Phenolic Compounds Profile and Antioxidant Capacity of Plant-Based Protein Supplements

The study aimed to determine the phenolic content and antioxidant capacity of five protein supplements of plant origin. The content and profile of phenolics were determined using the UHPLC-DAD-MS method, while antioxidant capacity (ABTS and DPPH assays) and total phenolic content (TPC) were evaluated using spectrophotometric tests. In the analyzed proteins, twenty-five polyphenols were detected, including eleven phenolic acids, thirteen flavonoids, and one ellagitannin. Hemp protein revealed the highest individual phenolics content and TPC value (1620 μg/g and 1.79 mg GAE/g, respectively). Also, hemp protein showed the highest antioxidant activity determined via ABTS (9.37 μmol TE/g) and DPPH (9.01 μmol TE/g) assays. The contents of p-coumaric acid, m-coumaric acid, kaempferol, rutin, isorhamnetin-3-O-rutinoside, kaempferol-3-O-rutinoside, and TPC value were significantly correlated with antioxidant activity assays. Our findings indicate that plant-based protein supplements are a valuable source of phenols and can also be used in research related to precision medicine, nutrigenetics, and nutrigenomics. This will benefit future health promotion and personalized nutrition in the prevention of chronic diseases.

In vitro anticholinergic and antiglycaemic properties of frost-hardy Actinidia fruit extracts and their polyphenol profile, L-ascorbic acid content and antioxidant capacity

The aim of this study was to investigate the inhibitory effects of Actinidia arguta ('Weiki', 'Skarlet September Kiwi') and Actinidia kolomikta ('Lande') fruit extracts against advanced glycation end-products (AGEs) formation and acetylcholinesterase (AChE) activity. The extracts were also tested regarding polyphenol profile and Lascorbic acid content (UHPLC-DAD-MS), and antioxidant capacity (DPPH, ABTS). 'Scarlet September Kiwi' showed the strongest anti-AGEs activity studied with BSAGLU (IC50 = 2.68) and BSA-MGO (IC50 = 18.06) models. The highest anti-AChE activity was found for the 'Lande' extract (IC50 = 4.56). 'Lande' showed the highest L-ascorbic acid content (8271.96 µg/g dw), ABTS (312.42 µmol TE/g dw) and DPPH (282.01 µmol TE/g dw) values. 'Scarlet September Kiwi' revealed the highest individual phenolics concentration (2321.43 µg/g dw). The contents of (+)-catechin and L-ascorbic acid were significantly correlated with anti-AChE activity. This research sheds new light on the bioactivity of Actinidia arguta and Actinidia kolomikta fruit elucidating the role of (+)-catechin and L-ascorbic acid in prevention of Alzheimer's disease.

Anti-Hyperglycemic Effects of Bioactive Compounds in the Context of the Prevention of Diet-Related Diseases

Diet-related diseases are health conditions primary caused by poor nutrition. These diseases encompass obesity, type 2 diabetes, cardiovascular diseases, osteoporosis, and certain types of cancer. Functional foods and nutraceuticals offer a promising dietary approach to addressing diet-related diseases across various clinical contexts. The bioactive compounds found in these foods are the subject of intensive studies aimed at discovering their anti-hyperglycemic effects, which are beneficial in alleviating chronic diseases and protecting human health. Hyperglycemia is a common risk factor for metabolic disease and mortality worldwide. Chronic hyperglycemic states can lead to many long-term complications, such as retinopathy, neuropathy, kidney disease, heart disease, cancer, and diabetes. This review explores the potential anti-hyperglycemic effects of bioactive compounds, specifically flavonoids and phenolic acids, and their proposed roles in mitigating chronic diseases and promoting human health. By thoroughly examining the existing literature, we investigated the potential anti-hyperglycemic effects of these bioactive compounds and their proposed roles in managing chronic diseases. The goal of this paper was to enhance our comprehension of how these compounds modulate glucose transporters, with the ultimate aim of identifying effective strategies for the prevention and treatment of diet-related diseases. Overall, this review investigated the use of bioactive compounds from functional foods as potential inhibitors of glucose transporters in the context of prevention/treatment of diet-related diseases.

