Evaluation of dose distribution of an intraoperative radiotherapy device using thermoluminescent dosimeters and radiographic films

Background: To investigate dose distribution of the 5cm spherical applicator of the INTRABEAM™ intraoperative radiation therapy (IORT) device via thermoluminescence dosimeters (TLDs) and Radiographic films. Independent dose distribution assessment of IORT devices is considered important. Several methods are described for this purpose, including TLDs and films. However, Radiographic films are not routinely used. Materials and methods: Twenty TLDs were used for depth dose measuring and evaluating the isotropy in water. Additionally, the isotropy was assessed separately via Radiographic films in air by drawing isodose curves. Results: TLD measurements showed a steep dose decline which the relative average dose of 0.94 at the applicator surface reduced to 0.32, 0.13, and 0.07 at 1, 2, and 3 cm depths in water, respectively. Some remarkable isodose curves prepared using Radiographic films showed forward anisotropy of the 5 cm applicator. Conclusion: A very steep dose decline and approximately isotropic dose distribution of the 5 cm applicator were observed via TLD measurements. Radiographic films showed acceptable potential for drawing dose distribution maps. However, they should be applied in more various radiation setups to be implemented more confidently

Health-Promoting Lifestyle among the Survivors of Colorectal Cancer: An Integrative Review

Introduction: Health-promoting lifestyle (HPL) among the survivors of colorectal cancer (CRC) is essential to reduce CRC complications, prevent its recurrence, and improve survival. Nonetheless, there is no comprehensive definition for the concept of HPL in CRC survivors. This study aimed to define the concept of HPL among CRC survivors based on the existing literature. Methods: This integrative review was conducted in 2021 using Whittemore and Knafl’s method. The national and international databases of SID, Magiran, ProQuest, Medline, ScienceDirect, Web of Science, and Scopus were searched. Quality appraisal was performed using the Mixed Methods Appraisal Tool (MMAT) and the data were analyzed using the four-step approach proposed by Whittemore and Knafl. Results: After data evaluation, 167 documents were included in final analysis. In total, 1863 codes were generated and categorized into eighteen main categories and the three main themes of antecedents, attributes, and consequences. Accordingly, HPL among CRC survivors was defined as "a set of behaviors in the areas of health responsibility, physical activity, nutrition, spiritual growth, psychological management, and interpersonal relations which are affected by socio-demographic characteristics, clinical characteristics, psychological status, physical conditions, time and place limitations, and patient education, and lead to better disease prognosis, better general health status, better bio-psycho-social status, and better quality of life". Conclusion: The definition of HPL among CRC survivors provided in the present study can be used in counseling, educational, supportive, and care programs for CRC survivors in order to improve their quality of life and survival

The Synergistic Effect of Cold Atmospheric Plasma Mediated Gold Nanoparticles Conjugated with Indocyanine Green as An Innovative Approach to Cooperation with Radiotherapy

Objective: The multimodality treatment of cancer provides a secure and effective approach to improve the outcomeof treatments. Cold atmospheric plasma (CAP) has got attention because of selectively target and kills cancer cells.Likewise, gold nanoparticles (GNP) have been introduced as a radiosensitizer and drug delivery with high efficacy andlow toxicity in cancer treatment. Conjugating GNP with indocyanine green (ICG) can develop a multifunctional drugto enhance radio and photosensitivity. The purpose of this study is to evaluate the anticancer effects of GNP@ICG inradiotherapy (RT) and CAP on DFW melanoma cancer and HFF fibroblast normal cell lines. Materials and Methods: In this experimental study, the cells were irradiated to RT and CAP, alone and in combinationwith or without GNP@ICG at various time sequences between RT and CAP. Apoptosis Annexin V/PI, MTT, and colonyformation assays evaluated the therapeutic effect. Finally, the index of synergism was calculated to compare the results.Results: Most crucially, the cell viability assay showed that RT was less toxic to tumors and normal cells, but CAPshowed a significant anti-tumor effect on melanoma cells with selective toxicity. In addition, cold plasma sensitizedmelanoma cells to radiotherapy so increasing treatment efficiency. This effect is enhanced with GNP@ICG. Incomparison to RT alone, the data showed that combination treatment greatly decreased monolayer cell colonizationand boosted apoptotic induction. Conclusion: The results provide new insights into the development of better approaches in radiotherapy of melanomacells assisted plasma and nanomedicine

