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Purpose: Sinonasal malignancies are a rare group of head and neck cancers. We aimed to report the oncological outcomes based on histological types in patients who underwent radiotherapy. Materials and Methods: In this single-institution study, we retrospectively retrieved and analyzed data of patients with sinonasal carcinomas who underwent radiotherapy during 2011-2016 as part of their treatment. The 3-year rate of local, regional, and distant recurrences, and overall survival were evaluated according to the histological type. Results: A total of 28 patients were evaluated in this study, the majority of whom were male (60%). Squamous cell carcinoma (SCC), adenoid cystic carcinoma (ACC), and adenocarcinoma (ADC) were found in 15 patients (53.5%), 8 (28.5%), and 5 (18%), respectively. The highest rates of local and regional recurrences were observed in ACC and SCC, respectively. Distant recurrences were numerically more common in ADC. The 3-year OS was 48%, 50%, and 73% in SCC, ADC, and ACC, respectively. Conclusion: Different histopathologies of sinonasal cancer seem to have different patterns of failure, and this may be considered in the treatment approach. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that statins can improve survival outcomes and ameliorate treatment-related side-effects in certain malignancies. Statins exhibit various mechanisms of action, including apoptosis induction, proliferation inhibition, tumor radiosensitization, lipid production suppression, and anti-inflammatory effects. This trial aimed to assess the impact of lovastatin on patients with locally advanced head and neck squamous cell carcinoma (HNSCC) undergoing definitive chemoradiation. Method: In this double-blinded randomized phase 2 clinical trial, 35 patients were randomly allocated to receive either 80 mg of lovastatin daily in conjunction with chemoradiotherapy (case group, n=18) or a placebo (control group). Primary outcomes included the response rate (RR) after three months, the occurrence of acute/late side-effects, median progression-free survival (PFS), and overall survival (OS). Results: The complete RR was slightly higher in the statin group (83.3% vs. 64.7%), although it did not reach statistical significance (P = 0.592). Acute adverse events did not significantly differ between the two groups. Grade 3 dermatitis occurred more frequently in the placebo group (35.3% vs. 11.1%), while grade 3 mucositis was more common in the statin group (38.9% vs. 11.8%). The median OS was 22 months (confidence interval (CI) 95% = 6.3-37.6) in the statin group and 17 months (CI 95% = 4.9-29.1) in the control group (P = 0.50). Median PFS was 20 months (CI 95% = 15.8-24.1) in the statin group and 15 months (CI 95% = 8.2-21.7) in the control group (P = 0.609). Conclusion: Combining lovastatin with chemoradiation augments the therapeutic effect in HNSCC. Larger-scale studies incorporating advanced radiotherapy techniques and baseline lipid profile assessments are necessary to investigate statins' efficacy in HNSCC further. [ABSTRACT FROM AUTHOR]

Purpose: Peripheral neuropathy is a dose-limiting adverse effect of oxaliplatin. The aim of this study was to evaluate the efficacy and safety of duloxetine in the prevention of oxaliplatin-induced peripheral neuropathy (OIPN). Method: Cancer patients receiving oxaliplatin based chemotherapy were randomized into two arms. Duloxetine 60 mg capsule was given in the first 14 days of each chemotherapy cycle to one arm and placebo was similarly given to another. We compared the two arms based on the incidence of neuropathy and the results of the nerve conduction study (NCS). Grade of complained neuropathy was recorded according to Common Terminology Criteria for Adverse Events (CTCAE). Results: Thirty-two patients mostly rectal cancer (90.6%) were randomized to duloxetine and placebo arms. Highest grade of neuropathy in each cycle was not significantly different between the two groups. Six weeks after treatment incidence of neuropathy of any grade was 52.9 in duloxetine arm compared to 76.9% in placebo arm (P: 0.26). Patients in the duloxetine arm had a lower percentage of chemotherapy cycles (mean) in which they reported distal paresthesia (51% vs. 84%, P = 0.01) and throat discomfort (37% vs. 69%, P = 0.01). Results of NCS were mostly comparable between the two arms except for the velocity in two of the examined nerve which was significantly higher in duloxetine group. Duloxetine was safe and well-tolerated. Conclusion: Although a definite conclusion might be difficult to draw but administering duloxetine for 14 days in each chemotherapy cycle could not decrease the incidence of acute OIPN based on CTCAE grading system. [ABSTRACT FROM AUTHOR]

