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Ahmadloo N, Heidarpourfard M, Najib FS, Shiravani Z, Omidvari S, Mosalaei A, Mohammadianpanah M, Ansari M, Nasrollahi H, Khanjani N, Kadkhodaei B, Hamedi SH. The Feasibility and Safety of Induction Chemotherapy Followed by Definitive Chemoradiation in Patients with Locally Advanced Cervical Cancer: A Single-Arm Phase II Clinical Trial. Asian Pac J Cancer Prev 2023; 24:1321-1330. [PMID: 37116155 DOI: 10.31557/apjcp.2023.24.4.1321] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The present study aimed at investigating the feasibility and safety of induction chemotherapy followed by definitive chemoradiation (dCRT) in patients with locally advanced cervical cancer. MATERIALS AND METHODS In this single-arm clinical trial, patients with cervical cancer (stages IB3-IVA) received a median four cycles of induction chemotherapy (paclitaxel and carboplatin, every three weeks) followed by dCRT (which consisted of the whole pelvis at the dose of 45-50 Gy along with weekly cisplatin (40 mg/m2) followed by intracavitary brachytherapy at the total dose of 80-90 Gy). Primary end point was local control at three months, which was assessed by gynecologic examination and pelvic MRI. The secondary outcome of the study was treatment-related toxicity. RESULTS Seventy-four patients with the mean age of 51.6 ± 9.5 years were included. The most frequent (51.4%) disease stage was IIB. Complete and partial clinical responses were observed in 60.8% and 14.9% of patients, respectively. The frequency of progressive disease and stable disease were 14.9% and 9.5%, respectively. Grade II and III neutropenia (during neoadjuvant chemotherapy were 13.5% and 2.7%, respectively; these figures during chemoradiation were 29.7% and 13.5%, respectively. A treatment interruption was observed for 60.8% (45 cases) of patients during chemoradiation and 31.1% during induction chemotherapy. DISCUSSION AND CONCLUSION Induction chemotherapy followed by chemoradiation is feasible in patients with locally advanced cervical cancer; however, the toxicity should be managed properly to avoid delayed e treatment. More than three quarters of the patients achieved complete or partial clinical response within a three-month follow-up.
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Affiliation(s)
- Niloofar Ahmadloo
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Heidarpourfard
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Sadat Najib
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Shiravani
- Division of Oncology and Gynecology, Department of Obstetrics and Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shapour Omidvari
- Breast Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Mosalaei
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mansour Ansari
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Nasrollahi
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nezhat Khanjani
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnam Kadkhodaei
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sayed Hasan Hamedi
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Ansari M, Askarpour S, Nasrollahi H, Mohammadianpanah M, Ahmadloo N, Omidvari S, Mosalaei A, Hamedi SH, Zare-Bandamiri M. Clinical and Pathological Features and Outcome of Patients with Salivary Gland Cancer a Single Centre Report. Asian Pac J Cancer Care 2022. [DOI: 10.31557/apjcc.2022.7.2.261-266] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction: Salivary gland tumors are rare tumors that account for 3 to 4% of head and neck neoplasms. These tumors may arise from 6 major and numerous minor salivary glands. This study was designed to investigate the factors affecting the prognosis of salivary gland tumors. Methods: This study is a retrospective descriptive study in which the records of patients with salivary gland tumors referred to the Radiotherapy and Oncology Center of Namazi Hospital from 2005 to 2015 were reviewed. Results: 158 patients were included in this study with a mean age of 55.37 years. 49% of the patients were men. Adenoid Cystic Carcinoma was the most common histological type (30.57%) and Adenocarcinoma with a prevalence of 1.91% had the lowest prevalence rate in this study. 65.19% of salivary gland neoplasms in this study had parotid gland involvement and sublingual gland involvement had the lowest prevalence (3.8%). The results of survival analysis clearly illustrated that surgery, pathology type and stage was statistically significant in survival. Discussion: Clinical, pathological and therapeutic factors in people with malignant salivary gland neoplasms have a significant relationship with their survival. controversies on treatment and outcome continues.
