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Background: In recent years, several studies have shown the association between exercise and decreased risk of mortality in patients with breast cancer. However, the effects of combined resistance and endurance training on salivary Interleukin-12 (IL-12), tumor necrosis factor (TNF-α), Cortisol, and Testosterone levels in patients with breast cancer have not been investigated. Objectives: This study aimed at determining the effect of 8 weeks of combined resistance and endurance training on salivary IL-12, TNF-α, Cortisol, and Testosterone levels in women with breast cancer. Methods: Forty-two postmenopausal women with breast cancer were randomly selected and divided into training (intervention) and control groups. The training group performed resistance training with 2 to 3 sets, 10 to 18 repetitions, 50 to 70% 1 repetition maximum (1RM), and aerobic exercise with 50 to 70% maximum heart rate (maxHR) (12-14 degrees borg scale) for 20 to 40 minutes for 8 weeks. The salivary IL-12, TNF-α, cortisol, and testosterone levels were measured, using the enzyme-linked immunosorbent assay (ELISA) method. Two-way analysis of variance repeated measure was also used to analyze variance with the confidence interval of 95%. Results: In the training group, there was a significant decrease in salivary TNF-α levels, cortisol, TNF-α/IL-12 ratio, and variables of weight, fat percentage, body mass index (BMI), and waist circumference (P < 0.05). Also, the results showed a significant increase in salivary testosterone and testosterone/cortisol ratio in the intervention group (P < 0.05). However, no significant changes were observed in the interaction between-group and time in IL-12 and waist–hip ratio (WHR) values (P > 0.05). Conclusions: The results indicate that resistance and endurance training could be used as a useful method to improve salivary pro-inflammatory factors and hormonal levels in patients with breast cancer. Medical oncologists can underline a resistance and endurance training program for patients with breast cancer under their care.

Introduction Human Cytomegalovirus (HCMV) is the most important viral pathogen in people undergoing bone marrow transplantation (BMT). HCMV detection in the early stages makes is possible to save the patients’ lives through immediate and timely treatment. The aim of this study was to investigate the status of HCMV using the real-time PCR method in BMT patients in Kermanshah, west of Iran. Methods HCMV monitoring was done in 120 patients who underwent BMT, 38 allogeneic cases and 82 autologous cases, using the ELISA serology test before transplantation. The participants were followed up 100 days after transplantation for HCMV detection in blood samples using real-time PCR. Preemptive therapy started with Ganciclovir and Foscarnet when the viral load was > 200 HCMV DNA copies/ml. Results Despite preemptive therapy, infection recurred in less than 1 month. HCMV recurred more frequently in patients undergoing allogenic transplation versus those receiving autologous transplantation. Recurrence was seen in 5 patients receiving allogenic transplantation. HCMV recurrence occurred in five patients with allogeneic transplantation. Twelve patients undergoing allogeneic or autologous transplantation (83%) and a virus load of > 1000 copies/ml showed HCMV-related symptoms. Three patients died, two due to HCMV-related pneumonia and the other one due to a fungal infection. Conclusion Real-time PCR may be a useful method for quantification and monitoring of HCMV recurrence and may be helpful in choosing more efficient HCMV preemptive treatment in BMT recipients.

Background: Concurrent training is more effective in developing fitness indicators than doing endurance and resistance training separately. However, there has been limited research to evaluate the effects of this type of exercise training on improvement of body composition and quality of life indicators in postmenopausal women with cancer. Objectives: The present study aimed to determine the effects of eight-week of concurrent training on body composition, quality of life, and sleep quality in postmenopausal women with breast cancer. Methods: This study was conducted on 42 women with breast cancer who were selected randomly and divided into exercise training and control groups. The training group followed eight-week of resistance training (2 - 3 sets, 10 - 18 repetitions, and 50% - 70% 1RM) and aerobic training (50% - 70% maximum heart rate, 12 - 14 Borg scale, and 20 - 40 minutes). Anthropometric characteristics were measured based on body composition (ZEUS 9.9), the sleep quality was measured by the Pittsburgh sleep quality index (PSQI), and the quality of life was measured by the McGill quality of life (MQOL) questionnaire. Two-way repeated measures ANOVA has been used for McGill’s analysis of variance (P < 0.05). Results: The results showed a significant decrease in sleep quality score, weight, fat percentage, BMI, and waist circumference in the training group (P < 0.05), as well as an increase in quality of life index in the training group (P < 0.05). However, no significant changes were observed in the Waist-hip ratio (WHR) values of the training group compared with the control group (P > 0.05). Conclusions: Although the changes in WHR index were not significant after eight weeks of concurrent training, this type of training program could be considered as a beneficial way for improving body composition, quality of life, and sleep quality in patients with breast cancer.

Background: BRAF V600E mutations were recently identified in the leukemic cells from patients with hairy cell leukemia (HCL) that this mutation in exon 15 is considered the disease-defining mutation in HCL. Objectives: This meta-analysis aimed to report the prevalence of BRAF V600E mutation in HCL patients. Methods: Three databases including PubMed, Scopus, and Web of Science up to 2017 were searched for the prevalence of BRAF mutation in HCL patients. A random effects meta-analysis was performed using the Comprehensive Meta-Analysis software version 2.0 with the event rate (ER) and 95% confidence interval (95% CI). Results: Out of 552 articles identified from the search, 11 were included included and were analyzed for meta-analysis study. The studies in meta-analysis included 437 patients with HCL, of which 353 (80.8%) patients had BRAF V600E mutation. The pooled ER of the studies was 81.5% (95% CI: 69.5%–89.5%). The Begg's test did not show publication bias, but the Egger's test showed publication bias. Conclusions: With regard to the mentioned limitations, the prevalence of BRAF mutation in HCL patients was >80%. In future studies, considering sex, age, and other variables can exactly show the correlation between these variables with the detection of BRAF mutation.

Background: Chromosome Xq11-12 is the place that the androgen receptor (AR) sequence appears. Herein, the prevalence of this biomarker and its relation with pT stage and tumor grade was reported. Methods: Four online sites (PubMed, Scopus, Web of Science, and Cochrane Library) have been searched up to Sep 2018 systematically. Meta-Analysis software version 2.0 (CMA 2.0) and STATA 14.0 statistical software were utilized. Publication bias did not exist. Results: From the initial 1141 articles identified from the systematically searches. At last, nine of them remained for analysis. The meta-analysis included 1447 patients that 345 of them had AR expression. AR expression significantly correlated with low tumor grade and low tumor pT stage. Conclusion: AR expression was 28.2%, and it had the relationship with tumor low grade and low pT stage. Additional studies required to figure out the role of it on RCC patients.

Multiple myeloma is described by the proliferation of malignant plasma cells, in which orbital involvement is rare. In this report, we collected all cases with orbital multiple myeloma from 2009 to 2018 and investigated the characteristics such as sex, age, common orbital symptoms, unilateral or bilateral and different therapeutic options. Also, we reported an uncommon case of multiple myeloma that has been developed into plasmacytoma. Our patient had been initially diagnosed with multiple myeloma, but after a few months, the disease had progressed to secondary extramedullary plasmacytoma in the retrobulbar. Therapeutic measures, such as surgery to prevent its development in the patient's eye, were successful.

