The use of compounds which can selectively protect normal tissues against radiation injury is of immense use because in addition to it protecting the normal tissue, will also permits use of higher doses of radiation to obtain better cancer control and possible cure. However, most of the radio protective compounds investigated possess inadequate clinical application principally due to their inherent systemic toxicity at their optimal protective concentrations. Plants commonly used as medicinal and dietary agents have recently been the focus of attention and studies have shown that Ocimum sanctum Linn. commonly known as the Holy Basil and its water soluble flavonoids, orientin and vicenin protects experimental animals against the radiation-induced sickness and mortality at nontoxic concentrations. Studies with tumor bearing mice have also shown that both Tulsi extract and its flavonoids selectively protect the normal tissues against the tumoricidal effects of radiation. Preclinical studies have also shown that the aqueous extract of the Tulsi leaves; its flavanoids orientin and vicenin, and eugenol, the principal nonpolar constituent present in Tulsi prevent radiation-induced clastogenesis. Mechanistic studies have indicated that free radical scavenging, antioxidant, metal chelating and anti-inflammatory effects may contribute toward the observed protection. In addition, clinical studies with a small number of patients have shown that Tulsi was effective as a radio protective agent. This review summarizes the results related to the radio protective properties of Tulsi and its phytochemicals and also emphasizes the aspects that warrant future research to establish its use as a radio protective agent.

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Introduction: Turmeric has been described in ayurveda, and is referred by different names in different cultures, the active principle called curcumin or diferuloylmethane, has been shown to exhibit numerous activities. Extensive research over the last half century has revealed several important functions of curcumin. It binds to a variety of proteins and inhibits the activity of various kinases. By modulating the activation of various transcription factors, curcumin regulates the expression of inflammatory enzymes, cytokines, adhesion molecules, and cell survival proteins. Various preclinical, clinical, and animal studies suggest that curcumin has potential as an antiproliferative, anti-invasive, and antiangiogenic, as a mediator of chemoresistance, chemopreventive, and as a therapeutic agent. Thus, curcumin a spice once relegated to the kitchen shelf has moved into the clinic and may prove to be "Curecumin." Methodology and Objectives: The focus of this publication is to provide research on curcumin with scientific publications on curcumin indexed in PubMed, Google J-Gate including systematic reviews, randomized controlled trials (RCT's), observational studies, or case series reports for various potentially malignant disorders (PMD's) with special attention to studies on oral submucous fibrosis. This research will be valuable in terms of identifying opportunities to provide recommendations for future research, in terms of the populations to research, the types of interventions needed, the types of outcomes to be measured, the study designs needed, to initiate a pathway for a low-cost research plan for future clinical trials in this field with an emphasis on conducting studies in regions of the world where PMD's are prevalent. Conclusion: There is a lacunae for scientific review of curcumin for PMDs specially on OSMF. Appropriate therapeutic interventions are needed for the initial, intermediate, and advanced stages of the disease. High-quality RCTs should be initiated.

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Purpose: Breast cancer is the most common cancer in women. Treatment responses are variable depending on tumor morphological characteristics, clinical characteristics, and hormonal receptor levels. In current medical practice, estrogen receptor (ER), progesterone receptor (PGR), and human epidermal growth factor receptor 2 (HER2) levels have been identified as important prognostic factors; they can change prognosis and treatment modalities. In this study, the prognostic factors of patients with triple-negative breast cancer (TNBC) were examined retrospectively. Materials and Methods: Some 110 cases with negative prognostic and predictive proteins (ER, PGR, and HER2) were included in this study. Median follow-up was 56 months. Recurrences, overall survival, and prognostic factors were evaluated. Results: We revealed in our triple-negative series that nodal status, tumor size, whole breast radiation doses, and type of surgery are the most useful prognostic markers. Conclusion: Triple-negative breast cancers, especially basal-like subtypes, have bad prognoses. They have high histopathological grades and high risk of invasion. This group can make early metastases and expected survival is usually short. We need to focus on new treatment strategy modalities on this group, and pretreatment values of different prognostic markers are well-identified, such as androgen receptors, basal cytokeratin expression, and BRCA gene status.

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The family of human matrix metalloproteinases (MMPs) comprises several tightly regulated classes of proteases. These enzymes and their specific inhibitors play important roles in tumor progression and the metastatic process by facilitating extracellular matrix (ECM) degradation. As scientific understanding of the MMPs has advanced, therapeutic strategies focusing on blocking these enzymes by MMP inhibitors (MMPIs) have rapidly developed. This paper reviews MMPs in detail. Their perspectives in therapeutic intervention in cancer are also mentioned.

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Aim: Information on the clinical behavior of ovarian Sertoli–Leydig cell tumors (SLCTs) as well as its prognostic factors and optimal management is limited due to a substantially low incidence of the disease. Also, limited data is available regarding the role of chemotherapy in the management of SLCTs. The aim of the study is to evaluate clinicopathological features and outcome of patients with ovarian SLCTs. Materials and Methods: Twenty-seven patients with SLCT treated at two centers were reviewed retrospectively during 21 years. Results: The median age was 45 years (range, 16–81) and the mean follow-up time was 86 months (range, 16–181). Twenty-three patients had stage IA, three patients had IC, and one patient had stage II disease. Eleven tumors (41%) were well-differentiated and 16 (59%) tumors were intermediately differentiated. Nine patients underwent unilateral salpino-oophorectomy and one patient, with a history of infertility, underwent cystectomy for fertility preservation. Eight patients with intermediately differentiated types of SLCT received adjuvant systemic chemotherapy including the combination bleomycin, etoposide, and cisplatin (BEP). Recurrence occurred in one patient with intermediated differentiated type SLCT with heterologous elements. She received four cycles of BEP chemotherapy. Twelve months later, she underwent cytoreductive surgery and received six cycles of cisplatin plus carboplatin. She died 24 months after the initial diagnosis. Conclusion: SLCTs of the ovary are usually in early stage, unilateral, and benign. Fertility-sparing surgery is the preferred option in young women. In the adjuvant treatment setting, although information about chemotherapy is limited, BEP is a commonly used regimen. The degree of differentiation and the presence of heterologous elements relate to a poor prognosis.

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Aim of Study: Embelin and celastrol, inhibitors of XIAP and NF-κB proteins respectively, have been derived from natural sources and shown anti-tumor activities against different cancer cell lines. Some interactions have recently been discovered between XIAP and NF-κB pathways, but the effects of these inhibitors in combination have not been investigated yet. We have studied possible synergistic effects of embelin in combination with celastrol, in an acute myeloid leukemia model, HL-60 cell line. Materials and Methods: Cytotoxicity of embelin and celastrol, separately and in combination, was determined by MTT assay and flow cytometry. Chou-Talalay's method was used to assess the synergistic effect of two components. Immunocytochemistry and western blot analysis of the two tumor marker proteins. (survivin and COX-2) was also performed to investigate downstream effects of two components. Results: Analysis of MTT assay and flow cytometry showed that there is a substantial synergistic effect in some affected fractions of drug-treated HL-60. cells, while in other affected fractions a mild synergism or additive effect was observed. Immunocytochemistry and western blot analysis revealed that the expression of survivin and COX-2 proteins was reduced in treated cells. Conclusion: Embelin and celastrol showed potent antitumor activity and synergistic effects in combination. Therefore targeting XIAP and NF-κB pathways simultaneously can be investigated in more detail to make use of embelin and celastrol as a combination therapy of cancer.

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Introduction: Oral squamous cell carcinoma is a major cause of death throughout the developed world. It is associated with smoking and alcohol consumption. Human papillomavirus (HPV) type 16 has also been suggested to play a role in etiology of head and neck squamous cell carcinoma (HNSCC). p16 expression is now being used as a surrogate marker of HPV infection in squamous cell carcinoma and provides important prognostic information and future therapy planning. Materials and Methods: In this prospective study, total of 75 cases of HNSCC were taken. Tumor grade was determined according to World Health Organization (WHO) criteria. p16 expression was determined by immunohistochemical staining. The obtained results were analyzed and evaluated using Chi-square test (Statistical Package for Social Sciences (SPSS) version 20), value of P <0.05 was taken significant. Results: Out of 75 cases, 78.7% cases were positive for p16 (inclusive of all grades), while 21.3% cases were negative. Expression of p16 was higher in nonsmokers and nonalcohol consumers and significantly associated with paan chewing habit. No significant correlation was seen with history of abnormal sexual habits, but p16 expression was significantly correlated in cases with multiple sexual partners (P = 0.003), with increasing histological grade (P = 0.045) and in cases with lymph node metastasis (P = 0.03). Conclusion: As HPV integration with transcription of viral oncoprotein induces overexpression of p16, immunohistochemical expression of p16 can be used as a surrogate marker of HPV. This approach can be implemented in diagnostic laboratories and can provide support for vaccination program in high risk group.

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Aims and Objective: Incidence of breast cancer is on the rise in developed as well as in developing countries. In India it has superseded cervical cancer as the commonest malignancy in women in urban areas. A lot of risk factors have been proposed from time to time that play a causative role in the natural course of this disease. However, they are based on data accumulated from studies conducted mostly in developed countries. Aim of this study was to find out whether these known and/or presumptive breast cancer risk factors hold true for women of developing countries like India also. Materials and Methods: From 2008 to 2012; 1,463 breast cancer patients were compared side by side with 1,440 matched controls by predetermined questionnaire and anthropometric variables. Data were analyzed by Statistical Package for Social Sciences (SPSS) V19 software todetermine whether selected risk factors were more common in the patient group than the control group. Results and Analysis: The risk factors under study were also found to be statistically significant for the study populationexcept duration of breastfeeding and family history of breast and ovarian cancers. Conclusion: Risk factors for breast cancer do not differ significantly between developed and developing countries. Hence appropriate time has come for developing countries to incorporate breast cancer risk factors in health education and to consider pharmacological interventions in high risk women.

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Context: Lung cancer is one of the most serious types of cancer that often diagnosed at advanced stage. MicroRNAs (miRNAs) are small non-coding molecules which silence gene expression of target gene (s) at posttranscriptional level. They are key regulators of cell cycle, apoptosis, anti-cancer drug responsiveness and metastasis. Aims: Identification of the differential expression level of miR-15a/16, miR-21, miR-34a, miR-126, miR-128 and miR-210 in A549 cell line versus normal tissues and their correlation with selected corresponding target genes. Materials and Methods: A549 cell line was cultured in F-12K medium and miRNA was extracted from normal tissues (2-3 cm adjacent to tumor tissue) and A549 cell line. cDNA was synthesized with specific stem-loop primers for each miRNA, while OligodT primer was used for target genes cDNA synthesis. Real-time quantitative polymerase chain reaction. (RT-qPCR) was used to analyze the expression pattern of miRNAs and target genes in A549 and normal non-small cell lung carcinoma. (NSCLC) tissues. Results: miR-15a/16, miR-34a, miR-126 and miR-128 were down-regulated significantly. (>2-fold change), while miR-21 and miR.210 were up-regulated in A549. Bcl-2 as miR-34a target gene was down-regulated while Hif-1α and Akt-3 were up-regulated that might be miR-210 and miR-34a target genes, respectively. Conclusion: The significant differential expression level of these miRNAs made them as candidate biomarkers in NSCLC tumor tissues of patients. Perhaps Bcl-2 down-regulation and Akt-3 up-regulation can be linked with survival signals in A549 cell line. We can conclude that Bcl-2 and Akt-3 might be therapeutic targets to inhibit cell proliferation in NSCLC.

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Context: The critical condition of the cancer patient and the stringent medical procedures do not often warrant the accessibility of the patient for psychological evaluation. Therefore, the study is conceptualized to assess the psychological problems of caregivers, which in turn have their impact upon cancer patients. Aims: The objective of the study was to explore the relationships between depression, anxiety, distress, and somatization in cancer patients and their caregivers along with age, gender, and relationship; and to measure whether these psychological problems of caregivers were predictors of the identical symptoms of the cancer patients. Materials and Methods: Four-Dimensional Symptom Questionnaire was used to measure depression, anxiety, distress, and somatization of cancer patients and their caregivers. The sample had 200 participants, with 100 patients (male = 47 and female = 53) and 100 caregivers. (male = 36 and female = 64) selected by purposive sampling method. Statistical Analysis Used: The data were analyzed by using descriptive statistics, product.moment correlations, simple and multiple linear regression analyses. Results: Significant correlations were found between cancer patients' depression and anxiety, and caregivers' depression, anxiety, distress, and somatization; patients' distress and somatization, and caregivers' anxiety and age, respectively. It was also found that anxiety was a significant predictor of distress in patients, and that caregivers' depression, anxiety, distress, and somatization significantly predicted depression and anxiety in cancer patients. Conclusions: The association between depression, anxiety, distress, and somatization of caregivers and patients indicates the need for psychological interventions to manage these problems of caregivers, which would in turn help managing the identical symptoms in patients.

