيمائي عباره عن عقاركابسيتابين 1000مج/م2 كل ساعه لمدة 14 يوم اليوم رقم 22 يبدا المريض علاج اشعاعي (45 جراى ) مقسم على 5 اسابيع متازمنا مع كابستيين 825مج/م2 كل 12 ساعه ايام الجلسات فقط. نتائج البحث: لم يتمكن 4 مرضى من استكمال البحث يسبب ازدياد الورم او مضاعفاته من الدرجه الثالثه سجلت مضاعفات من الدرجه الثالثه مرضى كالاتى انيميا 2 مرضى قيئ 1 مريض نقص في كرات الدم البيضاء 1 مريض ولقد كانت مضاعافات الجهاز الهضمي الاكثر تسجيلا بين المرضى بعد متابعه 24 شهر وجد 63,3 % من المرضى خاليا تماما من الورم بينما حدث ارتجاع المرضى في 45,5% والارتجاع البريثوني في 55,5% والانتشار خارج البطن55,5% . الخلاصه: عقاركابسيتابين عن طريق الفم متازمنا مع العلاج الاشعاعي علاج فعال وامن كعلاج مساعد ما بعد الجراحه لسرطان المعده.

الغرض: دراسه اكلينيكيه لتقيم فاعليه ومضاعفات العلاج الاشعاعي متازامنا مع عقاركابسيتابين كعلاج مساعد ما بعد الجراحه لسرطان المعده. طريقة البحث: سجلت الدراسه 30 مريض من مرضى سرطان المعده بعد الجراحه مع استئصال الغدداليمفاويه المقاربه تلقو المرضى جرعة علاج كيمائي عباره عن عقاركابسيتابين 1000مج/م2 كل ساعه لمدة 14 يوم اليوم رقم 22 يبدا المريض علاج اشعاعي (45 جراى ) مقسم على 5 اسابيع متازمنا مع كابستيين 825مج/م2 كل 12 ساعه ايام الجلسات فقط. نتائج البحث: لم يتمكن 4 مرضى من استكمال البحث يسبب ازدياد الورم او مضاعفاته من الدرجه الثالثه سجلت مضاعفات من الدرجه الثالثه مرضى كالاتى انيميا 2 مرضى قيئ 1 مريض نقص في كرات الدم البيضاء 1 مريض ولقد كانت مضاعافات الجهاز الهضمي الاكثر تسجيلا بين المرضى بعد متابعه 24 شهر وجد 63,3 % من المرضى خاليا تماما من الورم بينما حدث ارتجاع المرضى في 45,5% والارتجاع البريثوني في 55,5% والانتشار خارج البطن55,5% . الخلاصه: عقاركابسيتابين عن طريق الفم متازمنا مع العلاج الاشعاعي علاج فعال وامن كعلاج مساعد ما بعد الجراحه لسرطان المعده.

الغرض: دراسه اكلينيكيه لتقيم فاعليه ومضاعفات العلاج الاشعاعي متازامنا مع عقاركابسيتابين كعلاج مساعد ما بعد الجراحه لسرطان المعده. طريقة البحث: سجلت الدراسه 30 مريض من مرضى سرطان المعده بعد الجراحه مع استئصال الغدداليمفاويه المقاربه تلقو المرضى جرعة علاج كيمائي عباره عن عقاركابسيتابين 1000مج/م2 كل ساعه لمدة 14 يوم اليوم رقم 22 يبدا المريض علاج اشعاعي (45 جراى ) مقسم على 5 اسابيع متازمنا مع كابستيين 825مج/م2 كل 12 ساعه ايام الجلسات فقط. نتائج البحث: لم يتمكن 4 مرضى من استكمال البحث يسبب ازدياد الورم او مضاعفاته من الدرجه الثالثه سجلت مضاعفات من الدرجه الثالثه مرضى كالاتى انيميا 2 مرضى قيئ 1 مريض نقص في كرات الدم البيضاء 1 مريض ولقد كانت مضاعافات الجهاز الهضمي الاكثر تسجيلا بين المرضى بعد متابعه 24 شهر وجد 63,3 % من المرضى خاليا تماما من الورم بينما حدث ارتجاع المرضى في 45,5% والارتجاع البريثوني في 55,5% والانتشار خارج البطن55,5% . الخلاصه: عقاركابسيتابين عن طريق الفم متازمنا مع العلاج الاشعاعي علاج فعال وامن كعلاج مساعد ما بعد الجراحه لسرطان المعده.