Palbociclib, an oral inhibitor of cyclin-dependent kinases 4 and 6 (CDK 4/6), has been approved for metastatic breast cancer (mBC) treatment of hormone receptor (HR)-positive/ human epidermal growth factor receptor 2 (HER2)-negative. The study reported the efficacy of Palbociclib as a new oral drug in a patient with mBC. A 40-year-old female with stage 2 right BC change to stage 4 after about two years later referred to oncology clinic. Due to HR-positivity/HER2-negative, she has treated with Palbociclib 125 mg (per one day for twoweek and one-week intervals) with Letrozole. In new assessment and after 8 months of this oral combination therapy, the chest x-ray of lung showed the complete response. Treatment with Palbociclib plus Letrozole had a complete response in the mBC patient after the common chemotherapies and hormone monotherapy.

Objective: The associations between viruses and the cancer have been conducted in several studies while there has been no systematic review and meta-analysis about the association between viral infections and thyroid cancer (TC). Therefore, we investigated the association between viral infection and TC risk. Methods: Systematic search was done from 1994 to 2019 in Web of sciences (ISI), PubMed, and Scopus databases. Pooled logarithm of odds ratio (OR) and their corresponding 95 confidence interval (CI) and pooled prevalence of viral infections were calculated to find the association between the viral infections and TC risk and overall prevalence of the viral infections in TC. Results: Twenty-three of 852 original articles were selected and included in the study. According to the results of the random effect meta-analysis, the pooled prevalence of viral infections in the TC patients was 37 (95 C. I = 22 �55 ). In addition, there was a significant association between viral infections (log (OR) = 1.51, 95 credible interval = 0.68�2.39) and TC risk. The highest associations were observed between TC risk and Simian Vacuolating Virus 40 (SV40) and B19 infections, respectively. The lowest non-significant association was found between TC risk and Poliovirus type 1 infection. The significantly heterogeneity was observed between included studies (Q test: p-value

Purpose The purpose of this study was to compare the efficacy and safety of a proposed bevacizumab biosimilar to those of the reference product in patients with metastatic colorectal cancer (mCRC). Methods This Phase III, multicenter, randomized, double-blind (patient- and assessor-blind), active-controlled, 2-armed, parallel-group, noninferiority trial was conducted in patients with histologically verified colorectal cancer with evidence of at least 1 metastasis. Patients with mCRC were randomized 2:1 to receive 5 mg/kg IV of either study drug plus FOLFIRI-3 (with repeated irinotecan 100 mg/m2 60-min infusion on day 3) or the reference drug plus FOLFIRI-3 every 2 weeks for 1 year. Progression-free survival (PFS) was the primary end point, and overall survival, objective response rate, and time to treatment failure as well as safety and immunogenicity were secondary end points. The population assessable for PFS was per protocol, and the intention-to-treat population was used for sensitivity analysis. Safety was assessed based on reports of adverse events, laboratory test results, and vital sign measurements. Findings A total of 126 patients were enrolled; PFS values in the biosimilar and reference arms were 232 days (7.7 months) and 210 days (7 months), respectively (P = 0.47). The hazard ratio of the biosimilar arm versus the reference arm was 0.79 in the per-protocol population (90% CI, 0.46–1.35; P = 0.47). The upper limit for the 2-sided 90% CI was lower than the margin of 1.44, indicating that the biosimilar drug was noninferior to the reference drug. The hazard ratio for overall survival in the intent-to-treat population was 0.99 (95% CI, 0.55–1.80; P = 0.99). The difference between other efficacy end points among the groups was not statistically significant. No significant difference was observed in the comparison of the two arms for safety. The antidrug antibody was positive in 1 patient in each arm. Implications The proposed biosimilar BE1040V was noninferior to the reference product in terms of efficacy in the treatment of mCRC, and tolerability was comparable between the 2 drugs. ClinicalTrials.gov identifier: NCT03288987.

Context: Lung cancer is one of the most common cancers worldwide with high mortality and short survival rate. Radiotherapy is one of the treatment modalities in patients who are non-surgery candidates or refuse surgery. Objectives: The current study aimed at evaluating the effectiveness and safety of this technique compared to similar ones for lung cancer treatment. Methods: In order to answer the research question and find the available evidence, after the development of the search strategy, Pubmed, Cochran, Ovid, Medline, and DARE databases were searched and related articles were selected based on the inclusion criteria. Then, we chose all studies that had the PICO acceptance criteria (Participants: adults with lung cancer; Intervention: tomotherapy; Comparisons: tomotherapy with Cyberknife; Outcomes: local tumor control (LTC), survival rate (SR), complications, and degree of toxicity). The quality assessment of the studies was conducted using the CASP (Critical Appraisal Skills Programme) checklist. Two independent search engines evaluated the articles in terms of methodology, and information was extracted from the papers.ResultsOverall, 12 retrospective studies with 616 patients were found examining the efficacy and safety of a certain technology. According to the results of the studies, the local tumor control (LTC) index varied from 63% to 100%. The two and five-year SRs were 73% and 56%, respectively. In addition, the mortality rate of patients until the completion of the treatment course was 34%, indicating the higher efficacy of tomotherapy than the efficacy of other similar techniques. The toxicity of tomotherapy was less than that of Cyberknife, which indicates its more safety. Conclusions: According to the epidemiology of cancer, especially lung cancer, and due to aging of the population in Iran, and considering the higher efficacy and safety of tomotherapy in comparison with other similar technologies, i.e., Cyberknife and Gamma Knife, tomotherapy is a superior technique in the control and treatment of lung cancer although other aspects, such as cost-efficacy, should be considered.

Background: Recurrent breast cancer (BC) after initial treatments is usually associated with poor outcome. The objective of this study is to evaluate baseline characteristics of BC patients to determine their prognostic influence of recurrences. Materials and Methods: In this retrospective study of 481 BC patients, 182 patients who had recurrence within the first, second, or third 5 years after diagnosis were included in the study. The significant prognostic factors associated with late or very late recurrence were selected according to the Akaike Information Criterion. Early recurrence was defined as initial recurrence within 5 years following curative surgery irrespective of site. Likewise, late recurrence was defined as initial recurrence after 5 years. Also, very late recurrence was defined as initial recurrence after 10 years. Results: During the follow-up period, 182 recurrences occurred (local recurrence or distant metastasis). All patients were treated with chemotherapy and radiotherapy and the patients with estrogen receptor (ER)- or progesterone receptor (PR)-positive had hormone therapy. There was a significant correlation between histological grade and receptors status with recurrence. In binary logistic regression analysis, ER and PR were significant prognostic factors for early recurrence. Conclusion: High histological grade and immunohistochemical markers (ER- and PR-negative or human epidermal growth factor receptor 2-positive) are risk factors for recurrence, especially in early recurrence and also between of them, ER is the more significant prognostic factor in early recurrence.

