Austin Journal of Medical Oncology
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2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Jbali S ◽  
◽  
Ksontini FL ◽  
Dhambri S ◽  
Chelly B ◽  
...  

This is a case report of a CIC-rearranged sarcoma located in the neck. Our patient was a 36 year-old-woman with unremarkable past medical history who presented with a left lateralized neck mass evolving for one year without other signs. The physical examination showed a bulky left cervical mass of 12cm long axis, with infected and necrotic areas. There was no palpable lymph nodes. A computed tomography (CT) scan was performed and confirmed the suspicious nature of the lesion and did not show distant metastasis. Histology (completed with Fluorescence in situ Hybridization (FISH) analysis) of a biopsy confirmed the diagnosis of round cell sarcoma with CIC rearrangement. As the tumor was unresectable, we started with chemotherapy but the tumor progressed after three cycles. The patient could not receive a second line chemotherapy because of the deterioration of the general condition and died after 1 month. In conclusion, CIC-rearranged sarcoma is a rare tumor and has a poorer prognosis than the classic Ewing Sarcoma (ES). Its treatment is still challenging. More research is needed to establish the optimal treatment strategies.


2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Kamaraju S ◽  
◽  
Mohan M ◽  
Campbell G ◽  
Wright T ◽  
...  

Solid tumor oncology treatments are primarily performed in the outpatient setting. However, hospitalizations are inevitable due to complications of cancer and treatment-related toxicities. With rising health care spending, the length of hospital stay (LOS) is increasingly considered a proxy for healthcare costs. There are several ongoing efforts to abbreviate the inpatient LOS and ensure a safe and timely discharge to the outpatient setting. In addition to the acute illness and the associated comorbidities, various factors affect the LOS: social determinants of health, nutritional status in cancer patients, and endof- life issues. Furthermore, it is unclear how the institutional policies on social distancing and visitation during the current coronavirus disease (COVID-19) pandemic may impact the LOS. The purpose of this article is to review various factors and barriers that lead to longer LOS for solid tumor patients during the COVID 19 pandemic, and identify the critical areas of quality improvement.


2021 ◽  
Vol 8 (2) ◽  
Author(s):  
De Ornelas M ◽  
◽  
Mihaylov IB ◽  

Purpose: To determine the sensitivity of changes to IMRT delivery parameters for mass-based optimization schemes: Dose-Mass- (DM) and Energy-based (Energy), compared to Dose-Volume-based (DV) optimization. Methods: Twelve Head-and-Neck (HN) and twelve lung cases were retrospectively optimized using DM and Energy optimization. In both optimization approaches nine equidistant, split beams were used for step-and-shoot deliverable IMRT. Changes to two parameters were investigated: the number of IMRT segments (5 and 10 per beam) and the minimum allowed segment area (2 and 6 cm²). Plans were normalized such that 95% of the PTV received the same dose. Dose Indices (DIs) were used for evaluation. For the lung cases, DIs included: 1%_cord, 33%_heart, 20% and 30%_both-lungs, and 50%_ esophagus. In the HN cases: 1%_cord, 1%_brainstem, left/right parotids_50%, 50%_larynx, and 50%_esophagus. Results: The lung cases demonstrated that the Energy plans were more sensitive to segment area; changing the segment area resulted in a statistically significant dose increase for 1%_cord, 30%_both-lungs and 50%_esophagus. Changes to the number of segments yielded on average statistically significant differences in dose to 1%_cord in Energy plans, 50%_esophagus in DM plans, and 20%_both-lungs in DV plans. When the segment area was changed, the HN cases yielded statistically significant differences in doses to 1%_cord, 1%_ brainstem, 50%_left and right parotids, and 50%_larynx for the Energy plans and 50%_larynx for DM plans. Moreover, changing the number of segments resulted in significant dose decrease for 50%_parotids and 50%_esophagus for the Energy plans and 50%_larynx for DV plans. Conclusions: This study showed that both lung and HN Energy plans exhibit larger sensitivity than DV and DM plans to changing IMRT delivery parameters, especially when increasing the minimum segment area rather than with varying the number of segments.