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Objectives: Aerobic exercise can improve the levels of leptin and ghrelin in healthy people, but the effect of aerobic exercise on these proteins in colorectal cancer patients is not well known. The purpose of this study was to investigate plasma leptin and ghrelin concentrations in male patients with colorectal cancer after 8 weeks aerobic exercise and after a week of detraining. Materials and Methods: Thirty men with colorectal cancer (aged: 51.56 ± 11.28 years; ± standard deviation ( SD)) were randomly assigned to training group (n = 15) or control group (n = 15). Before the experiment, Rockport walking test was conducted in order to measure peak aerobic capacity (VO_2peak) of all subjects. Exercise training program consisted of 8 weeks walking and three 45-min sessions in each week with 50–60% of target heart rate. After 8 weeks of training, subjects underwent a week of detraining. A repeated measure analysis of variance (ANOVA) was used to evaluate time-course change in variables. Results: The results showed that body fat percentage was decreased and VO_2peak was increased in the training group compared to the control group (P < 0.05). Ghrelin concentration was increased significantly in the training group compared to the control group (P < 0.05), while plasma leptin concentration and insulin resistance did not change significantly. After a week of detraining, the variables did not change significantly in the training group. Conclusion: VO_2peak and ghrelin levels increased after 8 weeks aerobic exercise; however, plasma leptin and insulin resistance were not affected by this protocol in male patients with colorectal cancer.

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Context: The single most important factor that is known to improve the end result of head and neck cancer is the early diagnosis of these cancers while they are still localized and can be treated with a high probability of cure. Early diagnosis of cancer plays a lifesaving pivotal role in overall management. The technique of colposcopy enables evaluation of changes in surface topography and vascular patterns of the lining mucosa thus, aiding in selecting the most appropriate site of biopsy ruling out the possibility of taking biopsy from the most representative area supposed to reveal epithelial dysplasia. In view of the intra-oral application of micro-colposcopy, it was felt that colposcopy might provide a useful aid for the early enough diagnosis of oral precancerous and cancerous lesions and conditions affecting the oral mucosa to improve the prognosis. Aims: To clinicopathologically correlate cases of oral precancers; correlate the surface characteristics revealed by micro-colposcopy with the histopathological diagnoses of the sites under observation; and map out the areas of surface dysplasia to indicate the full extent of epithelial changes before taking the biopsy specimen to take specimen from areas most representative of dysplasic features (guided biopsies). Materials and Methods: A total 90 subjects were studied including 30 cases of oral submucous fibrosis, 20 cases each of hyperkeratotic lesions including homogeneous and nonhomogeneous leukoplakias and oral lichen planus and 20 cases of clinically diagnosed and histopathologically proven oral squamous cell carcinoma. Results: In this study, a sensitivity of colposcopic screening test came-out to be about 71% while specificity was about 91%. Positive predictive value was 91%. Conclusion: Although the degree of abnormality in colposcopic findings can be predicted by the vascular patterns of the lesion, the major advantage of colposcopy is to outline the most suspicious lesion for histologic diagnosis by directed biopsy, which is the mainstay in establishing the correct diagnosis. Colposcopy is valuable in the detection of early cancerous lesions. However the final diagnosis must rely on a meticulous histopathological examination by an expert pathologist.

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Purpose: Here we aimed to explore the possible mechanism and potential regulatory relationships in which the non.small.cell lung cancer. (NSCLC)-resisted epidermal growth factor receptor. (EGFR) tyrosine kinase inhibitor erlotinib. Materials and Methods: GSE38310, the gene expression profiles of NSCLC cell lines treated with dimethylsulfoxide or erlotinib, including HCC827, ER3, and T15-2, were downloaded from Gene Expression Omnibus database and preprocessed by normalization. Basing on the regulatory relationships of transcriptional factors obtained from University of California Santa Cruz. (UCSC) database, the differentially expressed genes. (DEGs) were screened using limma package in R with. |logFC| >1 and P < 0.05, and regulatory networks of these DEGs were built with supervised inference of regulatory networks (SIRENE). Subsequently, differentially regulatory networks were compared basing on Limit Fold Change. (LFC) method. Results: Totally 24,380 genes were obtained, 1,531 DEGs were identified in HCC827 cell lines, 37 DEGs in ER3 cell lines, 156 DEGs in T15-2 cell lines. After removing the redundancy genes, 1,575 differentially expressed genes were got at last. Basing on three regulatory networks of HCC827 cell lines, ER3 cell lines and T15-2 cell lies, sex-determining region Y (SRY).related high mobility group-box gene 9. (SOX9) and Suppressor of cytokine signaling 3 (STAT3) were identified by comparing with HCC827 and ER3 networks. And suppressor of cytokine signaling 5 B (STAT5B), early growth response-1 (EGR1) and STAT6 were obtained in comparison of HCC827 and T15-2 networks. Conclusions: The regulatory edges with remarkable changes between HCC827 and ER3, HCC827 and T15.2 included some transcription factors and genes. (e. g., STAT3 and SOX9). STAT3, SOX9, STAT5B, EGR1, and STAT6 might affect the resistance of NSCLC to erlotinib.

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Background: The aim of this study was to investigate medical-related reasons for misdiagnosis of nasopharyngeal carcinoma. (NPC) patients presenting with headaches alone or accompanied by other symptoms. Patients and Methods: Two-hundred and nineteen NPC cases describing headaches as one of the initial symptoms during primary treatment were selected for this prospective study. Medical records were carefully collected and all data were summarized for final analyses. Result: Distributions of NPC stage in the patients were: Stage II, 1.4%; stage III, 46.6%; stage IVA, 36.1%; stage IVB, 7.7%; and stage IVC, 8.2%. The ratio of men to women was 2.42:1 (155/64 cases). The total misdiagnosis rate was 43.4%. Patients that only complained of headaches had the highest misdiagnosis rate of 86.4% (19/22 cases). The lowest misdiagnosis rate of 10.9% (5/46 cases) was observed in patients with both headaches and epistaxis. The misdiagnosis rate in rural hospitals was more than two times that in provincial hospitals. Neurosurgery departments had a 100% misdiagnosis rate. Conclusion: Frequently, headaches are the only prominent symptom of NPC. Due to the various clinical manifestations, NPC patients encounter a high misdiagnosis rate, which leads to unsatisfactory treatment outcomes. Improved awareness of the various nonspecific symptoms of NPC by nonspecialist physicians will be a pivotal step in decreasing the misdiagnosis rate. Mini Abstract: The misdiagnosis rate of nasopharyngeal carcinoma (NPC) patients with headaches was 43.4%. Improved awareness of the various nonspecific symptoms of NPC is a pivotal step in decreasing the misdiagnosis rate.

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Introduction: Diffusion.weighted imaging. (DWI) combined with its apparent diffusion coefficient. (ADC) value shows great significance in the differential diagnosis of human tumors. This meta.analysis is to determine whether ADC valued in DWI could contribute to the differential diagnosis of positive and negative lymph node. (LN) metastasis in cervical cancer. (CC) or not. Materials and Methods: A series of types of computerized databases were used searching for eligible studies relied on a strict inclusion and exclusion criteria. Two investigators were involved in the process of selecting articles and extracting dataset. Standardized mean differences (SMD) for the assessment of ADC values in positive and negative LN metastasis in CC patients were calculated. Results: Fifteen cohort studies composed of 687 cases diagnosed with cervical tumor were incorporated into the current meta-analysis. Statistical analysis showed that the ADC value in positive LN metastasis was significantly lower than that with negative LN metastasis [SMD = 1.02, 95% confidence interval (CI) =0.54~1.50, P < 0.001]. Stratified by country, a lower ADC value in tumor tissues with LN metastasis was detected in comparison to that of tumor tissues without LN metastasis among China (SMD = 1.28, 95# CI = 0.62~1.94, P < 0.001) and Korea subgroups (SMD = 1.09, 95% CI = 0.65~1.52, P < 0.001). Conclusion: The ADC values in CC tissues with LN metastasis were significantly lower than those without LN metastasis, suggesting that DWI appears to improve diagnostic performance and can be a useful adjunct imaging for identifying LN metastasis in CC patients.

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Background: To compare the efficacy of concurrent and sequential administration of radiotherapy and chemotherapy on patients with operable breast cancer after breast.conserving surgery. (BCS). Materials and Methods: We searched MEDLINE (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier, Amsterdam, Netherlands) databases for eligible studies. Clinical outcomes (such as overall and locoregional recurrence-free survival, toxicity related complications) used as evaluation indexes of efficacy. Odds ratios (ORs) with 95% confidence intervals (CI) of each index was calculated and analyzed with the RevMan Version 5.2 software. Results: Three articles (two trials), which compared the clinical efficacy of concurrent and sequential administration of radiotherapy and chemotherapy for operable breast cancer patients, were eligible in this meta-analysis. There were significant differences between concurrent and sequential treatments in 5-year loco-regional recurrence free survival (OR: 0.39, 95% CI: 0.20–0.75, P = 0.005) and late skin toxicity of telangiectasia (OR: 2.00, 95% CI: 1.39–2.87, P = 0.0002). However, no significant difference was discovered in five-year overall survival (OR: 0.62, 95% CI: 0.35–1.11, P > 0.05), acute skin toxicity (OR: 1.73, 95% CI: 0.98–3.04, P > 0.05) and late skin toxicity of lymphedema (OR: 1.27, 95% CI: 0.88–1.83, P > 0.05). Conclusion: Our study demonstrated that the concurrent administration of chemotherapy (anthracycline-based) and radiotherapy was superior to the sequential administration in locoregional recurrence-free survival for the operable node positive breast cancer patients. However, choose of treatment for operable breast cancer patients must be cautious due to high risk of lymphedema.

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Introduction: There are different studies in the last decades focused on general surgery patients and the impact of perioperative blood transfusion (PBT) in cancer patients' survival, and most of them have supported an independent association between PBT and worse survival in those with solid tumor malignancies. The aim of this study is to evaluate the impact of perioperative blood transfusion on the postoperative outcomes and survival of patients after LRC. Materials and Methods: We performed a retrospective study analyzing our series of 218 patients surgically treated with LRC form 2005 to 2012. One-way analysis of variance test was used. Survival was estimated using the Kaplan - Meier method and was compared with log – rank and the Cox regression model was used to evaluate the association of PBT with the outcomes. Results: The PBT rate of LRC series was 16%. Patients' age, comorbidities and pathological stage were not related to the PBT rate. A statistically significant relationship was found between the PBT rate and the appearance of infectious complications. Overall 3 years survival estimated with the Kaplan-Meier method was significantly worse in the transfused group: 41.38% versus 63.57% for non-transfused patients. PBT was not a significant independent predictor factor in the survival of patients after LRC. The main independent factor was the TNM classification. Conclusions: Many studies including ours have reported a lower survival rate in patients who receive PBT after oncological surgery. There was a relationship between infectious complications and PBT. We have to make efforts to limit the use of blood products in patients surgically treated with radical cystectomy for bladder cancer.

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Aims: The aim of this study is to explore the antitumor efficacy of lidamycin (LDM) against human multiple myelomas (MM). Materials and Methods: Human MM RPMI 8226 cells and the xenograft model in nonobese diabetic/severe combined immunodeficient (NOD/SCID) mice were used to examine the antitumor activity of LDM. Results: Notably, LDM markedly suppressed the growth of human MM RPMI 8226 xenograft in NOD/SCID mice. In vitro, there was a significant reduction in cell proliferation after treatment with LDM. The overall growth inhibition correlated with the increase of apoptotic cells. The apoptosis-related proteins including caspase-3, 7, and 9 were activated, and poly adenosine diphosphate-ribose polymerase was cleaved. Further investigation revealed that cellular Bcl-2 and survivin decreased, whereas the level of Bax increased in the LDM-treated cells. Conclusions: LDM is highly effective against the growth of MM xenograft in NOD/SCID mice. The potent apoptosis.inducing effect of LDM may be mediated through caspase. and mitochondria.dependent pathway.

