Assessment of systemic effects of ginger on salivation in patients with post-radiotherapy xerostomia

BACKGROUND AND AIM: Our aim was to assess the clinical efficacy of ginger capsule (Zintoma herbal capsule) in the relief of symptoms in patients with post-radiotherapy xerostomia. METHODS: This study was a randomized double-blind, parallel clinical trial of ginger usage in patients with post-radiotherapy xerostomia. Sixty-one subjects were selected from patients with xerostomia of Imam Khomeini Cancer Institute, Tehran, Iran. Subject-based dry mouth scores derived from 100 mm visual analogue scales (VAS) were recorded at baseline. Patients also completed a questionnaire on the first visit regarding the symptoms of xerostomia. The patients received ginger capsule (30 persons) or placebo (31 persons) three times daily over a 2-weeks period. At the end of day 14, dry mouth scores derived from VAS were recorded again and patients responded to the additional variables regarding dry mouth symptoms and quality of life issues. P < 0.05 was considered significant. Data were analyzed using SPSS. RESULTS: The mean treatment effect on day 14 was 33.7 ± 20.9 mm in the ginger group and 23.6 ± 17.3 mm in the placebo group. The analysis indicated marginally significant improvement of xerostomia with ginger prescription (P = 0.057). At the end of intervention there was no significant difference between the two groups regarding improvement of quality of life or dry mouth symptoms. CONCLUSION: It seems that ginger could be helpful in the treatment of xerostomia. Since ginger is considered a safe herbal medicine with only few and insignificant adverse/side effects further studies in larger group of patients are recommended to provide the effect of ginger on different complaints of xerostomia. KEYWORDS: Ginger, Radiation, Xerostomi

Arterial hypoperfusion as a negative predictive marker for primary hepatic malignancies treated with Y-90 glass microsphere transarterial radioembolization

BackgroundRadioembolization with yttrium-90 (Y-90) is utilized to treat primary liver malignancies. The efficacy of this intra-arterial therapy in arterially hypoperfused tumors is not known.MethodsWe reviewed data of patients with primary liver tumors treated with Y-90 prescription doses of at least 150 Gy. Baseline patient characteristics, treatment history, imaging-based tumor response assessments, and clinical outcome metrics were recorded. Tumors were classified as arterially hyperperfused versus hypoperfused on post-TARE Y-90 SPECT/CTs or pre-TARE hepatic perfusion SPECT/CTs. Perfusion status was correlated with tumor response assessments and clinical outcomes. Cox proportional hazards models were utilized to compare survival and progression-free survival. Inverse probability weighting was utilized to account for clinical factors and adjusted multivariable proportional hazards analyses to examine the relationship of quantitative perfusion and cancer outcomes.ResultsOf 400 Y-90 treatments, 88 patients received a prescribed dose of at least 150 Gy and had pre- or post-treatment SPECT/CT images. 11 and 77 patients had arterially hypoperfused and hyperperfused lesions, respectively. On dedicated liver MRI or CT at 3 months after Y-90, the complete response rates were 5.6% and 16.5% in the hypoperfused and hyperperfused cohort, respectively (P = 0.60). When controlling for various clinical features, including tumor histology, patients with arterially hypoperfused tumors had significantly shorter progression-free survival (HR 1.87, 95% CI - 1.03 - 3.37, P = 0.039) and greater elsewhere liver (HR 3.36, 95% CI = 1.23 - 9.20, P = 0.019) and distant failure (HR 7.64 (2.71 - 21.54, P &lt; 0.001). In inverse probability weighted analysis, patients with arterially hypoperfused tumors had worse overall survival (P = 0.032). In the quantitative analysis, lower levels of lesion perfusion were also associated with worse clinical outcomes, again controlling for tumor histology.ConclusionCompared to arterially hyperperfused tumors, hypoperfused primary liver tumors treated with Y-90 may have worse clinical outcomes

Estimating the incidence of lung cancer attributable to occupational exposure in Iran

