Abstract Bladder urothelial carcinoma subtypes identified with gene expression profiling need to be bridged over to routine clinical practice. A simple immunohistochemical panel of markers was applied to 192 specimens, and the 4 major subgroups were identified in 92.2% without overlap. The identified characteristics of urothelial carcinoma detected in our population can be used for individualized treatment planning. Background: Although gene expression profiling provided a comprehensive molecular characterization of different subtypes of bladder urothelial carcinoma (UC), which are distinct in their biological features and prognosis, such a system is not yet applicable for routine clinical practice. This study aimed to examine the expression of these molecular classes of UC using simple panel of immunohistochemical markers. Materials and Methods: Tissue sections from 192 specimens of UC were stained with FGFR3, CK5, CCNB1, HER-2, and P53. The molecular classes identified were correlated with clinicopathologic characteristics and patient survival. Results: The most frequent class in our cohort was urobasal B (UroB) (44.1%), followed by squamous cell carcinoma-like (SCCL) (22%), genomically unstable (GU) (20.3%), and urobasal A (UroA) (13.6%). Patients with SCCL were significantly younger (P .0001). Both the SCCL and GU types were of significantly higher histopathologic grade (P .0001). UroA tumors were mainly of the T1 stage (75%), whereas 61.5% of the SCCL and 58.3% of the GU types were of stage T2 (P .001). Prognosis was significantly different among groups. The SCCL class showed the lowest overall survival (38.5%; P ¼ .030) and metastasis-free survival (69.2%; P ¼ .017). The best prognosis was for UroA, with an overall survival of 75% and no metastatic events. Conclusion: The distribution of UC subtypes in our study was uniquely different from other studies. This simple immunohistochemical panel could be suggested as a clinically applicable tool that has the potential to be used routinely in guiding individualized treatment of UC.

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Abstract Background: Adjuvant radiotherapy has increased disease-free and overall survival rates in breast cancer. Conventionally fractionated radiotherapy delivers 50 Gy over 5 weeks which is the standard approach. A shorter duration of hypofractionated radiotherapy (HFRT) will be more convenient for patients and treatment providers if found safe and equally effective. Material and Methods: Fifty-four breast cancer patients who underwent breast conservative surgery (BCS) were enrolled in this study. The patients received 4005 cGy/15 fractions. A boost to the tumor bed was administered in all patients. In this study, radiotherapy induced toxicity was evaluated. Results: In this study, the median age of our patients was 48 years with age ranged from 28 to 69 years. Acute skin toxicity was assessed, and it was noted that grade 2 skin toxicity was shown in only 6 patients (11.1%) at the end of radiotherapy and disappeared after 6 weeks of treatment. Late skin toxicity (telangectasia, hyperpigmentation, and subcutaneous fibrosis) was assessed and showed that most patients had grade 0 toxicity with no grade 3 toxicity at all. Regarding pulmonary toxicity, 5 patients (9.3%) developed acute pneumonitis and as regards chronic lung toxicity, it was evident in only 3 patients, 2 patients (3.7%) were grade 1 and 1 patient (1.9%) was grade 2. Cardiac toxicity was evident in 2 patients (7.1%) of the left breast cancer patients. Regarding lymphoedema, most patients that showed lymphoedema were grade 1. Conclusion: The results confirm the safety and feasibility of adjuvant hypofractionated whole breast radiotherapy in breast cancer patients in terms of acute and late toxicity.

Abstract Background: Adjuvant radiotherapy has increased disease-free and overall survival rates in breast cancer. Conventionally fractionated radiotherapy delivers 50 Gy over 5 weeks which is the standard approach. A shorter duration of hypofractionated radiotherapy (HFRT) will be more convenient for patients and treatment providers if found safe and equally effective. Material and Methods: Fifty-four breast cancer patients who underwent breast conservative surgery (BCS) were enrolled in this study. The patients received 4005 cGy/15 fractions. A boost to the tumor bed was administered in all patients. In this study, radiotherapy induced toxicity was evaluated. Results: In this study, the median age of our patients was 48 years with age ranged from 28 to 69 years. Acute skin toxicity was assessed, and it was noted that grade 2 skin toxicity was shown in only 6 patients (11.1%) at the end of radiotherapy and disappeared after 6 weeks of treatment. Late skin toxicity (telangectasia, hyperpigmentation, and subcutaneous fibrosis) was assessed and showed that most patients had grade 0 toxicity with no grade 3 toxicity at all. Regarding pulmonary toxicity, 5 patients (9.3%) developed acute pneumonitis and as regards chronic lung toxicity, it was evident in only 3 patients, 2 patients (3.7%) were grade 1 and 1 patient (1.9%) was grade 2. Cardiac toxicity was evident in 2 patients (7.1%) of the left breast cancer patients. Regarding lymphoedema, most patients that showed lymphoedema were grade 1. Conclusion: The results confirm the safety and feasibility of adjuvant hypofractionated whole breast radiotherapy in breast cancer patients in terms of acute and late toxicity.

Abstract Background: Adjuvant radiotherapy has increased disease-free and overall survival rates in breast cancer. Conventionally fractionated radiotherapy delivers 50 Gy over 5 weeks which is the standard approach. A shorter duration of hypofractionated radiotherapy (HFRT) will be more convenient for patients and treatment providers if found safe and equally effective. Material and Methods: Fifty-four breast cancer patients who underwent breast conservative surgery (BCS) were enrolled in this study. The patients received 4005 cGy/15 fractions. A boost to the tumor bed was administered in all patients. In this study, radiotherapy induced toxicity was evaluated. Results: In this study, the median age of our patients was 48 years with age ranged from 28 to 69 years. Acute skin toxicity was assessed, and it was noted that grade 2 skin toxicity was shown in only 6 patients (11.1%) at the end of radiotherapy and disappeared after 6 weeks of treatment. Late skin toxicity (telangectasia, hyperpigmentation, and subcutaneous fibrosis) was assessed and showed that most patients had grade 0 toxicity with no grade 3 toxicity at all. Regarding pulmonary toxicity, 5 patients (9.3%) developed acute pneumonitis and as regards chronic lung toxicity, it was evident in only 3 patients, 2 patients (3.7%) were grade 1 and 1 patient (1.9%) was grade 2. Cardiac toxicity was evident in 2 patients (7.1%) of the left breast cancer patients. Regarding lymphoedema, most patients that showed lymphoedema were grade 1. Conclusion: The results confirm the safety and feasibility of adjuvant hypofractionated whole breast radiotherapy in breast cancer patients in terms of acute and late toxicity.

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