2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Beuth J ◽  
◽  
Böwe R ◽  

This clinical investigation was performed to evaluate the benefit of Complementary Medicine (CM) in breast cancer patients undergoing adjuvant Chemotherapy (ChT). Patients and Methods: The patients (n=668) were treated according to international guidelines with adjuvant ChT. As to reduce the side effects, the patients were complementarily treated with a combination of sodium selenite, proteolytic plant enzymes (bromelaine and papain) and Lens culinaris lectin. On Case Report Formulas (CRFs) assessment of side effects of ChT was documented at defined times during adjuvant ChT and additional complementary treatment. Validation was carried out by scoring from 1 (no side-effects/optimal tolerability) to 6 (extreme side-effects/extremely bad tolerability), however, only patients suffering from severe side effects (symptom scores 4 and higher) were enrolled into this investigation. Results: The severity of side-effects of ChT was significantly reduced by complementary treatment. Mean scores of symptoms declined for sleep disorder, fatigue, lack of drive (p<0.05) and for arthralgia, hot flushes, mucosal dryness, nausea, vomiting, diarrhea, loss of appetite, pain of tumour (p<0.001). Conclusion: This investigation confirms benefits of indication-based complementary treatment with the combination of sodium selenite, proteolytic enzymes and Lens culinaris lectin in breast cancer patients, e.g. reduction of side-effects of adjuvant ChT.


