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Omar A, Kaseb A, Elbaz T, El-Kassas M, El Fouly A, Hanno AF, El Dorry A, Hosni A, Helmy A, Saad AS, Alolayan A, Eysa B, Hamada E, Azim H, Khattab H, Elghazaly H, Tawfik H, Ayoub H, Khaled H, Saadeldin I, Waked I, Barakat E, El Meteini M, Hamed Shaaban M, EzzElarab M, Fathy M, Shaker M, Sobhi M, Shaker M, ElGharib M, Abdullah M, Mokhtar M, Elshazli M, Heikal O, Hetta O, ElWakil R, Abdel Wahab S, Eid S, Rostom Y. Erratum: Egyptian Society of Liver Cancer Recommendation Guidelines for the Management of Hepatocellular Carcinoma [Corrigendum]. J Hepatocell Carcinoma 2023; 10:2101-2102. [PMID: 38035343 PMCID: PMC10683655 DOI: 10.2147/jhc.s442441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 12/02/2023] Open
Abstract
[This corrects the article DOI: 10.2147/JHC.S404424.].
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Omar A, Kaseb A, Elbaz T, El-Kassas M, El Fouly A, Hanno AF, El Dorry A, Hosni A, Helmy A, Saad AS, Alolayan A, Eysa BE, Hamada E, Azim H, Khattab H, Elghazaly H, Tawfik H, Ayoub H, Khaled H, Saadeldin I, Waked I, Barakat EMF, El Meteini M, Hamed Shaaban M, EzzElarab M, Fathy M, Shaker M, Sobhi M, Shaker MK, ElGharib M, Abdullah M, Mokhtar M, Elshazli M, Heikal OMK, Hetta O, ElWakil RM, Abdel Wahab S, Eid SS, Rostom Y. Egyptian Society of Liver Cancer Recommendation Guidelines for the Management of Hepatocellular Carcinoma. J Hepatocell Carcinoma 2023; 10:1547-1571. [PMID: 37744303 PMCID: PMC10516190 DOI: 10.2147/jhc.s404424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023] Open
Abstract
Globally, hepatocellular carcinoma (HCC) is the fourth most common cause of death from cancer. The prevalence of this pathology, which has been on the rise in the last 30 years, has been predicted to continue increasing. HCC is the most common cause of cancer-related morbidity and mortality in Egypt and is also the most common cancer in males. Chronic liver diseases, including chronic hepatitis C, which is a primary health concern in Egypt, are considered major risk factors for HCC. However, HCC surveillance is recommended for patients with chronic hepatitis B virus (HBV) and liver cirrhosis; those above 40 with HBV but without cirrhosis; individuals with hepatitis D co-infection or a family history of HCC; and Nonalcoholic fatty liver disease (NAFLD) patients exhibiting significant fibrosis or cirrhosis. Several international guidelines aid physicians in the management of HCC. However, the availability and cost of diagnostic modalities and treatment options vary from one country to another. Therefore, the current guidelines aim to standardize the management of HCC in Egypt. The recommendations presented in this report represent the current management strategy at HCC treatment centers in Egypt. Recommendations were developed by an expert panel consisting of hepatologists, oncologists, gastroenterologists, surgeons, pathologists, and radiologists working under the umbrella of the Egyptian Society of Liver Cancer. The recommendations, which are based on the currently available local diagnostic aids and treatments in the country, include recommendations for future prospects.