Epidemiology and Clinical Characteristics of Patients with Hepatocellular Carcinoma in North-East of Iran

Background: Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, is a life-threatening disease worldwide. The aim of this study was to investigate the epidemiology and clinical features of HCC patients who referred to Omid hospital in Mashhad, northeast of Iran.Materials and Methods: In this cross sectional retrospective study, we reviewed the medical records of patients who referred to Omid hospital – a cancer research center– in Mashhad during 1991 to 2012. Medical records of 29 patients with primary liver cancer proven with biopsy, CT scan or MRI were analyzed in this study.Results: Of 25 eligible cases, 68% were men and the rest were women. The majority of HCC patients were in the 60-69 age group. Also, 44% of patients were found to be hepatitis B virus surface antigen (HBsAg) positive.Conclusion: The age distribution and male preponderance of HCC patients observed in the present study in line with other conducted studies in Iran and other countries. Since this is a retrospective study, a comprehensive study with a larger sample size in a case-control study is needed to establish other HCC-related factors in our province

Preliminary Results of the Effects of Localized High-Dose Radiotherapy Combined with Total Body Low-Dose Irradiation on Tumor Growth and Stimulating the Immune System in Tumor-Bearing Mice

Background: The immune system plays an extensive role in eliminating tumor cells. On the other hand, low-dose irradiation stimulates the immune system.Objective: The present study aimed to investigate the therapeutic outcomes of localized high-dose radiotherapy (LH) alone and combined with total body low-dose irradiation (TB).Material and Methods: In this experimental study, B16F0 tumor cells were injected into the right flank of C57JL/6 mice. The mice were treated with LH alone (13 Gy X-rays to the tumor surface) (LH group) or combined with TB (85 mGy X-rays at the skin) (TB+LH group). Then the tumor volume, the mice’s lifespan, the number of lymphocytes extracted from the spleen, and interferon gamma (IFN-γ) production were measured.Results: Reduced number of lymphocytes, compared to non-irradiated mice (control group), was observed in LH and TB+LH groups. However, the identical number of cultured lymphocytes produced a higher level of IFN-γ in irradiated groups. Comparing the irradiated groups, the number of lymphocytes and their IFN-γ production, tumor growth control, and the mice’s lifespan were statistically higher in TB+LH group. Conclusion: Observing a higher level of IFN-γ in TB+LH group compared to LH group indicates that low-dose radiation enhanced the stimulating effects of high-dose radiation on the immune system. It caused the mice in TB+LH group to have a more prolonged lifespan and a lower tumor growth rate. Therefore, it is worth our attention for future studies to investigate whether total body low-dose irradiation can be utilized before radiotherapy to enhance its efficiency

Comparative proteome analysis of human esophageal cancer and adjacent normal tissues

Objective(s): Ranking as the sixth commonest cancer, esophageal squamous cell carcinoma (ESCC) represents one of the leading causes of cancer death worldwide. One of the main reasons for the low survival of patients with esophageal cancer is its late diagnosis. Materials and Methods: We used proteomics approach to analyze ESCC tissues with the aim of a better understanding of the malignant mechanism and searching candidate protein biomarkers for early diagnosis of esophageal cancer. The differential protein expression between cancerous               and normal esophageal tissues was investigated by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). Then proteins were identified by matrix-assisted laser desorption/ ionization tandem time-of-flight mass spectrometry (MALDI-TOF/TOF-MS) and MASCOT web based search engine. Results:We reported 4 differentially expressed proteins involved in the pathological process of esophageal cancer, such as annexinA1 (ANXA1), peroxiredoxin-2 (PRDX2), transgelin (TAGLN) andactin-aortic smooth muscle (ACTA2). Conclusion: In this report we have introduced new potential biomarker (ACTA2). Moreover, our data confirmed some already known markers for EC in our region

A genetic polymorphism in the CYP1B1 gene in patients with squamous cell carcinoma of the esophagus: an Iranian Mashhad cohort study recruited over 10 years