2021 ◽  
Vol 8 (2) ◽  
Author(s):  
El Tantawi AM ◽  

RORs isoforms are a metabolic strong regulators have their own functions in the lipid metabolism and in genes, subunits, and hormones reproductions, where during their necessary metabolic activities on lipid metabolism with the effects Mitochondrial enzymes on lipid molecules the acyl-CoA-synthase (RORbeta), acyl-CoA-phospholipase (ROR-alpha), and acyl-CoA-synthetase (RORgama) will be synthesised and released for running the lipid metabolic pathways. Where the RORs isoforms functions are strongly linked to FOX forkhead genes and strongly depending on mitochondrial anabolic active enzymes activities (phospholipase, synthase, synthetase), and are having a strong regulations by mitochondrial OPA1 membrane which act on long fatty acids molecules for releasing the three enzymatic acyl-CoA active molecules for the cholesterol productn, for TNF-a with TXA2 alpha subunits productions, for sestrin-Leu 1 synthesis, for prostaglandins synthesis which reflect the strengthen of ROR-beta with ROR-alpha activities, for S6K1 production, and for estrogen & insulin growth and their ratio biosynthesis. When lipid associated with absorbed nutrient molecules (pro-lipo-mTOR) will be firstly affect by ATPase and by Cox2 for releasing long fatty acids molecules and will be directed to FOX forkhead and to ROR genes, where first the ATPase and COX-2 will act on lipid molecules for releasing long fatty acids molecules then the mitochondrial anabolic enzymes effects will act fatty acids molecules for releasing the acyl-CoA-phospholipase (ROR alpha isoforms), acyl-CoAsynthase (ROR-beta), and acyl-CoA synthetase (ROR-gama isoforms), where all RORs isoforms are having the same molecular structure but differ only in their terminals. The decreasing in mitochondrial synthetase enzyme will reflect inhibition or decreasing in acyl-CoA-synthetase enzymatic molecules (ROR-gama) synthesis which adopted for carbohydrate metabolic cycles and the ratio of pyrimidine in biological molecules, that can reflect decreasing in the pyrimidine synthesis from purines which will lead to decreasing in hormone biosynthesis, and sestrin biosynthesis, and decreasing in RORs isoforms stabilities and activities, which can reflect decreasing in FOX genes stabilities, and decreasing in Thymine kinases molecules activities which consequently lead to inhibition or decreasing in cholesterol biosynthesis, and in estrogen or insulin hormones biosynthesis pathways. Long-fatty acyl-CoAs are produced due to the effects of mitochondrial anabolic enzymes on the long fatty acids molecules which produced from the effects of ATPase and mitochondrial COX-2 on the lipid molecules, which considered as necessary anabolic regulatory and intermediates molecules in lipid metabolic pathways and in the active kinases molecules resynthesis during the binding of Pro-nutrients-mTOR molecules. Following the long fatty acids formation by the effects of ribosomal ATPase is the effect of mitochondrial OPA1 membrane activities for producing its necessary anabolic mitochondrial enzymes (phospholipase, synthase, and synthetase) for producing the three RORs isoforms active enzymatic molecules acyl-CoA-phospholipase (ROR-alpha), acyl-CoA synthase (ROR-beta), acyl- CoA synthetase (ROR gama). The RORs isoforms consedered as three structures of RORs isoforms, each isoform bind to one of the anabolic mitochondrial enzymes (synthase, synthetase, and phospholipase enzymes)to form its own ROR-isoforms, and each of RORs isoforms has its own specific functions and pathological pathways but is contributing with others RORs-isoforms for running and completing their specific biosynthesis pathways during lipids metabolism. Those RORs (the enzymatic acyl-CoA) isoforms molecules are having same molecular structures but differs only in their terminal amino acids, and are incorporated into acylated proteins and complex active fatty molecules like triacylglycerol, phospholipids, and cholesterol esters for activating the brain metabolic processes, for the liver metabolic activities, and for the strengthen of immune efficiency through TNF-Alpha and TXA2 subunits productions by the acyl-CoA-synthase (ROR beta isoforms ) and for sestrin-Leu biosynthesis through the regulation of acyl-CoA-synthetase (ROR gama isoforms). The synthesis of each of acyl-CoA isoform firstly by the effects of ATPase and COX-2 on lipid molecules followed by the mitochondrial OPA1 activaties for releasing its active enzymatic acyl-CoA isoforms during lipid metabolism. As ribosomal ATPase act on lipo-mTOR protein will release long fatty acids molecules then will be followed by mitochondrial effects on long Fatty molecules for producing enzymatic acyl-CoAs (RORs) isoforms. Where acyl-CoA isoforms molecules will be binded to whether synthetase, phospholipase, or to synthases enzymes as intermediates for brain activities, for liver functions etc., depending on the type of signals activities received from brain and from cells to form RORs isoforms. The mitochondrial enzymes effects are necessary (anabolic snd antiinflammatory enzymes) for RORs isoforms biosynthesis, and are considered as anti-inflammatory regulating enzymes that synthase and synthetase are so necessary for TNF-a and for thromboxane-A (TXA2) biosynthesis, and regulate the releasing of the active four kind of kinases proteins during the FOX binding activities, and act as mediators for anti inflammations pathways as for prostaglandins productions, and are acting releasing the ROR-alpha isoforms which are active isoforms for phospholipid membranes and for antigen biosynthesis. Liver X Receptors (LXRs) are nuclear receptors, that LXRs were originally considered as ‘orphan’ nuclear receptors, and it’s origin depend on the synthesis of acyl-CoA phospholipase isoforms which is the basic of liver cells phospho-lipo-membrane. However, those receptors were ‘adopted’ for running lipid metabolism, cholesterol synthesis, and phospholipid membranes which act as so imp biological filter for and from nucleus. The phospholipid membranes formed from acyl-CoA-phospholipase (RORalpha) isoforms functions, where phospholipid are imp molecules for skeletal muscle development, for photoreceptor development and for liver activities. IFN gamma depending on biosynthesis effects of synthetase enzymes on long fatty acids chains for producing fatty acyl-CoAs synthetase which act as a protective IFN-gamma in regulating the retinal hydrations. PLC-gamma1 is implicated in a variety of cellular signalings and processes including mitogenesis and calcium entry. The Nerve growth factor is a neurotrophic factor and neuropeptide primarily involved in the regulation of growth, maintenance, and proliferation that has imp roles in carbohydrate biosynthesis for maintaining the necessary balances of purines related to pyrimidine nucleotides through the pyrimidines synthesis where their results will feed the sensor nerve and neuronal hyper reactivity for nerve activities. The effects of synthase and phospholipase on the productions of RORs beta and alpha isoforms respectively are cooperating together for running so imp osteogenic repressor in regulating bone formation and in new blood cells synthesis with their effective phospholipid membranes, and are imp for TNF-a and TXA2 alpha subunits productions, where PSTC-kinases (mTORC1) and thromboxane-A2 can used for the autophagy reactivities and biosynthesis. Heart failure is associated with decreased myocardial fatty acid metabolic pathways and decreasing in fatty acids functioning and oxidation capacity and has been likened to energy starvation. As the adenosine metabolism in tissues have been consumed due to extra ATPase and COX-2 activities as energy utilization will increased from breaking and analyzing genes and fatty acyl-CoA molecules and from pyrimidine molecules lead to precipitation of ub normal molecules which can block blood fluidity in arteries and veins leads to decreasing in heart muscle lead to heart failure.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Abdel-Fattah WI ◽  
◽  
El-Bassyouni GT ◽  

