فهرست مطالب

Middle East Journal of Cancer - Volume:7 Issue: 3, 2016
  • Volume:7 Issue: 3, 2016
  • تاریخ انتشار: 1395/04/12
  • تعداد عناوین: 9
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  • Amir Ehsan Lashkari* Pages 113-124
    Background
    In this paper we compare a highly accurate supervised to an unsupervised technique that uses breast thermal images with the aim of assisting physicians in early detection of breast cancer.
    Methods
    First, we segmented the images and determined the region of interest. Then, 23 features that included statistical, morphological, frequency domain, histogram and gray-level co-occurrence matrix based features were extracted from the segmented right and left breasts. To achieve the best features, feature selection methods such as minimum redundancy and maximum relevance, sequential forward selection, sequential backward selection, sequential floating forward selection, sequential floating backward selection, and genetic algorithm were used. Contrast, energy, Euler number, and kurtosis were marked as effective features.
    Results
    The selected features were evaluated by fuzzy C-means clustering as the unsupervised method and compared with the AdaBoost supervised classifier which has been previously studied. As reported, fuzzy C-means clustering with a mean accuracy of 75% can be suitable for unsupervised techniques.
    Conclusion
    Fuzzy C-means clustering can be a suitable unsupervised technique to determine suspicious areas in thermal images compared to AdaBoost as the supervised technique with a mean accuracy of 88%.
    Keywords: Breast cancer, Breast thermography, Thermogram, Feature selection, Classification, TH
  • Ghodratollah Roshanaei, Farshad Rostampour, Mohammadreza Javadi, Sepideh Behnoud, Masoud Sabouri Ghannad* Pages 125-129
    Background
    Gastric cancer is the second leading cause of cancer death. The aim of this study was to determine the survival rate affected by risk factors in patients with gastric adenocarcinoma.
    Methods
    We performed this retrospective cohort study on patients diagnosed with gastric adenocarcinoma during 2005-2012 in Hamadan, Iran. All patients with pathological diagnosis enrolled in the study. The effects of patients’ demographical and pathological data were assessed in terms of survival. The univariate and multivariate Weibull models were used to determine the effects of these factors on survival rate. Data was analyzed by SPSS16 and STATA10 software.
    Results
    A total of 112 gastric adenocarcinoma patients were followed. Patients included 74 (66.1%) males. During the follow-up, 102 (91.1) patients died. Patients’ had a mean (SD) survival of 21.9 (1.9) months and a median survival of 15 months. The “one-, three- and five-year survival rates were 62%, 16% and 9% respectively. The results showed that metastasis, chemotherapy, tumor site and grade had statistically significant impacts on patient survival.
    Conclusion
    A potentially important role for tumor grade, tumor site, metastasis, and pathologic stage of disease existed in terms of patient survival after surgery. The current research has indicated that neoadjuvant treatment increased survival in patients with gastric adenocarcinoma. It is expected that the prognostic model based on the mentioned factors may assist individual risk stratification and help in the planning of potential forthcoming studies.
    Keywords: Gastric adenocarcinoma, Survival, Adjuvants, Pharmaceutics, Therapeutics
  • Mahdi Shahriari* Pages 131-136
    Background
    Primary central nervous system involvement and central nervous system relapse are poor prognostic events in acute lymphoblastic leukemia. Due to severe skeletal and endocrine complications of craniospinal radiotherapy, only cranial radiotherapy is advisable. However only 15% of the cases with central nervous system relapse may remain in remission; a second central nervous system or bone marrow relapse is common. Prevention of central nervous system relapse is an extremely important way to decrease both mortality and morbidity in childhood leukemia.
    Methods
    This prospective study was conducted from June 1995 to May 2014. A total of 90 children diagnosed with acute lymphoblastic leukemia enrolled in this study following parental informed consent. There were 30 children with primary central nervous system involvement and 60 that had central nervous system relapse due to acute lymphoblastic leukemia. Patients were randomly divided into two groups: 30 patients in group A (control group) received triple intrathecal injections every 2 months according to high risk acute lymphoblastic leukemia protocols for a total of three years. Group A was divided into the following subgroups: A1 (primary central nervous system involvement; n=15) and A2 (central nervous system relapse; n=15). Group B (case group) comprised 60 patients that received additional triple intrathecal injections during the fourth and fifth years (2 years after discontinuation of maintenance chemotherapy). Group B was subdivided as follows: B1 (primary central nervous system involvement; n=20) and B2 (central nervous system relapse; n=40). For each patient in group A, two age and sex matched patients in group B were enrolled. Patients were followed for 2-15 years.
    Results
    From 15 patients in group A1 (control with primary central nervous system involvement), there were 5 central nervous system relapses, 3 bone marrow relapses, and 2 deaths. Boys had more relapses and deaths than girls (chi square: 15.63; P
    Conclusion
    Extended intrathecal injections after discontinuation of maintenance
    chemotherapy is advisable for cases with primary central nervous system involvement and central nervous system relapses. However, we propose that national and international studies with greater number of patients should be conducted.
    Keywords: Childhood leukemia, CNS involvement, CNS relapse, CNS prophylaxis, prognosis
  • Maher Soliman* Pages 137-143
    Background
    Radiation-induced lung toxicity is an important dose-limiting toxicity in lung cancer radiotherapy, for which there are no generally accepted predictive factors. This study seeks to identify risk factors associated with the development of severe radiation-induced lung toxicity using clinical and dosimetric parameters.
    Methods
    We reviewed the medical records of 54 patients with histologically proven stage III non-small cell lung cancer treated with three dimensional-conformal radiotherapy at Alexandria Main University Hospital between January 2008 and December 2011. The original treatment plans for those patients were restored and imported to a treatment planning system. Lung dose–volume histograms and various dosimetric parameters were calculated. Univariate and multivariate logistic regression analyses were performed.
