Surface guided 3DCRT in deep-inspiration breath-hold for left sided breast cancer radiotherapy: implementation and first clinical experience in Iran

Background: The aim of the study is to evaluate the overall accuracy of the surface-guided radiotherapy (SGRT) workflow through a comprehensive commissioning and quality assurance procedures and assess the potential benefits of deep-inspiration breath-hold (DIBH) radiotherapy as a cardiac and lung dose reduction approach for left-sided breast cancer irradiation. Materials and methods: Accuracy and reproducibility of the optical surface scanner used for DIBH treatment were evaluated using different phantoms. Patient positioning accuracy and reproducibility of DIBH treatment were evaluated. Twenty patients were studied for treatment plan quality in target dose coverage and healthy organ sparing for the two different treatment techniques. Results: Reproducibility tests for the surface scanner showed good stability within 1 mm in all directions. The maximum position variation between applied shifts on the couch and the scanner measured offsets is 1 mm in all directions. The clinical study of 200 fractions showed good agreement between the surface scanner and portal imaging with the isocenter position deviation of less than 3 mm in each lateral, longitudinal, and vertical direction. The standard deviation of the DIBH level showed a value of < 2 mm during all evaluated DIBHs. Compared to the free breathing (FB) technique, DIBH showed significant reduction of 48% for heart mean dose, 43% for heart V25, and 20% for ipsilateral lung V20. Conclusion: Surface-guided radiotherapy can be regarded as an accurate tool for patient positioning and monitoring in breast radiotherapy. DIBH treatment are considered to be effective techniques in heart and ipsilateral lung dose reductions for left breast radiotherapy

The Effects of Humor Therapy on the Fatigue in Breast Cancer Patients Undergoing External Radiotherapy

BACKGROUND AND OBJECTIVE: Cancer-Related Fatigue (CRF) is one of the most common symptoms reported among women with breast cancer and is the most prominent side effect of cancer treatments. This complication leads to a number of problems in the patient. The aim of this study was to determine the effects of humor therapy on the fatigue in breast cancer patients undergoing external radiation therapy. METHODS: This study was a clinical trial with parralel planning and before and after. The experiment was conducted on 58 cancer patients receiving radiation therapy in 5 weeks -from the beginning of July 2013 until early October 2013 for a period of 3 months. The research was assigned to two groups of humor therapy and control group (each group consisting of 29 subjects who were randomly assigned to their group). The patients in the experimental group attended the humor therapy sessions twice a week for a month (a total of 8 sessions). The sessions were held using approaches like playing comedy clips, telling jokes and taking part in fun games. Fatigue questionnaires were completed at the end of the first, second and the fifth week as  the post-test. The control group patients  received routine care. Ultimately, the two groups were put to comparison. FINDINGS: Fatigue in the laughter therapy group rose from 0.93±0.74 in the first week to 3.36±1.35 in the fifth. In the control group, on the other hand, it went from 1.01±0.96 in the first week to 7.29±2.67 in the fifth week (p=0.001). Thus, fatigue in the first, second, third, fourth and the fifth week was of significant statistical difference. (p=0.001). CONCLUSION: The results of this study indicated that humor therapy is largely effective in reducing cancer-related fatigue. The health system could enhance cancer patients’ well-being and improvement by providing them with a delightful, joyous environment

p63 is more sensitive and specific than 34βE12 to differentiate adenocarcinoma of prostate from cancer mimickers

Objective(s): Prostate cancer is the world’s leading cause of cancer and the second cause of cancer-related death in men after lung cancer. Differentiation of prostate adenocarcinoma from benign prostate lesions and hyperplasia sometimes cannot be done on the basis of morphologic findings. Considering the fact that in the prostate adenocarcinoma there is no basal cell layer, basal cell markers can help to differentiate prostate adenocarcinoma from cancer mimickers. Materials and Methods:We studied 98 prostate biopsy blocks (40 adenocarcinoma and 58 benign lesions) for basal cell marker expression. Results: p63 and 34βE12 were negative in all prostate adenocarcinoma specimens, but all benign prostate hyperplasia and high grade intraepithelial neoplasia cases expressed them. Conclusion: Basal cell markers can help to distinguish prostate adenocarcinoma from cancer mimickers

