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Aim: To compare the acute radiation-induced bowel and bladder toxicities of two hypofractionated radiotherapy (HFRT) regimens in localised prostate cancer (PCa). Materials and methods: This trial consists of patients with histologically confirmed stage T1-T3aN0M0 PCa, a prostate-specific antigen concentration of 40 ng/mL or lower, and Eastern Cooperative Oncology Group performance status of 0–2. Participants were randomly assigned (1:1) to 56 Gy in 16 fractions over 4 weeks (arm A) or 70·2 Gy in 26 fractions over 5 weeks (arm B). Acute bowel and bladder toxicities were assessed using Radiation Therapy Oncology Group criteria. Results: Between June 2018 and December 2019, 40 patients were randomly assigned to treatment with 4-week (n = 20) and 5-week HFRT (n = 20). In the third month after completion of radiotherapy, the cumulative incidence of acute bowel and bladder toxicities of arms A and B was 20 versus 5% and 70 versus 85%, respectively. The cumulative incidence of grade 2 or worse bowel and bladder toxicities of the 5-week regimen was non-inferior to 4-week HFRT [bowel toxicity: 5% (arm A) versus 5% (arm B), bladder toxicity: 50% (arm A) versus 60% (arm B), p = 0·52). Findings: The 5-week regimen of HFRT is non-inferior to 4-week HFRT in terms of acute bowel and bladder toxicities. [ABSTRACT FROM AUTHOR]

Background: In newly diagnosed glioblastoma, radiation with concurrent and adjuvant (six cycles) temozolomide (TMZ) is the established standard of postsurgical care. However, the benefit of extending adjuvant TMZ therapy beyond six cycles has remained unknown. Methods: We searched PubMed, Web of Science, Scopus, and Embase up to October 1, 2021. The search keywords were "glioblastoma," "adjuvant chemotherapy," and their synonyms. The data of randomized clinical trials were extracted and included in this meta-analysis if they had reported patients' median overall survival (OS) or median progression-free survival (PFS). The standard and extended chemotherapy regimens were considered as adjuvant TMZ up to six cycles and beyond six cycles (up to a total of 12 cycles), respectively. The median OS and median PFS were pooled and compared. Results: Four studies consisting of 882 patients (461 patients for the standard chemotherapy group and 421 patients for the extended chemotherapy group) were included in this meta-analysis. The extended TMZ regimen was associated with a nonsignificant improvement in PFS [12.0 months (95% CI 9.0 to 15.0) vs. 10.0 months (95% CI 7.0 to 12.0), P = 0.27] without corresponding improvement in OS [23.0 months (95% CI 19.0 to 27.0) and 24.0 months (95% CI 20.0 to 28.0), P = 0.73]. Conclusions: In newly diagnosed glioblastoma, continuing adjuvant TMZ beyond six cycles did not shown an increase neither in PFS nor OS. [ABSTRACT FROM AUTHOR]

Increased consumption of nonrenewable energy sources may lead to more air pollution, resulting in negative health impacts in a society. The main purpose of this study is to investigate the relationship between fossil fuel energy consumption and health issues using generalized method of moments estimation technique for data from 18 Asian countries (both low- and middle-income) over the period 1991–2018. The findings demonstrate that fossil fuel energy consumption increases the risk of lung and respiratory diseases. In addition, the results demonstrate the significant effect of CO2 emissions and fossil fuel consumption on undernourishment and death rates. Furthermore, we find that increases in the gross domestic product per capita and healthcare expenditure may help reduce undernourishment and death ratio. The conclusion recommends that diversification of energy in low- and middle-income countries from too much reliance on fossil fuels to more renewable energy sources can improve energy insecurity, at the same time reduce greenhouse gas emissions and minimize the negative impacts on human health. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most frequent cancer among women. In line with the survival improvement of patients with cancer, the issue of treatment-induced toxicities becomes more important. Objectives: This study aimed at evaluating acute radiation-induced cardiac damage. Methods: Between 2016 and 2019, women with histologically-confirmed early-stage left-sided breast cancer or ductal carcinoma in-situ (DCIS) without prior chemotherapy, who were candidates for adjuvant whole breast radiotherapy, entered the study. The radiation-induced cardiotoxicity was assessed, using a rise in high-sensitivity cardiac troponin I (hscTnI) over the radiotherapy. Likewise, the association between the percentage of heart receiving at least 25Gy (V25Gy) and the rise in hscTnI was evaluated as the secondary endpoint. Results: A total of 22 women were included in this study. Mean - standard deviation (SD) hscTnI for the whole study population was 12 ± 2 ng/L before and 15 ± 2 ng/L after radiotherapy. The median (interquartile range [IQR]) V25Gy was 8.05% (6.95% - 8.95%). The difference between hscTnI levels before and after radiotherapy was significant (P = 0.001). There was no correlation between V25Gy and the rise in hscTnI (P = 0.18). Conclusions: hscTnI is a sensitive marker to detect early radiation-induced cardiotoxicity. There is no association between V25Gy and the rise in hscTnI over radiotherapy. [ABSTRACT FROM AUTHOR]