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Affiliation(s)
- Ashraf Omar
- Department of Gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Kaseb
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tamer Elbaz
- Department of Gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed El-Kassas
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Amr El Fouly
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Abdel Fatah Hanno
- Department of Gastroenterology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed El Dorry
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Hosni
- Department of Interventional Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amr Helmy
- Department of Surgery, National Liver Institute Menoufia University, Menoufia, Egypt
| | - Amr S Saad
- Department of Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ashwaq Alolayan
- Department of Oncology, National Guard Hospital, Riyadh, Saudi Arabia
| | - Basem Elsayed Eysa
- Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Emad Hamada
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hamdy Azim
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hany Khattab
- Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hesham Elghazaly
- Department of Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hesham Tawfik
- Department of Oncology, Faculty of Medicine, Tanta University, TantaEgypt
| | - Hisham Ayoub
- Department of Gastroenterology, Military Medical Academy, Cairo, Egypt
| | - Hussein Khaled
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ibtessam Saadeldin
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Imam Waked
- Department of Gastroenterology, Menoufia Liver Institute, Menoufia, Egypt
| | - Eman M F Barakat
- Department of Gastroenterology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud El Meteini
- Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Hamed Shaaban
- Department of Interventional Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed EzzElarab
- Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Mohamed Fathy
- Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Shaker
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Sobhi
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Kamal Shaker
- Department of Gastroenterology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed ElGharib
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohammed Abdullah
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohesn Mokhtar
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Elshazli
- Department of Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Osama Hetta
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Reda Mahmoud ElWakil
- Department of Gastroenterology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sameh Abdel Wahab
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Samir Shehata Eid
- Department of Oncology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Yousri Rostom
- Department of Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - On behalf of the Egyptian Liver Cancer Committee Study Group
- Department of Gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
- Department of Gastroenterology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Interventional Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Surgery, National Liver Institute Menoufia University, Menoufia, Egypt
- Department of Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Oncology, National Guard Hospital, Riyadh, Saudi Arabia
- Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Oncology, Faculty of Medicine, Tanta University, TantaEgypt
- Department of Gastroenterology, Military Medical Academy, Cairo, Egypt
- Department of Gastroenterology, Menoufia Liver Institute, Menoufia, Egypt
- Department of Gastroenterology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Oncology, Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Rostom Y, Abdelmoneim SE, Shaker M, Mahmoud N. Presentation and management of female breast cancer in Egypt: an implementation study. East Mediterr Health J 2022; 28:725-732. [DOI: 10.26719/emhj.22.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/29/2022] [Indexed: 11/09/2022]
Abstract
Background: Exploration of the population profile and management of female breast cancer in Alexandria, Egypt, to identify system inefficiencies. Aims: To identify barriers to full implementation of international guidelines in female breast cancer patients. Methods: Data extraction and analysis from records of 3 public oncology services in Alexandria, Egypt in 2007–2016. Results: A total of 5236 of 7125 records were usable. Median patient age was 54 years, and 522 (31.5%) had a positive family history. Median duration of prediagnosis complaint was 3.1 months. For tumour stage, 2527 (55.2%) were early, 1717 (37.6%) were locally advanced and 331 (7.2%) were stage IV. Estrogen receptor, progesterone receptor and HER2 were positive in 3869 (85%), 3545 (78%) and 461 (15.3%) patients, respectively. Chemotherapy started after a median 1.03 months. Adjuvant chemotherapy was given to 3667 (91.7 %) patients and neoadjuvant chemotherapy to 333 (8.3%); 3686 (92.1%) received anthracycline-based combination chemotherapy, and 3613 (86%) received hormonal treatment. One hundred and eighty of 317 eligible patients received trastuzumab. Local and/or distant recurrence was seen in 1109 (21.2%) patients. In nonmetastatic cases, median overall and disease-free survival was 149.1 and 77.1 months, respectively. In metastatic cases, median progression-free survival was 19.6 months. Conclusion: There were defects in the record system, delayed diagnosis and treatment, and nonadherence to targeted therapy in many patients. Promotion of national and hospital-based registries is needed, along with targeted information, education and communication strategies, and a robust patient navigation system. Continuous monitoring of outcomes and adaptation to implementation needs must be sustained.
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Rostom Y, Mahmoud N, Abdelmoneim S, Shaker M, Elsaka R. Outcomes of Adjuvant Hypofractionated Radiotherapy in the Treatment of Post-Mastectomy Breast Cancer Patients. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rostom Y, Abdelmonem S, Shaker M, Mahmoud N, Labib N, Ismail AA, Soliman M. Abstract 16: Presentation and Management of Egyptian Female Breast Cancer In Alexandria, Egypt: An Implementation Study. Cancer Epidemiol Biomarkers Prev 2021. [DOI: 10.1158/1538-7755.asgcr21-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose: Exploration of the population profile and management of female breast cancer in a representative sample from Alexandria, Egypt, to identify system inefficiencies and barriers preventing full implementation of international guidelines, negatively impacting the outcome.