Aim of the study : Herein, this meta-analysis study evaluated the efficacy of palifermin after HSCT on the incidence and severity of OM or aGVHD in hematologic malignancy patients in randomized clinical trials (RCTs). Materials and methods : To compare the efficacy of palifermin on adverse events, OM and aGVHD compared with placebo , we searched databases of PubMed/Medline, Web of Science and Cochrane Library for RCTs based on a number of criteria. Results : There was no difference observed in the incidence of OM and aGVHD between two groups. The subgroup analysis didn’t show significant differences in two groups for aGVHD grade 2–4 (odds ratio [OR] = 1.54, 95% confidence interval (CI): 0.70–3.39, p = 0.28), aGVHD grade 3–4 (OR = 0.97, 95% CI: 0.48–1.94, p = 0.92), OM grade 2–4 (OR = 0.76, 95% CI: 0.42–1.38, p = 0.37) and OM grade 3–4 (OR = 0.54, 95% CI: 0.25–1.15, p = 0.11], but erythema as an adverse effect in palifermin group was higher than placebo group (OR = 1.86, 95% CI: 1.10–3.15, p = 0.02]. Conclusions : This meta-analysis of six clinical trials found no statistically significant difference in OM and aGVHD grades in patients receiving 60 µg/kg/day dose of palifermin compared with those receiving a placebo . However, oral mucosal erythema was more prevalent among patients receiving palifermin than patients receiving a placebo .

Necrotizing fasciitis is an uncommon disease and a soft tissue infection that spreads along fascial planes with associated inflammation and necrosis. Herein, this study reported necrotizing fasciitis as a rare complication after bone marrow transplantation (BMT) in a Iranian patient and the efficacy of early treatment in improvement it. A 28-year-old lady had known case of first relapse of Hodgkin’s lymphoma that admitted for auto-BMT in 2016. Five years ago due to abdominal-pelvic massive lymphadenopathy, she was treated with six courses of ABVD regimen combined with involved filed irradiation. Due to Hodgkin’s relapse, the patient was treated with six courses of ICE regimen and after complete remission was selected for auto-BMT. Necrotizing fasciitis was reported by MRI and the patients was treated with combination of a number of antibiotics after fasciectomy. In conclusion, necrotizing fasciitis is a rare complication of BMT, especially autologous type that drug selection and rapid surgical fasciectomy are important decisions for prevention of mortality and morbidity of this complication.

Context: Despite the fact that breast cancer (BC) is a major health issue, very few studies describe its characteristics in the Middle East. Aim: The aim of this study was to evaluate the use and value of Ki-67 as a prognostic marker in BC and associations between Ki-67, clinical, and histopathological parameters were evaluated. Subjects and Methods: In a retrospective study, 260 BC women and invasive ductal carcinoma were included to our study in Kermanshah city, Iran. Age, tumor size, lymph node involvement, histological grade, nuclear grade, and vascular invasion were other factors that determined in a lot of patients. Results: The mean age at diagnosis was 47.6 years (range, 24-84 years) with 100% female. Of 243 patients that tumor size was determined for them, 207 patients (85.2%) had tumor size ≥ 2 cm, and 36 patients (14.8%) had size

Breast cancer is the most common cancer with high morbidity and mortality among women worldwide. Aberrant hypermethylation in promoter regions of the tumor suppressor genes such as PTEN gene is a key event in the progression and development of breast cancer. The aim of the present study was to evaluate an association between PTEN gene methylation status with the risk of breast cancer in an Iranian population. We studied 255 individuals, including 103 patients with breast cancer, 102 first-degree female relatives of patients (mother, sister, or daughter of patients), and 50 healthy individuals as a control group. Genomic DNA was extracted from peripheral blood leukocytes, and the PTEN promoter methylation status was detected using methylation-specific PCR (MSP) method with specific methylated and unmethylated primers. In some samples, direct DNA sequencing was used to confirm the results obtained by the MSP method. The frequency of PTEN-methylated (MM) genotype was 6 % in the healthy control group, 23.3 % in relatives of patients, and 41.7 % in patients (χ 2 = 24.62, p

BACKGROUND CML includes 30% of all leukemias, and occurs from childhood to old age. The present study was a retrospective analysis of chronic phase CML patients registered to a Hematology Clinic in Kermanshah, Iran, with checking of treatment options. MATERIALS AND METHODS Between 2002 and 2014, 85 CML patients referred to our hematology clinic were enrolled in our study. We surveyed age, sex, B-symptoms, splenomegaly, Sokal score, Hasford score, treatment and survival in all patients. Philadelphia chromosome analysis was conducted for each patient by conventional cytogenetics. We compared treatment in the patients with three drugs, imatinib, hydroxyurea (HU) and interferon alpha (IFN-α). RESULTS The mean age of the patients at diagnosis was 47.5 ± 14.5 years (range, 23-82 years), with 43 (50.6%) being male. Some 13 (15.3%) were referred to our clinic for the first time with B-symptoms and 44 patients (51.8%) had splenomegaly. The Sokal score for 77 (90.6%) was low, 4 (4.7%) was intermediate and 4(4.7%) was high, but Hasford (Euro) scores for all patients were low. The 5-year survival rate for treated patients with imatinib, imatinib plus HU and imatinib plus HU plus IFN-α was 90.5%, 81.1% and 55.6%, respectively CONCLUSIONS The results show that imatinib therapy alone provides better survival in CML patients compared to HU or IFN-α. Combinations of IFN-α and/or HU with imatinib probably reduce survival.

Chronic lymphocytic leukemia (CLL)is the most common leukemia in adults in Western countries but is relatively rare in Asia. Immune hemolytic anemia, Evan's syndrome, lymphadenopathy, organomegaly and B symptoms are the main complaints of patients in CLL. The present retrospective analysis evaluated a group of 109 patients with CLL over a 9-year period, studying correlations between sex, age and overall survival. The patients were hospitalized in the Clinic of Hematology and Oncology, Kermanshah, Iran, between 2006 and 2014. Data analysis for sex and age was performed using IBM SPSS19 and overall survival was plotted by Kaplan- Meier plot, Log-rank test in Graph Pad prism 5 Software for five-year periods. The mean age of diagnosis for CLL patients was 60.73 years, 59.6% male. Survival rate patients was 64% and mean overall survival was 38.5 months. In the Rai system, fourteen patients (12.8%) had stage III and twenty eight patients (25.7%) had stage IV. Most frequent clinical features in patients with CLL were lymphadenopathy (38.7%) and organomegaly (34%), respectively. There is not relationship between sex and age in patients but overall survival rate in females was higher than in males. In Asian countries, CLL is more in male and in age above 60 years. Complaints about lymphadenopathy and virus infection are prevalent.