Relationship between the Consumption of Fermented Red Beetroot Juice and Levels of Perfluoroalkyl Substances in the Human Body's Fluids and Blood Parameters

Per- and polyfluoroalkyl substances (PFASs) are a group of fluorinated, organic, man-made chemicals; they do not occur naturally in the environment. This study aimed to determine the profile and content of PFASs in the volunteers' blood plasma and urine after the consumption of fermented red beetroot juice and then correlated it with the blood parameters. Over 42 days, 24 healthy volunteers ingested 200 mL/60 kg of body weight of fermented red beetroot juice. PFASs were analyzed using the micro-HPLC-MS/MS method. Five perfluoroalkyl substances were found in the volunteers' body fluids. After consuming the juice, it was discovered that regarding the perfluorocarboxylic acids, a downward trend was observed, while regarding the perfluoroalkane sulfonates, and their plasma content showed a statistically significant upward trend. Analysis of the hematology parameters indicated that the intake of fermented red beetroot juice showed a significant decrease in mean corpuscular volume (MCV), platelets concentration, mean platelet volume (MPV), platelet large cell ratio (P-LCR) at the significance level p < 0.01, and hematocrit (p < 0.05). On the other hand, the dietary intervention also indicated a significant (p < 0.01) increase in corpuscular/cellular hemoglobin concentration (MCHC). In the case of blood biochemistry, no significant change was observed in the blood samples after the intake of the fermented beetroot juice. However, a decreasing tendency of total cholesterol and low-density lipoprotein concentration (LDL-C) was observed. Based on the presented results, there is a need to analyze and monitor health-promoting food regarding undesirable substances and their impact on consumer health.

Effects of different processing methods on the polyphenolic compounds profile and the antioxidant and anti-glycaemic properties of horseradish roots (Armoracia rusticana)

Horseradish (Armoracia rusticana) provides human organisms with various effective treatments for improving human health, and it constitutes a salubrious root used for culinary purposes. This outcome derives from the chemical composition and polyphenols content of horseradish. This study's objective was to determine individual polyphenols, total phenolic (TPC) and total flavonoid (TFC) contents, colour parameters, inhibition of advanced glycation end product (AGEs) formation and Trolox Equivalent Antioxidant Capacity (TEAC) by DPPH and ABTS of horseradish products. Phenolic acids and flavonoids were analysed by HPLC-DAD-MS method. Horseradish products were obtained by thermal treatments such as boiling, baking and sous-vide. Fresh and sous-vide samples were characterized by the most abundant TPC values, whereas TFC horseradish indicated the highest value after boiling treatment. Moreover, the highest values of antioxidant capacity in fresh horseradish roots were detected. Flavonoids presented lower concentrations than phenolic acids, while syringic acid was the most abundant phenolic compound. Horseradish, after sous-vide treatment, appeared to have a higher inhibition of AGEs formation. Thermal treatment of horseradish root increased the saturation of yellow (b*) and red (a*) colours and decreased colour brightness. Our findings indicate that horseradish products are a valuable source of polyphenols, with their profile, content, and antioxidant and anti-AGEs formation activity modulated by applied processes.

Characteristics of contaminants in the polish-origin bee products and cancer risk assessment