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Context: Concurrent chemoradiation is presently the standard of care in locally advanced malignancy of the cervix uteri. But accelerated radiotherapy regimes have not been investigated much. Aims: We conducted a randomized trial to compare the results of pure accelerated radiotherapy given as six fractions weekly to standard chemoradiotherapy in locally advanced carcinoma cervix patients. Settings and Design: This was a prospective, phase III trial in which 106 patients of locally advanced (stage II and III) carcinoma cervix were randomized into two arms. Subjects and Methods: The study arm (ART) received 50 Gy accelerated radiotherapy in 25 fractions, six fractions weekly; while control (CRT) arm was treated with concurrent chemoradiation 50 Gy in 25 fractions with weekly injection cisplatin. This was followed by intracavitary brachytherapy (ICBT; total dose of 85 Gy to point A) in both the arms. Fifty-one patients completed treatment in the ART arm and 50 patients in the CRT arm. In these patients, response to treatment, toxicity, and overall survival (OS) and disease-free survival (DFS) were compared between both the arms. Statistical Analysis Used: Survival analysis was done using Kaplan.Meier estimates, logrank test was used to compare differences, while proportions were compared using the Fisher's t-test. Results: At a median follow.up of 36. months there was no difference between the two arms in terms of OS. (61 vs 62%,P = 0.9009) as well as DFS. (60 vs 64%,P = 0.6411) Conclusions: Accelerated radiotherapy given as six fractions per week is an effective alternative to concomitant chemoradiation in locally advanced carcinoma cervix and has shown lesser toxicities in our study.

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Context: Oral submucous fibrosis (OSF) is a potentially malignant oral disorder causally linked to the habit of chewing arecanut. The pathogenesis of the disorder is multifactorial and transforming growth factor beta (TGF-beta) is a prominent player in the induction of fibrosis. The alkaloids of the arecanut seem to target the TGF-beta and the deposition of collagen is predominantly mediated through this cytokine. Aims and Objectives: The present study attempts to induce OSF in Sprague-Dawley rats by injections with solutions of arecanut and pan masala extracts. The tissues were then analysed for the TGF-beta1 gene by real time polymerase chain reaction. (rtPCR). Materials and Methods: Buccal mucosa of Sprague-Dawley rats were injectedwith arecanut and pan masala solutions on alternate days over a period of 48. weeks. Quantitative real time PCR was done to assess the expression of TGF-beta1 in the tissues. Results: OSF-like lesions were seen in both the arecanut and pan masala.treated groups. The histological changes included atrophic epithelium, partial or complete loss of rete ridges, juxta-epithelial hyalinization, inflammation and accumulation of dense bundles of collagen fibers subepithelially. Quantitative real-time PCR showed a significant upregulation of TGF beta1. A. peak fold change of 4.74 in the 18^th. week was observed for the arecanut group while the pan masala group recorded a peak change of 4.9 in the 24^th. week. Conclusion: The study provides further evidence that arecanut and pan masala induce oral submucous fibrosisvia the TGF beta1 pathway.

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Objectives: The objective of this study was to assess the diagnostic value of combination of human papillomavirus (HPV) testing and cytology as compared to isolated cytology in screening cervical cancer. Materials and Methods: We searched public databases including PubMed and Embase before September 30, 2014. Sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio (DOR) of the two methods from included studies were meta-analyzed. The summary receiver operating characteristic (SROC) curve was constructed, and the area under curve (AUC) and an index Q* were summarized. Besides, a two-sample Z-test was conducted to evaluate the differences of the two diagnostic modalities. Results: Totally eight studies were involved. The included studies showed significant heterogeneity in estimating sensitivity, specificity, positive LR, negative LR, and DOR in both methods. The results of the above indexes in combination method were 0.937 (95% confidence interval (CI): 0.925–0.948), 0.858 (95% CI: 0.855–0.860), 3.924 (95% CI: 2.037–7.559), 0.083 (95% CI: 0.033–0.210), and 51.563 (95% CI: 14.682–181.09), respectively. The AUC and Q* index were 0.8841 and 0.8763, respectively. The results for isolated method were 0.743 (95% CI: 0.716–0.768), 0.951 (95% CI: 0.949–0.953), 6.408 (95% CI: 2.322–17.683), 0.226 (95% CI: 0.112–0.460), and 30.897 (95% CI: 7.170–133.15), respectively. The AUC and Q* index were 0.8550 and 0.7859, respectively. Combination method was superior to isolated method (Z = 13.375, P < 0.01) in sensitivity, while was inferior to isolated method (Z = 56.935, P < 0.01) in specificity. Conclusion: Combination of HPV testing and cytology may be appropriate for screening cervical cancer if conditions allow.

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Aim: The present meta-nalysis investigates the prognostic value of osteopontin. (OPN) expression in patients with non-small-cell lung cancer. (NSCLC). Materials and Methods: The Web of Science (1945 ~ 2013), the Cochrane Library Database (Issue 12, 2013), PubMed (1966 ~ 2013), EMBASE (1980 ~ 2013), CINAHL (1982 ~ 2013), and the Chinese Biomedical Database (CBM) (1982 ~ 2013) were searched, without language restrictions, to retrieve studies related to OPN and NSCLC. We compiled carefully selected data and a meta-analysis was conducted using STATA software (Version 12.0, Stata Corporation, and College Station, Texas USA). Hazard ratios (HR) with corresponding 95% confidence interval (95%CI) were calculated. Results: Ten clinical cohort studies were selected for statistical analysis, representing a total of 1,133 NSCLC patients. The main findings of our meta-analysis are that patients who were OPN-positive had significantly shorter overall survival than OPN-negative patients. (HR = 1.47, 95%CI = 1.15. ~ 1.79,P< 0.001). Ethnicity.stratified analysis revealed a significant correlation between expression levels of OPN and poor prognosis of NSCLC patients among both Caucasians and Asians. (Asians: HR = 1.53, 95%CI = 0.95. ~ 2.11, P < 0.001; Caucasians: HR = 1.56, 95%CI = 1.08. ~ 2.03, P < 0.001; respectively). Conclusions: The present meta-analysis is consistent with the hypothesis that increased expression of OPN protein may be significantly associated with poor prognosis in patients with NSCLC.

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Background: Oral submucous fibrosis (OSMF) is one of the most common premalignant conditions in Indian subcontinent due to the traditional use of Areca nut and its various preparations. The genetic predisposition has also been reported in its etiopathogenesis. The rate of malignant transformation is between 7% to 14%. Aim: To evaluate whether ABO blood group is related to OSMF risk. Subjects and Methods: It was a cross-sectional hospital-based study. A convenient sample of 164 study subjects constituted the cases and 180 subjects constituted the comparison group. Statistical Analysis Used: The results were analyzed using chi-square test and odds ratio. Results: The chi-square analysis could not establish any significant relationship between OSMF and ABO blood group. But, when the strength of the association was measured using odds ratio, subjects with blood group A had 1.181 times higher risk of developing OSMF in comparison to other groups. Conclusion: The subjects with blood group A were at higher risk of developing OSMF in comparison to others. By performing blood group determination using a routine method at outreach programs, the susceptible individuals can be identified and counselled to quit the habit, thereby avoiding potential complications.

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Objectives: Not all the patients harboring epidermal growth factor receptor (EGFR) mutations have a clinical response after the treatment of EGFR-tyrosine kinase inhibitor (TKI). The purpose of the present study was to find whether the baseline carcinoembryonic antigen (CEA) levels were associated with the efficacy of EGFR-TKI in patients harboring EGFR mutations. Materials and Methods: Clinical features, serum tumor marker levels, and survival time were analyzed, retrospectively, in 200 non-small cell lung cancer (NSCLC) patients harboring EGFR mutations treated with EGFR-TKI. Results: The total objective response rate (ORR) is 44.0% and disease control rate is 84.5%. The disease control rate in the patients with high CEA levels was significantly higher than that with low CEA levels (88.3 vs 74.5%, P = 0.029). There was no significant difference in progression-free survival (PFS) between high (≥5 ng/ml) and normal CEA groups (< ng/ml; 12.0 vs 8.3m, and P = 0.055). The PFS in patients with higher CEA levels (≥ 20 ng/ml) was longer than in patients with lower CEA levels (< ng/ml; 12.8 vs 8.7m, P = 0.016). Multivariate analysis shows that high CEA level (> ng/ml) were independent predictive factors for PFS (HR = 1.412, 93% CI: 1.042–1.913, P = 0.026). Conclusions: Baseline serum CEA levels can serve as predictive factors for the treatment of EGFR-TKI in NSCLC patients harboring EGFR mutations.

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Sunitinib-induced thrombotic microangiopathy (TMA) is a secondary TMA caused by sunitinib. Despite the extensive use of sunitinib in patients with renal cell carcinoma and other malignancies, little is known about this complication of sunitinib. No clinical trials of sunitinib have studied this complication in any group of patients. We here review the normal physiology of vascular endothelial growth factor in the kidney, and discuss the pathogenesis, clinical and laboratory manifestations, pathological changes in the kidney, and the management of this uncommon complication of sunitinib.

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Introduction: Breast cancer is one of the most women's cancers in the worldwide. In vivo and in vitro studies showed that all-trans-retinoic acid (ATRA) and docosahexaenoic acid (DHA) can modulate differentiation and apoptosis in both cancer and immune cells. Nuclear retinoic acid receptors (RARs) and retinoid X receptors (RXRs) activation in the presence of their ligands, plays a critical role in the proliferation, differentiation, and apoptosis of normal cells. Aim of Study: We hypothesized that ATRA and DHA, as ligands of RARs and RXRs respectively, may have synergistic effects on the induction of apoptosis in MCF-7 human mammary carcinoma cell lines. Materials and Methods: MCF-7 cells were seeded in a 24-well plate at 3 × 105 cells per well. The cells were treated with 5 µM ATRA, 30 DHA, and various combinations of them over a 3-day trial. Apoptosis was measured by Annexin V-FITC kit and flow cytometery. Results: Our results showed that the combination treatment of ATRA and DHA (5 µM and 30 µM and half dose at 2.5 µM and 15 µM, respectively) in a dose-dependent manner induced apoptosis rate in MCF-7 cells significantly more than single treatment of ATRA or DHA, as compared to control group (P < 0.05). Conclusion: We conclude that the combination of ATRA and DHA at the well-balanced proportion may be effective in cancer cell apoptosis. Further studies provide details about the potential synergistically effects of combination treatment of ATRA and DHA in growth inhibition and differentiation of human mammary cancer cells.

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Aim of Study: Genetic studies have shown a significant association between lung cancer risk and single nucleotide polymorphisms on chromosome 15q25.1. The potential association of three polymorphisms in the CHRNA3 (rs1051730(G > A)), CHRNA5 (rs16969968(G > A)), and AGPHD1 (rs8034191(A > G)) with the lung cancer risk has been widely investigated, but the results are inconsistent. The aim of meta-analysis was toclarify the link between three polymorphisms and susceptibility to lung cancer. Materials and Methods: All the relevant data were retrieved by Embase, PubMed, and Web of Science, and then 38 eligible studies were chosen in this meta-analysis. Results: There was no association of rs16969968 polymorphism with cancer risk in the overall pooled analysis. For the rs1051730 and rs8034191 polymorphisms, the results revealed that the five models were significantlyassociated with elevated risk of cancer. Further stratified analysis indicated that increased risk for lung cancer was foundinthe Caucasian, African American, and Asian population. Conclusion: In summary, CHRNA3 rs1051730 (G > A) and AGPHD1 rs8034191 (A > G) were more susceptible to lung cancers than noncarriers.