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Nasrollahi H, Khaki S, Ansari M, Ahmadloo N, Khanjani N, Hamedi SH, Omidvari S, Mosalaei A, Mohammadianpanah M, Kadkhodaei B. Evaluation of Mucosamin Effect on Treating Radiation Induced Oral Mucositis during and after Radiotherapy amongst Patients with Oral Cavity Squamous Cell Carcinoma. Asian Pac J Cancer Prev 2021; 22:3711-3715. [PMID: 34837931 PMCID: PMC9068180 DOI: 10.31557/apjcp.2021.22.11.3711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Oral mucositis is a serious complication radiation therapy for cancer. This is a major complication during radiation therapy of the head and neck tumors in approximately all patients. Therefore, this study was conducted to evaluate the effect of Mucosamin on treatment of radiation induced oral mucositis during and after radiotherapy amongst patients with oral cavity squamous cell carcinoma. Materials and Methods: In this prospective clinical trial, eligible patients who referred to radiation oncology department of Namazi Hospital, Shiraz, Iran from Jan 2018 till Jan 2019 were evaluated. The cases with confirmed pathologic diagnosis of squamous cell carcinoma of the oral cavity underwent 6,000 cGy radiation therapy and were randomly divided into two groups: 1- Intervention group; Mucosamin spray for 3-4 times a day (n = 40); 2 - Control group; standard medications (3 times a day) (n = 40). Oral mucositis was evaluated weekly based on RTOG scoring scale. Grade of mucositis was recorded during treatment and after radiation therapy. Results: A total of 80 patients were divided in two groups of Mucosamin and control. From week 3 until the end of radiotherapy (week 6) and after radiotherapy (week 8), there was a significant difference in the severity of oral mucositis between the Mucosamin and the control groups (P <0.05). Conclusion: The results of this study showed that Mucosamin spray was able to significantly improved radiation-induced oral mucositis in patients with oral squamous cell carcinoma.
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Affiliation(s)
- Hamid Nasrollahi
- Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeedeh Khaki
- Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansour Ansari
- Breast Diseases Research Center, Shiraz University of Medical Sciences Shiraz, Iran
| | - Niloofar Ahmadloo
- Department of Health Administration, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nezhat Khanjani
- Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sayed Hasan Hamedi
- Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shapoor Omidvari
- Breast Diseases Research Center, Shiraz University of Medical Sciences Shiraz, Iran
| | - Ahmad Mosalaei
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Behnam Kadkhodaei
- Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Ahmadloo N, Kadkhodaei B, Omidvari S, Mosalaei A, Ansari M, Nasrollahi H, Hamedi SH, Mohammadianpanah M. Lack of Prophylactic Effects of Aloe Vera Gel on Radiation Induced Dermatitis in Breast Cancer Patients. Asian Pac J Cancer Prev 2017; 18:1139-1143. [PMID: 28547955 PMCID: PMC5494228 DOI: 10.22034/apjcp.2017.18.4.1139] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Purpose: Radiotherapy induced dermatitis is a common and sometimes serious side effect. We conducted a randomized study to understand whether the adjunctive use of aloe vera gel might reduce the prevalence and/or severity of radiotherapy induced dermatitis. Methods: One hundred patients with newly diagnosed breast cancer were randomized to receive aloe vera gel or nothing during adjuvant radiotherapy consisting of conventional external beam radiation using 6 MV mega voltage linear accelerator photons. The radiation portals were composed of breast fields in all patients and supraclavicular and posterior axillary fields in node positive cases. The total dose was 50 Gy with a daily fraction of 2 Gy, five fractions per week. Results: Dermatitis was first found among patients of both groups after week 2. In the aloe vera and control groups, 2/8 patients and 5/12 patients had dermatitis grade 1 after weeks 2 (P value = 0.240) and 3 (P value = 0.317). After the 4th week, the numbers were 18 and, 23 fordermatitis grade 1 and only 1 for grade 3 dermatitis (P value = 0.328). After the 5th week, 31, 12 and 2 patients in the aloe vera group and 36, 6 and 5 of the controls had grades 1, 2 and 3 dermatitis, respectively (P value = 0.488). Conclusion: Aloe vera exerted no positive effect on prevalence orseverity of radiation dermatitis in this study.