The aim of this study was to evaluate the concentration of 5-hydroxymethylfurfural (HMF), furfural, polycyclic aromatic hydrocarbons (PAHs), and pesticide residues, as well as assessment of cancer risk of the Polish-origin bee products. The bee product samples were prepared using a modified QuEChERS method, then PAHs and pesticides were analysed by gas chromatography-mass spectrometry (GC-MS), neonicotinoids by high-performance liquid chromatography with a diode array detector (HPLC-DAD), and HMF and furfural by spectrophotometry (HPLC-UV/Vis). The results showed that the highest furfural content was found in bee bread from the northeast part of Poland; moreover, samples obtained from the same region were also characterized with a higher level of HMF. The total sum of PAHs ranged from 324.0 to 866.4 μg/kg; the highest content of PAH4 (the sum of benzo[a]anthracene, chrysene, benzo[b]fluoranthene and benzo[a]pyrene) was 21.0 μg/kg, but only benzo[a]anthracene and chrysene were detected in the samples. Imidacloprid and acetamiprid were found only in bee bread from the northeast part of Poland, while clothianidin was detected in honey samples. The acceptable cancer risk has been calculated for PAHs due to ingestion of honey, while increasing the risk of cancer was calculated for bee bread and bee pollen. Due to the high concentration of PAHs and excessively high recommended consumption dose, regular consumption of bee bread and pollen may pose a severe threat to human health and should be strictly limited.

Association between Intake of Fermented Dairy Product and Diet Quality, Health Beliefs in a Representative Sample of Polish Population

This study aimed to evaluate the association of diet quality and perception of consumption benefits with intake of fermented dairy products in a representative sample of the Polish population. The study was carried out in February 2020 and involved 2009 men and women randomly sampled from the representative Polish population stratified into two age groups (19-30 and 66-75 years). Dairy product intake was evaluated using a qualitative food frequency questionnaire. Diet quality was assessed by calculating the Mediterranean Diet Adherence Screener (MEDAS) score. The perceived health benefit of dairy product consumption was assessed by a literature-based questionnaire. The Health Concern Scale was used to measure participants' attitudes toward health. The median intake of fermented dairy products was 0.8 portion/day (IQR: 0.4-1.6). Intake of fermented dairy products was associated with a higher MEDAS score. We observed that people with the highest intake of fermented dairy products consumed more oils, vegetables, wine, legumes, fish and seafood, sweets and pastries, nuts, had a higher preference for white meat and were more likely to report their perceived benefits to maintain body weight, reduce cardiovascular risk, and improve immune and dental health. Moreover, a high intake of fermented dairy products was positively related to paying more attention to health. Our study identified patterns of health behaviors associated with the frequent consumption of fermented dairy products. We observed that the intake of fermented dairy products is associated with better diet quality, consumer self-consciousness, and a greater attitude toward personal health.

Antioxidant Activity and Profile of Phenolic Compounds in Selected Herbal Plants

Herbs are characterized by a high content of biologically active substances that positively affect human health. Phenolic compounds are one of the main bioactive compounds in these plants with highly beneficial properties (e.g., anti-carcinogenic, cardioprotective, immune system support and antibacterial). Therefore, this study aimed to determine the composition of free and bound phenolic compounds and antioxidant activity in 10 different herbs (bogbean leaves, sage leaves, whole Indian hemp, whole heartsease, whole horsetail, whole blessed thistle, whole thyme, chamomile flower, corn silk and pine buds). Phenolic compounds were analyzed using the HPLC-TOF-MS/MS method, total phenolic (TP) and flavonoid (TF) contents were measured using spectrophotometric methods, while antioxidant activity was determined by ABTS and DPPH assays. The highest content of free TP was found in thyme, while sage was characterized by the highest range of these compounds released from ester and glycosidic derivatives by hydrolysis. In turn, the highest values of TF in non-hydrolyzed extracts were found in Indian hemp. The highest values of TF, including bound phenols were observed in extracts obtained from sage leaves. In the analyzed herbs thirty-three phenolic compounds were found, constituting 16 phenolic acids, 9 flavonoids and eight stilbenes. Moreover, the analyzed compounds appeared in the bound form than in the free form. The antioxidant activity of herb extracts differed significantly across varieties (P < 0.05). The research showed that each tested herb possesses its own fingerprint of phenolic compounds and antioxidant properties.

