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To evaluate the diagnostic mismatch (discrepancy) of pathology reports in consulted specimens referred for second opinion.This cross-sectional study was conducted at a major cancer center, Omid Hospital. In this study, 350 primary pathology reports and 350 reviewed pathology reports were extracted from the archives of Omid Hospital from 2011 to 2020 and assessed in terms of the extent of discrepancy, by two pathologists and one oncologist. The required data for each sample were entered into a checklist and then statistically analyzed. Cases with the same diagnosis on both reports were assigned to the matched group and the rest were assigned to the minor or major mismatch (discrepancy) group. Minor mismatches included changes in diagnosis that did not lead to changes in treatment (may lead to changes in prognosis or provide additional information to the oncologist) and major mismatches included changes in diagnosis leading to changes in treatment or remedies.Two hundred seven cases (59.1%) out of three hundred fifty cases had concordant results between the diagnosis of the first pathologist and the reviewing pathologist. In one hundred forty-three cases (40.9%) mismatch (discrepancy) was observed, including eighty- two cases (23.4%) with minor mismatches (discrepancy) and sixty-one cases (17.4%) with major mismatches (discrepancy). In the major mismatch group, fifteen cases (4.3%) changed from malignant to benign, eighteen cases (5.1%) changed from benign to malignant, two cases (0.6%) changed from one stage to another stage of Disease and twenty-six cases (7.4%) had changes in the type of malignancy. In this study, it was found that there was no significant relationship between anatomical areas of sampling and diagnostic mismatch (Compared to most similar studies, the present study reported the highest discrepancy between the diagnosis of the first pathologist and the reviewing pathologist (40.9%).

As a waste material, the amazing potential of cellulose nanocrystals (CNCs) isolated from Citrus medica L. pericarp in being a natural resource of lingo-cellulosic products has never been investigated before. In the present study, an alkaline pretreatment and a two-step bleaching procedure were applied to conduct the desired acid hydrolysis by the usage of 64% sulfuric acid at 50°C for 105 min. The extracted CNCs were distinguished through the means of transmission electron microscopy (TEM), field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), atomic force microscopy (AFM), Fourier-transform infrared (FTIR) spectroscopy, dynamic light scattering (DLS), zeta potential, and energy-dispersive X-ray spectroscopy (EDX). The elimination of peaks, which were accountable for the inducement of hemicelluloses and lignin, was confirmed by the FTIR results and were also validated by the outcomes of XRD that proved the gentle removal of non-cellulosic components. The morphology and size of CNCs were indicated through the FESEM and TEM results. In addition, the spherical forms of synthesized CNCs were observed with a diameter of 46 nm throughout the FESEM images, while displaying a value of 42.54 nm as well due to TEM micrographs. The obtained zeta potential displayed a reasonable negative surface charge for CNCs. Furthermore, the cytotoxicity assessment of this product on fibroblast cells was performed to study their susceptibility for bio-medical and cosmetic industrial applications, which resulted in the lack of exhibiting any cytotoxic effects. In conformity to the outcomes of TEM and FESEM, the results of AFM revealed a fine dispersion and spherical form of cellulose nanoparticles. The interaction between HMG-CoA reductase and CNC was studied by the usage of multi-spectroscopic methods and enzyme kinetics to explore the binding mechanism of HMG-CoA reductase-CNC system. Reduced catalytic activity of the occurrence of changes in the secondary structure of HMG-CoA reductase was as a result of interacting with CNC causing a reduction in its catalytic activity.

Background: The northeast of Iran is one of the endemic regions of human T-cell lymphotropic virus type-1 (HTLV-1). This study aimed to evaluate the relationship between nasopharyngeal carcinoma and HTLV-1 infection in northeast Iran, an endemic area for HTLV-1. Methods: In this case-control study, paraffin-embedded nasopharyngeal tissue samples of patients with definitive nasopharyngeal carcinoma were evaluated for the presence of the HTLV-1 genome by polymerase chain reaction retrospectively. Results: Thirty patients with nasopharyngeal carcinoma and 30 healthy people were evaluated. All participants were matched in terms of age and gender, and all were living in Mashhad. The HTLV-1 genome was detected in only one of the people in the healthy group. Conclusions: The HTLV-1 infection and nasopharyngeal carcinoma did not correlate significantly.

