Basic and Clinical Cancer Research
Volume:5 Issue: 4, Autumn 2013

For patients suffering from refractory diseases, particularly cancer, quality of life, as a major consequence of medical interventions, is of great importance. Unbiased measuring of quality of life changes is thus crucial to them. A prevalent bias related to research on quality of life is the “response shift”. This review article aims to define “response shift” and the challenges to measure it. In addition, it addresses methodological approaches to measuring this bias in observational and clinical studies. “Response shift” indicates changes in person’s health condition as a result of changes in the meanings drawn from the self-assessment of his health condition. These changes are caused by changes in the patients’ criteria upon facing their new conditions and might reflect the measured changes either greater or smaller than they really are. The present article describes the individualized methods, the preference-based methods, the structural equation modeling and the then-test method used for evaluating “response shift”, and discusses their application. Finally, by comparing these subjects, it concludes that the simplest and most efficient approach for evaluating “response shift” is the then-test approach. By emphasizing that these methods should be applied in clinical studies, the present article describes the most significant methods for evaluating “response shift”. Since the effect of “response shift” has been neglected in the majority of studies conducted on quality of life, it is advised that, in longitudinal studies, quality of life changes be interpreted by monitoring the effect of “response shift”.

Theaim of radiation therapy treatment planning is to achieve an optimal balancebetween delivering a high dose to target volume and a low dose to healthytissues. In order to refrain any complications resulting from the dose to the surroundingnormal organs, the role of treatment plan has been critically evaluated in termof how large the volume or mass of normal tissues exposed in the radiation. Theintegral dose, hence, is one of the important guidance for predicting the radiationeffects and choosing the treatment plan. The goal of this study is to compareand investigate the integral doses in conformal 3D vs. IMRT plan.Dosimetric data from five patients of prostate cancer, treated bysimultaneous integrated boost IMRT and 3D CRT were evaluated in thisprospective study. Target volume and organs at risk were contoured usingM.I.R.S Treatment Planning System (ModuleIntegrated Radiotherapy System version 5.0.00).A dose of 80 Gy to the PTV1, 57 Gy to RTV2 and 62 Gy to the PTV3 and 70Gy in 3DCRT and for PTV, was prescribed. For each patient IMRT plans using S.A.S(dynamic Step and Shoot) and 3D CRT with 6, 10 and 18MV energies, were done. Tocalculate the ID to the normal healthy tissue all the target volumes wereachieved. The Integral Dose was calculated as the mean- dose times the volumeof the structure. A total of thirty IMRT and 3D CRT plans were performed forevaluation. The mean ID received by rectum for 3D CRT was almost 1.04% greaterthan IMRT while in bladder mean value of ID for IMRT is also bigger than 3D CRTapproximately about 1.04%. In RFH and LFH the mean values of ID for 3D CRT werealmost 1.05% and 1.06% greater than IMRT, respectively. Due to the three PTVsin IMRT the integral dose in target volume has the biggest value comparing with3D CRT, considerably. Keywords: Integral dose, IMRT, 3D CRT,radiotherapy, SIB-IMRT

Chronic Lymphocytic Leukemia (CLL) is among the most prevalent blood cancers in people over the age of 40. In addition to clinical-pathologic staging and blood tests, another crucial prognostic factor of CLL is the immunoglobulin variable heavy chain mutation analysis. Finding the most prevalent mutation type and conducting a molecular analysis of it in the majority of the patients can contribute to identifying the disease pattern in a specific region or country. In the present study, we have used molecular detection methods in order to find the relationship between clinical pathologic findings and immunoglobulin heavy chain mutations in CLL patients in Iran. From 2009-2011, 26 patients with a suspected diagnosis of CLL were randomly selected from patients referred to Imam Khomeini Hospital. All patients underwent a clinical staging of the disease and had flow cytometric analysis performed on blood samples. The panels of cell surface markers used for the diagnosis of Chronic Lymphoid Leukemia include CD19, CD3, CD23, CD10 and CD5. The diagnosis confirmed a minimum of 20% positive expression of dual CD5 and CD19 markers. Genomic DNA was then extracted from the patients’ blood and IGVH mutation analysis was conducted with pGEM-T kit. Patients were in an age range of 42 to 80, with their mean age being 62 (SE=1.87) and 73% of them being male. Their mean WBC count, lymphocytes percentage, average hemoglobin level and platelet count were, respectively, 56000/microliter, 85%, 12 gr/dl and 150000/microliter. According to their molecular analysis, 38.9% of patients were unmutated and 61.1% showed mutation in the variable heavy chain locus. The most common mutation had occurred in the IGVH3 allele (66.66%). The mean overall survival rate of patients, mutated and unmutated, was, respectively, 39 (95%CI 32, 46) and 31 (95%CI 26, 36) months (P=0.407).Benet stage had statistically meaningful relation to patients survival (p=0.02) Similar to the findings of other studies, IGVH3 mutations were found to be prevalent by this study too. Although a correlation was found to exist between the patients’ survival and IGVH mutation, it was not statistically significant due to the limited number of the patients. We can conclude that clinical methods are still valuable in determining the prognosis of patients with CLL today.

Background and Gastric cancer (GC) is one of the most common cancers worldwide and in Iran. As conventional therapies such as surgery and chemotherapy are invasive with adverse effects, current studies are important as they are conducted to find natural compounds with few adverse effects. In this study, melittin with 26 amino acids was isolated and purified from bee venom and its effect on the viability and proliferation of gastric cancer cells was investigated. At first, melittin was purified from honeybee venom by a reversed-phase high performance liquid chromatography (RP- HPLC) and using C18 column. The biologic activity of melittin was evaluated by hemolytic test on red blood cells to melittin standard. To investigate the effect of melittin on viability and proliferation of AGS human gastric adenocarcinoma cells, the related cells were cultured in a 96-well plate and treated with serially diluted concentrations of melittin for 6 and 12 hours and their mortality was determined by MTT [(3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] colorimetric method at 540 nm wavelengths. The obtained chromatogram from RP-HPLC showed that melittin comprised 50% of the studied bee venom. SDS-PAGE analysis of melittin fraction confirmed purity of isolated melittin. Hemolytic assay showed that the extracted melittin indicates a strong hemolytic activity (HD50=0.55μg/ml). MTT assay showed that melittin strongly inhibits proliferation of gastric cancer cells at concentrations more than 2μg/ml. This inhibitory effect depends on melittin concentration and time. The results of this study showed that melittin is a strong inhibitor of proliferation of the gastric cancer cells. Also, it was observed that this inhibitory effect is increased with increasing concentrations of melittin and incubation time.