Purpose
This paper aimed to assess the incidence of radiotherapy‐induced hypothyroidism (RIHT) in breast cancer patients and correlate it with different factors.
Methods
Patients with nonmetastatic ...breast cancer who received supraclavicular lymph node irradiation as a part of adjuvant radiotherapy from October 2019 to July 2020 were recruited and followed up for 18 months. All patients underwent three‐dimensional conformal radiotherapy and underwent computed tomography simulation. The levels of serum thyroid‐stimulating hormone (TSH), free triiodothyronine and free thyroxine levels were assessed at baseline (before starting radiotherapy) and 9,12, and 18 months after radiotherapy using immunochemilluminescence. Univariate and multivariate analyses were performed to identify significant factors associated with developing hypothyroidism.
Results
Twenty patients out of 96 (20.8%) developed hypothyroidism. Baseline TSH (cutoff value >1.42 μIU/ml) was significantly correlated with hypothyroidism.
Conclusion
Routine thyroid function tests assessment is recommended for all breast cancer patients at baseline and after radiotherapy.
Thyroglobulin (Tg) level is used for long-term follow-up of differentiated thyroid cancer (DTC). However, the prognostic value of the postoperative level and the level which can be considered risky ...are not clear in literature.
To evaluate the prognostic value of postoperative Tg in DTC for subsequent disease-free status. Also, to determine the cutoff with the highest sensitivity and specificity.
A retrospective analysis was performed of 62 patients with non-metastatic DTC presenting to our department from January 2018 to December 2019. Three groups were formed according to postoperative stimulated thyroglobulin (sTg) level: <1ng/ml, 1-5ng/ml, and >5ng/ml. Outcomes were compared at 12 months. ROC curve analysis determined the cutoff with the highest sensitivity and specificity.
Seven the 62 patients showed persistent or recurrent disease at 12 months after diagnosis. Comparing outcomes in the 3 sTg groups showed thyroglobulin to be a significant prognostic variable. A cut-off of 3.15ng/ml had the highest sensitivity and specificity on ROC curve analysis.
Postoperative stimulated thyroglobulin is a useful prognostic tool in the postoperative categorization of patients and can subsequently be tested for its value to guide radioactive iodine therapy.
Abstract
Background
Lung cancer represents the top cause of death and the most common cancer worldwide. In the United States, lung cancer is the second most common cancer accounts for 12.9% of new ...cancer diagnoses and 27.4 of all cancer deaths. Non small cell lung cancer (NSCLC) represents up to 80% of all lung cancers which divided into two major types: squamous cell carcinoma (SCC) and nonsquamous cell carcinoma (NSCC, including adenocarcinoma, large-cell carcinoma, and other subtypes).
Aim of the Work
To assess the correlation between CEA (carcinoembryonic antigen) levels and response to platinum-based chemotherapy assessed by RECIST criteria of advanced non-small cell lung cancer patients.
Patients and Methods
This is a prospective study conducted between November 2018 and July 2019, 30 consecutive patients with advanced NSCLC previously treated with at least one line of chemotherapy were prospectively enrolled in thoracic malignancies department in Ain-Shams university hospital and Ismailia Teaching Oncology Hospital. The study was approved by the ethics committee at the faculty of medicine, Ain Shams University.
Results
In our study we evaluated response by CTs according to RECIST criteria and considered patients with clinical response (PR and SD) as responders and patients with PD as non-responders.
Conclusion
Our study found correlation between CEA and radiological response and patients with CEA reduction equal or more than 18.5% have objective response to treatment with Sensitivity and specificity 66.67% and 85.71% respectively.
•Molecular radiotherapy has developed empirically over decades.•Prescription by administered activity is most often used.•This may result in a variable radiation absorbed dose to tumours.•There is a ...risk of undertreatment or possibly toxicity.•Routine use of tumour dosimetry may improve outcomes.
Molecular radiotherapy is the use of systemically administered unsealed radioactive sources to treat cancer. Theragnostics is the term used to describe paired radiopharmaceuticals localising to a specific target, one optimised for imaging, the other for therapy. For many decades, molecular radiotherapy has developed empirically. Standard administered activity schedules have been used without the prior estimation of the resulting tumour radiation absorbed dose by theragnostic imaging, or its subsequent measurement by serial scanning. This pragmatic approach has benefited many patients, however others who should have benefited have failed to do so as the radiation absorbed dose in the tumour was suboptimal. The accurate prediction and measurement of tumour and organ at risk radiation absorbed doses allows treatment to be personalised, and offers the prospect of improved clinical outcomes. To deliver this for all molecular radiotherapy patients would require not only a significant financial investment in equipment and skilled personnel, but also a change in attitude of those who believe that simple – or simplistic – schedules are easier to deliver, and that accurate dosimetry is too much trouble. Further clinical studies are required to demonstrate beyond doubt that the advantages of individualised treatment planning outweigh the inconvenience, and that the expense is justified by enhanced results.
•One-third of pediatric tumor patients require radiotherapy.•High pediatric radiotherapy utilization rate in a middle-income country.•Pediatric soft tissue sarcoma requires the highest radiotherapy ...utilization rate.•Palliative radiotherapy is frequently used for brainstem glioma patients.•Palliative radiotherapy is underutilized in childhood cancers.
Although the radiotherapy utilization rate (RUR) is determined for most adult cancers, it is seldom reported in childhood tumors, particularly in low- and middle-income countries (LMIC) where the majority of pediatric cancer patients reside. This study aims to investigate the real-life RUR for pediatric tumors in a large LMIC center.
The electronic files of patients treated at a single institution during 2010–2017 were reviewed and the RUR was defined as the percentage of patients who received at least one radiotherapy (RT) course from the total number of patients.
A total of 4390 out of 13,305 pediatric cancer patients received at least one RT course with a RUR of 33%. The curative, salvage, and palliative RURs were 27.8%, 2%, and 5.7%, respectively. There was a considerable variation in the RUR between various tumors, ranging from 0% in choroid plexus papilloma and other rare tumors to 100% in intracranial germinoma. Moreover, the RUR varied among different stages within each tumor type. Overall, 753 patients received 920 palliative RT courses (range 1–9) at a median dose of 30 Gy. The most commonly irradiated metastatic sites were the bone (34%) and the brain (9.8%).
This is the first analysis to provide valuable insights into the RUR for childhood tumors. Together with population-based pediatric cancer registries, this will help decipher pediatric RT needs and deficits. Additionally, the underutilization of palliative RT calls for multidisciplinary palliative care provision for pediatric cancer patients.