Chemotherapy induced nephrotoxicity is one of the most common complications in cancer patients, especially under treatment with cisplatin containing regimens, which may require cisplatin dose reduction and in some cases discontinuation of the treatment, which interferes with treatment process. Curcumin is an antioxidant and anti-inflammatory compound and the most important active component of curcuma longa. In this study, the preventive effect of nano-curcumin oral formulation on cisplatin-induced nephrotoxicity in cancer patients was investigated. In this triple-blind clinical trial 30 cancer patients were randomly divided into the treatment group, receiving 40 mg nano-curcumin capsules (15 patients) and the placebo group (15 patients) twice a day for four chemotherapy courses. Kidney function was measured at the beginning of the study and then at the end of each course of chemotherapy. There was no significant difference in acute kidney injury occurrence rate and creatinine and blood urine nitrogen serum levels between the treatment and placebo groups at the end of each chemotherapy course. (P value>0.05) and was not effective in preventing the cisplatin induced nephrotoxicity in cancer patients in comparison with the placebo. Additional studies with different doses and durations of administration are recommended.

Background: Breast and pelvic cancers are the most prevalent cancers among women globally. Several studies have reported on the effect of cell adhesion molecules on the growth, multiplication, invasion, and metastasis of tumor cells as well as inflammatory biomarkers, which are responsible for harmful inflammatory processes. Objectives: The purpose of the current study was to assess the serum levels of adhesion molecules intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin in patients with cancer before and after radiotherapy, compare these with the levels of healthy subjects, and consider the relationship of these levels with the tumor origin. Methods: The present case-control study investigated 14 patients with breast cancer and 14 patients with pelvic cancer who had been referred to Omid Teaching Hospital’s oncology clinic, Mashhad, Iran between 2015 and 2017. Evaluated by the ELISA method for ICAM-1, VCAM-1, and E-selectin were the serum samples of these 28 cancer patients before and after their course of radiotherapy treatment and the serum samples of the 28 healthy subjects who had no history of cancer, radiotherapy or the risk factor of coronary artery disease. Results: The ICAM-1, VCAM-1, and E-selectin serum levels of all patients with cancer before and after a course of radiotherapy were significantly higher than those of the control group (P-value ≤ 0.5). There was no significant difference between the two cancer groups before and after radiotherapy (P-value ≥ 0.05). Conclusions: The current study demonstrated that the serum levels of adhesion molecules in patients with cancer before and after radiotherapy increase significantly regardless of the initial location of the tumor.

PURPOSE: In this clinical trial, we evaluated Alpha® ointment efficacy in prevention of capecitabine induced hand-foot syndrome (HFS) in patients with gastrointestinal or breast cancers, for the first time. METHODS: During this pilot, randomized, triple-blinded, placebo-controlled clinical trial, the effect of Alpha® ointment (Lawsonia inermis 3 g and Curcuma longa 0.15 g/ 30 g) was assessed. It was applied on the palms and the soles, two times daily starting at the first day of chemotherapy for 4 consecutive courses. The severity of HFS was assessed at the end of the chemotherapy courses based on World Health Organization (WHO) scale and scored between 0–4. RESULTS: Ninety eligible patients were included randomly in the treatment or placebo group. Median WHO HFS grade was not significantly different between the two groups, during the follow-up period (P > 0.05). In the weekly assessment, the scores increased meaningfully in both the placebo and treatment groups, but there was a delay in HFS occurrence and deterioration in Alpha ointment group based on post hoc analysis. CONCLUSION: Administration of Alpha® ointment containing henna and curcumin could not significantly prevent capecitabine induced HFS during 4 courses of treatment, but can somewhat delay its occurrence in patients with gastrointestinal or breast cancer. GRAPHIC ABSTRACT: [Image: see text]

