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Statins have been reported to have a potential radiosensitizing effect that has not been evaluated in clinical trials. The aim of this study was to evaluate the efficacy and safety of simvastatin in addition to whole-brain radiation therapy (WBRT) in patients with brain metastases (BM). A prospective randomized, controlled, open-label pilot study was conducted on 50 Egyptian patients with BM who were randomly assigned to receive 30-Gy WBRT (control group: 25 patients) or 30 Gy WBRT + simvastatin 80 mg/day for the WBRT period (simvastatin group: 25 patients). The primary outcome was radiological response at 4 weeks after WBRT. Secondary outcomes were 1-year progression-free survival (PFS), 1-year overall survival (OS), and health-related quality of life (HRQL) that was assessed using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and its brain module (BN-20), at baseline, after WBRT, and 4 weeks after WBRT. The addition of simvastatin was tolerated. Twenty-one patients were not evaluated for radiological response because of death (n = 16), noncompliance to follow-up (n = 4), and clinical deterioration (n = 1). Response rates were 60% and 78.6% (p = 0.427), 1-year PFS rates were 5.2% and 17.7% (p = 0.392), and 1-year OS rates were 12% and 8% (p = 0.880) for the control group and simvastatin group, respectively. Nonsignificant differences were found between the two arms regarding HRQL scales. The addition of simvastatin 80 mg/day did not improve the clinical outcomes of patients with BM receiving WBRT.

Introduction This prospective, multicenter, phase III trial compares the efficacy and safety of celiac neurolysis versus palliative radiotherapy for pain control in patients with advanced pancreatic carcinoma. Methods 40 patients with advanced pancreatic carcinoma presented with epigastric pain had their numeric rating pain scores controlled to the range (0-2) by opioids. After pain control, patients were randomly assigned into two groups. Group I (n=22) received local radiotherapy. Group II (n=18) underwent fluoroscopic celiac neurolysis. After treatment, there was an attempt to gradually withdraw the daily dose of opioids to the least effective dose that maintains the pain scores at (0-2) unchanged. Evaluation was done at the 6th and the 12th weeks from neurolysis and radiation therapy. The comparison between both groups was based on the opioid milligrams that could be withdrawn. The adverse effects from radiation therapy, opioids and celiac neurolysis were monitored and reported. Results At the 6th week evaluation, 23% of patients in group I versus 88.8% in group II had 100% opioid withdrawal. By the 12th week, 0% of patients in group I versus 72.2% in group II had 100% opioids withdrawal. Conclusion A high statistical significant difference (P