The Impact of the Method Extraction and Different Carrot Variety on the Carotenoid Profile, Total Phenolic Content and Antioxidant Properties of Juices

The study assesses the antioxidant activity (AA), carotenoid profile and total phenolic content (TPC) of carrot juices obtained from three different varieties (black, orange and yellow) and prepared using high- (HSJ) and low-speed juicer (LSJ). The AA assessment was carried out using four assays (DPPH, ABTS, PCL ACW and PCL ACL). The content of carotenoids was conducted by high performance liquid chromatography equipped with a diode array detector (HPLC-DAD) method, while the total phenolic content by the spectrophotometric method. It was shown that orange carrot juices contain more carotenoids than yellow and black carrot juices, approximately ten and three times more, respectively. The total carotenoid content in orange carrot juice made by the HSJ was higher (by over 11%) compared to juice prepared by the LSJ. The highest total phenolic content was noticed in black carrot juices, while the lowest in orange carrot juices. In black carrot juices, a higher range of TPC was found in juices made by HSJ, while in the case of the orange and yellow carrots, the highest content of TPC was detected in juices prepared by the LSJ. AA of the juices was highly dependent on the carrot variety, juice extraction method. The most assays confirmed the highest AA values in black carrot juices. Furthermore, it was shown that the HSJ method is more preferred to obtain orange and yellow carrot juices with higher antioxidant properties, while the LSJ method is more suitable for black carrot juice extraction.

The Application of Lamiaceae Lindl. Promotes Aroma Compounds Formation, Sensory Properties, and Antioxidant Activity of Oat and Buckwheat-Based Cookies

Aroma plays an important role in designing innovative functional foods. This study aimed to study the influence of incorporating herbs from the Lamiaceae family (sage, mint, rosemary, oregano, thyme) on aroma compound formation and sensory properties in oat-buckwheat products. DPPH, FRAP and PCL have been used to describe possible antioxidant activity changes and reduce power of cookies after Lamiaceae Lindl. addition. The volatiles analysis by HS-SPME-GC/MS, has shown that Lamiaceae addition significantly influences the volatiles composition (29 molecules) with a predominance of molecules with a positive sensorial impression. Cookies elaborated with herbs were characterized by a greater share of monoterpenes (e.g., limonene, eucalyptol), in the volatile profile than in control cookies. These compounds’ occurrence was closely correlated with the appearance of herbal odor and taste among sensory attributes in cookies with herbs addition. In contrast, a decrease of negative oil aroma and the bitter aftertaste was noted by a sensory panel. Moreover, in cookies of mint and rosemary, hexanal share decreased about 13 and 9.7-times, respectively. Considering all presented experiments, rosemary addition was the most effective in forming a positive aroma profile with high sensory acceptance and increased functional properties.

Characterization of the profile and concentration of betacyanin in the gastric content, blood and urine of rats after an intragastric administration of fermented red beet juice

The aim of the study was to evaluate the profile and level of betacyanins in the gastric content, blood (portal and main veins) and urine of rats after an intragastric administration of fermented red beet juice with various betacyanin doses. Samples were collected within 2 h after juice administration into the stomachs, separated from the digestive tract of a living rat. In the gastric content, betacyanins administered underwent intensive degradation and changes in their profile, as a result of the conditions prevailing in the stomach and the intensity of the absorption process. Detection of 19 betacyanins (8 native compounds and 11 metabolites) in rats' physiological fluids with the HPLC-MS/MS method proves betacyanin absorption from the stomach. In addition, the study results suggest that betacyanin dose affects the rate and extent of betacyanin degradation in the gastric content, as well as the intensity of absorption, metabolism and excretion of these pigments.

