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Cisplatin (CDDP) is a highly potent chemotherapy drug. But its nephrotoxicity poses a significant limitation to its use. The renin-angiotensin system (RAS) has been proposed to play a role in drug-induced nephrotoxicity. This systematic review (SR) sought to identify the link between CDDP-induced nephrotoxicity and the RAS pathway. In this SR, relevant keywords were employed to explore databases such as PubMed (MEDLINE), Scopus (Elsevier), and Institute for Scientific Information (ISI) Web of Science up to October 2023. Nine studies were selected based on predefined inclusion/exclusion criteria. The findings support the involvement of the RAS in the CDDP-induced nephrotoxicity model, along with the activation of inflammatory mediators, lipid peroxidation, and changes in markers of kidney tissue damage. Furthermore, physiology and pathology of RAS-related interventions in CDDP-induced nephrotoxicity models have involved the factors such as human organic cation transporter 2 (hOCT2), organic anion transporting polypeptides 1B1 (OATP1B1) and 1B3, kallikrein-kinin system, and bradykinin receptors. CDDP-induced nephrotoxicity has been found to be substantially influenced by both classic and nonclassic RAS axes. Angiotensin II exacerbates renal damage induced by CDDP. Conversely, inhibiting the pressor arm of RAS in males mitigates this damage. However, activation of the renal vasodepressor arm of RAS exacerbates CDDP-induced nephrotoxicity in females. These findings underscore gender differences in renal function and response to RAS-related interventions in the presence of CDDP. This SR provides insights into both beneficial and adverse interventions associated with RAS in the CDDP-induced nephrotoxicity, offering valuable considerations for researchers and clinicians. [ABSTRACT FROM AUTHOR]

Derived from hazelnuts, hazel leaf has been utilized in traditional folk medicine for centuries in countries such as Portugal, Sweden, and Iran. In our previous investigations, we conducted a preliminary assessment of the hazel leaf polyphenol extract (referred to as ZP) and identified nine compounds, such as kaempferol and chlorogenic acid, in its composition. ZP has shown promising properties as an antioxidant and anti-inflammatory agent. Our research has revealed that ZP has protective effects against cisplatin-induced acute kidney injury (AKI). We conducted a comprehensive examination of both the pathological and ultrastructural aspects and found that ZP effectively ameliorated renal tissue lesions and mitigated mitochondrial damage. Moreover, ZP significantly suppressed malondialdehyde levels while increasing glutathione and catalase concentrations in the kidneys of AKI-induced mice. ZP decreased the number of apoptotic cells and decreased pro-apoptotic protein expression in the kidneys of mice and human renal tubular epithelial cells (HK-2). Furthermore, treatment with ZP increased the levels of proteins marking anti-ferroptosis, such as GPX4, FTH1, and FSP1, in experiments both in vivo and in vitro. We elucidated the underlying mechanisms of ZP's actions, revealing its inhibitory effect on Yap phosphorylation and its regulation of Lats expression, which exert a protective influence on the kidneys. Furthermore, we found that inhibiting the Hippo pathway compromised ZP's nephroprotective effects in both in vitro and in vivo studies. In summary, this research shows that ZP exhibits renoprotective properties, effectively reducing oxidative damage, apoptosis, and ferroptosis in the kidneys by targeting the Hippo pathway. [ABSTRACT FROM AUTHOR]

We aimed to assess the effects of pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios on the response to neoadjuvant chemotherapy and survival rates in patients with extremity osteosarcoma. Patients with high-grade osteosarcoma admitted to oncologic centers affiliated with Iran University of Medical Sciences, Tehran, Iran from 2015 to 2021 were evaluated retrospectively to assess the impact of complete blood count-related parameters on the pathologic response after neoadjuvant chemotherapy. Then, patients were followed up prospectively to evaluate the survival rates. All patients received at least three cycles of cisplatin/doxorubicin regimen, preoperatively. In this study, the cut-off values for high neutrophil-to-lymphocyte and high platelet-to-lymphocyte ratio were considered 3.28 and 128, respectively. One hundred eighty-six patients were enrolled. Patients with high neutrophil-to-lymphocyte ratio and high platelet-to-lymphocyte ratio had a significantly lower overall survival rates (20.7 [95% CI 18–23.5] month vs. 34.6 [95% CI 33.2–36], p = 0.003 and 21.9 [95% CI 20.2–23.6] month versus 35.3 [95% CI 33.9–36.7], p = 0.002; respectively). Moreover, disease-free survival of patients with high platelet-to-lymphocyte ratio was worse than patients with low platelet-to-lymphocyte ratio (20.4 [95% CI 18.4–22.4] month vs. 32.7 [95% CI 30.8–34.7], p = 0.02). Our study showed that neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios at the baseline can predict the survival of patients with high-grade osteosarcoma. [ABSTRACT FROM AUTHOR]