Methods: The study surveyed 7125 records from three major public oncology services at Main University Hospital, Gamal Abd-elnasser Hospital and Ayadi Almostakbel Oncology Center, between 2007 and 2016.
Results: 73.4% (5236 records) of the records contained usable information. The median age was 54 years, with positive family history in 31.5%. The median duration of complaint before diagnosis was 3.1 months (IQR 1.6-7.5). 55.2% were early stage, 37.6% were locally advanced and 7.2% were stage IV. Breast surgery was performed for 4976 cases. Axillary surgery was done for 4945 cases. Most cases were hormone receptor positive. 15.3% were HER2 positive. The median duration to start chemotherapy was 1.03 months (IQR 0.7-1.6). Adjuvant chemotherapy was given to 3667 and neoadjuvant chemotherapy was given to 333. Anthracycline-based combination chemotherapy, with or without Taxanes was the commonest. 86% received hormonal treatment. 180/317 trastuzumab-eligible patients received trastuzumab. 69.5% started radiotherapy > 6 months from presentation. Conventionally and hypofractionated regimens were used in 46.6% and 53.5%, respectively. 1109 developed relapse (local in 155, distant in 130 and 794 had both). In non-metastatic cases, median overall and disease free survivals were 149.1 and 77.1 months respectively. In metastatic cases, the median progression free survival was 19.6 months.
Conclusion: The study revealed defects in the record system, delayed diagnosis and treatment, and inadherence to targeted therapy protocols in a significant part of eligible patients. Suggested implementation strategies include promotion of national or hospital based registries, information, education and communication with target populations and health carers, establishing a patient navigation system and monitoring outcomes of the interventions.
Citation Format: Yousri Rostom, Salah Abdelmonem, Marwa Shaker, Nayera Mahmoud, Nevine Labib, Abdelsalam A. Ismail, Maher Soliman. Presentation and Management of Egyptian Female Breast Cancer In Alexandria, Egypt: An Implementation Study [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 16.
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Affiliation(s)
| | | | | | | | - Nevine Labib
- 2Sadat Academy for management sciences, computer and information systems
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Kiser K, Meheissen M, Mohamed A, Kamal M, Ng S, Elhalawani H, Jethanandani A, He R, Ding Y, Wang J, Rostom Y, Hegazy N, Fuller C. Quality Assessment of Commercially Available MRI-CT Deformable and Rigid Registration Algorithms. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kiser K, Meheissen MA, Mohamed AS, Kamal M, Ng SP, Elhalawani H, Jethanandani A, He R, Ding Y, Rostom Y, Hegazy N, Bahig H, Garden A, Lai S, Phan J, Gunn GB, Rosenthal D, Frank S, Brock KK, Wang J, Fuller CD. Prospective quantitative quality assurance and deformation estimation of MRI-CT image registration in simulation of head and neck radiotherapy patients. Clin Transl Radiat Oncol 2019; 18:120-127. [PMID: 31341987 PMCID: PMC6630195 DOI: 10.1016/j.ctro.2019.04.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/19/2019] [Accepted: 04/22/2019] [Indexed: 11/23/2022] Open
Abstract
MRI-CT deformable image registration was not superior to rigid registration. Dice similarity coefficients were 0.65, 0.62, and 0.63 for deformable registrations. Dice similarity coefficient was 0.63 for rigid registration. Registration quality was superior in muscle and gland compared to bone and vessel.