Addition of immunotherapy in adjuvant setting could be a promising avenue of colorectal cancer (CRC) treatment, especially in patients with higher levels of programmed cell death ligand-1 (PD-L1) positive circulating epithelial tumor cells (CETC) after neoadjuvant chemotherapy

e14036

Background: CRC is the third most frequent cancer in men and second in women worldwide. Recently, immune checkpoint molecules such as PD-1/PD-L1 have been identified as a possible target for immunotherapy in CRC and are increasingly being tested in clinical trials in combination with chemotherapy. However, the role of PD-L1 expression in CRC tumor cells and its interaction with other clinicopathologic factors remains elusive. In this study, we evaluated the impact of neoadjuvant chemotherapy on the fraction of PD-L1 positive CETCs and to compare its expression to the primary tumor. Methods: CETCs were determined from the blood of 20 patients suffering from CRC in different stages of the disease. The number of CETCs and their expression of PD-L1 were investigated using the maintrac method. In parallel, PD-L1 expression and tumor infiltrating lymphocytes (TILs) were assessed by immunohistochemistry on tissue biopsies. Results: PD-L1 expression could be assessed in all patients with detectable CETCs with a median of 50%. CETCs were more frequently found to be PD-L1 positive than tissue, and no correlation was observed between tissue and CETCs PD-L1 expression. Interestingly, patients with neoadjuvant chemotherapy had more positive PD-L1 CETCs compared to patients without chemotherapy (mean 66,7 vs. 35,2 p < 0.05), but the total number of CETCs was significantly lower in the neoadjuvant group. Also, patients with mucinous adenocarcinoma had more PD-L1 positive CETCs compared to other histological subtypes. The number of TILs was higher in patients with lymph node metastasis and larger tumors. TILs count did not differ in patients with and without neoadjuvant chemotherapy. Conclusions: Assessment of PD-L1 expression in CETCs is feasible, and CETCs are more often positive than in tissue. PD-L1 expression on CETCs was higher in patients who received neoadjuvant chemotherapy. Further studies are necessary to validate these findings.

Profile and Content of Betalains in Plasma and Urine of Volunteers after Long-Term Exposure to Fermented Red Beet Juice

The aim of this study was to determine profile and content of betalains in volunteers' plasma and urine after long-term exposure to fermented red beet juice. During 6 weeks, 24 healthy volunteers consumed juice with a dose of 0.7 mg betalains/kg body weight. Betalains were analyzed by means of micro-HPLC-MS/MS. Twelve betalain derivatives were found in blood plasma and urine after juice intake. The highest betalains level in blood plasma (87.65 ± 15.71 nmol/L) and urine (1.14 ± 0.12 μmol) was found after the first and second week of juice intake, respectively. During juice consumption, the contribution of betalain metabolites was higher than that of native betalains, and interindividual variability in profile and content of betalains was observed. Summarizing, it was observed that long-term and regular consumption of the juice causes stabilization of profile and content of betalains in physiological fluids of volunteers, which include native compounds and their decarboxylated and dehydrogenated metabolites.

The effects of boiling and fermentation on betalain profiles and antioxidant capacities of red beetroot products

The aim of study was investigation the impact of boiling and spontaneous fermentation on profile and content of betalains and antioxidant capacity of red beetroot. Betalains were analyzed by micro-HPLC-TOF-MS/MS method, while antioxidant capacity by three in vitro assays. Red beet products were abounded in betalains, with betanin, isobetanin, betanidin and vulgaxanthin I predominating among twenty two pigments identified. Boiling and fermentation of red beet reduced the content of betalains by 51-61% and 61-88%, respectively, however, this decline was limited when the peel was present. Microbial activity and softening of the matrix induced by the fermentation process led to the release of betalains responsible for strong antioxidant capacity of the juice formed. Generally, the treatment applied maintained and/or lowered antioxidant capacity of red beet materials obtained. Our findings indicate that red beet-derived products are valuable source of betalains, with their profile, content and antioxidant capacity being modulated by processes applied.

