Conservative treatment in early-stage breast cancer is considered a standard approach. Breast preserving surgery with adjuvant radiotherapy is as effective as mastectomy in the early stages of breast cancer to control local disease and distant metastasis and maintain the overall survival rate. Minimally invasive surgery for the treatment of axillary spread and new techniques of breast preservation surgery will probably lead to a reduction in mastectomy-related complications. However, the complications of adjuvant radiotherapy remain a challenge. Cutaneous, cardiac, and pulmonary toxicity are the main complications of adjuvant breast irradiation. The multidisciplinary features (systemic treatment, endocrine therapy, and surgery), patient profile (history of underlying diseases, age, and habits), and irradiation-associated parameters are the factors affecting safe adjuvant radiotherapy. Advances in irradiation techniques and facilities related to the preservation of organs at risk (such as IGRT, tracing and tracking systems, and respiratory gating) are modern tools for reducing the risk of toxicity. Reported data from clinical trials or retrospective surveys greatly help physicians in consulting the patients on the efficacy and potential side effects of treatment and leads to the improvement of the decision making process.

The outcome of locally advanced carcinoma cervix patients treated with chemoradiotherapy is highly variable and depends on various prognostic factors. The aim of this study is to evaluate the prevalence and prognostic significance of thrombocytosis in this group of patients of our institution. Between January 2008 and December 2012, 195 patients with locally advanced carcinoma cervix [International Federation of Gynecology and Obstetrics (FIGO) stage IIB-IIIB], were treated with external beam radiotherapy (EBRT) to a dose of 45 Gy in 25 fractions along with concurrent chemotherapy (cisplatin 40 mg/m2), followed by HDR brachytherapy EQD2 of 30 Gy. The platelet counts were recorded pre treatment and during treatment in all the patients. Among the 195 patients, 101 (51.5%) belonged to stage IIB and 94 (48.5%) to stage IIIB. Thrombocytosis (platelet count > 400 × 109/L) was seen in 31 (15.8%) patients. The overall survival in thrombocytosis group is 41% which is significantly less than the OS of the non-thrombocytosis group which is 62%. Thrombocytosis is not a frequent finding in patients with locally advanced carcinoma cervix in our population, but when present it is associated with poor outcome in terms of survival.

Many patients with cancer tend to use vitamin supplements alongside their conventional cancer treatments. They have the presumption that vitamins can help them feel better or fight the disease. The aim of this study was to determine the use of vitamins among cancer patients in a referral cancer center in Tehran, Iran. Two hundred cancer patients who were undergoing outpatient chemotherapy or chemo-radiation were chosen. The data about the use of vitamins and whether they have prescribed by their physician were collected by a questionnaire. Among the patients who were being treated with chemotherapy alone (81.5% of the cases), 20.4% reported regular use of vitamins. This figure for the remaining 18.5% who were undergoing chemoradiation was 23.7%. The interesting finding was that 43.9% of the cases who were taking vitamins, it was prescribed by the treating oncologist. More than half (52.5%) of the patients who were taking vitamins had no other medical illness apart from cancer. Multivitamin capsules were the most commonly used form of vitamins. More than 20% of our patients took vitamins regularly. In more than 40% of these cases, vitamin supplements were prescribed by the treating physician. As there is some evidence that vitamins can interfere with chemotherapy and probably radiotherapy treatments, it would be prudent for oncologists to prescribe them more cautiously for the cancer patients who are under active treatment.

The most common site for extramedullary plasmacytomas (EMP) is the upper respiratory tract, including the oropharyngeal and nasal cavities, paranasal sinuses, and larynx. The EMPs of the head and neck area are uncommon malignancies comprising only 3% to 4% of all the plasmacytomas. We presented a 78-year-old man with right facial swelling, right exophthalmos, diplopia, and decrease in visual acuity of the right eye for three weeks. A right nasal mass was identified on nasal endoscopic examination. Computed tomography scan of the paranasal sinuses revealed a mass in the right maxillary and ethmoid sinuses with orbital extension. Histopathologic examination showed plasmacytoma of paranasal sinuses. Patient received 56 Gy in 28 fractions of radiotherapy. He was well in the follow-up visits during the next one year. Although sinonasal EMP is rare, it is worth being considered in the differential diagnoses of paranasal malignancies. Radiotherapy is the treatment of choice for solitary EMPs of paranasal sinuses. Long-term follow-up is essential in EMPs.

Dysembryoplastic neuroepithelial tumor (DNET) is a benign tumor commonly observed in young people and mostly in the temporal lobe. This tumor usually presents with seizure and involves glial and neuronal cells. The current report presents a case of a 25-year-old female, with intractable seizures including complex partials and secondary generalized seizure. The brain magnetic resonance (MR) showed multiple nonspecific hyperintense lesions in the bilateral temporal lobe. The patient underwent surgery, and selective temporal lobectomy was performed. Microscopic examination showed multifocal DNET, and the patient was seizure-free after surgery. Although DNET is very rare, the presentation of this case can help with its diagnosis and treatment.