Background MRI-guided radiotherapy planning (MRIgRT) may be superior to CT-guided planning in some instances owing to its improved soft tissue contrast. However, MR images do not communicate tissue electron density information necessary for dose calculation and therefore must either be co-registered to CT or algorithmically converted to synthetic CT. No robust quality assessment of commercially available MR-CT registration algorithms is yet available; thus we sought to quantify MR-CT registration formally. Methods Head and neck non-contrast CT and T2 MRI scans acquired with standard treatment immobilization techniques were prospectively acquired from 15 patients. Per scan, 35 anatomic regions of interest (ROIs) were manually segmented. MRIs were registered to CT rigidly (RIR) and by three commercially available deformable registration algorithms (DIR). Dice similarity coefficient (DSC), Hausdorff distance mean (HD mean) and Hausdorff distance max (HD max) metrics were calculated to assess concordance between MRI and CT segmentations. Each DIR algorithm was compared to DIR using the nonparametric Steel test with control for individual ROIs (n = 105 tests) and for all ROIs in aggregate (n = 3 tests). The influence of tissue type on registration fidelity was assessed using nonparametric Wilcoxon pairwise tests between ROIs grouped by tissue type (n = 12 tests). Bonferroni corrections were applied for multiple comparisons. Results No DIR algorithm improved the segmentation quality over RIR for any ROI nor all ROIs in aggregate (all p values >0.05). Muscle and gland ROIs were significantly more concordant than vessel and bone, but DIR remained non-different from RIR. Conclusions For MR-CT co-registration, our results question the utility and applicability of commercially available DIR over RIR alone. The poor overall performance also questions the feasibility of translating tissue electron density information to MRI by CT registration, rather than addressing this need with synthetic CT generation or bulk-density assignment.
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Key Words
- CT, computed tomography
- CT-MRI image registration
- DICOM, digital imaging and communications in medicine
- DIR, deformable image registration
- DSC, dice similarity coefficient
- Deformable image registration
- HD max, Hausdorff maximum distance
- HD mean, Hausdorff mean distance
- HNC, head and neck cancer
- HPV, human papillomavirus
- HU, Hounsfield units
- IMRT, intensity-modulated radiation therapy
- MAE, mean absolute error
- MRI, magnetic resonance imaging
- MRI-guided radiotherapy
- MRIgRT, MRI-guided radiotherapy planning
- MRL, MRI linear accelerator
- OAR, organ(s) at risk
- Quality assessment
- RIR, rigid image registration
- RT, radiation therapy
- Rigid image registration
- sCT, synthetic computed tomography
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Affiliation(s)
| | - Kendall Kiser
- University of Texas, John P. and Kathrine G. McGovern Medical School, 6431 Fannin Street, Houston, TX 77030, USA
- UT Health School of Biomedical Informatics, 7000 Fannin Street, Suite 600, Houston, TX 77030, USA
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Mohamed A.M. Meheissen
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, 17 Champilion Street, Alazarita, Alexandria, Egypt
| | - Abdallah S.R. Mohamed
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, 17 Champilion Street, Alazarita, Alexandria, Egypt
- MD Anderson Cancer Center/UT Health Graduate School of Biomedical Sciences, 6767 Bertner Avenue, Houston, TX 77030, USA
| | - Mona Kamal
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Ain Shams, Lofty El-Said Street, 1156 Cairo, Egypt
| | - Sweet Ping Ng
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
- Department of Radiation Oncolog, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, VIC 3000, Australia
| | - Hesham Elhalawani
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Amit Jethanandani
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
- College of Medicine, University of Tennessee Health Science Center, 910 Madison Avenue #1002, Memphis, TN 38103, USA
| | - Renjie He
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Yao Ding
- Department of Radiation Physics, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Yousri Rostom
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, 17 Champilion Street, Alazarita, Alexandria, Egypt
| | - Neamat Hegazy
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, 17 Champilion Street, Alazarita, Alexandria, Egypt
| | - Houda Bahig
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
- Department of Radiation Oncology, Centre Hospitalier de l’Universite de Montreal, 1051 Rue Sanguinet, Montreal, QC H2X 3E4, Canada
| | - Adam Garden
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Stephen Lai
- Department of Head and Neck Surgery, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Jack Phan
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Gary B. Gunn
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - David Rosenthal
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Steven Frank
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Kristy K. Brock
- Department of Radiation Physics, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
- Department of Imaging Physics, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Jihong Wang
- Department of Radiation Physics, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Clifton D. Fuller
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
- Corresponding author.