Background: There is increasing evidence that HER2-neu is an important biomarker in gastric carcinomas (GC) and gastroesophageal junction (GEJ) adenocarcinomas. The aim of this study was to evaluate HER2-neu expression and also some clinicopathological features of these neoplasms. Materials and Methods: We selected 211 paraffin-embedded blocks, 193 GC and 18 GEJ. Then 4 micron sections were prepared for staining with hematoxylin and eosin and also for IHC (Her2-neu). The Chi-square test was used for significance between expression of HER2-neu and clinicopathological parameters. Results: In patients with advanced cancer of GC and GEJ, HER2-neu overexpression was more associated with the intestinal cancer subtype. Conclusions: This could be a guide to new complementary therapy for affected patients.

Background: Matrix metalloproteinases (MMPs) are upregulated in tumors. The MMP-7 A-181G polymorphism is associated with increased expression of the MMP-7 gene. Aim of the present study was to investigate the association between the MMP-7 A-181G polymorphism and susceptibility to breast cancer. Patients and Methods: The MMP-7 A-181G variants were studied in a cohort of 251 subjects consisting of 100 breast cancer patients and 151 healthy controls; all were from Western Iran. The MMP-7 A-181G genotypes were identified using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Results: The frequencies of the MMP-7 AA, AG, and GG genotypes in healthy individuals were 34.4, 50.4, and 15.2%, respectively. In breast cancer patients, the frequencies of AA (34%), AG (52%), and GG (14%) genotypes (p = 0.95) were similar to those in the controls. There was a trend toward an increased frequency of the combined genotype of MMP-7 AG+GG in patients with lymph node metastasis (70.4%) compared to those without metastasis (66.7%). Also, in patients with invasive lobular carcinoma, the frequency of the MMP-7 AG+GG genotype tended to be higher (71.4%) compared to that in patients with invasive ductal carcinoma (66.2%) (p = 0.78). Conclusion: Our findings indicate that the MMP-7 A-181G polymorphism may not be correlated with susceptibility to breast cancer in our population.

The aim of this study is survey of effects of Imatinib with dose 400 mg per day after 6 months in the patients with CML chronic phase. Between of 2010 - 2014, fifty four patients with high risk CML referred to Taleghani hospital in Kermanshah, Iran. We used the questionnaire about adverse events (AEs) of Imatinib capsule (Cipla manufacture, India) in these patients. For grading AEs, We used Common Terminology Criteria for AEs (CTCAE) manuscript (low AE equals grade 1, 2: high AE equals 3, 4 and grade 5 is optional) that diagram related to them was plotted with Excel 2007 software. 54 patients that referred to hospital, 27 patients were female and 27 patients were male. Mean of age for the patients was 45.7 ± 13.8 years (range, 23 to 78 years). Fatigue, (66.7%), myalgia (61.6%), joint pain (61.6%) and cramp (57.4%) are the most AEs in the patients after In the future studies we should evaluate non-hematological AEs for Imatinib in a lot of CML patients and apply to CTCAE manuscript exactly.

Background: Health-related quality of life in cancer patients has been interested to researchers in the domain of health in recent decades. Mental adjustment to cancer is a concept known as an important indicator of life quality, well-being and health of cancer patients. The aim of this paper is to examine the relation between mental adjustment to cancer and health-related quality of life (HRQoL) among some women with breast cancer. Methods: 100 patients were non-randomly selected from hospitals and oncology clinics in Kermanshah and Shiraz cities, Iran. These patients completed the functional assessment of cancer treatment-breast (FACT-B) in order to measure HRQoL and mini-mental adjustment to cancer questionnaire (Mini-MAC). Data were analyzed by using correlation and regression. Results: The results show that helplessness/hopelessness (58%), fighting spirit (40%), fatalism (33%) and preoccupation anxiety (18%) explain the variance of HRQoL. Conclusions: According to the findings, there is no relation between cognitive avoidance styles and HRQoL, and it can be concluded that coping styles helplessness/hopelessness and fighting spirit are the best predictors of HRQoL in patients with breast cancer. Consequently, the evaluation of the coping styles and emergency interventions in order to enhance coping with illness in cancer patients, decrease the sense of helplessness/hopelessness and anxiety are recommended, which in turn are accompanied by increasing HRQoL.

Background: Testicular germ cell tumors (TGCTs) account for only 1% - 2% of all male neoplasma. Objectives: The aim of this study is to evaluate clinicopathological features, treatment options and overall survival (OS) in patients with TGCT in Kermanshah province, Iran. Methods: In this retrospective study, 39 patients that referred to oncology clinic in Kermanshah Province, Iran were included. All patients were diagnosed with TGCT between 2000 and 2014 and completed primary therapy (orchidectomy) than 37 patients was treated with chemotherapy and out of 37 patients, 9 patients were treated with radiotherapy in different parts of body (brain, mediastinal, or retro peritoneal). In the first diagnosis, serum tumor markers such as lactate dehydrogenase, α-fetoprotein, and human chorionic gonadotropin had been measured. Statistical analyses, survival and diagrams were performed using the SPSS 19, Prism and Excel 2007, respectively. Results: The mean age at diagnosis for the patients was 34.6 years (ranging 16 - 63 years). We divided the patients to two age groups, twenty-five (64.1%) were placed in age < 40 years group. Among nine metastatic patients, metastasis to brain, lung, kidney and lung + liver were 44.44%, 33.34%, 11.11 and 11.11%, respectively. The 5-year OS rate was 77.8%. Twenty-one patients had seminoma (53.8%) and 18 (46.2%) had non-seminoma. Conclusions: First of all, seminoma has a higher percentage in TGCT patients. Second, the mean age in TGCT patients is between 30 and 35 years. Third, in our study, brain metastasis had higher prevalence compared to other studies. At last, the OS in our study was similar to those of other studies.

Introduction: Renal cell carcinoma (RCC) has known as the most frequent urological malignancy among adults, which occured mostly among male patients. Sunitinib malate (SUTENT®, Pfizer Inc., New York, NY, USA) is an oral, multitargeted tyrosine kinase inhibitor (TKI) which acts on VEGF receptors 1–3. Herein, we have presented two simultaneous adverse effects (nail changes and erythematous lesions over the knuckles) of 26-year-young woman with a high risk RCC during the sunitinib therapy. Case Presentation: Our patient was a 26-year-young woman, who has undergone left radical nephrectomy in December 2013. Microscopic pathological analysis has shown a 40 mm clear cell carcinoma of grade 2. She has started on target therapy with sunitinib, at over 3 months of TKI Sutent 50 mg four weeks on and two weeks off in this drug. We have seen, nails changes and erythematous lesions over the knuckles. After decreasing the dosage of the drug to 12.5 mg four weeks on and two weeks off the severity of lesions have decreased and subside the complaints of patients. Conclusions: Sunitinib therapy could have different side effects among patients. We have not known that a benign side effect could affect a female patient like discoloration despite, or not. This matter that you had not any interference for its treatment, but it has exited so we must try to know more about it.

