Early CT and FDG-metabolic tumour volume changes show a significant correlation with survival in stage I-III small cell lung cancer: A hypothesis generating study

BACKGROUND: Many patients with stage I–III small cell lung cancer (SCLC) experience disease progression short after the completion of concurrent chemoradiotherapy (CRT). The purpose of the current study was to evaluate whether CT or FDG metabolic response early after the start of chemotherapy, but before the beginning of chest RT, is predictive for survival in SCLC. METHODS: Fifteen stage I–III SCLC patients treated with concurrent CRT with an FDG-PET and CT scan available before the start of chemotherapy and after or during the first cycle of chemotherapy, but before the start of radiotherapy, were selected. The metabolic volume (MV) was defined both within the primary tumour and in the involved nodal stations using the 40% (MV40) and 50% (MV50) threshold of the maximum SUV. Metabolic and CT response was assessed by the relative change in MV and CT volume, respectively, between both time points. The association between response and overall survival (OS) was analysed by univariate cox regression analysis. The minimum follow-up was 18 months. RESULTS: Reductions in MV40 and MV50 were −36 ± 38% (126.4 to 68.7 cm(3)) and −44 ± 38% (90.2 to 27.8 cm(3)), respectively. The median CT volume reduction was −40 ± 64% (190.6 to 113.8 cm(3)). MV40 and MV50 changes showed a significant association with survival (HR = 1.02, 95% CI: 1.00–1.04 (p = 0.042); HR = 1.02, 95% CI: 1.00–1.04 (p = 0.048), respectively), indicating a 2% increase in survival probability for 1% reduction in metabolic volume. The CT volume change was also significantly correlated with survival (HR = 1.01, 95% CI: 1.00–1.03, p = 0.007). CONCLUSIONS: This hypothesis generating study shows that both the early CT and the MV changes show a significant correlation with survival in SCLC. A prospective study is planned in a larger patient cohort to allow multivariate analysis, with the final aim to select patients early during treatment that could benefit from dose intensification or alternative treatment

Influence of Schroth Best Practice Therapy on Ventilatory Function in Adolescent Idiopathic Scoliosis: Randomized Controlled Study Design

Introduction: Approximately 2%-3% of the population develops idiopathic scoliosis, making it the most prevalent structural spinal deformity in children as well as adolescents. Objective: To find out the efficacy of Schroth Best Practice therapy on pulmonary functions in adolescent idiopathic scoliosis. Methods: Sixty female subjects with adolescent idiopathic scoliosis were recruited from Outpatient Department at AlKasr Al-Ainy Hospital from May 2022 to July 2023 were enrolled in that study. They were randomized into two equivalent groups: Either the intervention group: Group A (Study group) consists of 30 subjects received the Schroth Best Practice exercises program for 18 weeks, or the control group Group B: consists of 30 subjects received traditional exercise program for 18 weeks. Both groups were given 3 sessions a week. Both groups received assessment of pulmonary functions: Forced Vital Capacity (FVC), forced expiratory volume in the first second (FEV1) As well as Peak Expiratory Flow (PEF) on 1st and 18th week. Measuring pulmonary function with digital handheld spirometer before and after treatment. These selective subjects were randomized into two equal groups. Results: There was a statistically significant difference (p<0.05) among the two groups when comparing the mean values of all measured variables pre and post treatment. All analyses were performed at the 0.05 level of significance. With the initial alpha level set at 0.05, in favor of group A. Conclusion: Both Schroth Best Practice exercise program and traditinal exercise program have a significant effect in adolescent idiopathic scoliosis, and the integrated Schroth Best Practice exercise program was more effective than traditional exercise alone

Preoperative bone quality as a factor in dual-energy X-ray absorptiometry analysis comparing bone remodelling between two implant types

Recently it was shown that the design changes from the ABG-I to ABG-II hip stem resulted in a better, although not significant, proximal bone preservation. Our hypothesis was that by matching patients for preoperative bone quality, statistical power would increase and that the trend of better proximal bone preservation in ABG-II might become significant. Twenty-four ABG-II patients were compared to two different ABG-I groups: (1) 25 patients from our earlier prospective study and (2) a group of 24 patients selected to perfectly match the ABG-II group regarding gender, age and preoperative bone quality. Postoperative changes in periprosthetic bone mineral density (BMD) were quantified at 2 years postoperatively using DEXA scanning. Bone preservation (less BMD loss) was better for the ABG-II than the ABG-I (all two groups) in the proximal zones 1 and 7. In Gruen zone 7, a statistically significant difference was found for group B (p = 0.03). By matching patients for preoperative bone quality and gender, a statistical significant difference was found in proximal bone preservation in favour of ABG-II. In future comparative bone remodelling studies using DEXA, patients should be matched for preoperative bone quality and gender