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Aims: The purpose of this study was to evaluate the prognostic factors associated with overall survival (OS) in nonsmall cell lung cancer (NSCLC) patients with brain metastasis who received whole-brain radiotherapy (WBRT). Materials and Methods: This study included 264 consecutive NSCLC patients with brain metastasis who received WBRT. Patients with leptomeningeal metastasis and those who underwent craniotomy or stereotactic radiotherapy before WBRT were excluded. The evaluated prognostic factors for OS included gender, neurological deficit, histology, epidermal growth factor receptor (EGFR) mutation status, previous cytotoxic chemotherapy, previous EGFR-tyrosine kinase inhibitor treatment, recursive partitioning analysis (RPA) class, and diagnosis-specific graded prognostic assessment (DS-GPA) score. All factors with a P < 0.05 in univariate analysis were entered into multivariate analysis using Cox regression and a confidence interval of 99%. Results: Two hundred thirty patients had died, 14 patients were alive, and 20 patients were lost to follow-up. The median follow-up time was 20.9 months. The median survival time was 5.5 months (95% confidence interval; 4.8–6.3). Univariate analysis showed that gender, neurological deficit, histology, EGFR mutation status, RPA class, and DS-GPA score were significant prognostic factors for OS. In multivariate analysis, RPA class and histology were found to be significant prognostic factors for OS, with P values of 0.0039 and 0.0014, respectively. Conclusions: RPA Class I or II (Karnofsky Performance Status ≥70) and adenocarcinoma histology were associated with longer OS. These factors should be taken into account when considering indication for WBRT.

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Introduction: Androgens play a fundamental role in the growth, differentiation, and maintenance of prostate tissue. The objective of the study was to evaluate and compare the androgen receptor (AR) expression in benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia (PIN), and prostatic adenocarcinoma. A relationship between the Gleason score and AR expression was also determined in cases of prostatic adenocarcinoma. Materials and Methods: A total of 25 cases were collected which included 10 cases of prostatic adenocarcinoma, 10 cases of BPH, and five cases of PIN. Histopathological evaluation was done to determine the type of lesion including Gleason scoring. Immunohistochemistry (IHC) was performed for AR using monoclonal anti-AR antibody. Results: Specific AR immunostaining was present in all 25 cases in varying intensity. The staining was more intense in cases of adenocarcinoma and PIN as compared BPH. There was no significant statistical difference in the intensity of staining of AR. The Gleason score was inversely related to the intensity of AR staining in adenocarcinoma. There was no significant statistical association between the AR expression and tumor, necrosis, metastasis (TNM) stage. Discussion: AR nuclear expression is present in benign and malignant prostatic epithelium. In this study, cases of prostate cancer demonstrated a higher staining intensity for AR when compared with BPH. The intensity of AR staining in prostate cancer significantly reduces as the Gleason grade of the tumor increases. The staining intensity for AR was heterogeneous specifically in cases of prostate cancer. Our results indicate that AR maybe considered as a prognostic marker in prostate cancer.

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Aim: This paper discusses the retrospective analysis conducted to determine the significance of diagnostic biomarkers, carcinoembryonic antigens (CEA), cytokeratin fragment antigens 21-1 (CYFRA 21-1), neuron-specific enolases (NSE), and tumor-specific growth factors (TSGF) upon patients who suffered with non-small cell lung cancer (NSCLC). Materials and Methods: From June 2010 to December 2011, we analyzed the positive rates of biomarkers in 276 NSCLC patients. We assessed the relationship between biomarkers and clinical characteristics of sex, smoking history, and disease stage. Results: The median and positive rates of each serum biomarker were marked as 1.91–22.77 ng/ml and 35.86% (CEA), 2.0–6.77 ng/ml and 50% (CYFRA 21-1), 13.91–23.78 ng/ml and 62.31% (NSE), and 56–67 μ/ml and 10.14% (TSGF). The level of CEA in peripheral (2.43–23.76 ng/ml) was significantly higher than the level at central position (1.97–3.63 ng/ml) (P < 0.05). Conclusion: Although the positive CEA, CYFRA 21-1, NSE, and TSGF rates were observed at low values during the NSLCLC serum diagnosis, they still played an important role in diagnosing lung cancer. Significant levels of CEA, CYFRA 21-1, NSE, and TSGF were detected in the serum. The amounts found were useful for diagnosing NSCLC patients who depended on the currently limited biomarker development.

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Background: The objective of the current meta.analysis was to assess the arterial spin labeling. (ASL) perfusion imaging measurement of cerebral blood flow. (CBF) in patients with brain tumors, and assessing preoperative tumor grade in brain. Materials and Methods: PubMed, Web of Science, Embase, China BioMedicine (CBM), CINAHL, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases were chosen to evaluate the associations between ASL and brain cancer. Two reviewers separately evaluated the quality of the included trials. Standardized mean difference (SMD) at 95% confidence interval (95% CI) was also calculated. Results: Finally, 475 patients were enrolled into this meta-analysis from 12 eligible studies and were selected for statistical analysis. Results showed that relative tumor blood flow (rTBF) and relative cerebral blood flow (rCBF) in high-grade brain cancer patients were faster than those in low-grade brain cancer patients. Subgroup analysis stratified by country implied that ASL may be the main prediction of increased rTBF in high-grade brain cancer patients among USA, Korea and China; and rCBF was faster in high-grade brain cancer using ASL in USA and China. Further reference by tissue-stratified analysis revealed a positive association of rTBF with high-grade brain cancer by utilization of ASL in all the experimental subgroups, while rCBF was only correlated in white subgroups. Conclusion: These results showed that rTBF and rCBF were faster in high-grade brain cancer patients, suggesting that ASL may provide suitable measurement for the differential diagnosis of tumor grade in brain.

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Aim: To study the clinicopathological features of oral verrucous carcinoma (VC). Methods: Archives of the department were retrieved for verrucous lesions. After thorough histopathologic examination, 10 cases were confirmed as VC. Age, sex, site, tobacco habit, clinical presentation, and histologically, the presence of dysplasia and koilocytic changes were studied. Results: Oral VC showed a distinct male preponderance with male:female ratio of 8:2 and occurring predominantly in sixth and seventh decade. Tobacco association in the form of chewing (50%), smoking (40%) or both (10%) was found in all the cases. In chewers, the site of lesion corresponded to the site of tobacco placement that is gingivobuccal sulcus. In smokers, the posterior part of the oral cavity was affected, and the lesions were extensive. Painless, exophytic, cauliflower-like growth was the most common presentation with surrounding whitish (leukoplakic) mucosa. Fifty percentage of the cases showed human papilloma virus-induced changes in the epithelium. Dysplasia was seen in two cases. Conclusion: Oral VCs are invariably associated with tobacco habits. In smokers, the lesions are extensive, affecting the posterior parts of the oral cavity. Although evidence of viral infection was seen but its role as an etiological agent is still controversial. Site and depth of the biopsy along with thorough histopathological sampling is essential to avoid erroneous diagnosis.

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Background: Laparoscopic total mesorectal excision (TME) for rectal cancer has become a widely used surgical strategy in the treatment of rectal cancer. Laparoscopic rectal cancer surgery aims to provide patients with curative resection as well as minimize postoperative morbidity. This study was designed to analyze the foreseeable risk factors linked to postoperative morbidity in patients undergoing laparoscopic total mesorectal excision. Materials and Methods: From February 2008 to May 2010, 306 consecutive patients underwent laparoscopic TME. Postoperative complications including wound infection, pneumonia, urethritis were recorded. Eleven potential risk factors for postoperative complications were analyzed. Results: The overall postoperative complication rate was 22.3%, and the complications included wound infection (5.2%), pneumonia (4.5%), urethritis (3.9%), anastmosis bleed (1.9%), anastmosis leakage (3.2%), and obstruction (3.6%). The risk factors responsible for the complications were conversion (P = 0.002); operation time > 210 min (P = 0.047); age > 70 yr (P = 0.026); tumor size >4 cm (P = 0.005); preoperative chemoradiotherapy (P = 0.017); and a lower tumor location (P = 0.048). Conversion was positively related to wound infection and obstruction. Tumor size >4 cm and preoperative chemoradiotherapy were high-risk factors for urethritis. Operating time >210 min and age >70 year were associated with postoperative pneumonia. Lower tumor and age >70 yr were significant risk factors for anastmosis leakage. Conclusions: Aged patients, large tumor, lower tumor location and conversion were risk factors in performing laparoscopic TME for locally advanced rectal cancer. Patients with these characteristics should be carefully considered before undergoing laparoscopic total mesorectal excision.

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Background: Worldwide, breast cancer is the second most prevalent cancer among women and its incidence is increasing alarmingly. Aim: To determine a dose-response effect of Pleurotus ostreatus on oxidant/antioxidant status in 7,12-dimethylbenz. (a) antheracene induced. (DMBA) mammary carcinoma in experimental rats. Materials and Methods: Cancer bearing female Sprague Dawley rats were orally treated with Pleurotus ostreatus ethanolic extract (POEet) (150, 300 and 600 mg/kg body weight) for 16 weeks. By means of high performance liquid chromatography (HPLC) analysis, ergosterol (48.82%) were identified and quantified in POEet. Body weight of experimental rats in each groups and the biochemical parameters of plasma, liver and mammary tissues were carried out. Histopathological analyses were also determined. Statistical Analysis Used: Results were analyzed using SPSS software package, version 16.0. The values were analyzed by one way analysis of variance (ANOVA) followed by Duncan's multiple range test (DMRT). Result: The result showed that depleted activities of enzymatic and non-enzymatic antioxidant level and significant elevated TBARS level were observed in DMBA group of plasma, mammary and liver tissues of experimental rats. The effects were dose.dependent and the above noted parameters were renovated to near normal after supplementation with different dose of POEet (150 mg, 300 mg and 600 mg/kg bwt). The data obtained from the study indicate that POEet at a dose of 600 mg/kg bwt possesses optimum anticancer effects against DMBA induced mammary carcinogenesis. Conclusion: Based on the scientific appraisal, we conclude that the POEet is having a potent antioxidant capacity; thereby it offers maximum protection against DMBA-induced mammary carcinogenesis

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Aim: To obtain a correlation between HER-2 expression and the clinicopathological features incolorectal cancers. (CRCs) using a meta.analysis based approach. Materials and Methods: Electronic databases and reference lists were searched for relevant published studies. After inclusion and exclusion criteria were applied, case and control studies related to research topic were included in present meta-analysis. Data analysis was performed using Comprehensive Meta Analysis. (CMA) 2.0 software. Result: A total of 30 studies comprising 4,942 CRC patients and 521 healthy controls met the inclusion criteria. Our major results implied that the expression level of HER-2 was significantly higher in CRC patients than healthy controls (odds ratio (OR) = 10.436, 95% confidence interval (CI) = 5.498–19.810, P < 0.001). Sample stratification based on Dukes stages suggested that increased expression level of HER-2 protein was found in CRC patients with Dukes C/D compared with CRC patients with Dukes A/B (OR = 0.335, 95% CI = 0.198–0.568, P < 0.001). The current meta-analysis also found that, in CRC patients with lymph node metastasis (LNM), the HER-2 expression was significantly higher than that in CRC patients without LNM (OR = 1.987, 95%CI = 1.209–3.265, P = 0.007). Conclusion: Our meta-analysis study strongly suggests that HER-2 expression levels are clearly correlated with the clinicopathological features in CRC; therefore, HER-2 may be a potential biomarker for diagnosis and prognosis of CRC.

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Context: Gliomas are irregular in shape unlike benign brain tumors like meningiomas or schwannomas. Simplifying assumptions about glioma geometry are therefore more likely to lead to wrong calculations of glioma volumes than for other tumors. Aims: We compared simple linear measurement.based techniques of measuring glioma volume with manual region of interest.based image segmentation and to assess concordance. Settings and Design: This study was a retrospective radiology archive-based study. Subjects and Methods: The volumes of gliomas were measured by two assessors using five different techniques - manual image segmentation and four linear measurement-based formulae, which included the formulae for the volume of a sphere, cylinder, ellipsoid and its simplification v = abc/2. Statistical Analysis Used: Intra-ssessor concordance was evaluated using mean vs. difference. (Bland-Altman) plots and raw agreement indices. Inter-rater agreement was assessed by calculating the intra-class correlation coefficient for each technique. Results: The best inter.rater concordance was for volume measured by manual segmentation. The tumor volumes measured using the formulae for volume of a sphere and cylinder had poor agreement with the planimetric volume and low inter.rater concordance. The formula for volume of an ellipsoid and its simplification had good agreement with the manual planimetric volume and had good inter.rater concordance. However, for larger tumors, the agreement with planimetric volume was poorer. Conclusions: Manual region of interest-based image segmentation is the standard technique for measuring glioma volumes. For routine clinical use, the simple formula v = abc/2 (or the formula for volume of an ellipsoid) could be used as alternatives.