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Zaghloul HA, Khedr GA, Rostom Y, Refaat T. The Predictive Value of Pretreatment 18-F-FDG-PET-CT in Locally Advanced Nasopharyngeal Cancer Patients Treated Definitively with Induction Chemotherapy Followed by Concurrent Chemo-Radiotherapy. ACTA ACUST UNITED AC 2014; 5. [PMID: 26779385 PMCID: PMC4714838 DOI: 10.4172/2155-9619.1000166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Aims This study aimed to evaluate the role of pretreatment 18F-Fluorodeoxyglucose positron emission tomography (18F-FDG-PET-CT) as a predictor of disease-free survival (DFS), and overall survival (OS) in locally advanced nasopharyngeal carcinoma (LANPC) patients treated definitively with docetaxel-based induction chemotherapy followed by concurrent chemoradiation (CRT). Materials and methods This is a retrospective study approved by the institutional review board and included LANC patients treated definitively and consecutively between January 2008 and December 2012 with induction chemotherapy; docetaxel, cisplatin, and 5-flurouracil (TPF) followed by CRT utilizing weekly cisplatin. All patients had baseline pretreatment 18F-FDG-PET-CT. We studied the association between the baseline primary tumor maximum standardized uptake value (SUVmax) and the treatment outcomes; OS and DFS. Results The study included 70 eligible LANPC patients. The 4-year OS and DFS rates were 86.7% and 78.6%, respectively. The median OS and DFS intervals were not reached. On a univariate analysis, the 4-years DFS was significantly higher in patients with pretreatment SUVmax <8 compared versus ≥ 8 (95% vs 57.7%, P=0.002). Furthermore, DFS was significantly correlated with pretreatment T stage (P=0.01), N stage (P=0.02), treatment response (P<0.001) and treatment breaks (P<0.001). On a multivariate analysis, the SUVmax category was the only factor correlated with 4-year DFS (Hazard ratio=10.2, 95% C I 1.3-116.8, P=0.035) but not OS (P=0.085). Disclosure statement There is no actual or potential conflict of interest with the production and publication of this work. No author has a direct or indirect commercial financial incentive associated with the publication of this article. Conclusion This study shows that the pretreatment primary tumor 18F-FDG-PET-CT SUVmax is a potential independent prognostic predictor of clinical outcomes in patients with LANC treated definitively with TPF induction chemotherapy followed by CRT. Further controlled clinical trials are worthwhile.
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Affiliation(s)
- Hala A Zaghloul
- Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Gehan A Khedr
- Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Yousri Rostom
- Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Tamer Refaat
- Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt ; Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Tawfik H, Rostom Y, Elghazaly H. All-oral combination of vinorelbine and capecitabine as first-line treatment in HER2/Neu-negative metastatic breast cancer. Cancer Chemother Pharmacol 2013; 71:913-9. [PMID: 23344713 DOI: 10.1007/s00280-013-2082-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 01/08/2013] [Indexed: 01/26/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of an all-oral vinorelbine and capecitabine combination therapy in anthracycline- ± taxane-pretreated HER2/Neu-negative metastatic breast cancer (MBC). METHODS A phase 2 trial including women >18 years with HER2/Neu-negative MBC previously exposed to anthracycline- ± taxane-based chemotherapy in the adjuvant or neoadjuvant setting. Enrolled patients received oral vinorelbine 60 mg/m(2) on days 1 and 8 and oral capecitabine 1,000 mg/m(2) twice daily on days 1-14 on a 3 weekly schedule. Patients with progressive disease after 3 cycles discontinued the study, while the remaining patients continued treatment for a maximum of 6 cycles. RESULTS From January 2007 to March 2011, 30 patients were enrolled in this study (median age 47 years). In the 28 evaluable patients, the overall response rate was 57.1 % (95 % CI 30-67 %), including 3 complete (10.7 %) and 13 partial (46.4 %) responses. Six (21.4 %) patients suffered from disease progression. With a median follow-up time of 13 months, the median time to disease progression was 8.6 months (95 % CI 6.2-10.6 months) and the median survival time was 27.2 months. Treatment-related adverse events were manageable, and no World Health Organization grade 4 toxicities were noted. Neutropenia observed in 6 (21.4 %) patients was the main grade 3 toxicity. Grade 3 nausea and vomiting were reported in 2 (7.1 %) and 3 (10.7 %) patients, respectively. Two (7.1 %) patients developed grade 3 hand and foot syndrome. CONCLUSION These results show that the combination of oral vinorelbine and capecitabine is an effective and well-tolerated first-line regimen for HER2/Neu-negative MBC patients pretreated with anthracyclines ± taxanes.