Context: Lung cancer is the most leading cause of cancer mortality worldwide. Despite being the leading cause of cancer death, there are a few studies that have characterized survival in the geographical area in Kermanshah, Iran. Aims: The current investigation was conducted to identify factors associated with survival after lung cancer in Iranian patients with lung cancer. Settings and Design: The study has designed a retrospective study of 73 patients with lung cancer in the clinic of oncology and hematology. Subjects and Methods: The data were analyzed using SPSS package software version 16. The log-rank test was performed to determine the relationship between different variables and the survival of patients. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) for overall mortality. Kaplan–Meier method and Cox proportional hazards model were used to analyze the survival rate at different times after diagnoses and HRs, respectively. Results: The average age of patients was 59.49 ± 11.12. Patients with non-small cell adenocarcinoma had more prevalence (65.8%), and 68.5% of them were in Stage IV. 1-, 2-, and more than 2-year survival rates for patients with non-small cell lung carcinoma are 28%, 23%, and 17%, respectively. There was a significant relationship between survival and maintenance treatment (P = 0.003). Conclusion: The most obvious finding to emerge from this study is that the survival time in patients received maintenance therapy is higher than other patients. Further studies with large sample size are required with a focus on factors such as the risk of lung cancer and lung cancer incidence patterns.

To evaluate the concordance and discordance between IHC and FISH results for detection of Her2/neu protein, analyses of ER and PR, and also evaluation of the benefit of adjuvant trastuzumab in patients diagnosed with human epidermal growth factor receptor 2 (HER2) –positive invasive ductal carcinoma enrolled onto the Herceptin adjuvant. IHC analysis of ER, PR and HER2 was performed in 133 patients of breast cancer with invasive ductal carcinoma. 90(67.6%) cases were confirmed by FISH. Statistical analysis was performed with IBM SPSS version 19, Kaplan-Meier method and log-rank test. Age mean of patients was 46.39±10.81 years (range, 24-78 years). Concordance rates between IHC and FISH were 32.4% for IHC 2+ and 81.25% for IHC 3+ (P 50 years. Of 133 the patients, 48(36.1%) patients were treated with trastuzumab and 85(63.9%) were treated without trastuzumab. The overall survival(OS) for patients treating with trastuzumab were mean of 37.8 months and the OS for patients treating without trastuzumab were mean of 20.8 months (P

Background: Non-Hodgkin’s lymphoma (NHL) is the fifth most frequently diagnosed cancer whose incidence has risen by at least 100 percent over the past five decades especially in the West. Objectives: The aim of this study is to investigate Clinicopathology figures, overall survival (OS) and Progression-free survival (PFS) in patients with NHL in Iran. Methods: In a descriptive study, 143 patients referred to Clinic of Hematology in two centers between 2005 and 2014. We checked age, sex, types and subtypes of NHL; recurrence, Ki-67, organomegaly, lymphadenopathy, radiotherapy, OS and PFS in the patients. The mean follow-up was 49 months. All patients received R-CHOP regimen for 6 to 8 cycles. Results: The mean age at diagnosis for the patients was 46 years (range, 16 - 82) and 76.9% had age < 60 years and 62.2% were male. 58% patients had primary nodal NHL and out of 139 patients, 88.5% were aggressive NHL. Organomegaly and lymphadenopathy were in 12 patients (8.4%) and 80 (55.9%), respectively. Of all patients, 106 patients (74.1%) were treated with radiotherapy. 2-year OS rate was 91.5% and 5-year OS rate was 85%.2-and 5-year PFS rates were 79.6% and 63.3%, respectively. Conclusions: Percentage of NHL in males is more than females and the median age is around 45 years. Also, the prevalence of nodal is more compared with extranodal in NHL patients.

Aim of the study: The aim of this trial was to compare overall survival (OS), disease-free survival (DFS), and toxicity of two adjuvant regimens in triple negative patients with Iranian ethnicity. Material and methods: In a phase II trial, patients with previously untreated triple negative breaststroke cancer were randomly assigned by using docetaxel 70 mg/m 2 and carboplatin AUC = 7 every three weeks with granulocyte colony-stimulating factor for sin courses (arm A) or doxorubicin hydrochloride 60 mg/m 2 and cyclophosphamide 600 mg/m 2 every three weeks with G-CSF for four courses followed by docetaxel 70 mg/m 2 and carboplatin AUC = 7 every three weeks with G-CSF for four courses (arm B). Results : A total of 119 patients were randomly enrolled in our study (60 patients in Arm A and 59 patients in Arm B) between 2011 and 2016. The mean follow-up was 40 months at the time of treatment analysis. The 2-year and 5-year DFS rates for Arm A were 92.7% vs. 85% and for Arm B were 82.6% vs. 64.4%. The 2-year and 5-year OS rates for Arm A were 96.5% vs. 91.7% and for Arm B were 90.5% vs. 81.3%. There was a significant correlation for DFS and OS in the two arms. There was no significant difference between adverse events with the two regimens. Conclusions : In our research, less progression was found with Arm A as compared to Arm B. Adding of anthracyclines such as doxorubicin hydrochloride did not increase OS and DFS in triple negative breast cancer (TNBC) patients.

In the patients with metastatic colorectal cancer (mCRC), RAS testing is the first step to identify those that could benefit from anti-EGFR therapy. This study examined associations between KRAS mutations and clinicopathological and survival data in Iranian patients with mCRC. Between 2008 to2015 in a retrospective study, 83 cases of mCRC were referred to the Clinic of Medical Oncology. The mean follow-up was 45 months that there were 27 deaths. The 3 patients that did not complete follow-up were censored from the study. KRAS and NRAS were analyzed using allele-specific PCR primers and pyrosequencing in exons 2, 3 and 4. Multivariate survival analysis using Cox's regression model was used for affecting of variables on overall survival (OS). The mean age at diagnosis for patients was 57.7 (range, 18 to 80 years) and 61.4% were male. There was no significant different between prognostic factors and KRAS mutation with wild-type. Also, There was no significant different between KRAS mutation and KRAS wild-type for survival, but there was a significant different between KRAS 12 and 13 mutations for survival (HR 0.13, 95% CI 0.03-0.66, P=0.01). In conclusion, the prevalence of KRAS mutations in CRC patients was below 50% but higher than in other studies in Iran. As in many studies, patients with KRAS 12 mutations had better OS thn those with KRAS 13 mutation. In addition to KRAS testing, other biomarkers are needed to determine the best treatment for patients with mCRC.