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Context: Dihydroartemisinin (DHA) exhibits anticancer activity in a number of human cancer cells. However, it is still unknown whether DHA has anticancer effect on nasopharyngeal cancer (NPC) cells. Aims: To investigate the anticancer activity of DHA on CNE-2 cells. Materials and Methods: Cell cycleand invasion assay were used to detect the effect of DHA on CNE-2 cells. Protein molecular differences were examined by Western blot. Results: DHA strongly inhibited cell proliferation by induced cell cycle G1 arrest and apoptosis in CNE-2 cells. In addition, cell motility, invasion, and colony formation were suppressed by DHA. Conclusions: DHA shows significant anticancer effects on human NPC cells, and may be a preventive and therapeutic agent against NPC.

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Background: The aim of our study was to analyze the possible relationships between treatment efficacy, and germinal gene polymorphisms linked to the irinotecan in combination with bevasizumab or panitumumab and capecitabine or 5-FU that has been routinely used in our practice, in the management of metastatic colorectal cancer (CRC). Materials and Methods: Ninety-four Greek with histologically proven metastatic CRC were included in the study. Treatment was administered until disease progression or unacceptable toxicity, for a maximum of eight cycles. Patients were stratified into stable disease. (SD) and progressive disease. (PD). Associations between clinical data, KRAS, UGT1A1. (UGT1A1*28) and DPD (IVS14+1 G. > A) polymorphisms, and toxicity were analyzed. Results: Fifty-eight (61.70%) patients were characterized with SD disease and 36 (38.30%) with PD. There were not statistical significant differences between carriers of KRAS mutated alleles between SD and PD groups. No significant difference was found between response rates and toxicity and DPD or UGT1A1 genotypes. Our results suggested that determination of DPD or UGT1A1 genotypes could not be useful for predicting severe toxicity of irinotecan in our population. Conclusions: The clinical significance of the findings requires replication in larger populations. Furthermore, as 5.FU and irinotecan metabolism is complex, numerous genes in addition to DPD and UGT1A1 should be investigated.

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Aim of the Study: The purposes of this retrospective study were to identify survival rates for limited stage small cell lung cancer (LD-SCLC) and analyze treatment outcomes and influencing factors on survival. Materials and Methods: We conducted data from patients diagnosed with LD.SCLC between January 1998 and December 2012 at our institution. Dermographic information, treatment modalities, pretreatment clinical asessment, were recorded. Most of the patients. (88.4%) were treated with curative intent. The survival probabilties were asessed by Kaplan.Meier analysis. Cox regression was used to assess prognostic factors on overall survival and disease.free survival. Results: A total of 129 patients were examined as a LD-SCLC. The median age was 60 (range; 31–86). Median follow-up time was 9.4 (SE ± 20.5) months and the median overall survival was 13.9 months [95% cumulative incidence (CI): 10.1–17.6]. On multivariate analysis, concurrent chemotherapy [HZ: 2.7 (95% CI: (1.0–7.2)] (P = 0.037) and doses of radiation therapy (<50, ≥50) [HZ: 1.4 (95% CI: (1.0–2.2)] (P = 0.046) were statistically significant on overall survival. With regard to multivariate anlaysis age (<60, ≥60) [HZ: 2.2 (95% CI: (0.6–3.7)] (P = 0.011), doses of radiation therapy (<50, ≥50) [HZ: 2.7 (95% CI: (1.0–7.2)] (P = 0.046), precense of surgery [HZ: 15.3 (95% CI: (1.5–152)] (P = 0.020), prophilactic cranial radiation therapy (PCI) [HZ: 2.3 (95% CI: (1.1–4.5)] (P = 0.014), and presence of concurrent chemoradiotherapy [HZ: 3.0 (95% CI: (1.3–6.8)] (P = 0.008) were important variable affecting disease-free survival. Conclusion: For LD-SCLC patients concurrent chemoradiation therapy and 50. Gy and over doses radiation therapy provided improvement on overall and disease.free survival.

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Background: Uterine sarcomas are rare, malignant, gynecological tumors and show diverse histopathological features. Therefore, there is no consensus on risk factors for poor outcome and optimal treatment. The aim of this retrospective analysis is to report the clinical outcome of patients with uterine sarcoma treated at a single center. Materials and Methods: The data was obtained regarding the patient's demographic characteristics, pathological results, treatments given, survival, and complications of all uterine sarcoma patients treated in a single center between the years 2000 and 2012. The 80.month overall survival. (OS) was determined with respect to prognostic factors including age, stage of disease, histopathological type, and adjuvant treatment. Results: A total of 57 case records are retrieved for this retrospective analysis. The mean age of the patients is 62.5 ± 11.2 years. International Federation of Gynecology and Obstetrics (FIGO) stage distribution is stage I: 29; stage II: 13; stage III: 9; stage IV: 6. Fifty-seven patients underwent surgery, 33 received postoperative radiotherapy (PORT), and 32 received chemotherapy. Median follow-up period was 25 months (range 2–85 months). The 80-month OS for the entire group of patients was 36.7%. The significant prognostic factors for survival are age under 50 years, stage of disease, and adjuvant chemotherapy. Conclusion: Although limited by small sample size and retrospective nature, age under 50 years, stage of disease, and adjuvant chemotherapy are significant prognostic factors for survival for uterine sarcomas.

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Background: Radiation stents made of Lipowitz metal or cerrobend alloy are commonly used to shield uninvolved tissues from electron beams used in therapeutic radiation treatment of head and neck cancers. However, studies investigating the efficacy of cerrobend shielding stent in patients with unilateral buccal carcinoma remain rare. Purpose: To evaluate the efficacy of cerrobend shielding stents in minimizing the potential adverse effects of radiation on oral tissues in buccal carcinoma patients. Materials and Methods: Twenty.eight participants were selected for the study based on predetermined inclusion criteria, out of which four participants were lost to follow-.up. Half of the remaining participants. (N = 12) were randomly given cerrobend shielding stent and the remaining 12 formed the control group. The effects of radiotherapy were evaluated by using Radiation Therapy Oncology Group. (RTOG) 0435 Head and Neck adverse effects grading tool. All participants were evaluated for xerostomia, mucositis, dysphagia, salivary changes, dysguesia, pain, trismus and radiation caries at baseline and 1 and 3. months post.radiotherapy. Results: All adverse effects were higher in control compared to study group, with post therapy difference for pain in swallowing, salivary changes, mucositis, dysphagia, dry mouth and caries being statistically significant. Conclusions: Cerrobend alloy can be used effectively as shielding stent to reduce the adverse effects associated with external beam radiation therapy in unilateral buccal carcinoma patients.

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Background: KRAS mutations have a significant role in the consecutive activation of RAS.RAF.MEK.ERK pathway in colorectal cancer.Approximately 30.35% of sporadic colorectal cancers have KRAS mutation. While the predictive role of KRAS is commonly accepted at the present time, its prognostic role and association with different clinical and histopathological properties are currently unclear and inconsistent. The intent of this study, has been to evaluate the associations between KRAS gene mutations and clinicopathological features and survival times in Turkish colorectal cancer patients. Materials and Methods: In this study, the file records of 115 metastatic colorectal cancer patients who applied to the Department of Medical Oncology between 2000 and 2011 were monitored; data on clinicopathological features and survival times were collected. DNA.sequencing method with PCR amplification from archival paraffin blocks were used for KRAS mutation status analysis. The associations between KRAS mutation status and clinicopathological features and survival times were compared statistically. Results: While a significant association hadbeen determined between KRAS mutation status and tumor localization, there was no determined significant association with other clinicopathological properties. Similarly, there was no association between KRAS mutation status and survival parameters. Conclusions: As a result, the effect of KRAS mutation status on clinicopathological features, survival time and prognosis is unclear.

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Aim: Apparent diffusion coefficient (ADC) value measurement of nodes in diffusion-weighted images (DWI) has been widely used for diagnosis and differential diagnosis of human tumors. We evaluated whether the ADC provided by DWI varies according to the state of estrogen receptors (ER) and progesterone receptors (PR) in breast cancer (BC). Materials and Methods: English and Chinese electronic databases were searched for potentially relevant studies followed by a comprehensive literature search. Summary standardized mean difference (SMD) with 95% confidence interval (CI) was used for ER and PR category of ADC value with the use of the Z test. Results: Final analysis from 6 eligible cohort studies between 2010 and 2012 were selected for inclusion. Overall estimates revealed that the mean ADC of ER-positive or PR-positive cancer was significantly lower than that of ER-negative or PR-negative breast cancer (ER- VS. ER+: SMD = 0.64, 95% CI: 0.02–1.27, P = 0.042; PR- VS. PR+: SMD = 0.45, 95% CI: 0.04–0.86, P = 0.032). Country-stratified analysis indicated the mean ADC of ER-positive cancer was significantly lower in China (SMD = 3.92, 95% CI: 2.22–5.62, P < 0.001). Further subgroup analysis by MRI machine type implied that ADC values may be a potential diagnostic indicator for PR levels in breast cancer only when using Non-Phillips 1.5T scanner (SMD = 0.88, 95% CI: 0.64–1.12, P < 0.001). Conclusion: ADC values vary significantly according to the ER and PR levels in BC patients, indicating that cancer heterogeneity affects imaging parameters. DWI could therefore be critical for clinical applications of ADC values.

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Context: It has been verified that dendritic cell (DC) vaccination can improve the prognosis of malignant glioma. However, recent evidence suggests the problems with DC vaccines lies, at least in part, with the cancers ability to induce an immunosupressive response that suppresses any vaccine-mediated active immunity. Our previous studies indicate that subcutaneous vaccine can restrain the cancer cells implanted in the brain, but the effect is limited on vascularized tumor in the brain. Furthermore, vascular endothelial growth factor (VEGF) and vascular cell adhesion molecule (VCAM) play an important role in immunoevasion. Aims: To identify the effects of DC vaccination on antiangiogenesis induced by endostatin in rat glioma. Materials and Methods: Rat basal ganglia glioma model was constructed and authenticated. The concentration of immunoglobulin G (IgG) was detected using rat IgG enzyme-linked immunosorbent assay (ELISA) kit. CD8+ T cell infiltration was measured by immunofluorescence. The expression of VEGF, VCAM, and intercellular adhesion molecule 1 (ICAM-1) tested by real-time reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot. The expression of VEGF and apoptosis in rat glioma tissues is tested by immunohistochemical staining. Statistical Analysis Used: Two group comparisons were analyzed by a two-tailed Student's t test. Multiple group comparisons were analyzed by one-way analysis of variance (ANOVA). P values less than 0.05 were considered statistically significant. Results: The combination of DC vaccination and antiangionesis inhibited the rats with malignant glioma by stimulating immune response, supressing the expression of angiogenesis-related proteins VEGF, VCAM, and ICAM-1. In addition, the combination therapy inhibited glioma stem–cell-like cells. Conclusions: DC vaccination enhances antiangiogenesis induced by endostatin in rat glioma.

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Objection: The aim of this study is to investigate the association between promoter methylation of RASSF1A and p16 and the clinicopathological features in lung cancers. Materials and Methods: PubMed, EBSCO, Ovid, Wiley, Web of Science, Wanfang, and VIP databases were searched using combinations of keywords related to RASSF1A, p16, methylation, and lung cancers. After screening for relevant studies, following a strict inclusion and exclusion criteria; the selected studies were incorporated into the present meta.analysis conducted using Comprehensive Meta Analysis 2.0. (CMA 2.0). Results: We initially retrieved 402 studies, out which 13 studies met the inclusion and exclusion criteria for this meta.analysis, and contained a total of 1,259. patients with lung cancers. The results of this meta.analysis showed that the differences in promoter methylation ratio between the lung cancer patients in tumor, node, metastasis. (TNM) I.II and III.IV were not statistically significant. Based on histological types, patients with adenocarcinoma. (AC) and squamous cell carcinoma. (SCC) showed no significant differences in the promoter methylation ratios of RASSF1A, while the promoter methylation ratio of p16 was significantly higher in SCC patients compared to AC patients. Based on smoking status, the promoter methylation ratios of both RASSF1A and p16 was significantly higher in lung cancer patients with smoking history compared to nonsmokers. Conclusion: The present meta.analysis provides convincing evidence that the promoter methylation ratio of RASSF1A and p16 is associated with clinicopathological features in lung cancers, and could be used as effective biomarkers in early diagnosis in lung cancers.