Background: The incidence of gastric cancer is known to be high in the elderly population. Identification of the best perioperative chemotherapy regimen is challenging in patients with resectable gastric cancer. In this study, we aimed to evaluate and compare the outcomes and safety of epirubicin, cisplatin, and 5-fluorouracil (ECF), docetaxel, cisplatin, and 5-fluorouracil (DCF), oxaliplatin plus 5-Fluorouracil and leucovorin (FOLFOX), and docetaxel, oxaliplatin, leucovorin, and 5-Fluorouracil (FLOT) chemotherapy regimens to identify the most appropriate treatment option for elderly patients with resectable gastric cancer. Materials and Methods: In this retrospective observational cohort study, data were extracted from the medical archives (2017-2021) of Omid Hospital, which is a tertiary oncology referral hospital in Isfahan, Iran. Patients with resectable gastric cancer, above 60 years of age, who were perioperatively treated with one of the mentioned chemotherapy regimens and met the inclusion criteria, were enrolled in this study. The survival parameters and safety profile of the regimens were evaluated and compared in this population. Results: A total of 63 patients were included in this study. The median follow-up period of the patients was 24 months (range, 7-51 months). The results of survival analysis revealed that the FLOT and DCF regimens were significantly associated with longer overall survival (OS) as compared to the other regimens (median OS: 38 and 33 months, respectively). Based on the results, the progression-free survival was longer in the DCF regimen (median: 24 months) compared to the other regimens; however, only the difference with the ECF regimen (median: 14 months) was significant. The results of Cox regression analysis showed no significant difference in the overall adjusted hazard ratio of mortality between the FLOT and DCF regimens (P = 0.802). The DCF and FOLFOX regimens accounted for the highest and lowest rates of adverse events (e.g., neutropenia and mucositis), respectively. Conclusion: Considering the higher rate of adverse events in the DCF group, besides the significant improvement of OS and the acceptable adverse event profile of patients treated with the FLOT regimen, it can be proposed that this chemotherapy regimen is the most appropriate treatment option for elderly patients with resectable gastric cancer. [ABSTRACT FROM AUTHOR]