    Results
    The following grades of radiation-induced lung toxicity were observed in patients - grade 0: 17 (31.5%), grade 1: 5 (9.3%), grade 2: 13 (24.1%), grade 3: 15 (27.8%), and grade 5: 4 (7.4%). A total of 19 (35.2%) patients developed grade ≥3 and were considered to have an event. Univariate analysis showed that age, presence of chronic obstructive pulmonary disease and location of the primary tumor had significant associations with severe radiation-induced lung toxicity. Other dosimetric variables such as tumor side, histology, forced expiratory volume in 1 s, smoking, and gender showed no significant correlations with severe radiation-induced lung toxicity. Multivariate analysis showed that the presence of chronic obstructive pulmonary disease (P=0.001) and location of the primary tumor (P=0.010) were the only predictive factors for severe radiation-induced lung toxicity.
    Conclusion
    This study demonstrates that patients with chronic obstructive pulmonary disease and lower lung lobe tumors have a high risk of severe radiation- induced lung toxicity when treated with combined chemoradiotherapy. These easily obtained clinical factors should be considered when calculating the risk for radiation- induced lung toxicity.
    Keywords: Dose–volume histogram, Lung cancer, Radiotherapy, Toxicity
  • Hatem Bouzaiene, Bassem Mezghani *, Maher Slimane, Aida Goucha, Amir Ariane, Lamia Naija, Amor Gamoudi, Tarek Dhieb, Khaled Rahal Pages 145-159
    Background
    Mammary Paget’s disease is an uncommon form of primary breast cancer. The aim of this study is to assess our institution’s experience in its management.
    Methods
    We retrospectively reviewed the medical records of 53 female patients with histologically confirmed Paget’s disease, treated at the Salah Azaïz Institute between 2001 and 2010.
    Results
    There were palpable masses in 71.7% of cases, of which 90% revealed invasive carcinoma. Approximately 48% of underlying malignancies were multifocal/multicentric. Overall, invasive carcinoma accounted for 69.8% with a median tumor size of 40 mm, high grade in 62.2%, and negative hormone receptor in 47.6% of cases. There was only one case with direct dermis invasion among those with no underlying invasive carcinoma. After a median follow-up of 45 months, 49% of patients presented with relapse/progression and 47.1% died from their disease. Median overall survival was 67 months, whereas disease-free survival was 65 months. Tumor and node advanced clinical stages correlated with poor survival, as well as the presence of invasive carcinoma with additional negative impacts of large tumor size and lymph node involvement. Tumor stage was the only independent indicator on multivariate analysis.
    Conclusion
    The general trend for decreased incidence of Paget’s disease is noted parallel to earlier breast cancer diagnosis. Paget’s disease is at high risk of multifocal/multicentric underlying tumors. The presence of a palpable mass is almost pathognomonic of invasive neoplasm. The major challenge concerns aggressiveness of surgical procedures with breast and axilla preservation perspectives. Prognosis is mainly determined by that of an eventual underlying breast tumor.
    Keywords: Breast neoplasms, Paget's disease, Mammary, Diagnosis, Therapy, Prognosis
  • Seied Hosein Ahmadi, Shahram Momtahen, Fereshteh Ensani, Afsaneh Alikhasi, Sanambar Sadighi, Farhad Samiee, Zahra Sedighi, Mohammad Ali Mohagheghi* Pages 161-164
    Primary cardiac sarcomas are very rare and there is no consensus on management. Clinical presentation is usually late. Despite newer diagnostic technology, prognosis remains dismal. We report a case of right atrial sarcoma in a 28-year-old man who presented with acute cardiac tamponade. Emergency subxiphoid pericardial drainage stabilized the patient's critical condition. The lesion was advanced. Therefore, we only performed a suboptimal surgical resection. Despite planning for radiation, the patient's status deteriorated. Only palliative measures continued during the next four months before his death due to disseminated metastasis and progressive cardiopulmonary failure.
    Keywords: Cardiac tumor, Surgical resection, Synovial sarcoma
  • Majid Akrami, Saba Ebrahimian *, Sedigheh Tahmasebi, Abdolrasoul Talei Pages 165-167
    Gastrointestinal stromal tumors are mesenchymal neoplasms of the gastrointesti- nal tract that originate from all areas of the gastrointestinal tract. Metastases to the liver, peritoneum, bones, lungs and soft tissues have been reported. We present the case of a 47- year-old woman with rectal gastrointestinal stromal tumor that underwent wide local excision. She was treated with imatinib for a few months after surgery. After eight months, she was admitted to the emergency service with complaints of epigastric pain, nausea, vomiting, and anorexia. Imaging studies showed the presence of a pancreatic head tumor and three hepatic masses. The patient underwent exploratory laparatomy. Excisional biopsy of one hepatic mass and core needle biopsy of the pancreatic head mass revealed metastases to the liver and pancreas. During the hospital course the patient's condition deteriorated and she subsequently expired.
    Keywords: Metastasis, Pancreas, Gastrointestinal stromal tumors (GIST)
  • Sabah Nayef Nemri, Nazima Haider, Sohaila Fatima* Pages 169-172
    Mammary sarcomas are a heterogeneous group of malignant neoplasms that arise from the mammary stroma. Primary sarcomas of the breast are extremely rare and comprise less than 0.1% of all malignant tumors of the breast. We present the case of a 56-year-old female diagnosed as stromal sarcoma, not otherwise specified - a very rare entity.
    Keywords: Breast sarcoma, Undifferentiated
  • Calendar of Events
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