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Aim: Concurrent chemoradiotherapy (CRT) is the standard therapy for patients with unresectable Stage III nonsmall cell lung cancer (NSCLC). The aim of this study was to assess the efficacy and safety of concurrent CRT in unresectable Stage III NSCLC in Turkey. Patients and Methods: The study included 82 patients with histologically proven unresectable Stage III NSCLC, Eastern Cooperative Oncology Group performance status 0–1, who received concurrent CRT in two different referral centers. Treatment consisted of two cycles of cisplatin at 50 mg/m ² on days 1, 8, 29, and 36 and etoposide 50 mg/m ² between days 1 and 5, 29–33 and concurrent radiotherapy administered once daily, 1.8–2.0 Gy per fraction, at a total dose of 60–66 Gy. Results: The stages of the patients were Stage IIIA in 39 (47.5%) and IIIB in 43 (52.5%) patients. Complete and partial responses were achieved in 15 (18.2%) and 31 (37.8%) of the patients, respectively. Twenty-eight (34.2%) patients had stable disease and 8 (9.8) had progressive disease. Forty-one (50%) patients recurred during follow-up. The primary site of recurrence was as distant metastasis in 19 (23.2%) patients. Median overall survival (OS) was 20 months (95% confidence interval; 12.9–27.09 months), 3 and 4 years survivals were 27.9% and 20.9%, respectively. Median progression-free survival (PFS) was 9 months, 3 and 4 years PFSs were 20.1% and 16.1%. Myelosuppression was the most common toxicity. In 15 (19.2%) patients grade 2–3 lung toxicity and in seven (8.5%) patients' grade 2–3 dysphagia were reported. Conclusion: Concurrent CRT with cisplatin and etoposide schedule is a well-tolerated regimen with acceptable toxicity profile and survival rates in patients with unresectable Stage IIIA/IIIB NSCLC. Median survival and OS results were consistent with the literature.

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Background: Gemcitabine is the first-line drug for nonsmall cell lung cancer, and ¹⁸F-fluorodeoxyglucose. (¹⁸F-FDG) and ¹⁸F-fluorothymidine. (¹⁸F-FLT) are positron emission tomography. (PET) imaging agents. The aim of this study was to explore the effect of gemcitabine on the uptake of ¹⁸F-FDG and ¹⁸F-FLT in A549 cells and the animal tumor model. Materials and Methods: The inhibitory effects of gemcitabine on cell growth were determined by tetrazolium blue method, and uptake rates of ¹⁸F-FDG and ¹⁸F-FLT were determined under the same conditions. The adenocarcinoma-bearing nude mice before and after gemcitabine treatments were performed microPET imaging with ¹⁸F-FDG and ¹⁸F-FLT. Hematoxylin and eosin staining and immunohistochemical analysis of tumor specimens were conducted. Results: After the administration of gemcitabine, positive correlations were observed between inhibition of ¹⁸F-FDG or 18F.FLT uptake and cell growth. (r = 0.957 or 0.981, P < 0.01). SUV_max values by ¹⁸F-FDG in the tumor, before and after administration of gemcitabine at the dose of 60 mmol/L, revealed an increase by. (35.83 ± 10.58) %. After administration of 120 mmol/L gemcitabine, the SUV_max values decreased by (12.37 ± 7.33) %. The SUV_max values by ¹⁸F-FLT at the dose of 60 mmol/L gemcitabine revealed a decrease by (56.47 ± 10.83) %. Pathological staining showed obvious vasodilation and invasion of lymphocytes and plasma cells at the dose of 60 mmol/L, and the expression of glucose transporter protein-1, Ki-67 and proliferating cell nuclear antigen in tumor cells were inhibited. Conclusion: ¹⁸F-FLT imaging can assess the proliferation of tumor cells and ¹⁸F-FDG imaging can reflect the changes of the tumor microenvironment after administration of gemcitabine.

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Aim of Study: The aim was to explore the structure and functions of new target spot c-Myc target from laryngeal cancer cell. (MTLC) of c-Myc gene. Methods: This study adopted bioinformatic methods to analyze the physicochemical property, secondary structure, hydrophobic region, a transmembrane region, and prediction of functions. Results: The results showed that the whole length of the open reading frames was 708 bp, coding was 235 amino acids. This protein was a basic protein possessed two transmembrane structures and weight was about 26592.5 Da. The main elements of secondary structure were alpha-helix and random coil. MTLC was a membrane constitutive protein that possessed signal transduction and regulation may locate on karyotheca as results of subcellular localization and function prediction. Conclusion: This study has provided the theoretical basis for the further discussion of the effect and mechanism of action of MTLC in the occurrence of laryngeal cancer.

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Aims: Cisplatin, a platinum-based drug, is an important weapon against many types of cancer. It is well-known that cisplatin induces apoptosis. Potassium channel plays very important role in several signaling pathways. To investigate the possibility that potassium channels also have a role in the cellular response to cisplatin, we examined the effect of cisplatin on the activity of potassium channels on CT26 cell, the colon carcinoma cell line. Materials and Methods: The cells were cultured in DMEM, supplemented with 10< heat-inactivated fetal bovine serum. At mid-log phase, cultures were harvested, washed twice in phosphate-buffered saline, and resuspended in culture medium before use. Cells were voltage-clamped using the whole-cell patch clamp technique. Membrane current data were collected and amplified. Statistical Analysis: Differences between two groups were assessed by paired t-test and one sample t-test to compare the relative values. One-way ANOVA was used for all experiment with more than two groups. Results: Potassium currents were detected in CT26 cells and the currents were reduced by the application of tetraethylammonium (TEA) chloride, iberiotoxin, a big conductance calcium-activated potassium channel blocker and barium. The potassium currents were enhanced to 192< by the application of cisplatin (0.5 mM). Moreover, the increase of potassium currents by cisplatin was further inhibited by the application of TEA confirming the action of cisplatin on potassium channels. In addition, relative current induced by cisplatin in CT26 cells was bit larger than in normal IEC-6 cells. Conclusion: Potassium currents were detected in CT26 cells and the currents were reduced by the application of tetraethylammonium (TEA) chloride, iberiotoxin, a big conductance calcium-activated potassium channel blocker and barium. The potassium currents were enhanced to 192< by the application of cisplatin (0.5 mM). Moreover, the increase of potassium currents by cisplatin was further inhibited by the application of TEA confirming the action of cisplatin on potassium channels. In addition, relative current induced by cisplatin in CT26 cells was bit larger than in normal IEC-6 cells.

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Objectives: The aim of this study was to evaluate the sensitivity and specificity of autofluorescence bronchoscopy (AFB) according to the macroscopic appearance of airway lesions under white light bronchoscopy (WLB). Materials and Methods: The bronchoscopic findings of 708 patients, who were pathologically and clinically diagnosed with airway lesions and underwent both WLB and AFB, were analyzed. Results: We recruited 708 patients for this study, of which 336 (47.5%) had benign lesions; 300 and 254 benign lesions were detected by AFB (specificity, 89.3%) and WLB (specificity, 75.6%), respectively. In 372 (52.5%) patients with bronchiogenic carcinoma, 356 and 235 lesions were identified by AFB (sensitivity, 95.7%) and WLB (sensitivity, 63.2%), respectively. The sensitivity and specificity of AFB for diagnosing lung cancer were higher than those of WLB (P < 0.05). Moreover, AFB showed high sensitivity for detecting lung cancer in cases in which WLB revealed hyperplasia, infiltration, and stenosis (P < 0.05). Conclusions: AFB combined with WLB could effectively improve the diagnosis of airway lesions.

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Purpose: The use of positron emission tomography (PET) for radiotherapy planning purposes has become increasingly important in the last few years.In the current study, we compared the SUV values of images at the PET CT console to the SUV values obtained at the RT planning workstation. Materials and Methods: The PET-CT cylindrical body phantom was filled with a uniform 18F solution of 5.3. ± 0.27 kBq/mL radioactivity concentration. PET-CT scans were performed on a16 slice Time of Flight system. On a single day, the three consecutive scans were done at three time points 15 minutes apart to generate time points image data sets titled T1, T2, and T3. SUV calculations were performed by drawing region of interest. (ROI) encompassing the entire hot spot on each slice on the PET-CT console and the iPlan workstation. Minimum SUV, Maximum SUV and the Mean SUV were recorded. Statistical analysis was done using the SPSS software. (SPSS Inc.) (Version 18). Results: The absolute difference in average max SUV values i.e. Max (PET-CT) – Max (iPlan) for the time points T1, T2 and T3 were -0.168 (SD 0.175), -0.172 (SD 0.172) and -0.178 (SD 0.169). The difference in the minimum SUV values were -0.513 (SD 0.428), -0.311 (SD 0.358) and -0.303 (SD 0.322), respectively. Finally, the difference in the mean SUV values were -0.107 (SD 0.040), -0.096 (SD 0.067) and -0.072 (SD 0.044), respectively. Conclusions: Our study found out that the average difference in the two systems for maximum SUV values was < 0.2 absolute units.Our study suggests good reproducibility of SUV between the two systems. The relevance of these findings would be of seminal importance in current and future SUV-based PET-CT-based contouring in treatment planning systems.

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Background: In the roadmap to design diagnostic and therapeutic markers for breast cancer, EphB4 is of special interest due to its multiple roles in tumor initiation, progression and invasion. The aim of present study was to characterize a rapid and sensitive ELISA-based method to measure EphB4 level and its phosphorylation status following stimulation with its ligand, ephrinB2, in an invasive breast cancer cell line. Materials and Methods: MDA-MB-231 breast cancer cells were lysed and EphB4 level was measured using ELISA. EphB4 level was measured in sub- and post-confluent states in culture dishes. Receptor phosphorylation was also detected by ELISA assay, using various concentrations of pre-clustered ephrinB2 for 20 minutes. Results: Expression of EphB4 receptor was detected by ELISA in all samples. EphB4 level was significantly higher in post.confluent than sub.confluent cells. Phosphorylated receptor was also detectable with this method when cells were exogenously stimulated. Conclusions: Quantitative data from ELISA manifested a difference between levels of EphB4 in two states of different invasive properties. Moreover, ELISA method may be considered rapid and sensitive enough to detect even low levels of total and phosphorylated EphB4 Cost-effectiveness of this method for the detection of differential expression of EphB4 proteins in clinics is also noticeable.

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Objective: This study explored the potential association between epidermal growth.factor receptor. (EGFR) mutation status and brain metastasis in patients with nonadenocarcinoma nonsmall cell lung cancer. (NSCLC). Patients and Methods: We analyzed clinical data from 286 patients with nonadenocarcinoma NSCLC, who were tested for EGFR mutations and underwent brain magnetic resonance imaging at diagnosis. We examined the relationship between EGFR mutation and brain metastasis at initial presentation. Results: Of the 286 patients, 20 patients (7.0%) had EGFR mutations. EGFR mutations were more frequent in younger patients (11.1% in patients =64 years vs. 3.3% in patients >64 years: P = 0.01), females (21.4% vs. 3.5% in males: P <0.001), never-smokers (25.0% vs. 3.4% in smokers: P < 0.001), and tumors with nonsquamous histology (25.0% vs. 4.1% in squamous histology: P < 0.001). At diagnosis, the frequency of EGFR mutations was significantly different in patients with metastasis to different sites (4.0% [no metastases] vs. 10.4% [extracranial metastases] vs. 40.0% [brain metastases], P < 0.001). The strong association between EGFR mutation and brain metastasis remained significant in multivariate analysis (adjusted odds ratio [OR] = 9.68, 95% confidence interval [CI] =2.32–40.45; P = 0.002). Associations were also found for EGFR mutation status with nonsquamous histology (adjusted OR = 4.46, 95% CI = 1.46–13.56; P = 0.008). Conclusion: This study indicates that the likelihood of nonadenocarcinoma patients having EGFR mutant tumors may differ according to brain metastasis and squamous cell histology.