Background & Aims: Cancer is one of the causes of morbidity and mortality in developed and under-developed countries. Different strategies are under evaluation for cancer therapy including chemotherapy, radiotherapy, and surgery. However, the treatment can be affected because of the lack of the desired effect and severe side effects. For these reasons, discovering an improved cancer therapy strategy has been one of the most important research efforts worldwide. Cisplatin is considered one of the most effective used chemotherapy agents in the treatment of a variety of tumors. However, its use is limited because of its toxicity to normal cells. In addition, nonspecificity and high dosage of drugs are the other important reasons which practically limit their application. Drug delivery systems can overcome these challenges by enhancing the therapeutic efficacy and reducing the adverse effects of anticancer agents. The application of nanoparticles as drug carriers has been widely studied for more than a decade (3). Magnetic nanoparticles are popular candidates in therapeutic systems and diagnostic applications that approved for clinical use by the Food and Medicine Administration (FDA) (5). In this study, we prepared superparamagnetic iron oxide nanoparticles Fe3O4 (SPIONs) that were modified through triblock poly (ethylene glycol)-poly (e-caprolactone)-poly (ethylene glycol) nanoparticles. These modified nanoparticles have been utilized for Cisplatin delivery on the lymphoma cell line (U937). Methods: Magnetic nanoparticles were prepared by a co-precipitation method in the presence of Fe2+ and Fe3+ (9). In order to synthesize the polymer, ε-caprolactone and polyethylene glycol were polymerized by a ring-opening polymerization method. Triblock copolymer PCL-PEG-PCL was prepared through the ring-opening polymerization method (10). Magnetic iron nanoparticles were also prepared and confirmed using Fourier Transform Infrared Spectroscopy (FTIR) and X-ray diffraction spectrum (XRD). Superparamagnetic nanoparticles modified with PCLPEG-PCL copolymers loaded with cisplatin were developed using the double emulsion solvent evaporation method (11). The encapsulation efficiency of cisplatin loaded in nanoparticles was evaluated through UV spectroscopy at 280 nm (12). Synthesized nanoparticles were evaluated in terms of particle size and morphology by dynamic light scattering (DLS) analysis and Scanning Electron Microscope (SEM), respectively. In addition, the chemical structure of PCL-PEG-PCL triblock copolymer and superparamagnetic nanoparticles modified with PCL-PEG-PCL copolymers loaded with cisplatin was confirmed using FTIR and proton nuclear magnetic resonance (1H-NMR). Finally, the effect of synthesized nanoparticles on the lymphoma cell line (U937) was investigated using MTT assay (13). Results: Magnetic iron nanoparticles were confirmed using FTIR and XRD. The size and shape of the nanoparticles were evaluated using DLS and SEM. The results show that the particle size was around 100-130 nm and the synthesized nanoparticles had uniform dispersion without aggregation. High entrapment of cisplatin was achieved using the double emulsion solvent evaporation method (98/07%). The hysteresis curves of iron magnetic nanoparticles and cisplatin-encapsulated magnetic nanoparticles PCL-PEG-PCL exhibited that in the presence of a magnetic field with an intensity up to 8000 Gauss, these particles have shown the magnetic properties (about 70 emu/g). When the magnetic field was removed, these nanoparticles lost their magnetic properties (0 emu/g). So, in the presence of a magnetic field, a magnetic orientation was demonstrated. The results of the cell viability assay using MTT dye showed that IC50 of free Cisplatin and Cisplatin-encapsulated magnetic nanoparticles PCL-PEG-PCL on the U937 cancerous cell line is 119.70 ± 4.46 µg/ml, 17.35 ± 1.48 µg/ml, 13.58 ± 1.59 µg/ml and 29.67 ± 1.99 µg/ml, 11.24 ± 0.82µg/ml, 7.10 ± 1.37µg/ml respectively for 24, 48 and 72 hours incubation time. The antiproliferative effect of cisplatin encapsulated in magnetic nanoparticles was more significantly cytotoxic on the cancerous target cells than free cisplatin. Conclusion: Over the last decade, scientists have tried to develop new strategies for enhancing the therapeutic index while reducing side effects. In this regard, nanotechnology is considered one of the most effective strategies to which a huge share of research in this area is dedicated (3). Among all the nanoparticles SPIONs have attracted significant attention in cancer therapy because of their unique properties such as biocompatibility, biodegradability, and ease of chemical modification (5). The results of the study demonstrated that superparamagnetic nanoparticles modified with PCL-PEG copolymers efficiently delivered cisplatin into the U937 cells and demonstrated potent in-vitro anticancer activity which had a significant cytotoxic effect against lymphoma cell line (U937). Therefore, this delivery system can potentially be applied for the delivery of anti-cancer drugs and holds a great promise as an effective strategy for cancer treatment. [ABSTRACT FROM AUTHOR]