BACKGROUND Overexpression or amplification of human epidermal growth factor receptor-2 (HER2) is associated with grade of malignancy and a poor prognosis in breast cancer (BC). The aim of this study was to evaluate of value of HER2 as a prognostic marker, and to analyze associations with common histopathological parameters in BC cases. MATERIALS AND METHODS Between of 2007 to 2014, 260 patients with BC referred to Oncology Clinic provided cancer tissue samples which underwent immunohistochemistry (IHC) for markers. ER and PR positivity was defined as ≥10% positive tumor cells with nuclear staining. HER2-positive was defined as either HER2 gene amplification by fluorescent in situ hybridization (FISH) or scored as 3+ by IHC. For HER2 (2+), FISH was performed to determine HER2 positivity. RESULTS The mean age at diagnosis for the patients with HER2-negative was significantly higher than in HER2-positive cases. Also, there were significant correlations between histological grade, nuclear grade, lymph node metastasis, tumor size, ER status, PR status, p53 overexpression and Ki-67 index with HER2 expression. HER2-negative lesions were of higher grade and more likely to be ER-negative, PR-negative, p53-positive, lymph node metastasis, with a tumor size

Background: A combination of rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is one of the most effective front-line therapies to treat B-cell non-Hodgkin's lymphoma (NHL). The aim of this trial was to evaluate overall survival (OS), progression free survival (PFS) and toxicity of R-CHOP-14 compared to R-CHOP-21 in untreated stage III and IV B-cell NHL patients with Iranian ethnicity. Materials and Methods: In a phase III trial, patients with previously untreated stage III and IV indolent and aggressive B-cell NHL were randomly assigned by using a minimization method to receive six to eight cycles of either R-CHOP-21 (administered every 21 days) or R-CHOP-14 (administered every 14 days with granulocyte colony-stimulating factor). Results: A total of 143 patients were randomly enrolled in our study (66 patients in R-CHOP-14 group and 77 patients in R-CHOP-21), between 2011 and 2014. The mean follow-up was 45 months at the time of treatment analysis. The 2-year and 5-year PFS rates for the R-CHOP-14 group were 83.6% vs 73.6% and for R-CHOP-21 group were 75% vs 54%. The 2-year and 5-year OS rates for R-CHOP-14 group were 98% vs 89% and for R-CHOP-21 group were 84.4% vs 67.5%. There was a significant correlation for PFS and OS in the two arms. There was no significant difference between adverse events with the two regimens. Conclusions: In our research improved survival was found with CHOP-14 as compared to CHOP-21. It is possible that drug metabolism in different races/ethnicities may be one important factor.

Background Breast cancer is a very common health problem in Iranian women. The HER2-neu gene is a transmembrane receptor tyrosine kinase with homology to members of the EGF receptor family. The aim of this study was to investigate the association between HER2-neu oncogene status with prognostic factors of breast cancer in Kermanshah province, Iran. Materials and methods Relationship between HER2-neu and prognostic factors of 130 cases of breast cancer were evaluated during two years in Imam Reza hospital in Kermanshah, Iran. Data were analyzed using descriptive statistics and the T-test and Mann-Whitney U non-parametric test using SPSS 19. Results The mean age for the patients was 46.0±8.0 years, all being female. Among the predictive factors for breast cancer were family history, stage of disease, involvement of the lymphovascular system, number of involved lymph nodes in axillaries, grading and hormone receptor status with HER2-neu oncogene had direct correlation and between factors, tumor location, patient age and histological characteristics and HER2-neu oncogene had no significant relationship. We found significant correlation between HER2 with ER and PR and also HER2 with ER, PR negative. Conclusions HER2-neu is risk factor that can be a good prognostic and also predictive factor. For these reasons, we recommend that it be evaluated for all types of BC.

We aimed to evaluate the effect of regular prophylaxis with a Factor X (FX) concentrate for patients with severe FXD in Iran and to assess the correlation of the genotype and phenotype in these patients. Ten patients with severe FXD (FX activity

Background:: In Iran, bladder cancer is one of the most common malignancy sites among men, ranking as the fifth with age-specific incidence rate of about 11.2 per 100,000 males. It causes 8% of all malignancies in men and 3% of all malignancies in women. Objectives:: The aim of this study was to report the epidemiological, clinical, and pathological features of bladder cancer in Western Iran compared to other studies. Patients and Methods:: This is a retrospective study between 2003 and 2014 when forty-four patients with bladder cancer referred to Hematology Clinic of Kermanshah, Kermanshah, Iran. Transitional cell carcinoma (TCC) was in 39 patients. Results:: In the patients with TCC, the mean age in diagnosis for them was 65.43 years (± 11.64), range of age 42 to 88 years , thirty-three patients (84.6%) were male, and six patients (15.4%) were female. Of 39 patients with TCC, 16 patients (41%) had metastasis. 21 patients (53.8%) were smoker and 16 patients (41%) had muscle invasive. 35 patients (89.7%) were histological high grade and the rest of patients were low grade. In the TCC patients with increasing age, metastasis and muscle invasive increased. Conclusions:: The age presentation of TCC in West Iran was similar to other studies. Percentage of patients with high grade is more than other studies, and also the number of patients with bladder cancer has increased during last 4 years. For better results, studies must be conducted with more patients in this area, and other areas of Iran with checking of genetics, race and environmental factors.

Background: Overexpression of HER2-neu has been reported in many epithelial malignancies, including cancers of the breast, ovaries, lungs, prostate, bladder, pancreas, colorectum and stomach as well as osteosarcomas. The aim of this study was evaluation of expression of HER2-neu immunohistochemistry (IHC) status and clinicopathologic features in a series of colonic adenocarcinomas. Materials and Methods: In this descriptive and analytical study, we surveyed 211 samples of colon adenocarcinoma from 182 patients (86.3) undergoing total or partial colectomy and 29 (7.13) with biopsies by colonoscopy. A sufficient sample size was obtained from all cases and the slides were stained with hematoxylin and eosin and also by IHC (HER2) staining. Results: The mean age for the patients at diagnosis was 57.9 years (range, 15-88 years). One hundred and twenty one patients (57.3) were male. Of all patients, 201 samples (95.3) were conventional adenocarcinomas (159, 29 and 13 cases were well, moderately and poorly differentiated, respectively) and 10 (4.7) were mucinous type. Out of 211 cases, 171 were checked for lymph nodes metastasis and 64 were positive. There is a correlation between HER2 scores and differentiation, most score 3 cases being well differentiated (P < 0.05). Conclusions: In patients with advanced colon cancer, surgery alone is not curative and other forms of therapy may be required to prolong patient survival. HER2 overexpression was found in some cases and this could be a guideline to new adjuvant therapy for these patients.

The chemotherapeutic agent oxaliplatin can cause acute and chronic forms of peripheral neuropathy. The aim of this study was to evaluate the incidence of chronic neuropathy and its risk factors in colorectal cancer (CRC) patients treated with FOLFOX or XELOX regimens in the Oncology Ward of Hazrat-e-Rasoul Hospital in Tehran.A total of 130 patients with CRC were entered into our study, aged over 18 years, without history of receiving other neurotoxic agents or other predisposing factors such as diabetes or neurologic diseases and kidney and liver dysfunction. For the FOLFOX regimen, patients received oxaliplatin, 85 mg/m2, every 2 weeks for 12 courses and with the XELOX regimen, oxaliplatin was 130 mg/m(2), every 3 weeks for 8 courses. Based on Common Toxicity Criteria (CTC or NCI-CTC v.3), the patients were divided into 5 groups (grades) based on the severity of their symptoms.Fifty-seven patients (43.8%) were male and 73(56.2%) female. Some 19 patients (14.7%) had BMI20, 97(74.6%) were between 20-25 and 14 (10.8%) ≥ 25. In 105 patients (80.7%) neuropathy was found. There was significant correlation between BMI, hypomagnesaemia and especially, severity of anemia in patients with neuropathy compared to those without.Oxaliplatin regimens can induce chronic neuropathy in CRC patients, with anemia, high BMI and hypomagnesaemia as risk factors that can predispose to this kind of neurotoxicity.