Background: Based on the literature review, the available information regarding late toxicities after intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) is limited to a few countries. Objectives: This study provides an opportunity to evaluate the delayed toxicities among Iranian patients with NPC that underwent IMRT. Methods: Between February 2016 and September 2018, 32 patients were treated with IMRT for NPC at Shohada-e Tajrish Hospital. The majority of them were in the advanced clinical stage and all received platinum-based induction and/or concurrent chemotherapy. Our typical prescription dose was 70.2 Gy to the gross tumor volume (GTV) in 2 Gy per fraction. Uninvolved regional lymph nodes received 59.4Gy. Considering theminimumfollow-up time of 6 months, we aimed mainly at evaluating the rate of delayed toxicities, including xerostomia, hearing loss, and eyeball damages. Toxicities were categorized based on either RTOG/EORTC or LENT/SOMA criteria. Results: The median follow-up time was 12 months (6 - 32 months). The occurrence rates of grade ≥ 2 xerostomia, grade ≥ 2 hearing loss, optic neuropathy, and retinopathy were 28%, 10%, 4%, and 7%, respectively. Based on the dose-volume histogram analysis, averages of mean doses to the parotid glands, submandibular glands, oral cavity, and cochlea were 32.3 Gy, 58.9 Gy, 41.8 Gy, and 44.9 Gy, respectively. Conclusions: Our experience of using IMRT in the treatment of NPC revealed equivalent toxicities (except for hearing loss) in comparison with high-experienced centers. [ABSTRACT FROM AUTHOR]

Introduction: Post-irradiation mammary stromal sarcoma (MSS) is a rare condition, and it is worth learning new knowledge from each case. Case Presentation: We present the case report of a 59-year-old female with a medical history of breast cancer, who presented with an axillary mass on the same side. The patient was further evaluated and finally diagnosed with MSS with chondroid differentiation. Thereafter, she underwent neoadjuvant chemotherapy to facilitate the surgical resection of the tumor. However, she experienced local progression and lung metastasis during chemotherapy. Conclusions: MSS with chondroid differentiation was resistant to the standard chemotherapy regimens of sarcoma. Radiotherapy is a potential choice in the case of chemoresistant MSS. Further trials may reveal this notion. [ABSTRACT FROM AUTHOR]

The present study deviates from previous approaches as it focuses on the concept of energy to illuminate cancer-related issues. Energy is a prerequisite for any function; cellular function is no exception, and thus, reduced energy in human cells can impair their performance. This hypothesis provides a novel view of cancer formation. It shows that a normal cell transforms into its cancerous counterpart in response to cellular adenosine triphosphate (ATP) depletion. Moreover, it presents a new definition for the origin of cancer stem cells and how they can regenerate cancer. This article regards a distinct aspect of cancer that helps to differentiate various phases of its progression and shed light on some of the uncharted zones of its pathway for the first time that needs further confirmation by empirical studies. [ABSTRACT FROM AUTHOR]