Background: One of the most prevalent complications of chemotherapy and radiotherapy is oral mucositis (OM) and manifests as erythema and ulceration. Curcumin is one of the components of turmeric and possesses anti-inflammatory and anti-oxidative features. Some of studies have proved the effectiveness of Curcumin in OM. This study aimed to investigate the effects of nanomicelle Curcumin on OM related chemotherapy and head and neck radiotherapy. Methods: In this clinical trial study, 50 patients underwent chemotherapy with or without head and neck radiotherapy were divided into study and control group. The study group was received Curcumin nanomicelle capsules 80 mg twice a day and the control group took placebo two times a day for 7 weeks and the severity and pain of OM was measured. Results: Oral mucositis severity in control group in the first (P = 0.010), fourth (P = 0.022) and seventh (P < 0.001) weeks were significantly more than the study group. Pain grade in study group was lower than control group only in the seventh week. (P = 0.001) Additionally, NRS incremental gradient in control group was more than study group. OM severity in patients who underwent only chemotherapy in the control group were significantly more than the study group in all weeks. In patients who were under chemotherapy and head and neck radiotherapy, OM in control group was significantly more intense than the study group only in the fourth and seventh weeks. Conclusions: Nabomicelle Curcumin capsules is effective on prevention and treatment of head and neck radiotherapy and especially chemotherapy induced OM. Trial registration: Registered 12 February 2019 at Iranian Registry of Clinical Trials (IRCT). IRCT code: IRCT20100101002950N6. https://en.irct.ir/trial/36665. GUMS ethical code: IR.Gums.Rec.1397.296. [ABSTRACT FROM AUTHOR]

Cancer chemotherapies may result in resistance, and therefore, contemporary treatments including natural products may find an increasing consideration. As per Persian medicine (PM), many natural products have been used for malignant and chronic diseases. Triphala, with a combination of Terminalia chebula Retz., Terminalia bellirica Retz., Phyllanthus emblica L., and honey, is a multi-ingredient traditional formulation attributed to anticancer activities in PM. This study is aimed at evaluating the cytotoxic activity of this preparation on HepG2, the human liver cancer cell line. Hydroalcoholic extracts were prepared from the formulation and its components. Compared with the control and Cisplatin, the extracts were tested using MTT assay at different concentrations. All concentrations of the preparation, as well as Cisplatin, were effective significantly against HepG2 cells. All extract preparations at multiple concentrations were significantly effective as evidenced by MTT assay when compared to the control group. The IC50 level for Triphala extract was 77.63 ± 4.3 μ g / ml. Based on the results, Triphala and its components have cytotoxic activity on the HepG2 cancer cell line and they can reduce the survival rate significantly. [ABSTRACT FROM AUTHOR]

The aim of current study was to assess the antioxidant and renoprotective effects of Stachys pilifera Benth (S.P.B.) hydroalcoholic extract on nephrotoxicity induced with cisplatin (CP). Adult rats with bodyweight of 180–220 g were divided into five groups (n = 7) treated as follows: group 1, control; group 2, CP; group 3, pretreatment with S.P.B. before CP; group 4, posttreatment with S.P.B. after CP; and, group 5, S.P.B. extract. A single dose of CP (7 mg/kg) was intraperitoneally injected on the fifth day and hydroalcoholic extract of S.P.B. (500 mg kg–1 day–1) was orally administered. The levels of oxidative stress markers, biochemical tests, and histopathological staining were assayed in serum and renal tissue. Also, the chemical composition of S.P.B. extract was determined by GC‐MS analysis. The main compositions of S.P.B. extract identified by GC‐MS analysis, were hexadeca‐2,6,10,14‐tetraen‐1‐ol, 3,7,11,16‐tetramethyl (24.77%), thymol (14.1%), and linolenic acid (13.4%). In groups treated and pretreated with S.P.B., blood urea nitrogen, creatinine, malondialdehyde, and nitric oxide metabolite in serum as well as malondialdehyde and protein carbonyl content of kidney tissues were significantly decreased in comparison to CP group; in contrast, total thiol group showed a significant increase in treated group as compared to CP group. Furthermore, histological investigation indicated that treatment with S.P.B. improved renal damages induced by CP. The current study showed that S.P.B. hydroalcoholic extract improved the biochemical parameters and kidney function as well as restored antioxidant activity in CP‐induced nephrotoxicity. However, it needs more investigations to define the mechanism of S.P.B. action. Practical applications: In different regions of Iran, Stachys is demonstrated by 34 species, out of which 13 are endemic, one of these endemic species is Stachys pilifera Benth (S.P.B.). The oil of S.P.B. is mainly consisted of cis‐chrysanthenyl acetate, cis‐chrysanthenol, spathulenol, β‐caryophyllene, linalool, and terpinen‐4‐ol. Moreover, phytochemical studies have shown the presence of compounds such as diterpenes, phenylethanoid glycosides, saponins, terpenoides, and flavonoids in Stachys species. The aerial parts of S.P.B. are consumed as herbal tea to treat several disorders, for example, infections, asthma, and rheumatoid arthritis in Iranian folk medicine. The aim of current study was to evaluate the antioxidant and protective effects of S.P.B. hydroalcoholic extract on nephrotoxicity induced with cisplatin (CP). The current study showed that S.P.B. hydroalcoholic extract improved the biochemical parameters and kidney function as well as restored antioxidant activity in CP‐induced nephrotoxicity. However, it needs more researches to define the mechanism of S.P.B. action. [ABSTRACT FROM AUTHOR]

