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Middle East Journal of Cancer - Volume:3 Issue: 4, Oct 2012

Middle East Journal of Cancer
Volume:3 Issue: 4, Oct 2012

  • 54 صفحه،
  • تاریخ انتشار: 1391/12/15
  • تعداد عناوین: 6
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  • Mohsen Ayati, Shahryar Zeighami, Majeed Safavi, Mohammad Reza Nowroozi, Hasan Jamshidian, Alipasha Meysamie Page 95
    Background
    Insulin-like growth factor-1 can act in both an autocrine and paracrine manner to promote normal growth and malignant cellular proliferation. The importance of this factor as a major regulatory peptide has been established for cells, in vitro and in vivo. However, the role of serum insulin-like growth factor-1 levels in the etiology of benign prostatic hyperplasia and prostate cancer has not received sufficient attention. The aim of this study was to determine the relationship between benign prostatic hyperplasia, prostate cancer, and serum insulin-like growth factor-1 levels.
    Methods
    We collected blood samples from 68 individuals with prostate cancer (cases) and 68 individuals with benign prostatic hyperplasia (controls) who were patients at Imam Khomeini Hospital in Tehran, Iran. Those with benign prostatic hyperplasia had normal prostatic specific antigen levels <4 ng/ml and normal prostate according to digital rectal examination. The case group was selected from patients with pathologically confirmed prostate cancer. Insulin-like growth factor-1 concentrations were measured by a radio immunoassay kit. We used the t-test to compare insulin-like growth factor-1 levels between groups.
    Results
    Patients in the prostate cancer group had a mean age of 68 years, whereas those with benign prostatic hyperplasia had a mean age of 65 years (P>0.05). Mean serum insulin-like growth factor-1 levels were 219 ng/ml for the case group and 133 ng/ml for the control group, which was significant (P=0.0009). We did not observe any correlation between age and insulin-like growth factor-1 in the case group (P=0.83, r= -0.47), however there was a significant correlation in the control group (P=0.007, r=0.549). Although correlation between prostate volume and serum insulin-like growth factor-1 levels was not statistically significant in the case group (P=0.38, r=0.213), there was a positive correlation observed in the control group (P<0.008, r=0.537).
    Conclusion
    Our findings suggest that insulin-like growth factor-1 may have an etiologic role in prostate cancer. This interpretation is strengthened by the significant difference observed between serum insulin-like growth factor-1 levels in benign prostatic hyperplasia and prostate cancer patients. These results also offer additional opportunities for evaluating patients who have abnormal digital rectal exams or prostate specific antigen levels, yet their biopsies are normal. Under these circumstances, measurement of serum insulin-like growth factor-1 may assist with the decision for a second biopsy.
    Keywords: Insulin, like growth factor, BPH, Prostate cancer
  • Amal Halim Page 101
    Background
    This study retrospectively evaluated the prognostic factors and treatment outcome of patients with hormone-refractory prostate cancer who received chemotherapy.
    Methods
    We reviewed records of hormone-refractory prostate cancer patients who received chemotherapy between December 2004 and May 2011 at the Clinical Oncology and Nuclear Medicine Department, Mansoura University and the Oncology Outpatient Clinic of East Delta Insurance Institute, Egypt with regards to patient characteristics, response to chemotherapy, toxicity, survival and prognostic factors.
    Results
    A total of 37 records were analyzed. Patients'' median age was 66 years. The majority (70%) had bone metastases. One patient received single agent prednisolone and 2 received single agent vinorelbine. There were 34 (92%) who received a docetaxelbased chemotherapy regimen for whom we determined the treatment outcome and prognostic factors. Patients underwent a median of six cycles of treatment (range: 4–11). Fourteen of 34 patients (%41) had ≥50% decrease in serum prostatic-surface antigen. Among 16 patients who had measurable disease at the baseline, 8 (50%) achieved a partial response according to radiographic criteria. Of the 25 patients who experienced cancer pain before treatment initiation, 15 (60%) reduced their analgesic drug intake. Grades 3-4 neutropenia occurred in 13 (38%) patients. The median follow-up period was 13 months and the median event-free survival was 7 months (range: 4-31). The median overall survival period was 12 months (range: 4.5-37). According to multivariate regression analysis, multiplicity of metastatic sites was the only independent prognostic factor (P=0.005).
    Conclusions
    Hormone-refractory prostate cancer is not considered totally resistant to chemotherapy. In this study, multiplicity of metastatic sites is the only independent prognostic factor. Survival figures are not satisfactory, therefore additional research is needed for achieving a better treatment outcome.