<p>Abstract</p> <p>Objective</p> <p>The aim of this study was to estimate the fraction of lung cancer incidence in Iran attributed to occupational exposures to the well-established lung cancer carcinogens, including silica, cadmium, nickel, arsenic, chromium, diesel fumes, beryllium, and asbestos.</p> <p>Methods</p> <p>Nationwide exposure to each of the mentioned carcinogens was estimated using workforce data from the Iranian population census of 1995, available from the International Labor Organization (ILO) website. The prevalence of exposure to carcinogens in each industry was estimated using exposure data from the CAREX (CARcinogen EXposure) database, an international occupational carcinogen information system kept and maintained by the European Union. The magnitude of the relative risk of lung cancer for each carcinogen was estimated from local and international literature. Using the Levin modified population attributable risk (incidence) fraction, lung cancer incidence (as estimated by the Tehran Population-Based Cancer Registry) attributable to workplace exposure to carcinogens was estimated.</p> <p>Results</p> <p>The total workforce in Iran according to the 1995 census identified 12,488,020 men and 677,469 women. Agriculture is the largest sector with 25% of the male and 0.27% of female workforce. After applying the CAREX exposure estimate to each sector, the proportion exposed to lung carcinogens was 0.08% for male workers and 0.02% for female workers. Estimating a relative risk of 1.9 (95% CI of 1.7–2.1) for high exposure and 1.3 (95% CI 1.2–1.4) for low exposure, and employing the Levin modified formula, the fraction of lung cancer attributed to carcinogens in the workplace was 1.5% (95% CI of 1.2–1.9) for females and 12% (95% CI of 10–15) for males. These fractions correspond to an estimated incidence of 1.3 and 0.08 cases of lung cancer per 100,000 population for males and females, respectively.</p> <p>Conclusion</p> <p>The incidence of lung cancer due to occupational exposure is low in Iran and, as in other countries, more lung cancer is due to occupational exposure among males than females.</p

Cutaneous Metastasis of Gastrointestinal Cancer

Occurrence of cutaneous metastasis of gastrointestinal cancer is uncommon, with a reported frequency of less than 5 percent.They can occur as the first sign of disease recurrence in a treated patient or as a sign of terminal disseminated cancer or rarely as the first manifestation of an occult malignancy. The cases reported here represent three different manifestation of cutaneous metastasis of gastrointestinal cancers

Chemoradiation in Nasopharyngeal Carcinoma: A 6-Year Experience in Tehran Cancer Institute

To determine the addition of value of neoadjuvant, concurrent and adjuvant chemotherapy to radiation in the treatment of nasopharyngeal carcinoma with regard to the overall survival (OS) and disease free survival (DFS) within a six year period in Tehran cancer institute. Files of all patients with nasopharyngeal carcinoma treated by radiotherapy with or without concurrent chemotherapy in a curative setting in Tehran cancer institute during the period of 1999-2005 were retrospectively reviewed.. A total of 103 patients with nasopharyngeal carcinoma had been treated during the study period with radiotherapy or chemoradiotherapy in our institute. There were 29 (28.2%) females and 74 (71.8%) males. The median age at the time of radiotherapy was 47 years old (range 9-75 years). The patients were followed 2 to 76 months with a median follow-up of 14 months. Time of first recurrence after treatment was 3-44 months with a median of 10 months.. Survival in 2 groups of patients treated with radiotherapy alone or chemoradiation did not have a significant difference (P>0.1). Two-year survival in patients treated with or without adjuvant chemotherapy and had local recurrence after treatment did not have significant difference (P>0.1). Two-year survival in patients with or without local recurrence after treatment did not have significant difference (P>0.1). A beneficial affect or a survival benefit of adjuvant/neoadjuvant chemotherapy and concurrent chemoradiation was not observed in Iranian patients

Assessment of systemic effects of ginger on salivation in patients with post-radiotherapy xerostomia

BACKGROUND AND AIM: Our aim was to assess the clinical efficacy of ginger capsule (Zintoma herbal capsule) in the relief of symptoms in patients with post-radiotherapy xerostomia. METHODS: This study was a randomized double-blind, parallel clinical trial of ginger usage in patients with post-radiotherapy xerostomia. Sixty-one subjects were selected from patients with xerostomia of Imam Khomeini Cancer Institute, Tehran, Iran. Subject-based dry mouth scores derived from 100 mm visual analogue scales (VAS) were recorded at baseline. Patients also completed a questionnaire on the first visit regarding the symptoms of xerostomia. The patients received ginger capsule (30 persons) or placebo (31 persons) three times daily over a 2-weeks period. At the end of day 14, dry mouth scores derived from VAS were recorded again and patients responded to the additional variables regarding dry mouth symptoms and quality of life issues. P < 0.05 was considered significant. Data were analyzed using SPSS. RESULTS: The mean treatment effect on day 14 was 33.7 ± 20.9 mm in the ginger group and 23.6 ± 17.3 mm in the placebo group. The analysis indicated marginally significant improvement of xerostomia with ginger prescription (P = 0.057). At the end of intervention there was no significant difference between the two groups regarding improvement of quality of life or dry mouth symptoms. CONCLUSION: It seems that ginger could be helpful in the treatment of xerostomia. Since ginger is considered a safe herbal medicine with only few and insignificant adverse/side effects further studies in larger group of patients are recommended to provide the effect of ginger on different complaints of xerostomia