Background: Rather body mass index (BMI) has a potential prognostic role in determining the outcome of patients suffering from colorectal cancer or not should be clear. Objectives: We aimed at determining the potential effects of BMI on the prognosis of patients with colorectal cancer. Methods: In this cohort study, documents of 1550 patients with colorectal cancer between 2002 and 2020 from Omid hospital and Emam Reza hospital (Mashhad, Iran) databases were evaluated, retrospectively. The multivariable logistic regression and Cox proportional hazard regressions were used at the significance level of P < 0.05. Results: Nine hundred twenty patients included in the current study. Most of patients were categorized as normal weight (38.91%). The prevalence of underweight and overweight/obese were 26.19% and 34.9%, respectively. There was no significant difference in the overall survival (OS) and disease-free survival (DFS) based on BMI (OS: 108.2 ± 7.0 months for underweight, 124.0 ± 6.2 months for normal weight, and 130.9 ± 4.5 months for overweight/obese patients; P = 0.2 and DFS: 97.0 ± 6.5, 110.0 ± 5.6, and 113.7 ± 5.0, respectively; P = 0.3). Conclusions: The BMI had no significant effect on long-term outcomes of patients with colorectal cancer. However, there was an insignificant trend to better outcome in patients with higher BMI comparing the underweight group.

Radiation-induced dermatitis is one of the most common side effects of radiotherapy. Silymarin, a flavonoid extracted from the Silybum marianum, exhibits antioxidant and anti-inflammatory activities. The purpose of this study was to investigate the efficacy of silymarin gel in prevention of radiodermatitis in patients with breast cancer. During this randomized, double-blinded, placebo-controlled clinical trial, the preventive effect of silymarin 1% gel was assessed in comparison with placebo, on radiodermatitis occurrence. Forty patients randomly received silymarin gel or placebo formulation on chest wall skin following modified radical mastectomy, once daily starting at the first day of radiotherapy for 5 weeks. Radiodermatitis severity was assessed weekly based on Radiation Therapy Oncology Group (RTOG) and National Cancer Institute Common Terminology for Adverse Events (NCI-CTCAE) criteria radiodermatits grading scale for 5 weeks. The median NCI-CTCAE and RTOG scores were significantly lower in silymarin group at the end of the third to fifth weeks (p value < 0.05). The scores increased significantly in both placebo and silymarin groups during radiotherapy, but there was a delay in radiodermatitis development and progression in silymarin group. Prophylactic administration of silymarin gel could significantly reduce the severity of radiodermatitis and delay its occurrence after 5 weeks of application.

PURPOSE Local recurrence is a common failure pattern in adenocarcinoma of the cecum. This study aimed to investigate the potential role of adjuvant radiation therapy on oncologic outcomes of patients with adenocarcinoma of the cecum. MATERIALS AND METHODS This retrospective study was carried out at three large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of 162 patients with adenocarcinoma of the cecum that were treated and followed up between 2000 and 2013. All the patients had undergone a right hemicolectomy and received chemotherapy with (n = 48) or without (n = 114) adjuvant radiation therapy. RESULTS The subjects were 65 females and 97 males with a median age of 56 years (range, 17 to 90 years) at diagnosis. The 5-year local control (LC), disease free survival (DFS), and overall survival (OS) rates were 72.7%, 57.2%, and 62.6% respectively. In a multivariate analysis, age, tumor stage, node stage, and adjuvant radiation therapy were determined to be independent prognostic factors. Age more than 55 years (hazard ratio [HR] = 1.0; 95% confidence interval [CI], 0.06-0.32; p = 0.003], T4 stage (HR = 6.8; 95% CI, 3.07-15.36; p < 0.001), node positive disease (HR = 4.2; 95% CI, 1.94-9.13; p < 0.001), and the absence of adjuvant radiation therapy (HR = 3.0; 95% CI, 1.39-6.46; p = 0.005) had a negative influence on OS. CONCLUSION Adjuvant radiation therapy significantly improves DFS and OS in patients with adenocarcinoma of the cecum.

