Current Issue : April - June Volume : 2019 Issue Number : 2 Articles : 5 Articles
Background and Objectives: Chronic myeloid leukemia (CML) accounts for\napproximately 15% of newly diagnosed cases of leukemia in adults. In this\nstudy, the efficacy of nilotinib at 400 mg BID is compared with imatinib at\n400 mg BID in CML patients with suboptimal molecular response after at\nleast 12 months of daily dose 400 mg of imatinib therapy. Patients and Methods:\nThis study included a total number of 50 patients, divided into two\ngroups (25 patients each). The first group (Group I): Patients received imatinib\nat 400 mg BID, second group (Group II): Patients had a suboptimal molecular\nresponse to imatinib and received nilotinib at 400 mg BID in early\nchronic phase. During the two years period of data collection, the primary\nend included median survival. The secondary end included response rate,\ntype of response, duration of response and progression free survival. Also side\neffects were recorded. Patients were followed up every month by complete\nand differential blood counts, liver function test, renal function test and\n(PCR) every three months for two year. Results: Nilotinib group had significantly\nhigher frequency of major molecular response (MMR) where 23 (92%)\npatients achieved it while only 16 (64%) patients in Imatinib group achieved\nMMR (P = 0.01). Nilotinib had better toxicities profile than Imatinib. Conclusion:\nBoth Nilotinib and high dose Imatinib achieved response in CML\npatients with suboptimal response with rapid and deeper molecular response,\nbetter survival outcomes and less side effects in nilotinib....
The aim of the research is to investigate the expression of the cell cycle relative\nproteins (P53, P16, Cyclin D1, and Ki67) in Esophageal Cancer (EC) patients\nof the Chaoshan area, China. In China, Chaoshan has the high incidence\nof EC. Different areas have shown different rate for expression of these\nproteins in EC. We investigated the expression of p53, p16, cyclinD1, and\nki67 for the first time in Chaoshan. In this research, DNA was extracted from\nformalin fixed and paraffin embedded tissues of esophageal cancer (EC) patients.\nThe expression level of proteins cycle was detected by using immunohistochemistry\n(IHC). And the data was checked byâ?¦â?¦ test or Fisherâ??s exact\ntest of SPSS17.0. The positive immunohistochemical staining of p53, p16,\ncyclinD1, and ki67 were observed in 65.7% 39.2%, 69.1%, and 83.5% specimens\nrespectively. There was a positive correlation between p53 positive\nstaining and p16, cyclinD1, ki67 staining at p < 0.05. CyclinD1 has the high\ncorrelation with ki67 at p < 0.05. A significant inverse correlation was considered\nbetween the expression of p16 and cyclinD1 and there was no correlation\nobserved between p16 and ki67. In Conclusion, this study demonstrated\nthe high expression of p53, Cyclin D1 and Ki67 and low expression of P16\nand the association of these cell cycle relative proteins in esophageal cancer\nare new data in Chaoshan area of China. Geographical distribution of EC on\nthe molecular basis is revealed in this research....
Background and Objective: Based on retrospective trials, most progression\nsites after first line systemic therapy for metastatic non small cell lung cancer\n(NSCLC) were the primary disease sites rather than new sites. Therefore we\nconducted phase II randomized study to determine whether oligometastatic\nNSCLC without disease progression after first line chemotherapy, have prolonged\nprogression free survival when treated with local consolidation therapy\nof residual disease followed by surveillance compared with no local consolidation\ntherapy (observation). Patients and Methods: Forty eight eligible\npatients were randomized to either immediate or no local consolidation radiotherapy.\n26 patients of immediate local consolidation radiotherapy received\n3 D-conformal radiation therapy to primary tumor site and metastatic sites of\ndisease. 22 patients were followed up by observation. Results: Patients in local\nconsolidation arm had significantly better progression free survival (PFS)\ncompared with patients in observation group. Median PFS was 9.5 months\n(95% CI 7.8 - 11.08) in local consolidation arm and 4.5 months (95%CI 3.9 -\n5.7) in observation arm. Patients in local consolidation arm had longer median\ntime to appearance of new metastatic sites (10 months CI 9.3 - 12.6)\nthan those patients in observation arm (4.5 months CI 4.2 - 6.9). Median\noverall survival (OS) of patients in local consolidation arm was 12 months\n(95% CI 12.1 - 18.01) and in observation arm 10 months (95% CI 8.7 - 13.8).\nOne year OS rate was 42.3% in local consolidation arm and 31.8% in observation\narm; 2 year OS rate was 23.1% in local consolidation arm and only 4.5%\nin observation arm. Conclusion: Local consolidation radiotherapy is simple,\nsafe, efficient, and not expensive treatment for oligometastatic non small cell lung cancer after upfront chemotherapy. Local consolidation radiotherapy\nachieved significantly prolonged progression free survival and delayed appearance\nof new metastatic sites. Phase III studies are recommended to test\nbenefit of local consolidation radiotherapy to gain prolonged progression free\nsurvival and overall survival. Also, define optimal patientsâ?? subgroups that are\nmore likely to benefit of local consolidation radiotherapy....