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Affiliation(s)
- Hesham Tawfik
- Clinical Oncology Department, Tanta University, Tanta, Egypt.
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Rostom Y, El-Hasafy M, El Yamany A, Lashen S. Efficacy and Safety of 3-dimensional Conformal Radiation Therapy in Treatment of Portal Vein Thrombosis in Hepatocellular Carcinoma Patients. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rostom Y, Zaghloul H, Khedr G, El-Shazly W, Abd-Allah D. Docetaxel-Based Preoperative Chemoradiation in Localized Gastric Cancer: Impact of Pathological Complete Response on Patient Outcome. J Gastrointest Cancer 2012; 44:162-9. [DOI: 10.1007/s12029-012-9449-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Dawod T, Mosad M, Rostom Y, Abouzeid M. IMRT Commissioning and Verification Measurements on Siemens (ARTISTE)Linear Accelerator. Kasr-Al-Aini J of Clin Onc and Nuc Med 2012. [DOI: 10.21608/resoncol.2012.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Refaat T, Abdelmoneim S, Rostom Y. Comparative evaluation of two methods of chemotherapy dose calculation according to body surface area and body mass index in obese females with breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
e13539 Background: Hair loss is a common, unavoidable, and stressful side effect of chemotherapy. This work was performed to evaluate the role of scalp cooling in reducing anthracycline-induced hair loss and its impact on Quality of life (QOL). Methods: The study was conducted from July 2007 to August 2008. It included 120 females with breast cancer, treated in adjuvant setting. Patients were chosen according to certain criteria (age ≤ 70 years, WHO performance status 0–1, no cardiac disease, no serious psychiatric conditions, no previous chemotherapy). Patients were divided randomly into 2 groups according to whether scalp cooler was used or not during chemotherapy. Chemotherapy consisted of doxorubicin (50 mg/m2), 5-FU (500 mg/m2) and cyclophosphamide (500 mg/m2) for 6 cycles. Paxman Scalp Cooler was used. The cap was applied 20 minutes before, during and 2 hours after infusion. Hair loss was assessed using WHO criteria at each cycle and after 6 cycles of chemotherapy. QOL was assessed using EORTC QLQ-C30 and BR23. Results: After 4 cycle, 61.7 % of patients in scalp cooling group had grade 4 hair loss compared to 81.7 % of patients in control group. After 6 cycles, 85% of patients in scalp cooling group experienced grade 4 hair loss compared to 100% of patients in the control group. Only 9 patients (15%) in the scalp cooling group developed grade 1–2 hair loss. No significant relation was found between the degree of hair loss and the liver function tests. Most patients (73.3%) were comfortable during cooling. QOL scores were comparable between the two groups except for emotional functioning and body image. In the hair loss group, 71.2% of patients showed severe disturbance of emotional functioning and 54.1% of patients had moderate disturbance in body image. In hair preservation group (9 patients), 77.8% developed moderate disturbance of emotional functioning and all patients had mild disturbance in the body image. Conclusions: The role of scalp cooling is limited at the total dose of 300 mg/m2 doxorubicin. It may be more effective with fewer cycles or less aggressive drug combination. Hair loss affects various aspects of QOL, especially emotional functioning and body image. More time is needed to assess the long term effect of hair loss on QOL and the incidence of scalp metastasis in the two study groups. No significant financial relationships to disclose.
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Affiliation(s)
| | | | - Y. Rostom
- Faculty of Medicine, Alexandria, Egypt
| | - A. Salama
- Faculty of Medicine, Alexandria, Egypt
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El Nashar E, El Nashar E, El Noweim S, Abdel Moneim S, Rostom Y. A phase II trial using altered fractionation irradiation with concomitant chemotherapy in the management of patients with muscle invasive bladder cancer (MIBC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Acharki A, Mornex F, Sentenac I, Romestaing P, Reibel S, Rostom Y, Xie CH, Gérard JP. P68 Le repositionnement des patients en radiothérapie de conformation. Expérience du centre hospitalier Lyon-Sud. Cancer Radiother 1998. [DOI: 10.1016/s1278-3218(98)80109-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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