The current treatment approaches for esophageal cancer are associated with poor survival, and there are ongoing efforts to find new and more effective therapeutic strategies. There are several reports on the antitumoral effects of low‐molecular‐weight heparins (LMWHs). We have assessed the possible survival benefit of LMWHs in esophageal malignancies. This was a randomized, single‐blind, multicenter, Phase II clinical trial on nonmetastatic esophageal cancer candidate for neoadjuvant chemoradiotherapy. Patients were randomly assigned to the chemoradiotherapy‐only arm or chemoradiotherapy plus enoxaparin arm using 1:1 allocation. Radiotherapy was delivered in 1.8‐Gy daily fractions to a dose of 50.4 Gy in both groups. Paclitaxel 50 mg/m2 and carboplatin (AUC 2) were administered weekly, concurrent with radiotherapy. In the intervention group, patients received enoxaparin (40 mg) and chemoradiation daily. 4–6 weeks after treatment, all patients underwent esophagectomy. After a median follow up of 7 months, estimated 1 year disease‐free survival (DFS) in the intervention group was 78.9% and was 70% in the control groups ( p = 0.5). Toxicity from the experimental treatment was minimal, and there were no treatment‐related deaths. A pathologically complete response in intervention and control group was 64.8% and 62.5%, respectively ( p = 0.9). There was a nonsignificant trend toward improved survival by the addition of enoxaparin to the concurrent chemoradiotherapy regimen. However, 1 y DFS of both groups were high as expected. A longer follow‐up and a larger sample size are required.delivered in 1.8-Gy daily fractions to a dose of 50.4 Gy in both groups. Paclitaxel 50 mg/m2 and carboplatin (AUC 2) were administered weekly concurrent with radiotherapy. In the intervention group, patients received enoxaparin (40 mg) daily as well as chemoradiation. Four to six weeks after treatment, all patients underwent esophagectomy. After a median follow up of 7 months,estimated one year disease free survival (1y DFS) in the intervention group was 78.9% and in the control groups was 70% (p=0.5). Toxicity from the experimental treatment was minimal and there were no treatment-related deaths. A Pathologically complete response in intervention and control group was 64.8% and 62.5%, respectively (p=0.9). There was a non-significant trend toward improved survival by the addition of enoxaparin to the concurrent chemoradiotherapy regimen. However, 1y DFS of both groups were high as expected. A longer follow-up and larger sample size is required.

Mucositis is a frequent severe complication of radiation therapy in patient with head and neck cancer. Silymarin is a polyphenolic flavonoid extracted from the milk thistle that exhibits strong antioxidant and antiinflammatory activities. In this study, we evaluate silymarin efficacy in prevention of radiotherapy induced mucositis in patients with head and neck cancer, as the first human study. During this pilot, randomized, double-blinded, placebo-controlled clinical trial, the effect of oral silymarin 420 mg daily in three divided doses starting at the first day of radiotherapy for 6 weeks, on oral mucositis occurrence was assessed. Twenty-seven patients fulfilled the inclusion criteria assigned to the silymarin or placebo group. World Health Organization and National Cancer Institute–Common Terminology Criteria oral mucositis grading scale scores were recorded at baseline and weekly during these 6 weeks. The median World Health Organization and National Cancer Institute Common Terminology Criteria scores were significantly lower in silymarin group at the end of the first to sixth week (p

Background Most of the patients with head and neck cancer who undergo radiotherapy experience some degrees of mucositis. Silymarin is a polyphenolic flavonoid that exhibits strong anti-inflammatory activity but has low oral bioavailability. In this research, we evaluated the effect of nano-formulation of silymarin on prevention of radiotherapy induced mucositis in patients with head and neck cancer. Methods Thirty-one patients who fulfilled the inclusion criteria randomly assigned to medicine (n = 16) or placebo (n = 15) group and received 5 mL nano-silymarin solution (70 mg/5 mL) or placebo solution three times daily for 6 weeks started from the first day of radiotherapy. European Organization for Research and Treatment of Cancer (EORTC) mucositis grading scores were recorded at baseline and weekly during 6 weeks of radiotherapy. Results The median EORTC scores were not significantly different between silymarin and placebo groups at the end of the sixth week (p > 0.05). Moreover, the scores increased significantly in both groups during radiotherapy. However, after 4 weeks of treatment with silymarin, the scores had a non-significant decreasing trend in contrast to placebo group. Conclusion It seems that increasing the duration of treatment and modification of nano-formulation could improve its efficacy in prevention of radiotherapy induced mucositis.