Background: Esophageal-cancer is the seventh most common-cause of cancer-related-deaths in men. Cytochrome-P450-family-1-subfamily-B-polypeptide-1 (CYP1B1) plays a role in the metabolism of xenobiotics, and is associated with several cancers. Here we investigated the association between a genetic-variant, CYP1B1-rs1056836, with the clinical-characteristics of patients with esophagus-squamous-cell-carcinoma (ESCC). Method: 117-patients with ESCC and 208 healthy-subjects were recruited. DNA was extracted and genotyped. Kaplan-Meier curves were utilized to assess overall and progression-free survival. The relationship between clinicopathological-data, disease-prognosis, and survival, were evaluated with the genotypes. Results: the genotypic frequency for GG, GC, and CC were 58.6%, 29.8%, 11.5% respectively in the healthy subjects and 51.8%, 36.14% and 12% in the ESCC group. An association between the GG genotype and stage of ESCC was found. Conclusion: Our findings suggest a relationship between the CYP1B1-rs1056836 genetic polymorphism and clinical features of ESCC, supporting further studies in larger-populations in different-ethnic groups, taking into account potentially important environmental-factors

The treatment outcome of definitive chemoradiotherapy in patients with esophageal squamous cell carcinoma

Background & Objective: Surgery and /or radiotherapy are major local treatments for esophageal carcinoma. The results of radiotherapy alone have been unsatisfactory. The purpose of this study was to evaluate the treatment outcome of definitive chemoradiotherapy for patients with esophageal SCC.   Materials & Methods: This prospective histological descriptive study was done on 190 nonmetastatic esophageal SCC patients which received definitive chemoradiotherapy (55-64 Gy, Cisplatin 80-100 mg/m2 day 1-5FU 750-1000 mg/m2, 24h infusion days 1-4) with curative intent in cancer research center, Mashhad University of Medical Sciences between Jan 2000-Jan 2004. At least one course of chemotherapy was prescribed concurrently with radiotherapy.   Results: There were 99 male and 91female patients with the median age of 65 (range, 25-87). The median radiation dose prescribed was 60 Gy (range, 55-64) and median chemotherapy courses was 4 (range, 1-8). With a median follow-up time of 12 months (range, 3-60), one, two and three-year survival rates were 67.8%, 48.7% and 36.3% respectively and median survival was 22 months. Reduction of symptoms was shown in 84% of patients with dysphagia. 109 patients remained disease free with a median follow-up of 14 months (range, 3-60), among which 34 were followed more than 24 months. We found 81 cases (42.6%) with treatment failure during the follow-up (34 locoregional failure, 14 distant metastases, 33 distant metastases accompanied with locoreginal failure).   Conclusion: Although definitive chemoradiotherapy can result in long term disease free survival and even cure in a subset of patients with SCC of esophagus, locoregional failure and distant metastasis has remained the main causes of treatment failure

Screening for Celiac Disease Using Anti Tissue Transglutaminase in Patients with Esophageal SCC between 2004 and 2009

  Introduction: Esophageal Squamous-Cell Carcinoma (SCC) is one of the most common malignancies in Iran. To reduce the incidence of esophageal SCC, it is important to recognize the controllable risk factors and prevent them. Celiac disease is widely known as a possible risk factor for esophageal SCC.  Thus, we decided to assess the frequency of celiac disease in esophageal SCC patients in North east of Iran in order to suggest correlation between two diseases. Materials and Methods: In a Cross-sectional study one hundred and forty-three cases of esophageal SCC were examined for anti tissue transglutaminase antibody (anti-tTG) between the years 2004 and 2009 in Ghaem and Omid Hospitals of Mashhad University of Medical Sciences, Iran. The enzyme-linked immunosorbent assay was the test of choice in this study since it provides the sensitivity and specificity needed for the diagnosis and screening of celiac disease. The results of this test were compared with those of the control group which were compatible in terms of sex and age. Data were analyzed through SPSS software and statistical analysis such as x2, exact x2 and T-test. Results: 19.6% patients (SCC) had positive anti-tTG (>20) which was significantly different to 7.9% in control group (p -value=0.005). Comparing age groups of patients for positive anti_tTG using exact x square test showed significant difference in patients with Conclusion: There seems to be a correlation between positive anti_tTG and esophageal SCC; that is to say, celiac disease might play a role in the earlier manifestations of esophageal SCC