Mental adjustment to cancer is known as a psychological, physical, and psychological health variable among cancer patients. The present study examines the factor structure and psychometric properties of the Mini-Mental Adjustment to Cancer scale (Mini-MAC) in a sample of Iranian adults who suffer from cancer. The sample consists of 320 cancer patients selected through non-random convenient sampling procedure from the hospitals and clinics in the cities of Kermanshah and Shiraz in Iran, using the Mini-MAC scale. One hundred of these patients also completed the Hospital Anxiety and Depression scale. Statistical methods used to analyze the data included confirmatory and exploratory factor analysis, discriminate validity, and Cronbach alpha coefficients for internal consistency. Factor analysis confirms five factors in the Mini-MAC. The values of fit indices are within the acceptable range. Significant correlations between the Mini-MAC and other measures also show that this scale has discriminate validity. Alpha coefficients for the subscales are Helplessness/Hopelessness,.94; Cognitive Avoidance.76; Anxious Preoccupation,.90; Fatalism,.77; Fighting Spirit.80; and total scale.84, respectively. The results confirm the five-factor structure of the Persian Mini-MAC scale and also prove that it is a reliable and valid scale. They show that this scale has sufficient power to measure different aspects of mental adjustment in patients with cancer.

Hemoglobinopathies are the most common single gene disorders worldwide with a considerable frequency in certain area particularly Mediterranean and Middle Eastern countries. Hemoglobinopathies include structural variants of hemoglobin (Hb S, Hb C, HbE,...) and thalassaemias which are inherited defects in the globin chains synthe‐ sis. The present study was conducted to determine the prevalence of hemoglobinopa‐ thies in western Iranian patients. A total of 344 patients (151 males and 193 females) with abnormal CBC and/or hemoglobin electrophoresis were enrolled in the present study. Cellulose acetate gel electrophoresis was performed for all patients and abnor‐ mal bands were identified by citrate agar gel electrophoresis and PCR based methods. Iron deficiency anemia (IDA) was present in 156 (45.3%) individuals. Thirty four (9.8%) patients had both iron deficiency anemia and α-thalassemia trait trait, 41(11.9%) patients were with both iron deficiency anemia and minor β-thalassemia. There were 31(9%) patients with α-thalassemia trait and 5 (2.2%) patients with Hb H disease. Fifty six (16.2%) patients had minor β-thalassemia. Also, there were 10 (2.9%) individuals homozygous for hemoglobin D-Punjab and one patient with hemoglobin G (0.3%). There was one sample with hemoglobin C. Further, we found 3 patients (0.9%) with sickle cell trait and more 3 patients (0.8%) with S/ β +-thalassemia. Our results indicated that the most frequent cause of hypochromic and/or microcytic ane‐ mia in our population was IDA and the minor β-thalassemia was the second cause that needs to more attention in screening programs.

BACKGROUND Breast cancer (BC) is the most frequent malignancy among females and is a leading cause of death of middle-aged women. Herein, we evaluated baseline characteristics for BC patients and also compared these variables across ealry and late recurrence groups. MATERIALS AND METHODS Between 1995 to 2014, among female breast cancer patients referred to our oncology clinic, eighty-six were entered into our study. All had distant metastasis. Early recurrence was defined as initial recurrence within 5 years following curative surgery irrespective of site. Likewise, late recurrence was defined as initial recurrence after 5 years. No recurrence was defined for survivors to a complete minimum of 10 years follow-up. Significant prognostic factors associated with early or late recurrence were selected according to the Akaike Information Criterion. RESULTS The median follow-up was 9 years (range, 1-18 years). During follow-up period, 51 recurrences occurred (distant metastasis), 31 early and 20 late. According to the site of recurrence, there were 51 distant. In this follow-up period, 19 patients died. Compared with the early recurrence group, the no recurrence group had lower lymph node involvement and more p53 positive lesions but the late recurrence group had lower tumor size. In comparison to no recurrence, p53 (odds ratio [OR] 6.94, 95% CI 1.49-32.16) was a significant prognostic factor for early recurrence within 5 years. CONCLUSIONS Tumor size, p53 and LN metastasis are the most important risk factors for distance recurrence especially in early recurrence and also between of them, p53 is significant prognostic factor for early recurrence.

Background Triple negative breast cancer (TNBC), characterized as estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 Her2 negative and accounting for 10-17% of all breast carcinomas, is only partially responsive to chemotherapy and suffers from a lack of clinically established targeted therapies. The aim of the current study was to evaluate the patterns of treatment and clinicopathology figures in Kurdish patients with triple-negative breast cancer, and to compare these to other reports. Materials and methods Between 2001 and 2014, 950 breast cancer patients were referred to our clinic. There were 74 female patients with TNBC, including 70 patients was invasive ductal carcinoma entered into our study. ER and PR positivity was defined as positive immunohistochemical staining in more than 10% of tumor cells. Immunohistochemistry assay with anti-HER2 antibodies was used to identify HER negative (0 and 1+) or positive (2+ and 3+). HER2 gene amplification was determined by fluorescent in situ hybridization (FISH). Overall survival (OS) was plotted with GraphPad Prism 5 Software using Kaplan-Meier and log-rank tests for comparison of results. Results The mean age in the first diagnosis for 70 patients with triple TNBC and invasive ductal carcinoma was 49.6 years that range of age was 27-82 years. All of the patients were female. Of 70 patients, 23 patients had metastasis. Thirty-two patients (45.7%) were treated with tamoxifen and 39 (55.7%) with radiotherapy. Three-year, 5-year and 10-year OS rates for all patients were 82%, 72% and 64%, respectively. Conclusions The OS in our West Iran TNBC patients is less than reported elsewhere. However, treatment with combination of tamoxifen plus radiation increases the OS and reduces the mortality rate.

Background: The Functional Assessment of Cancer Therapy - Breast (FACT-B) scale is widely used to measure health-related quality of life in cancer patients. The aim of the present study is to validate the FACT-B in a sample of Iranian women with breast cancer. Materials and Methods: The sample consisted of 300 women selected through non-random convenient sampling procedure from oncology hospitals and clinics in Kermanshah and Shiraz cities. They were asked to fill in the Persian versions of the FACT-B scale, Hospital Anxiety and Depression Scale, the European Organization for Research and Treatment of Cancer quality of life EORTC QLQ30. Confirmatory factorial analysis of the methods, concurrent validity and discriminant, and Cronbach’s alpha for internal consistency were applied. Results: Internal consistency using Cronbach’s alpha was 0.63 to 0.93 for the subscales and 0.92 for the total scale. Significant correlations between FACT- B and other measures indicate that this scale had concurrent and discriminant validity. The values of fit indices were satisfactory. Conclusions: The Persian version of the FACT-B scale is valid and reliable and, therefore, the scale can be used in research and clinical settings to assess health-related quality of life in Iranian patients with breast cancer.