Double primary malignancies could be divided into two categories, depending\non the interval between tumor diagnoses. A secondary malignancy could\nbe defined as a new cancer that has occurred as a result of previous treatment\nwith radiation or chemotherapy. Second primary malignancy can occur at\nany age but itâ??s commonly at old age. A 46 premenopausal female patient\npresented to our outpatient clinic complaining from a mass in her right\nbreast, routine metastatic work-up for distant metastasis declared multiple\nhepatic metastases, RT renal mass, and bone metastases. Palliative radiotherapy\nto tender and weight bearing sites followed by 4 cycles of systemic chemotherapy\nFEC regimen were received. Tru-cut needle biopsy from renal\nmass detected renal cell carcinoma of clear cell type, the patient started sunitinib\nand tamoxifen with bisphosphonate (Zoledronic acid), assessment of the\nresponse revealed reduction of the size and number of HFLs, and the size of\nrenal mass, so the patient was decided to do cytoreductive nephrectomy and\nthen continued on TAM and sunitinib. Collectively, due to the rising incidence\nof multiple primary malignancies, further studies should be done not\nonly for better clinical evaluation and treatments but also for accurate determination\nof possible causes, pathogenesis, effective managements and\nscreening programs....
Introduction: Metaplastic breast carcinomas are a rare, heterogeneous group\nof breast malignancies characterized by an intrinsically aggressive histology\nand an unfavorable prognosis. Objective: To determine the clinical and pathological\ncharacteristics of metaplastic breast cancers in Tunisian patients,\nand evaluate their impact on its evolution. Methods: A retrospective study of\n44 cases of metaplastic cancers archived during a 26-year period in the Cancer\nRegistry of the Tunisian Center. Results: The frequency of metaplastic\ncancer was 0.97%. Mean age at diagnosis was 55.4 years (range 26 - 84). Average\ntime to diagnosis was 5.5 months. Average clinical tumor size was 4.95\ncm (range 1.5 - 15). Axillary ipsilateral adenopathy was present at diagnosis\nin 45.9%. The clinical stages IIB (31.8%) and IIA (22.7%) predominated.\nSquamous metaplasia was the most common (68%) followed by the heterologous\nmesenchymal subtype. Ganglionic invasion was histologically proven\nin 17 cases, of which 77% had only adenocarcinomatous contingents. Absence\nof hormone receptor expression and HER2 overexpression predominated.\nPrimary surgery was carried out in 95% of cases. Average follow-up\nwas 40 months (range 2 - 135). Average overall survival (OS) was 74 months,\n63% at 5 years and 60% at 10 years. Average progression free survival (PFS)\nwas 29 months (range 3 - 129), 38% at 5 years and 32% at 10 years. Factors\nsignificantly influencing OS and PFS were histological lymph node involvement\n(p = 0.001 and p = 0.002 respectively). Conclusion: Metaplastic breast\ncancer observed in Tunisian women constitutes a histological type with an\nunfavorable prognosis whose improvement requires a more adapted therapeutic\nstrategy....
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