Using the SPE and Micro-HPLC-MS/MS Method for the Analysis of Betalains in Rat Plasma after Red Beet Administration

The objective of this study was to develop a simple and reproducible method for the qualitative and quantitative analysis of betalains in plasma samples, based on Solid Phase Extraction (SPE) and micro-high performance liquid chromatography coupled with mass spectrometry (micro-HPLC-MS/MS). The eight betalain compounds detected and quantified were characterized in the fortified rat blood plasma samples. The developed method showed a good coefficient of determination (R² = 0.999), good recovery, precision, and appropriate limits of detection (LOD) and quantification (LOQ) for these compounds. Application of this method for the treatment of rat plasma samples collected after the betalain preparation administration, for the first time, revealed the presence of native betalains and their metabolites in plasma samples. Moreover, among them, betanin (2.14 ± 0.06 µmol/L) and isobetanin (3.28 ± 0.04 µmol/L) were found at the highest concentration. The results indicated that the combination of an SPE method with a micro-HPLC-MS/MS analysis may be successfully applied for the determination of betalains in the blood plasma.

Methyl jasmonate stimulates biosynthesis of 2-phenylethylamine, phenylacetic acid and 2-phenylethanol in seedlings of common buckwheat

Methyl jasmonate has a strong effect on secondary metabolizm in plants, by stimulating the biosynthesis a number of phenolic compounds and alkaloids. Common buckwheat (Fagopyrum esculentum Moench) is an important source of biologically active compounds. This research focuses on the detection and quantification of 2-phenylethylamine and its possible metabolites in the cotyledons, hypocotyl and roots of common buckwheat seedlings treated with methyl jasmonate. In cotyledons of buckwheat sprouts, only traces of 2-phenylethylamine were found, while in the hypocotyl and roots its concentration was about 150 and 1000-times higher, respectively. Treatment with methyl jasmonate resulted in a 4-fold increase of the 2-phenylethylamine level in the cotyledons of 7-day buckwheat seedlings, and an 11-fold and 5-fold increase in hypocotyl and roots, respectively. Methyl jasmonate treatment led also to about 4-fold increase of phenylacetic acid content in all examined seedling organs, but did not affect the 2-phenylethanol level in cotyledons, and slightly enhanced in hypocotyl and roots. It has been suggested that 2-phenylethylamine is a substrate for the biosynthesis of phenylacetic acid and 2-phenylethanol, as well as cinnamoyl 2-phenethylamide. In organs of buckwheat seedling treated with methyl jasmonate, higher amounts of aromatic amino acid transaminase mRNA were found. The enzyme can be involved in the synthesis of phenylpyruvic acid, but the presence of this compound could not be confirmed in any of the examined organs of common buckwheat seedling.

Impact of the grasping test on women’s cardiovascular systems, and the possibility of replacing the orthostatic tolerance test with it

The aim of this study was to test the impact of the Grasping Test (GT) on the female cardiovascular system and to ascertain the possibility of using this to replace the Orthostatic Tolerance Test (OT). In this study, 15 volunteer female students were examined, and their physiological parameters - their systolic (SBP) and diastolic blood pressures (DBP), and their heart rates (HR) - were compared. We found that the Orthostatic Tolerance Test (changing the position of the body from recumbent to upright) and the Grasping Test induced meaningful but similar changes in the functioning of the women’s cardiovascular system. The results confirm that there were significant similarities between the cardiovascular system measurements as produced through the Orthostatic Tolerance Test and the Grasping Test. The possibility of introducing the procedure into clinical practice is a crucial factor for continuing our research in the wider population.

Sequential adjuvant chemotherapy and radiotherapy in endometrial cancer--results from two randomised studies

INTRODUCTION

Endometrial cancer patients with high grade tumours, deep myometrial invasion or advanced stage disease have a poor prognosis. Randomised studies have demonstrated the prevention of loco-regional relapses with radiotherapy (RT) with no effect on overall survival (OS). The possible additive effect of chemotherapy (CT) remains unclear. Two randomised clinical trials (NSGO-EC-9501/EORTC-55991 and MaNGO ILIADE-III) were undertaken to clarify if sequential combination of chemotherapy and radiotherapy improves progression-free survival (PFS) in high-risk endometrial cancer. The two studies were pooled.

METHODS

Patients (n=540; 534 evaluable) with operated endometrial cancer International Federation of Obstetrics and Gynaecology (FIGO) stage I-III with no residual tumour and prognostic factors implying high-risk were randomly allocated to adjuvant radiotherapy with or without sequential chemotherapy.