Intracranial germ cell tumors (GCTs) are rare brain tumors that typically arise in the pineal or suprasellar regions. A young man (22 years old) was presented with complaint of one year of headache, and recently vomiting, and in exam papilledema, lethargy, somnolence, diabetes insipidus. A Phase II trial with carboplatin based regimen was conducted in this newly diagnosed patient histologically and was confirmed radiologically evaluable CNS germinomas before they received radiotherapy. This patient was presented with a localized hypothalamic germinoma and had a CR after two courses of carboplatin based regimen (the CEB regimen). He received 30 Gy of involved field radiotherapy and now at end of treatment after three months is well being without any sign of relapse. Neoadjuvant chemotherapy carboplatin based regimen was highly active in treating newly diagnosed CNS germinomas. Further chemotherapy studies eventually may permit additional dose reductions and/or elimination of radiotherapy for patients with CNS germinomas.

Colorectal cancer (CRC) is one of the most common cancers in the World that KRAS mutations are considered as a key step in the progression of CRC. This meta-analysis study aimed to evaluate the prevalence of KRAS mutations in CRC patients in Iran. Six online databases including PubMed, Science direct, Scopus, Web of science, Cochran Library, and Scientific Information Database (SID) were searched systematically up to January 2017. A random-effects meta-analysis was used to calculate the estimation of the prevalence of KRAS mutations in CRC patients by the event rate (ER) with 95% confidence interval (95%CI). Out of 82 articles identified from the search, eleven studies included and analyzed for meta-analysis study. The studies included 1814 CRC patients that mean age of the patients was 57.5 years. The pooled ER of the studies for estimation of the prevalence of KRAS mutation in CRC patients was 32.8% (95%CI=28.7-37.3%). The pooled ER of the studies for the prevalence of codon 12 mutation was 72.5% (95%CI=59.8-82.3%) and for codon 13 mutation was 20% (95%CI=14.6-26.7%). The results showed that the prevalence of KRAS mutation in Iran was different with more studies that therefore the geographical area and race can impact on the prevalence of KRAS mutation in CRC patients. Also, codon 12 had the most prevalence among mutant codons, followed by codon 13 that Gly to Asp and Gly to Val were the most mutations in codon 12. Peer Review Details Peer review method: Single-Blind (Peer-reviewers: 02) Peer-review policy Plagiarism software screening?: Yes Date of Original Submission: 07 September 2017 Date accepted: 02 October 2017 Peer reviewers approved by: Dr. Lili Hami Editor who approved publication: Dr. Phuc Van Pham

Oral mucositis (OM) is one of the most common side effects after hematopoietic stem cell transplantation (HSCT) and palifermin is used for prophylactic use to prevent OM. We conducted a meta-analysis study that evaluates the efficacy of palifermin on OM after HSCT in hematologic malignancy patients. Databases of PubMed/Medline, Web of Science and Cochrane Library for English-language publications were searched for finding the relevant studies. The RevMan 5.3 software with random-effects models (odds ratio (ORs) and 95% confidence intervals (CIs)) was used for to estimate of the efficacy of palifermin in palifermin group compared with control group. Begg's and Egger's tests were used for assessment of bias between the studies. Ten studies were included in the meta-analysis study. The results of the meta-analyses showed that there were significant differences in OM (grade 1-4) [odds ratio (OR) = 0.17; 95%CI= 0.10,0.29; p

Background: The oncologic behavior of mucinous adenocarcinoma (MA) of colorectal differs from non-mucinous adenocarcinoma (NMA). MA is more advanced at diagnosis and has a poorer prognosis than NMA. We aimed to evaluate prognostic factors and survival rate in patients with MA compared with NMA in Western Iran. Methods: During 2008-2015 in a retrospective study, 83 patients with CRC referred to the Oncology Clinic in Kermanshah, Iran. Binary logistic regression analysis was used for the correlation between risk variables with the type of pathology. Results: The mean follow-up was 32 months (range, 12-72 months) and in this interval, there were 26 deaths and 3 patients were lost to follow-up and therefore, were omitted them from survival analysis. There was no significant correlation between NMA and MA with sex, degree of differentiation of tumor, tumor site, tumor size, KRAS mutation and lymph node metastasis, but a significant correlation was observed with age (P

In developing countries, majority of cancer patients have low income. Therefore, we could hardly do maintenance therapy about the number of patients with non-small-cell lung cancer and other cancers. Maintenance therapy for advanced non-small-cell lung cancer (NSCLC) refers to the use of an effective agent in the absence of disease progression following platinum-based combination chemotherapy to improve progression-free survival. In our Clinic, we identified three cancerous patients with metastasis for lung cancer. The Epidermal Growth Factor Receptor mutation on exon 19 started erlotinib therapy for several courses. After a short time, in all patients, lesions decreased and patients became stable.

Objective: To investigate and compare the prognostic value of P53 and Ki67 markers with age and metastasis and survival in patients with breast cancer in Kermanshah, western Iran. Methods: In our study on 116 patients with breast cancer that all of them were women and kind of pathology was invasive ductal carcinoma and patients had Her2 positive. The expression of ki67 marker and p53 genes were determined by immunohistochemistry. Statistical analysis was performed with SPSS version IBM 19 and Disease free survival was calculated using the Kaplan-Meier method and log-rank test. Patients were followed up to 5 years. Results: The age mean of patients was 46.5±10.75.Of 116 patients, 23 patients (19.8%) had breast cancer with metastasis and 93(80.2%) without metastasis. expression of P53 (50%) in 58 patients was positive and 58(50%) was negative. there is a statistically significant relationship between the p53 and metastasis ( P 0.05). Conclusions: The results showed that the Ki67 marker and P53 protein are important factors in the breast cancer patients with emphasis on therapeutic agents. Normal 0 false false false EN-US X-NONE AR-SA

Among patients with acute myeloid leukemia (AML), treatment regimens and outcomes may differ among younger and older adults. Although there is no clear dividing line when considering age in AML, in most studies, "older adults" was defined as over age 60.The management of older patients with AML is a difficult challenge (1). Older adults are more likely to have comorbidities that can limit treatment options; disease tends to be more aggressive biologically; and outcomes are worse than in younger patients. Decisions regarding the optimal treatment of acute myelogenous leukemia in the elderly patient requires the consideration of multiple factors. Population-based studies have demonstrated that, for all age groups, aggressive therapy results in improved survival and quality of life when compared with palliative care. The optimal induction and post remission regimen for older patients has yet to be determined. Furthermore, not all patients are candidates for such therapy. Consideration of patient and disease-related factors can help to determine the appropriateness of intensive therapy in a given patient. For those patients for whom aggressive induction therapy does not seem to be in their best interest, novel agents are being investigated that will hopefully address the issues of induction death and early relapse associated with these patient populations. This topic review will discuss the treatment of older adults with AML.