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Purpose: This study investigates the failure pattern after chemoradiotherapy of patients with resectable esophageal squamous cell carcinoma (ESCC). Materials and Methods: We retrospectively analyzed 92 patients with T1-2, N0-1, and M0 ESCC. These patients were inoperable because of poor performance, comorbidities, poor tumor region, or refusal of operation. Results: Among the 92 patients, 29 cases displayed simple locoregional recurrence, 12 cases displayed simple distant metastasis, and 6 cases displayed distant metastasis with locoregional recurrence. Univariate analysis shows that the incidence of recurrence in the middle thoracic region was significantly higher than other regions (χ² = 14.415, P = 0.001). For the 18 patients with distant metastasis, incidence of distant metastasis in the lower thoracic region was significantly higher than the other regions (= 39.359, P < 0.001). Among 35 cases with regional recurrence, 7 cases reached complete remission (14.6%) and 28 cases reached partial remission (PR; 63.6%) (χ²= 23.435, P < 0.001). Multivariate analysis shows that the patient age, tumor node metastasis (TNM) stage, and short-term efficacy were independent factors for locoregional recurrence. Patient age, TNM stage, X-ray length of the lesions, and short-term efficacy were the independent factors for distant metastases. Conclusion: The incidence of locoregional recurrence and distant metastasis in patients with upper thoracic esophageal cancer was lower than those who had middle thoracic and lower thoracic esophageal cancer. The incidence of locoregional recurrence and distant metastasis in patients who achieved complete response after treatment was low.

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Objective: To analyze the changes of bronchoalveolar lavage fluid (BALF) and serum tumor markers in lung cancer. Materials and Methods: Fifty patients with lung cancer (study group) and 50 cases with benign lung lesions (control group) were selected from May, 2010 to May, 2013. The observation group included squamous cell carcinoma subgroup (n = 25), adenocarcinoma subgroup (n = 19), and small cell undifferentiated carcinoma subgroup (n = 6). The carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and cytokeratin 19 fragment (CYFRA21-1) concentration were compared; and the comparisons among subgroups were also performed. Results: Three kinds of tumor markers in BALF and serum of the observation group were higher than that of the control group. NSE concentration of small.cell lung cancer was the highest, CYFRA21.1 concentration was highest in the squamous cell carcinoma, and CEA concentration was highest in the adenocarcinoma group; the former increased more significantly. Conclusion: BALF and serum NSE, CEA, and CYFRA21.1 elevated in lung cancer, which had prompt value for pathology, especially significant for BALF.

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Aims and Objectives: The present study was taken up to evaluate the AgNOR counts in the buccal mucosa cells of gutkha chewers and compare that with the sex-matched controls. Materials and Methods: In all, 100 gutkha chewers and 50 sex-matched non-chewers (controls) were chosen. None of the patients in both groups had any clinical oral lesions or systemic diseases. After rinsing with 0.9% sodium chloride, cytologic smears were prepared and stained using the AgNOR method and observed in immersion oil at 1000 × magnification. Finally, 50 cells were selected at random; AgNOR dots were counted and their mean was recorded. The student t-test was used for analysis of data. Results: Comparison between mean AgNOR counts of gutkha chewers (2.68 ± 0.23) and non-chewers (2.01 ± 0.14) was found to be statistically significant. Conclusion: Cytology associated with AgNOR staining can effectively detect the early molecular changes within buccal mucosa cells of oral mucosa.

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Aim: Cholecystokinin (CCK) and gastrin (Gs) are a well known trophic factor for the gastrointestinal tract and their trophic effects are shown mainly toward pancreas and stomach, respectively. Though, the exact characterization of CCK and Gs receptors subtype (cholecystokinin type A receptor [CCKAR] and cholecystokinin type B receptor/gastrin receptor [CCKBR/GR]) in stomach cancer (SC) and pancreatic cancer (PC) is still controversial and necessities further validation. Subjects and Methods: CCKAR and CCKBR/GR expression was analyzed by immunohistochemistry in 55 SC, 25 benign gastric diseases (BGDs), 38 PC (including periampullary carcinoma), and 10 normal pancreatic tissue. The results were statistically correlated with the patient's clinical history to observe the prognostic significance if any. Result: CCKAR expression was detected in 18.2% of SC, 20% of BGD, 65.8% of PC, and 30.0% of normal pancreas tissue samples. The CCKBR/GR expression was detected in 58.2% of SC, 48.0% of BGD, 18.4% of PC, and 60.0% of normal pancreas tissue samples. CCKBR/GR expression was significantly high in well and moderately differentiated SC samples as compared to poorly differentiated samples. Conclusion: Our study showed significantly higher expression of CCKAR and down regulation of CCKBR in PC as compared to control while CCKBR/GR was detected in majority of SC samples. Thus, our study suggests that CCK and Gs receptors may have diagnostic and therapeutic implications. However, study need to be validated in significantly bigger sample size and need to be replicated in different cohorts.

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Aims: Gastroesophageal reflux disease is considered to be a major risk in the development of esophageal adenocarcinoma. Nuclear factor-kappa B (NF-κB) plays important roles in the regulation of several genes coding for cytokines, cell proliferation, and apoptosis. To understand the role of bile and acid in the causation of esophageal cancer, we have examined the effects of bile acids and acid on NF-κB activation in the esophageal epithelial cells OE33 and SKGT-4 qualitatively and quantitatively. Materials and Methods: Analysis of NF-κB activation in esophageal epithelial cells in response to bile acids and acid was performed by electrophoretic mobility shift assay, Western blotting and the translocation NF-κB was assessed by high content analysis (HCA). Cyclooxygenase-2 (COX-2) promoter activity was assessed by transient transfection assays. Results: This study demonstrated that bile acids and acid activated NF-κB in a dose- and time-dependent manner. HCA analysis was an invaluable method in quantifying NF-κB translocation at the single cell population level following bile or acid treatment. Furthermore, deoxycholic acid (DCA) and acid-induced COX-2 promoter activity, and a mutation in the NF-κB and activator protein-1 (AP-1) binding sites remarkably reduced the reporter gene activity induced by DCA or acid. Conclusions: Our data demonstrate that bile and acid induce NF-κB activation in esophageal cells qualitatively and quantitatively. The induction of COX-2 promoter activity by DCA and acid was mediated via NF-κB and AP-1 transcription. The activation of NF-κB signaling pathway in esophageal cells may contribute to the development of esophageal cancer, and, therefore, modulating of NF-κB pathway may uncover new therapeutic strategies.

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Purpose: We aimed to assess the clinical outcome of consolidation chemotherapy for resectable esophageal squamous cell cancer (ESCC) after trimodality therapy. Materials and Methods: From January 2005 to December 2012, a total of 192 consecutive locally advanced ESCC patients who underwent trimodality therapy successfully was included. Grouping was based on the degree of myelosuppression occurred during preoperative chemoradiotherapy. Of the 192 patients, 120 patients underwent trimodality therapy only (TT group), while 72 patients received consolidation chemotherapy additionally after trimodality therapy (TC group). Preoperative chemoradiotherapy included two cycles of chemotherapy concurrently with radiotherapy. The chemotherapy regimen consisted of cisplatin 20 mg/m²/day and fluorouracil 400 mg/m²/day administered intravenously infusion on days 1–5 of a 21 days cycle. Concurrent radiotherapy was delivered in a total of 40 Gy in 20 fractions. All patients underwent surgery successfully. For 72 patients in TC group, additional 1–4 cycles of consolidation chemotherapy were administered, and chemotherapy regimen was as before. Results: The 5-year survival rate was 43.5% in TT group, as compared with 48.8% in TC group. (P = 0.238). The 5.year progression.free survival. (PFS) rates were 34.0% in TT group and 38.8% in TC group. (P = 0.049). Risk reduction in PFS was remarkable for males and those who did not achieve pathologic complete response. (pCR). The incidence rate of disease progression did not differ significantly. (P = 0.200). Conclusions: The addition of consolidation chemotherapy demonstrates no survival benefit for patients with locally advanced ESCC, but PFS is significantly improved, especially for males and those who did not achieve pCR.

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Introduction: Tumors within the pancreatic head show a variable density and enhancement on computerized tomography (CT). The relationship between the radiological appearance of pancreatic adenocarcinoma on CT and survival remains unclear. The aim of this study was to evaluate the relationship between the tumor density on CT and survival. We also evaluated the correlation between lymph node (LN) size and overall survival in patients undergoing pancreaticoduodenectomy for head of pancreas adenocarcinoma. Materials and Methods: Case records of patients undergoing pancreaticoduodenectomy for the adenocarcinoma of pancreas head, between 2005 and 2009, were evaluated. CT was interpreted to document tumor density – Hounsfield unit (HU) and LN size of enlarged LNs. Histology was analyzed to review tumor differentiation and LN status. Survival was correlated with LN size and tumor density (HU). Results: Increasing tumor density was significantly associated with an adverse outcome (P = 0.042, hazard ratio [HR] 1.034, 1.002–1.067 95% confidence interval [95% CI]). Patients with well-differentiated tumors had significantly lower tumor density as compared to moderately differentiated tumors (39.00 ± 26.00 vs. 71.31 ± 21.03 HU, P = 0.005). LN size more than 1 cm irrespective of LN status strongly correlated with the survival and was found to be an important prognostic factor (19.37 ± 2.71 months vs. 27.44 ± 2.74 months; P = 0.025; HR 2.70; 1.09–6.68 95% CI). Conclusion: Increasing pancreatic tumor density and the lymph nodal size of more than 1 cm are strong predictors of unfavorable overall survival for resectable adenocarcinoma of the pancreatic head. Further studies are required to identify the value of these proposed prognostic factors.

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Aim: The aim of this study is to investigate the rectal complication probabilities for various rectum volumes with intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in patients undergoing prostate cancer radiotherapy. Materials and Methods: Thirteen patients undergoing prostate cancer radiotherapy were consecutively selected for this study. All patients were treated with IMRT to a dose of 78 Gy in 39 fractions. Three different rectum volumes: (i) planned rectum (plan-rectum) (ii) Boolean sum of rectum volume based on the cone-beam computed tomography (CBCT) for first five fractions (planning organ at risk volumes [PRV]-CBCT-5), (iii) Boolean sum of rectum volume from all the CBCTs (PRV-CBCT-All) in addition to an average rectal complication (PRV-CBCT-AV) were used for computing the probabilities of rectal complications. To assess the rectal complications with 3D-CRT, a five-field plan was generated for comparison with IMRT. The Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) model was used to assess the rectal complications for all of the defined rectal volumes. Results: The NTCPs for rectum as assessed from plan-rectum, PRV-CBCT-5, PRV-CBCT-All, and PRV-CBCT-AV with IMRT were 9.71% ±4.69%, 16.34% ±9.51%, 19.39% ±9.71%, and 12.81% ±7.22%, respectively. Similarly, with 3D-CRT, the NTCPs were 17.41% ±10.44%, 19.61% ±11.08%, 21.03% ±11.06%, and 17.72% ±10.29%, respectively. Conclusion: Our results showed that the rectal complications are reduced significantly with IMRT as compared to 3D-CRT. As such, the analyses of NTCP with various defined composite rectum volumes indicate that IMRT requires image-guided adaptive radiotherapy as opposed to 3D-CRT.

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Objective: The efficiency of implantable intra-arterial interventional chemotherapy before the operation for synovial sarcoma on limbs was evaluated. Materials and Methods: Drug delivery device (chemotherapy pumps) was implanted percutaneously for 36 patients, and the interventional chemotherapy was conducted for 3-4 cycles. The surgical resection was carried out after obvious improvement was observed by clinical and imaging examination. The evaluation standard for the efficiency of chemotherapy was tumor cell necrosis rate obtained from postoperative pathological test. Results: The response rate (RR) of pain alleviation was 91% (32/36), and the RR of the changing of lesion imaging was 83% (30/36). Thirty cases received extensive tumor excision, and six cases received amputation because of poor response to tumor chemotherapy and local carcinelcosis. The postoperative pathological test showed 81% moderate and severe chemotherapy response (29/36). The average follow-up time was 39 months. There were three cases presenting with local tumor recurrence, and seven deaths due to pulmonary metastasis. Conclusion: Intra-arterial interventional chemotherapy before operation for synovial sarcoma can effectively control pain. After chemotherapy, the imaging performance significantly changed, and tumor cells were necrotized extensively. The pathological changes were obvious.