Drug innovation using natural products is an interesting mission for planning new leads. It describes the bioactive compounds resulting from natural resources, characterization and pharmacological examination. It emphases on the triumph of these resources in the process of finding and realizing new and effective drug compounds that can be beneficial for human resources. For medicinal devotions and for the progress of pharmaceutical substances, medicinal plants were used such as Physalis angulata L which is a medicinal plant used for numerous therapies including wound healing [1]. Physalis peruviana (golden berry) is an herbaceous annual plants belongs to the family Solanaceae [2]. This plant has a tremendous medicinal value for curing out different diseases: cancer, leukemia, diabetes, ulcers, malaria, asthma, hepatitis, dermatitis, rheumatism and several other diseases [3]. The golden berry fruit tastes like a sweet tomato and includes high levels of vitamin C, vitamin A and the vitamin B-complex. The fruit was demonstrated to have both antiinflammatory and antioxidant properties [4,5]. Herbal specialists and local people of several countries have used many extracts of medicinal plants to achieve and treat various diseases comprising wound healing [6]. Physalis with its notable benefits related to high nutrients and bioactive compounds with extraordinary antioxidant activity and other several medicinal properties have been ascribed to these compounds [7,8]. The bioactive compounds are formed as primary and secondary metabolites of the fruits. These compounds are biologically active with cytotoxic, antimicrobial, antioxidant, antiviral, fungicidal, insecticidal, tranquilizing, analgesic, anti-inflammatory, and contraceptive actions, among others. Such compounds are used for several dedications, such as in medical therapy, to cure diseases, in the cosmetics, and in the food industry as antioxidants or flavorings [9] (Figure 1).


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Mbaye EHS ◽  

Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross National Income (GNI), per capita, Purchasing Power Parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 664,650.944 (thousands of U.S $) for a population of 22,409,381 persons in Sri Lanka.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Dehaene A ◽  
◽  
Smeets A ◽  
Vos H ◽  
Van Ongeval C ◽  
...  

Introduction: Screening programs and improved imaging result in higher frequency of non-palpable breast lesions, requiring preoperative localisation. Several localisation methods have been developed, with Magseed® among the more recent techniques. This observational study registered safety, effectiveness and surgeon satisfaction of Magseed® localisation. Data were compared with hooked-wire procedure. Methods: Data regarding safety, effectiveness and surgeon satisfaction of 100 patients who underwent Magseed® localisation were prospectively collected between September 2018 and April 2019, and compared with retrospectively collected data of 91 patients who underwent hooked-wire localisation between March 2018 and September 2018. Results: In total, 103 seeds and 102 wires were included. All magnetic seeds were placed under ultrasound guidance, with a median of two days preoperative. Complication rate did not significantly differ between Magseed® and hooked-wire (2.97% vs. 2.13%; p = 1.000). 94.06% of the seeds were detected with Sentimag®, with a retrieval rate of 100%. Positive margin rate was lower for Magseed®, although not significant (4.76% vs. 10.39%; p = 0.233). Due to positive margins, 1 additional mastectomy was performed, in contrast with 3 mastectomies and 1 additional re-excision in the hooked-wire group. Surgeons scored 81% of the Magseed® procedures as ’easier than hookedwire’. Conclusion: Rate of positive margins and re-excision/mastectomy showed a tendency to be lower with Magseed® localisation compared to hooked-wire localisation. Complication rate was equal. Moreover, high surgeon satisfaction and logistical advantages designate Magseed® as preferable over hooked-wire.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Liu C ◽  
◽  
Sun M ◽  
Jiang X ◽  
◽  
...  

Diffuse Large B-Cell Lymphoma (DLBCL) is the most common lymphoid malignancy in adults, which often takes a nonlymph nodes organ as the primary focus. Primary lymphoid malignancy of thyroid gland is not common in clinic, EBV-positive primary diffuse large B-cell lymphoma of thyroid gland is rare in clinic, and its pathogenesis, treatment and prognosis are rarely studied. We reported an 85-year-old female patient with EBV-positive primary diffuse large B-cell lymphoma of thyroid gland, and the disease eventually relapsed in skeletal muscle of the patient. The pathological type after relapse was consistent with that of the primary focus. As far as we know secondary EBV-positive DLBCL of skeletal muscle from EBV-positive primary DLBCL of thyroid gland. For elderly patients with multiple adverse prognostic factors, individualized treatment on the premise of ensuring their quality of life may be more important.


2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Chauhan SJ ◽  
◽  
Thyagarajan A ◽  
Sahu RP ◽  
◽  
...  

Accumulating evidence has documented the significance of miR-149 as a promising tumor-suppressive non-coding RNA that plays critical roles in regulating genes involved in cancer growth and metastasis. Notably, the ability of miR-149 to be utilized as a potential biomarker in the diagnosis/prognosis or a therapeutic target has also been explored using various cellular and preclinical models, as well as in clinical settings of lung cancer. While the applicability of miR-149 in assessing tumor progression has been suggested, its potential in predicting treatment outcomes is needed to be verified in diverse settings of lung cancer patients. The current review presents an overview of the functional significance of miR-149 with ongoing challenges in non-small cell lung cancer.


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