Radiation-induced dermatitis is one of the most common side effects of radiotherapy. Silymarin, a flavonoid extracted from the Silybum marianum, exhibits antioxidant and anti-inflammatory activities. The purpose of this study was to investigate the efficacy of silymarin gel in prevention of radiodermatitis in patients with breast cancer. During this randomized, double-blinded, placebo-controlled clinical trial, the preventive effect of silymarin 1% gel was assessed in comparison with placebo, on radiodermatitis occurrence. Forty patients randomly received silymarin gel or placebo formulation on chest wall skin following modified radical mastectomy, once daily starting at the first day of radiotherapy for 5 weeks. Radiodermatitis severity was assessed weekly based on Radiation Therapy Oncology Group (RTOG) and National Cancer Institute Common Terminology for Adverse Events (NCI-CTCAE) criteria radiodermatits grading scale for 5 weeks. The median NCI-CTCAE and RTOG scores were significantly lower in silymarin group at the end of the third to fifth weeks (p value 0.05). The scores increased significantly in both placebo and silymarin groups during radiotherapy, but there was a delay in radiodermatitis development and progression in silymarin group. Prophylactic administration of silymarin gel could significantly reduce the severity of radiodermatitis and delay its occurrence after 5 weeks of application.

The incidence of esophageal squamous cell carcinoma (ESCC) is increasing, causing catastrophic health burdens on communities. Curcumin has shown promise as a therapeutic agent in the treatment of colon, colorectal, pancreatic, and esophageal cancers but it has very poor bioavailability. The application of nano-carriers as drug delivery systems increases curcumin's bioavailability. Cyclin D1 is overexpressed in ESCC and curcumin may change its expression.In this study, the effect of SinaCurcumin®, a novel nano-micelle product containing 80 mg curcumin, on the growth of KYSE-30 cells and expression of cyclin D1, was investigated. Paclitaxel and Carboplatin served as reference drugs.Nano-curcumin increased cell cytotoxicity, decreased ICNano-curcumin suppressed proliferation of KYSE-30 cells and expression of cyclin D1 although its use in combination with other chemotherapeutic agents requires further testing.

Background A growing amount of data has indicated the possibility that tumor location may play a prognostic role in colon cancer. The present study set out to investigate the relation between the location of colon cancer (right side vs. left side) and the patient’s oncologic outcome. Methods This retrospective chart review studied 654 colon cancer patients who had been treated and followed up on at three tertiary hospitals between 2010 and 2015. To determine the most important independent factors of oncologic outcomes, the Cox regression multivariate analysis model used to analyze the prognostic impact of the primary tumor location and other clinical-, pathologic-, and treatment-related factors. Results In the univariate analysis, the prognostic factors for disease-free survival (DFS) were the primary tumor stage ( Conclusions Although right-sided colon cancers present more aggressive clinical features, tumor location is not a significant prognostic factor for DFS and OS in colon cancer patients. Legal entity responsible for the study The present study was approved by the University Research Ethics Committee and all procedures were performed in accordance with the ethical standards of the National Research Committee and with the Helsinki Declaration. Funding Has not received any funding. Disclosure The author has declared no conflicts of interest.

Purpose Mucinous adenocarcinomas account for about 10% of all colorectal cancers. This study aimed to investigate the prognostic impact of mucinous histologic subtype on oncologic outcomes in patients with colorectal cancer. Methods This retrospective study was performed at two large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of patients with colorectal cancer who were treated and followed up between 2000 and 2013. Results Totally, 144 of 1,268 patients with a colorectal adenocarcinoma (11.4%) had mucinous histologic subtype. Statistically significant results found in this research are as follows: Mucinous histologic subtype tended to present in younger patients and to have larger tumor size, higher histologic grade, higher node stage, larger number of positive nodes, and higher rate of perineural invasion compared to nonmucinous histologic subtype. On the univariate analysis, mucinous subtype was a prognostic factor for disease-free and overall survival. On the multivariate analysis, primary tumor location, node stage and lymphatic-vascular invasion were independent prognostic factors for the local control rate. Rectal tumor location, higher disease stage, tumor grade II, and presence of lymphatic-vascular invasion had negative influences on disease-free survival, as did rectal tumor location, higher disease stage and presence of lymphatic-vascular invasion on overall survival. Conclusion Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer; however, it was not an independent prognostic factor for oncologic outcome.