All components of Ziziphus jujube (ZJ) were used in medicine and food in ancient Iran and China. Cisplatin is one of the most important drugs in the treatment of solid tumors. Taking this drug can result in nephrotoxicity through several mechanisms. The purpose of this study was to evaluate the effects of ZJ on the nephrotoxicity induced by cisplatin in rats. Thirty-five experimental rats were randomly divided into the following five groups (n = 7 per group) for an 8-day study: 1- Group C1 was the control group and received distilled water (1 ml/day); 2- Group C2 received a single dose of intraperitoneal cisplatin (5 mg/kg); 3- Group ZJ received 1500 mg/kg/day Ziziphus Jujube extract orally; 4- Group ZJ1 was given 1500 mg/kg/day of Ziziphus Jujube extract orally with taking a single dose of cisplatin (5 mg/kg) on the first day only; 5- Group ZJ2 received 3000 mg/kg/day of Ziziphus jujube extract orally with taking a single dose of cisplatin (5 mg/kg) on the first day only. Eventually, histopathological parameters, blood urea nitrogen (BUN), malondialdehyde (MDA), alanine transaminase (ALT), and aspartate transaminase (AST) were assessed. The findings showed that cisplatin administration resulted in severe degeneration in all parts of the nephron tubules. Also, the present study showed that MDA levels were significantly lower in both ZJ1 and ZJ2 groups compared with those in group C2 (p < 0.01). Moreover, the cisplatin-induced elevation of serum BUN levels significantly decreased in both ZJ1 and ZJ2 groups in comparison with that in group C2 (p < 0.01). In addition, serum levels of both ALT and AST were significantly higher in group C2 in comparison with those in group C1 (p < 0.05). Extensive tubular necrosis was seen in group C2. In brief, results of this research indicated that ZJ could prevent cisplatin-induced kidney injury in rats. [ABSTRACT FROM AUTHOR]

Background: Cancer is one of the major causes of mortality and as an effective factor in the burden of diseases for the future. Among all cancers, gastric cancer is the fourth most common and the second leading cause of cancer mortality worldwide. In this study, we aim to evaluate the cost-utility of two chemotherapy regimens -- epirubicin, oxaliplatin, and capecitabine versus docetaxel, cisplatin, and fluorouracil in patients with advanced gastric cancer in a hospital in southern Iran. Method: This cross-sectional study was an economic evaluation of cost-utility type that included all patients at Amir Hospital (Shiraz, Iran) who had advanced gastric cancer and received either the epirubicin, oxaliplatin, and capecitabine or docetaxel, cisplatin, and fluorouracil chemotherapy regimen. All costs and the quality-adjusted life years were calculated, followed by one-way sensitivity analysis to verify the results. Results:A total of 54 patients participated in this study, amongst whom 20 received the epirubicin, oxaliplatin, and capecitabine regimen and 34 received the docetaxel, cisplatin, and fluorouracil regimen. The mean quality of life of patients that received docetaxel, cisplatin, and fluorouracil was 0.747, whereas it was 0.836 for patients that received epirubicin, oxaliplatin, and capecitabine. The docetaxel, cisplatin, and fluorouracil treatment group ($5573) was more expensive than the epirubicin, oxaliplatin, and capecitabine group ($3108). The results obtained from the cost-utility analysis showed that the epirubicin, oxaliplatin, and capecitabine drug regimen was costeffective due to lower cost and higher utility than the docetaxel, cisplatin, and fluorouracil regimen. One-way sensitivity analysis confirmed the accuracy of these results. Conclusion: Due to the cost-effectiveness of the epirubicin, oxaliplatin, and capecitabine drug regimen compared to docetaxel, cisplatin, and fluorouracil, we recommend that oncologists use this regimen to treat gastric cancer patients. [ABSTRACT FROM AUTHOR]