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Affiliation(s)
- Niloofar Ahmadloo
- Department of Radiation Oncology, Shiraz University of Medical Sciences, Shiraz, Iran.
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Omidvari S, Zohourinia S, Ansari M, Ghahramani L, Zare-Bandamiri M, Mosalaei A, Ahmadloo N, Pourahmad S, Nasrolahi H, Hamedi SH, Mohammadianpanah M. Efficacy and Safety of Low-Dose-Rate Endorectal Brachytherapy as a Boost to Neoadjuvant Chemoradiation in the Treatment of Locally Advanced Distal Rectal Cancer: A Phase-II Clinical Trial. Ann Coloproctol 2015; 31:123-30. [PMID: 26361613 PMCID: PMC4564663 DOI: 10.3393/ac.2015.31.4.123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 06/25/2015] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Despite advances in rectal cancer treatment over the last decade, local control and risk of late side effects due to external beam radiation therapy (EBRT) remain as concerns. The present study aimed to investigate the efficacy and the safety of low-dose-rate endorectal brachytherapy (LDRBT) as a boost to neoadjuvant chemoradiation for use in treating locally advanced distal rectal adenocarcinomas. METHODS This phase-II clinical trial included 34 patients (as the study arm) with newly diagnosed, locally advanced (clinical T3-T4 and/or N1/N2, M0) lower rectal cancer. For comparative analysis, 102 matched patients (as the historical control arm) with rectal cancer were also selected. All the patients were treated with LDRBT (15 Gy in 3 fractions) and concurrent chemoradiation (45-50.4 Gy). Concurrent chemotherapy consisted of oxaliplatin 130 mg/m(2) intravenously on day 1 plus oral capecitabine 825 mg/m(2) twice daily during LDRBT and EBRT. RESULTS The study results revealed a significant differences between the study arm and the control arm in terms in the pathologic tumor size (2.1 cm vs. 3.6 cm, P = 0.001), the pathologic tumor stage (35% T3-4 vs. 65% T3-4, P = 0.003), and the pathologic complete response (29.4% vs. 11.7%, P < 0.028). Moreover, a significantly higher dose of EBRT (P = 0.041) was found in the control arm, and a longer time to surgery was observed in the study arm (P < 0.001). The higher rate of treatment-related toxicities, such as mild proctitis and anemia, in the study arm was tolerable and easily manageable. CONCLUSION A boost of LDRBT can optimize the pathologic complete response, with acceptable toxicities, in patients with distal rectal cancer.
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Affiliation(s)
- Shapour Omidvari
- Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shadi Zohourinia
- Department of Radiation Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansour Ansari
- Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Ghahramani
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ahmad Mosalaei
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloofar Ahmadloo
- Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeedeh Pourahmad
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Nasrolahi
- Department of Radiation Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sayed Hasan Hamedi
- Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Ghahramani L, Moaddabshoar L, Razzaghi S, Hamedi SH, Pourahmad S, Mohammadianpanah M. Prognostic Value of Total Lymph Node Identified and Ratio of Lymph Nodes in Resected Colorectal Cancer. ACTA ACUST UNITED AC 2013. [DOI: 10.17795/acr-15311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Omidvari S, Hamedi SH, Mohammadianpanah M, Razzaghi S, Mosalaei A, Ahmadloo N, Ansari M, Pourahmad S. Comparison of abdominoperineal resection and low anterior resection in lower and middle rectal cancer. J Egypt Natl Canc Inst 2013; 25:151-60. [DOI: 10.1016/j.jnci.2013.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/12/2013] [Accepted: 06/15/2013] [Indexed: 01/23/2023] Open
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