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Introduction: Gastrointestinal polyps commonly affect the pediatric population. The commoner variety amongst these is the solitary rectal polyp. Juvenile polyposis coli (JPC) is rare, characterized by multiple polyps occurring throughout the gut. Aim: The role of cyclooxygenase-2 (COX-2) has been implicated in gastrointestinal tumorigenesis. We aimed to look at the clinicopathological spectrum of solitary vs juvenile polyposis and compare their differences in expression of COX-2 and p53. Materials and Methods: We studied 38 polyps from eight cases of JPC, collected over the past 10 years along with 40 solitary rectal polyps (SRP). Results: The size of polyps was significantly more in cases of JPC compared to SRP. Adenomatous change was observed significantly more often in JPC. COX-2 expression was also significantly higher in the JPC group compared to SRPs. All cases of JPC polyps with adenomatous change showed strong COX-2 expression. There was no significant difference in expression of p53 in the JPC and SRP groups. Conclusion: We observed significantly higher COX-2 expression in JPC. Establishment of the role of COX-2 in JPC will help us formulate chemopreventive therapies as an adjunct to its surgical management.

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Objective: Patient positioning accuracy is critical in radiotherapy. To improve the patient positioning accuracy, a double lower limb auxiliary device has been developed to fix pelvis patients to treatment couch. A clinical study for comparing new device to conventional devices has been performed. Materials and Methods: Thirty patients with pelvic tumor were randomly divided into conventional thermoplastic membrane fixation group (conventional fixing group) and conventional thermoplastic membrane plus lower limb auxiliary fixture group (auxiliary fixing group). The setup error was acquired by simulator position alignment with center field digital radiograph reconstruction (DRR) image from treatment planning system, The correlations between the conventional fixing group and the auxiliary fixing group were analyzed using Pearson's Chi-squared test. Results: Set-up errors in conventional fixing group and auxiliary fixing group were respectively 3.8 ± 1.5 mm and 1.4 ± 0.9 mm (P< 0.02), 5.4 ± 2.5 mm and 1.2 ± 1.2mm (P < 0.001), 2.2 ± 1.3 mm and 1.9 ± 1.0 mm (P < 0.05) in the bilateral, superior-inferior and anterior-posterior direction. Conclusion: The double lower limbs auxiliary device can reduce pelvic patient positioning errors. It is very helpful in improving the daily clinical setup accuracy.

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Aim of Study: WEE1, a member of serine/threonine protein kinase family is the master inhibitor of cyclin-dependent kinase 1 in cell cycle. Over-expression of WEE1 in glioblastomas (GBMs) and some other cancers has been shown. Here, we investigated the expression of WEE1 in 13 brain samples from GBM patients and two GBM cell lines. Further to that, we asked whether if knocking down WEE1 expression in the cell lines change tumor cells' reaction. Materials and Methods: All brain tumor samples were collected after confirmed pathological diagnosis. Western blotting was used to screen the expression of WEE1 and a panel of tumor markers. As a model of WEE1 gene silencing with small hairpin RNA (shRNA) technology in GBMs, A172, and U373GM cell lines were transfected with four WEE1 specific shRNAs. The growth characteristics of the cells and the expression of a panel of downstream genes were investigated after gene suppression. Results: All GBMs and both cell lines over-expressed WEE1. Transduction of the cell lines with different shRNAs suppressed WEE1 expression with different extent and pooling of four shRNAs together resulted in additive effect. Suppression of WEE1 not only repressed cellular growth but also changed the profile of gene expression of the cells. Quantitative real-time polymerase chain reaction showed also reduced expression of genes such as hypoxia-inducible factor-1, B-cell lymphoma-2, vascular endothelial growth factor, and p53 with crucial roles in tumor survival and invasiveness. Conclusion: These results highlight the key role of WEE1 suppression to combat GBMs. Moreover, it showed beneficial possibilities of WEE1 suppression with different anticancer approaches for neurological malignancies.

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Purpose: The aim of this study was to compare the delineation and treatment planning of 2 Phase based (end-expiration and end-inspiration) internal gross tumor volume (IGTV) with 10-phase based (four-dimensional [4D]) IGTV. Materials and Methods: Patients with lung tumors at different sites were selected for the study. The location of the tumor in Groups A, B, C were at the upper lobe (attached to the chest wall), middle lobe, and lower lobe, respectively. We contoured the GTV on each of the 10 respiratory phases of the 4D computed tomography (4DCT) data set. The combination of these GTVs produced the IGTV “All Phases.” GTV was also generated on the extreme respiratory phases. The combination of these two GTVs produced IGTV “2 Phases.” Treatment planning was done, and dose to organs at risks (OARs) were compared in both cases. Results: The average volume of IGTV “2 Phases” and IGTV “All Phases” for Group A were nearly same. However, for Group B and Group C, IGTV “2 Phases” were smaller than the IGTV “All Phases.” Lung-GTV doses were less in “exp-insp” phases than in “4DCT” for Groups B, C, whereas it was same for “expiration-inspiration” and “4DCT” in Patient A. Conclusion: Patients with tumor upper lobe tumor have no difference in tumor coverage and OARs sparing in the 2 Phase and all phases but middle lobe and lower lobe have a greater excursion during respiration and hence greater all phases IGTV.

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Objective: Our experience with endoscopic surgery for vascular leiomyomas of the nasal septum was reviewed. Patients and Methods: All patients with vascular leiomyomas of the nasal septum who were treated with endoscopic surgery from May 1995 to June 2007 were reviewed retrospectively. Results: Twelve patients had vascular leiomyomas of the nasal septum removed successfully; there were no recurrences or endocrine complications during the 15–62-month follow-up postoperatively. Conclusion: The endoscope technique offers simple, rapid access to the nasal septum, and excellent visualization; it is a safe, minimally invasive, efficient procedure for removing benign nasal septum tumors that leaves no scar on the face.

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Objective: The aim of this study was to investigate the value of two quantitative indicators, the apparent diffusion coefficient (ADC) and the exponent apparent diffusion coefficient (EADC), of magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) in the differential diagnosis of ovarian epithelial tumors. Materials and Methods: Clinical and MRI data from ovarian epithelial tumors were analyzed after pathology confirmation of 85 lesions from 76 cases (47 lesions from 41 benign cases; 38 lesions from 35 malignant cases). Patients underwent routine MRI examination and DWI before surgery. The average ADC and EADC values of the solid sections of the tumors were measured when the b value was 1000 s/mm ². Results: The mean ADC value of the solid sections in the benign group was 1.28 ± 0.23 × 10⁻³ mm ²/s; the average EADC value was 27.96 ± 5.78 × 10⁻². In the malignant group, the mean ADC value of the solid sections was 0.86 ± 0.17 × 10⁻³ mm ²/s; the average EADC value was 42.37 ± 5.96 × 10⁻². When the b value was 1000 s/mm ², there was a statistically significant difference in ADC and EADC values between benign and malignant ovarian tumors (P < 0.05). Conclusion: ADC and EADC values of DWI can be used to differentiate benign and malignant ovarian epithelial tumors.

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Objective: To explore the outcome and prognostic factors of recursive partitioning analysis (RPA) Class III brain metastatic patients treated with stereotactic radiotherapy (SRT). Materials and Methods: Fifty-six consecutive patients with metastatic brain tumors and Karnofsky performance scale (KPS) scores <70 treated with SRT from January 2008 to October 2013 were involved in the analysis. Twenty-five patients (44.6%) were with symptomatic extracranial lesions (SELs), and the other 31 patients (55.4%) were without SELs. The detailed follow-up data of KPS scores were available in 44 patients. The KPS score drop time (KDT) was calculated as the time between SRT and 10 points drop of KPS scores compared to the baseline. Kaplan–Meier and Cox proportional hazards regression analyses were performed for univariate and multivariate analyses. Results: The median overall survival time was 5.0 months (95% confidence interval [CI] 3.42–6.59) for the whole group. In multivariate analysis, the presence of SELs (P = 0.007, relative risk = 4.44, 95% CI 1.036–20.818) was the independent prognosis factor for survival. Median survival time was 3 months for the patients with SELs, 8 months for the patients without SELs. The median KDT of the 44 patients was 3.0 months (95% CI, 1.927–4.073 months). Again only the presence of SELs (P = 0.001, OR = 6.622, 95% CI, 2.108–20.801) was significantly related to KDT in multivariate analysis. The median KDT of the patients with SELs was 1.5 months, which was 5 months for the patients without SELs. Conclusion: The presence of SELs was a negative prognosis factor for the survival of RPA Class III brain metastatic patients. If RPA Class III brain metastatic patients were without SELs, SRT may be a reasonable treatment option, but if they had SELs, SRT may not be a reasonable treatment due to the short overall survival time and KDT.

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Aim of the Study: Synthesized CO (II) and Pt (II) of sulfadimethoxine. These compounds were tested for potential antitumor activity against two of human tumor cell lines, colon carcinoma cell line [Hct₁₁₆], and breast carcinoma cell line MCF7. Materials and Methods: The structures of the resulting compounds have been investigated by elemental, FT-IR and H ¹ NMR analyzes to insure the purity and confirmed the structures of them. The surface properties studies and octanol/water partition coefficients, P_o/w were measured. Results: The synthesized compounds exhibit biological activities with the lowest log P_o/w and critical micelle concentration (CMC) values. In addition, in this article we provide an insight into this subject in order to increase the drug bioavailability. Inhibitory activity against colon carcinoma cells was detected for Pt and cobalt ion complex with IC₅₀ = 4.5, 2.2 µg and against breast carcinoma cells IC₅₀ = 18.2, 5.7 µg, respectively. Summary: The main goal of cancer therapy is to attain the maximum therapeutic damage of tumor cells in combination with a minimum concentration of the drug. This can be achieved in principle via selective antitumor preparations, the cytostatic effects of which would be restricted within tumor tissue. While 100% selectivity may be impractical, the achievement of reasonably high selectivity seems to be a feasible aim. Platinum and cobalt complex surfactants in our research affect tumor tissue at a very low concentration at values lower than their CMC values; this indicate that the sulfadimethoxine complexes merit further investigation as potential antitumor drugs.

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Background: We sought to determine whether patients with high-volume, low-risk prostate cancer are suitable candidates for ultrasound-guided brachytherapy, monotherapy alone, without supplemental external beam radiation. Materials and Methods: The study cohort comprised 200 consecutive patients who received ultrasound.guided monotherapy from November 02, 1998 to March 26, 2010. Real.time intraoperative treatment planning was performed for all patients. 145. Gy with I125 was prescribed to the prostate with no margin. The primary endpoint was time to prostate-specific antigen. (PSA) failure using the phoenix definition. Cox multivariable regression analysis was used to determine the factors significantly associated with time to PSA failure. Results: Median follow-up was 59 months (range 1.2–146.8 months). The median PSA was 5.0 ng/ml. For the overall cohort, both 5- and 8-year PSA failure-free survival was 92.3% (95% confidence interval [95% CI]: 86.5–95.7%). Low-risk patients per the NCCN criteria had 5- and 8-year PSA failure-free survival of 93.6%. On cox multivariable analysis, only baseline PSA (adjusted hazard ratio: 1.29 [95% CI: 1.02–1.65], P = 0.036) was associated with outcome. Among patients with <33% cores positive, 33–<50% cores positive, and ≥50% cores positive, the 5-year PSA failure-free survival was 92.3% (95% CI: 85.1–96.1%), 91.0% (95% CI: 68.5–97.6%), and 93.3% (95% CI: 61.2–99.0%), respectively. Conclusions: Our analysis indicates that patients with a high number of cores positive for cancer can be adequately treated with modern brachytherapy as monotherapy and be spared the additional morbidity and cost of supplemental external beam radiation or androgen deprivation therapy.

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