RESULTS

In the NSGO/EORTC study, the combined modality treatment was associated with 36% reduction in the risk for relapse or death (hazard ratio (HR) 0.64, 95%confidence interval (CI) 0.41-0.99; P=0.04); two-sided tests were used. The result from the Gynaecologic Oncology group at the Mario Negri Institute (MaNGO)-study pointed in the same direction (HR 0.61), but was not significant. In the combined analysis, the estimate of risk for relapse or death was similar but with narrower confidence limits (HR 0.63, CI 0.44-0.89; P=0.009). Neither study showed significant differences in the overall survival. In the combined analysis, overall survival approached statistical significance (HR 0.69, CI 0.46-1.03; P=0.07) and cancer-specific survival (CSS) was significant (HR 0.55, CI 0.35-0.88; P=0.01).

CONCLUSION

Addition of adjuvant chemotherapy to radiation improves progression-free survival in operated endometrial cancer patients with no residual tumour and a high-risk profile. A remaining question for future studies is if addition of radiotherapy to chemotherapy improves the results.

EPR/alanine dosimetry in LDR brachytherapy--a feasibility study

In this study, we present the results of in vivo dosimetry, using electron paramagnetic resonance in l-alanine, performed on 13 patients treated for gynaecological cancers. The doses from (137)Cs (12 samples) and (192)Ir (one sample) brachytherapy sources were determined inside vagina. The detectors had a form of small cellulose capsules tightly filled with crystalline alanine. The positions of the detectors were reconstructed from two orthogonal radiographs. The planned doses were calculated with a computer planning system (PLATO, Nucletron). The relative deviations between planned and measured doses ranged from -23 to +14%. The mean deviation from the prescribed dose was relatively low (-5%) with SD of 10%. The main sources of differences between the measured and calculated doses were attributed to uncertainty in the determination of the detector position inside the patient's body and to uncontrolled changes in the detector position during the treatment.

The feasibility study on continuous 7-day-a-week external beam irradiation in locally advanced cervical cancer: a report on acute toxicity

PURPOSE

To evaluate the feasibility and toxicity of continuous 7-day-a-week pelvic irradiation with no breaks between external beam irradiation and intracavitary applications.

MATERIAL AND METHODS

Between November 1998 and December 1999, 30 patients with FIGO Stage IIB or IIIB cervical cancer were treated with continuous 7-day-a-week pelvic irradiation, to the total Manchester point B dose of 40.0-57.6 Gy. The first 13 patients (group A) were applied a daily tumor dose of 1.6 Gy and the remaining 17 patients (group B)-10.8 Gy. One or two immediate brachytherapy applications (point A dose 10-20 Gy, each) were performed in 28 cases.

RESULTS

Two patients did not complete the irradiation due to apparent early progression of disease during the irradiation. Of the remaining 28 evaluable patients 11 (39%) completed treatment within the prescribed overall treatment time and 17 had unplanned treatment breaks. For the latter group overall treatment time ranged from 103 to 122% (mean 114%) and from 103 to 197% (mean 138%) of the planned treatment time for group A and B, respectively. The majority of patients experienced acute toxicity. Severe toxicity (EORTC/RTOG grade 3 and 4), predominantly gastrointestinal, occurred in 5 of the 13 patients in group A, and in 7 of 17 patients in group B.

CONCLUSION

The studied regimen was accompanied by considerable toxicity, hindering delivery of irradiation within planned treatment time.

[Primary brain lymphoma: diagnostic problems]

Diagnostic difficulties in a patient with primary malignant lymphoma of the brain are presented. Computerized tomography scans disclosed, at the beginning, a large mass located in the frontocallosal region, and 15 months later another focus in the cerebellum. Differential diagnostic considerations based on CT and NMR pictures, included infectious diseases, demyelinating diseases also metastatic tumours. The patient was successfully treated surgically, and had than radiotherapy.