Cisplatin, as a platinum-based chemotherapeutic medication, is applied for various types of solid tumors. Regarding the treatment of cancer cells, cisplatin is potentially accompanied with some side effects such as nephrotoxicity, neurotoxicity, and ototoxicity in spite of high efficacy of Cisplatin. The present study aimed to determine whether the use of oral sertraline can contribute to preserve hearing threshold among the patients who receive cisplatin or not. This research has done for one year, along with a 3 months course and follow-up. This is a double-blind, randomized, and placebo-controlled trial study. The study was conducted in Oncology Clinic and Audiology Department of Firoozgar University Hospital in Tehran, Iran. Among 112 patients, 79 patients who were suffering from different types of solid tumors and were candidates for receiving cisplatin for chemotherapy treatment were selected. The grade of hearing impairment and otoacoustic emission in the first day and the last stage of the study was used for data analysis. Among 112 patients, 79 patients were randomly selected to receive either sertraline (50 mg/d) as the case group, or placebo as the control group. Before and after the treatments, the patients were assessed by High-Frequency Audiometry and dpOAE tests. First, the two groups were distributed homogeneously based on sex and age. Based on Common Terminology Criteria for Adverse Events (CTCAE), the Ototoxicity Grade indicated a significantly lower grade of deficits in the Sertraline group (p<0.001), compared to that of the control group. In addition, a significant difference was observed between the two groups regarding the changes in the threshold of dpOAE (p=0.000). The daily consumption of sertraline (50 mg/d) among the adults who were candidates for chemotherapy treatment with cisplatin could result in preserving the hearing threshold significantly. [ABSTRACT FROM AUTHOR]

Introduction: Esophageal squamous cell carcinoma (ESCC) accounts for 80% of all esophageal cancers worldwide. It is the most common histological type of esophageal carcinoma in low-resource countries. ESCC is prevalent in Asian countries, accounting for more than 95% of esophageal cancers. The epidermal growth factor receptor (EGFR) is involved in cancer development, as its gene is often mutated and/or amplified in cancer cells. According to recent statistics, esophageal cancer is the eighth most common cancer in Iran. Methods: In this retrospective study, we assessed EGFR overexpression, using immunohistochemistry (IHC) in 68 patients with ESCC, undergoing neoadjuvant chemoradiotherapy and esophagectomy in 2011-2014. The treatment protocol included external beam radiotherapy (40 Gy), concomitant with cisplatin 20mg/m² and 5- fluorouracil (5-FU) 1000 mg/m² for 4 consecutive days during the first and fourth weeks of treatment. To compare the two groups (EGFR positive and negative) in terms of complete pathologic response, Chi-square test was performed using SPSS version 16. Results: The median age of the patients was 59 years (range: 27-70 years), with a female-to-male ratio of 1.06. Overall, 70% of the subjects showed EGFR overexpression. Complete pathologic response to neoadjuvant treatment was significantly higher in EGFR-positive patients (40% vs. 15.8%, P = 0.05). In all cases, 1- and 3-year overall survival rates were 86.6% ± 4.1 and 48% ± 6.9, respectively. The 1- and 3-year disease free survival rates were calculated as 71.8% ± 5.4 and 44.3% ± 6.5, respectively. The overall survival rate was relatively higher in cases with EGFR overexpression, although the difference was not statistically significant (5-year survival rate: 47.9 ± 8.2 vs. 30.9 ±13, P =0.23). Conclusion: EGFR overexpression was reported in the majority of patients with ESCC in northeastern Iran. Moreover, EGFR overexpression was significantly associated with complete pathologic response. [ABSTRACT FROM AUTHOR]