    Keywords: Prostate cancer, Chemotherapy, Docetaxel, Hormone refractory cancer, Corticosteroids
  • Mina Shabani, Minoosh Moghimi, Reza Eghdam Zamiri, Fatemeh Nazari, Nouraddin Mousavinasab, Zahra Shajari Page 109
    Background
    Patients with breast cancer are predisposed to some psychiatric symptoms and mental disorders as a result of their diagnosis or lifestyle. These problems cause patients to have daily stress, feelings of guilt, anxiety, a dysphoric mood, and impaired social relations. Such problems will lead to serious mental disorders. Therefore, life skills training may enable patients to cope better with these problems and improve their mental health.
    Methods
    In an experimental study 50 breast cancer patients were randomly selected and assigned to two groups, experimental and control. The experimental group attended life skills training classes continuously for ten weeks. The duration of each class was two hours. Participants in both groups completed a General Health Questionnaire-28 form before the commencement of classes, after two weeks of training, and again at two months after course completion. The statistical method used in this study was the t-test.
    Results
    In the life skills training group, patients'' depressive and anxiety symptoms, somatization disorders, sleep disorders, and disorders of social functioning significantly decreased (P<0.0001). There was no change in the control group.
    Conclusion
    The results show that life skills training can be considered a supportive method for symptoms of depression, anxiety, sleep, and somatic disorders in patients with breast cancer.
    Keywords: Breast cancer, Life skills training, GHQ, 28, Quality of life
  • Hossein Ghayoumi Zadeh, Omid Pakdelazar, Javad Haddadnia, Gholamali Rezai, Rad, Mohammad Mohammad, Zadeh Page 119
    Background
    Breast cancer is one of the most prevalent cancers among women today. The importance of breast cancer screening, its role in the timely identification of patients, and the reduction in treatment expenses are considered to be among the highest sanitary priorities of a modern country. Thermal imaging clearly possesses a special role in this stage due to rapid diagnosis and use of harmless rays.
    Methods
    We used a thermal camera for imaging of the patients. Important parameters were derived from the images for their posterior analysis with the aid of a genetic algorithm. The principal components that were entered in a fuzzy neural network for clustering breast cancer were identified.
    Results
    The number of images considered for the test included a database of 200 patients out of whom 15 were diagnosed with breast cancer via mammography.Results of the base method show a sensitivity of 93%. The selection of parameters in the combination module gave rise measured errors, which in training of the fuzzy-neural network were of the order of clustering 1.0923×10-5, which reached 2%.
    Conclusion
    The study indicates that thermal image scanning coupled with the presented method based on artificial intelligence can possess a special status in screening women for breast cancer due to the use of harmless non-radiation rays. There are cases where physicians cannot decisively say that the observed pattern in the image is benign or malignant. In such cases, the response of the computer model can be a valuable support tool for the physician enabling an accurate diagnosis based on the type of imaging pattern as a response from the computer model.
    Keywords: Adaptive Neuro Fuzzy Inference System (ANFIS), Breast cancer, Thermograph, Genetic algorithm, artificial neural net
  • Heba A. Sayed, Mona M. Sayed, Mohamed I. El-Sayed Page 131
    Background
    We conducted a retrospective analysis to investigate the clinical outcome of combined modality therapy using multiagent chemotherapy, nephrectomy, and radiotherapy in treatment of children with Wilms'' tumor.
    Methods
    This study was conducted on 91 cases of newly diagnosed Wilms'' tumor from January 2001 until February 2012. Patients were categorized into two groups according to treatment approach: i) preoperative chemotherapy with delayed surgery (group A; n=66) and ii) immediate surgery (group B; n=25).
    Results
    Preoperative chemotherapy showed a 54.5% partial response rate in group A patients. A final stage distribution indicated that the majority of patients (64%) from both groups were considered to be in the early disease stages (I and II). The median follow up was 49 months (range 3-124). The five-year overall survival rate was 66.5%, whereas the event-free survival rate was 62.5%. In univariate analysis, factors associated with statistically significant reduction in overall (P<0.0001) and event-free survival (P=0.0001) rates included advanced disease stages (P<0.0001 for both) and blastimal subtype (P=0.0067 for overall survival; P=0.012 for event-free survival). Age of >24 months was associated with a significant reduction in the overall survival rate (P=0.038, HR: 0.438, 95% CI: 0.192-0.953), but was not significant in terms of eventfree survival (P=0.104, HR: 0.539, 95% CI: 0.256-1.136). Age >24 months (P=0.0095), disease stage (P=0.0014), and blastimal subtype (P=0.006) were associated with significant increases in relapse rate.
    Conclusion
    Preoperative chemotherapy resulted in a final stage redistribution that placed the majority of patients in the early stages of the disease. Age at diagnosis, disease stage, and histological subtype significantly affected survival and relapse rates.
    Keywords: Nephroblastoma, Chemotherapy, radiotherapy, Survival
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