Background Mucinous adenocarcinoma accounts for approximately 5% - 15% of all colorectal cancers. Objectives The aim of this study was to investigate the clinicopathological characteristics of patients with mucinous colorectal adenocarcinoma. Patients and Methods This retrospective study was carried out by reviewing the medical records of 70 mucinous colorectal cancer (MCC) patients who were diagnosed and treated at a tertiary academic hospital between 2005 and 2010. For the comparative analysis, 491 patients with non-mucinous colorectal cancer (NMCC) were included. Results Of 561 patients with colorectal adenocarcinoma, 70 patients (12.5%) had the mucinous type. There were 42 (60%) men and 28 (40%) women, with a median age of 55 years old (range 24 - 81 years) included in the study. We did not find any differences regarding the patients’ mean age (P = 0.408) and male/female ratio (P = 0.700) between the MCC and NMCC; however, there was a predilection for the right colon and sigmoid colon in the MCC, when compared to the NMCC (P = 0.012). In addition, the MCC tended to have a larger tumor size (P = 0.004), higher histological grade (P < 0.001), higher node stage (P < 0.001), higher number of dissected nodes (P = 0.013), higher number of positive nodes (P < 0.001), and a higher rate of perineural invasion (P = 0.013) compared to the NMCC. Conclusions This study indicates that most clinicopathological characteristics of MCC are different from those of NMCC. In addition, there was an association between the mucinous subtype and adverse pathological features in the patients with colorectal cancer.

Background: Olfactory neuroblastoma or esthesioneuroblastoma is a rare malignant neoplasm of the olfactory neuroepithelium. Objectives: This study aimed to investigate the clinical presentation, characteristics and treatment outcome of fourteen patients with olfactory neuroblastoma. Patients and Methods: This retrospective study reviewed and analyzed 14 patients with olfactory neuroblastoma during the last 15 years at two referral tertiary academic hospitals of Shiraz University of Medical Sciences. Patients under 16 years old were excluded from the study. Kadish classification was used for staging the tumors. In addition, the tumors were histopathologically graded according to Hyams’ grading classification. Results: There were 6 women (43%) and 8 men (57%) ranging from 16 to 56 years old, with a median age of 40 years at diagnosis. Nasal obstruction (93%), facial or sinus pain (57%), and nasal bleeding (43%) were the most frequent presentation. Two patients (14%) had stage A, 3 (21.5%) had stage B, 6 (43%) had stage C, and 3 (21.5%) had stage D disease. After initial treatment, five patients developed local and/or distant recurrent disease. After a median follow-up of 73 (range 14 - 108) months for surviving patients, 10 patients (71.5%) were alive and without disease, one (7%) was alive with disease, and 3 (21.5%) died due to the disease. The 5-year disease-free and overall survival rates were 71.4% and 75.7%, respectively. Conclusions: At our center, patients with olfactory neuroblastoma tend to present at advanced stages; therefore, combined local treatment and incorporation of chemotherapy may improve outcome.

Background Primary Gastric Lymphoma (PGL) is an uncommon malignancy with various histological subtypes and treatment outcomes. The aim of this study was to investigate the potential prognostic factors and clinicopathological characteristics of Iranian patients with PGL. Methods The clinicopathological characteristics of 60 patients with PGL were retrospectively reviewed from 2001 to 2012. The patients underwent various combinations of chemotherapy, radiotherapy, and surgery. We evaluated multiple potential prognostic factors and their associations with patient survival rate. Results According to the results, Diffuse Large B-cell Lymphoma (DLBCL) and Mucosa-Associated Lymphoid Tissue (MALT) were two predominant histological subtypes. The majority of cases were diagnosed with stage I tumor in the distal part of the stomach. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 60% and 70%, respectively. It was revealed that poor World Health Organization (WHO) performance status, presence of B symptoms, and International Prognostic Index (IPI) score≥3 were significantly associated with decreased patient survival. Conclusion Most of the patients with PGL in early stage have a favorable prognosis.