Introduction: Despite improvements in survival of patients with high-grade osteosarcoma after the implementation of perioperative chemotherapy, osteosarcoma remains among the most lethal cancers. Prescription of all chemotherapy courses before the surgery may provide this opportunity to eliminate micrometastases more efficiently, increase the chances of pathologic complete response and organ preserving surgery. This study aimed to compare the outcomes of total neoadjuvant chemotherapy vs. standard perioperative chemotherapy with cisplatin/doxorubicin regimen in patients with extremities osteosarcoma., Methods: In this retrospective cohort, all patients with high-grade osteosarcoma admitted to oncologic centers affiliated to Iran University of Medical Sciences in Tehran, Iran from 2015 to 2021 were included. Organ preserving rates, pathologic responses, and survival of patients who received all six courses of cisplatin/doxorubicin regimen preoperatively were compared to those who received the regimen perioperatively., Results: Sixty-three patients were enrolled (total neoadjuvant chemotherapy: 32 patients and perioperative chemotherapy: 31 patients). In total neoadjuvant chemotherapy and perioperative chemotherapy groups, favorable pathology responses (necrosis>90%) were reported in 80.6% and 15.6% of patients, respectively (p<0.001). With a median follow-up of 24 months, mean overall survival of total neoadjuvant chemotherapy and perioperative chemotherapy groups were 21.29 months (95% CI; 19.3-23.27) and 23.46 months (95% CI; 22.7-24.1), respectively (p=0.2). The mean disease-free survival of patients in total neoadjuvant chemotherapy and perioperative chemotherapy groups were 19.54 months (95% CI; 17.0-22.0) and 21.37 months (95% CI; 19.4-23.2), respectively (p=0.2)., Conclusion: Our results showed that prescription of all courses of doxorubicin/cisplatin chemotherapy prior to surgery can increase favorable pathologic response rates, although this improvement is not translated into overall and disease-free survival benefits.

Background: Osteosarcoma is one of the most common childhood bone malignancies. Although chemotherapy protocol including methotrexate is an effective treatment for osteosarcoma, some other regimens have excluded it because of its complications., Methods: This retrospective study was conducted on 93 children younger than 15 years old who were diagnosed with osteosarcomafrom March 2007 to January 2020. Two chemotherapy protocols were administrated for patients, namely, DCM protocol (Doxorubicin-Cisplatin-Methotrexate) and German protocol (excluding methotrexate). All statistical analysis was conducted using SPSS-25 software., Results: Among patients, 47.31% were male. Patients' age ranged from 3 to 15 with the mean of 10.41 ± 0.32 years. Femur was the most frequent primary tumor site (59.14%), followed by tibia (22.58%). Metastasis rate at diagnosis was 17.20% in our study. Furthermore, the 5-year overall survival (OS) of total patients was 37.3 ± 7.5%, whereas the 5-year OS of males and females was 33.6 ± 10.9% and 39.8 ± 10.6%, respectively. The 5-year OS of methotrexate regimen was 15.6 ± 9.6%, whereas that of methotrexate-free protocol was 50.2 ± 9.0%., Conclusions: Female patients had better survival rates than males. In addition, the chemotherapy protocol excluding methotrexate significantly increased the overall and event free survival of patients.

Introduction. Cisplatin still has a central role in cancer chemotherapy, but is associated with the risk of toxicities, the most common of which is nephrotoxicity. The aim of the present study is evaluation of cisplatin nephrotoxicity in Iranian population of cancer patients. Materials and Methods. All admitted patients to the oncology service who received cisplatin were included in a prospective study from 2004 to 2010. Clinical and laboratory data including kidney function tests were recorded at baseline and during follow-up visits. Results. One hundred patients (56% men) were included. Their mean age was 44 years. Common adverse events were nausea (85%) and vomiting (78%), followed by anorexia and fatigue (20%), taste change (10%), hearing loss (8%), cramping abdominal pain (8%), and tinnitus (5%). The most important finding was normal kidney function, except for mild hypomagnesemia (grade 1 toxicity) in 18%, without any symptoms or other electrolyte abnormalities. None of the patients with hypomagnesemia had significant serum electrolyte imbalances, diarrhea, severe allergic reactions, difficulty in walking, or chest pain. Conclusions. Cisplatin has the potential to produce both mild and severe side effects. Although the neurologic and gastrointestinal toxicities were observed, renal toxicity (rising blood urea and creatinine or electrolyte abnormality) was not observed, and the only toxicity was grade 1 hypomagnesaemia. [ABSTRACT FROM AUTHOR]