Simple and cost-effective laboratory methods to evaluate and validate cell-free DNA isolation

Abstract Objective In the present study, we investigated different simple and cost effective methods to evaluate and validate cell free DNA (cfDNA) isolation. The ability of the QIAamp DNA Blood Mini Kit method to extract cfDNA was assessed by several approaches, including purification of endogenous cfDNA and exogenous spike-in control material, prior to plasma extraction, and followed by quantitative-PCR. Results Using QIAamp DNA Blood Mini kit, nearly 27% (380 bp) to 35% (173 bp) cfDNA was recovered with a higher recovery of smaller size cfDNA (173 bp) in comparison to larger ones (380 bp). These simple laboratory methods can be used to assess the efficiency of any cfDNA isolation method

The importance of stool DNA methylation in colorectal cancer diagnosis: A meta-analysis

<div><p>A large number of tumor-related methylated genes have been suggested to be of diagnostic and prognostic values for CRC when analyzed in patients' stool samples; however, reported sensitivities and specificities have been inconsistent and widely varied. This meta-analysis was conducted to assess the detection accuracy of stool DNA methylation assay in CRC, early stages of CRC (advanced adenoma, non-advanced adenomas) and hyperplastic polyps, separately. We searched MEDLINE, Web of Science, Scopus and Google Scholar databases until May 1, 2016. From 469 publications obtained in the initial literature search, 38 studies were included in the final analysis involving 4867 individuals. The true positive, false positive, true negative and false negative of a stool-based DNA methylation biomarker using all single-gene tests considering a certain gene; regardless of a specific gene were pooled and studied in different categories. The sensitivity of different genes in detecting different stages of CRC ranged from 0% to 100% and the specificities ranged from 73% to 100%. Our results elucidated that <i>SFRP1</i> and <i>SFRP2</i> methylation possessed promising accuracy for detection of not only CRC (DOR: 31.67; 95%CI, 12.31–81.49 and DOR: 35.36; 95%CI, 18.71–66.84, respectively) but also the early stages of cancer, adenoma (DOR: 19.72; 95%CI, 6.68–58.25 and DOR: 13.20; 95%CI, 6.01–28.00, respectively). Besides, <i>NDRG4</i> could be also considered as a significant diagnostic marker gene in CRC (DOR: 24.37; 95%CI, 10.11–58.73) and <i>VIM</i> in adenoma (DOR: 15.21; 95%CI, 2.72–85.10). In conclusion, stool DNA hypermethylation assay based on the candidate genes <i>SFRP1</i>, <i>SFRP2</i>, <i>NDRG4</i> and <i>VIM</i> could offer potential diagnostic value for CRC based on the findings of this meta-analysis.</p></div

Summary estimates of SFRP1 and SFRP2.

<p>(A) Summary estimates of SFRP1. hypermethylation in stool samples used for TP (CRC+ Adenoma) diagnosis. Red circles represent each study that was included in the meta-analysis. The size of each study is indicated by the size of the red circle. Error bars indicate the 95% confidence interval (CI). Positive LR: positive likelihood ratio, Negative LR: negative likelihood ratio, Diagnostic OR: diagnosis odd ratio, SROC curves: summary receiver operating characteristic curve. (B) Summary estimates of SFRP2. hypermethylation in stool samples used for TP (CRC+ Adenoma) diagnosis. Red circles represent each study that was included in the meta-analysis. The size of each study is indicated by the size of the red circle. Error bars indicate the 95% confidence interval (CI). Positive LR: positive likelihood ratio, Negative LR: negative likelihood ratio, Diagnostic OR: diagnosis odd ratio, SROC curves: summary receiver operating characteristic.</p

Performance of a certain gene in all single-gene stool-based DNA methylation biomarker tests included in this meta- analysis.

<p>Performance of a certain gene in all single-gene stool-based DNA methylation biomarker tests included in this meta- analysis.</p

Publication bias of studies in different categories.

<p>CRC: colorectal cancer, TA: total adenoma, TP: total patients.</p

Summary of basic characteristics and performance of studies included in meta-analysis.

<p>Summary of basic characteristics and performance of studies included in meta-analysis.</p