Background: Small cell esophageal carcinoma (SCEC) is a highly aggressive and rare neoplasm. Objectives: This study aimed to report the characteristics, prognostic factors, and treatment outcomes of 22 patients with SCEC. Patients and Methods: This brief report was carried out by reviewing the medical records of 22 patients with newly histologically proven SCEC that were treated between 2000 and 2010 at 2 tertiary academic hospitals. All the potential prognostic variables, including the patients’ characteristics, tumor features, and treatment modalities were analyzed to establish their influence on the patients’ survival rates. Results: This study was conducted on 7 males and 15 females with a median age of 61 years. Dysphagia and weight loss were the most prevalent symptoms. According to the results, 14 patients (64%) had limited diseases and 8 cases (36%) had extensive diseases. In those with extensive diseases, liver, lung, and lymph nodes (LNs) were the most metastatic sites. Besides, most tumors were located in lower (50%) and middle (32%) part of the esophagus. Most patients (91%) were treated with sequential (55%) or concurrent (36%) chemoradiation (CRT). Surgical resection was also performed for 7 patients. Chemotherapy regimen consisted of cisplatin and etoposide in 14 patients (64%). The median follow up time was 12 months. The 1, 3, and 5-year overall survival rates were 27%, 14%, and 4%, respectively. Yet, no prognostic factors were found because of the small sample size of the study. Conclusions: Primary SCEC is a rare and highly aggressive tumor. However, prognosis is poor and long-term survival is exceptional. CRT could be an appropriate alternative to operation.

Background Chemotherapy-induced amenorrhea is one of long term side effects of adjuvant chemotherapy in patients with breast cancer which may interfere with their future reproductive function. Although amenorrhea is well recognized, the actual incidence following taxanes remains uncertain. Methods In a cross sectional study, we identified breast cancer patients aged 45 years or younger who were treated with adjuvant anthracycline and taxane-based regimens at three different oncology departments from 2001-2008. Results One hundred and nineteen patients met all eligibility criteria and consented to participate in a regular follow up program. The median age at diagnosis was 33.5 years (range, 25-41). Seventy (58%) patients developed amenorrhea for at least 12 months following completion of treatment, and regular menses were maintained in another 49 (42%) patients. No statistically significant association was found between age and development of amenorrhea, although those who experienced cessation of menses were older. Conclusion Although taxane containing chemotherapy was associated with higher rate of amenorrhea compared to FAC, this was not statistically significant (P=0.11). Also, treatment with tamoxifen and Estrogen Receptor (ER) positive status was significantly correlated with chemotherapy induced amenorrhea.

Background: Meningioma constitutes 20% of the intracranial neoplasms. Followed by surgery as the primary treatment for most patients, radiotherapy becomes indicated in high-grade tumors with incomplete surgical removal. We evaluated the prognostic factors and overall outcome in meningioma patients who underwent radiotherapy. Materials and Methods: In this retrospective analysis, data from all patients with documented diagnosis of meningioma who referred to the Omid and Ghaem Oncology Centers (Mashhad, Iran) from 2002 to 2013 were included. We calculated the overall survival rates using the Kaplan–Meier method and compared the survival curves between groups by the log-rank test. Results: Eighty-three patients with a median age of 50 years (ranging: 16–84) were included. Grade I, II, and III meningiomas were seen in 40 (48%), 31 (37%), and 12 (15%) patients, respectively. Radiation therapy was indicated due to tumor recurrence, incomplete excision, or tumor grade in 32, 8, and 43 patients, respectively. Tumor grade had a significant effect on the overall survival with a 3-year overall survival of 76.7%, 43.5%, and 13.3% in Grade I, II, and III, respectively (P < 0.001). Gender, age, and tumor location were not correlated with the overall survival. Moreover, patients with Grade II and III who underwent total resection had a significantly higher overall survival than those with subtotal resection or biopsy alone (5-year survival rates of 82% vs. 17.1%, respectively; P = 0.008). Conclusion: Tumor grade was the most important prognostic factor in meningioma patients undergoing radiation therapy. In patients with Grade II and III tumors, the extent of surgical resection is significantly correlated with the overall survival.