Background. The nephroprotective effect of vitamins E and C or losartan against cisplatin (CP)- induced nephrotoxicity when they are accompanied by estrogen was investigated. Methods. The ovariectomized rats received estradiol valerate for two weeks. At the end of the first week, a single dose of CP (7 mg/kg, IP) was also administered, and they received placebo (group 1), vitamin E (group 2), vitamin C (group 3), or losartan (group 4) every day during the second week, and they were compared with another three control groups. Results. CP alone increased the serum levels of blood urea nitrogen (BUN), creatinine (Cr), and kidney tissue damage score (KTDS), significantly (P < 0.05), however at the presence of estradiol and CP, vitamin C, vitamin E, or losartan not only did not decrease these parameters, but also increased them significantly (P < 0.05). The serum level of superoxidase dismutase (SOD) was reduced by CP (P < 0.05), but it was increased when estradiol or estradiol plus vitamin C or losartan were added (P < 0.05). Conclusion. The particular pharmacological dose of estrogen used in this study abolish the nephroprotective effects vitamins C and E or losartan against CP-induced nephrotoxicity. [ABSTRACT FROM AUTHOR]

Introduction. Nephrotoxicity is one the side effect of cisplatin therapy and erythropoietin has been candidate as a nephroprotectant agent. However, its nephroprotective effect when it is accompained with estrogen has not been studied in female. Methods. 27 ovariectomized female Wistar rats divided into five groups. Groups 1 & 2 received estradiol valerate (0.5mg/kg/week) for four weeks, and single dose of cisplatin (7mg/kg, ip) was administrated at the end of week 3. Then the group 1 was treated with erythropoietin (100 U/kg/day), and the group 2 received vehicle during week 4. Groups 3 and 4 were treated similar to group 1 and 2, except for placebo instead estradiol valerate. Group5 (negative control) received placebo during the study. Animals were killed at the end of week 4. Results. In non-erythropoietin treated rats, cisplatin significantly increased the serum levels of blood urea nitrogen and creatinine (P < 0.05). However, these biomarkers significantly decreased by erythropoietin (P < 0.05). The weight loss, kidney weight, and kidney tissue damage score in rats treated with cisplatin but without estradiol were significantly less than the values in similar group when estradiol was present (P < 0.05). Conclusion. It seems that erythropoietin could protect the kidney against cisplatin-induced nephrotoxicity. This protective effect was not observed when estrogen was present. [ABSTRACT FROM AUTHOR]

Bioassay-guided fractionation of a dichloromethane extract of the aerial parts of Salvia urmiensis , an endemic plant species of Iran, led to the isolation of two new cytotoxic ursane triterpenoids, Salvurmin A and Salvurmin B. Their structures were elucidated by a combination of 1D and 2D NMR, HR-ESI-MS, IR and UV analysis. Cytotoxicity of the above-mentioned compounds were evaluated against two human cancerous cell lines (SW1116, MCF-7). IC 50 values for Salvurmin A and Salvurmin B on colon cancer cell line (SW1116) were 41.6 ± 2.6 and 23.2 ± 0.4 μM respectively, in comparison to cisplatin as control positive. In addition, these two compounds exhibited cytotoxic activity on breast cancer cell line (MCF-7) with an IC 50 of 54.2 ± 5.3 and 40.2 ± 3.1 μM for Salvurmin A and Salvurmin B, respectively. The cytotoxic activities of these two compounds present a promising potential for the future investigation on this endemic species of Salvia. [Display omitted] [ABSTRACT FROM AUTHOR]