Background: Fear of cancer recurrence (FCR) in cancer patients, including those with breast cancer is a special and highly conscious experience affecting emotional, cognitive and behavioral domains. This study examines the effect of cognitive emotion regulation on FCR with the mediation of illness perception and psychological well-being in breast cancer survivors in a structural model. Methods: The population of this study included all women with breast cancer who were referred to Cancer Institute for their regular checkups in 2022. Overall, 300 patients were recruited based on convenience sampling. They completed the validated questionnaires online for FCR, cognitive emotion regulation, illness perception and psychological well-being. The proposed model was evaluated using structural equation modeling. Results: The findings indicated the model did fit the data. In addition to the direct effect of adaptive and maladaptive strategies of cognitive emotion regulation on FCR, the indirect effect of adaptive strategies on FCR through psychological well-being (β=0.148, p=0.001) and illness perception (β=0.233, p=0.001) was negative and significant. Furthermore, the indirect effect of maladaptive strategies on FCR through psychological well-being (β=0.109, p=0.001) and illness perception (β=0.212, p=0.001) was positive and significant. Therefore, psychological well-being and illness perception negatively and significantly mediated the effect of adaptive strategies on FCR and positively and significantly mediated the effect of maladaptive strategies on FCR. Conclusion: Patients who possessed adaptive strategies of cognitive emotion regulation, less-threatening perception of illness and higher psychological well-being were exposed less to FCR. Psychological interventions for strengthening these factors in breast cancer survivors are suggested. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC), as the top neoplasm in prevalence and mortality in females, imposes a heavy burden on health systems. Evaluation of quality of care and management of patients with BC and its responsible risk factors was the aim of this study. Methods: We retrieved epidemiologic data of BC from the Global Burden of Disease (GBD) 1990–2019 database. Epidemiology and burden of BC and its risk factors were explored besides the Quality of Care Index (QCI) introduced before, to assess the provided care for patients with BC in various scales. Provided care for BC risk factors was investigated by their impact on years of life lost and years lived with disability by a novel risk factor quality index (rQCI). We used the socio‐demographic index (SDI) to compare results in different socio‐economic levels. Results: In 2019, 1,977,212 (95% UI: 1,807,615–2,145,215) new cases of BC in females and 25,143 (22,231–27,786) in males was diagnosed and this major cancer caused 688,562 (635,323–739,571) deaths in females and 12,098 (10,693–13,322) deaths in males, globally. The all‐age number of deaths and disability‐adjusted life years attributed to BC risk factors in females had an increasing pattern, with a more prominent pattern in metabolic risks. The global estimated age‐standardized QCI for BC in females in 2019 was 78.7. The estimated QCI was highest in high SDI regions (95.7). The top countries with the highest calculated QCI in 2019 were Iceland (100), Japan (99.8), and Finland (98.8), and the bottom countries were Mozambique (16.0), Somalia (8.2), and Central African Republic (5.3). The global estimated age‐standardized rQCI for females was 82.2 in 2019. Conclusion: In spite of the partially restrained burden of BC in recent years, the attributable burden to risk factors has increased remarkably. Countries with higher SDI provided better care regarding both the condition and its responsible risk factors. [ABSTRACT FROM AUTHOR]

Rhabdomyosarcoma (RMS) is the most common pediatric soft-tissue sarcoma, mostly involving the genitourinary (GU) tract, head and neck, and extremities. This study reports the long-term outcome of two infants with recurrent GU-RMS who underwent combination therapy with chemotherapy (ChT) and salvage brachytherapy (BT). An 18-month-old girl with vaginal bleeding and a 7-month-old boy with urinary retention presented with a diagnosis of vaginal, and bladder/prostate embryonal RMS, respectively. Surgical resection and ChT were done for both patients. However, both developed local recurrences after one year and subsequently, underwent second-line ChT and salvage interstitial high dose rate BT. The clinical target volumes for the first and second patients were treated to a totaldose of 32 Gy in 10 fractions and 35 Gy in 10 fractions, respectively, with two fractions delivered per day with a 6-h interval between fractions. After 9 years of follow-up, both patients are alive with natural growth and no late complication or evidence of recurrence. Our report shows that BT (for patients with no prior history of irradiation) could result in long-term disease-free survival in well-selected pediatric patients with recurrent GU embryonal RMS without inflicting expected adverse effects of external beam radiotherapy. [ABSTRACT FROM AUTHOR]

Background: Hypopharyngeal carcinoma (HPC) is a rare head and neck cancer which poses many therapeutic challenges. There is limited evidence regarding the outcomes of HPC treatment in Iran. Method: In this retrospective cohort study, we evaluated patients treated with chemoradiation or radiation alone, between 2007 and 2016 in the radiation oncology ward of the cancer institute affiliated to Tehran University of Medical Sciences. The design of the study was reviewed and approved by the local institutional review board (code: 86100142). All patients underwent definitive radiotherapy with or without concurrent or sequential chemotherapy. We assessed the two-year overall survival (OS) as the primary outcome. The progression-free survival (PFS) was our secondary outcome. Results: We studied 40 patients whose median age was 58 years. 37 patients were stage 3 or 4, while the most common stage was T3N1-2, observed in 35% of the cases. The most common site of involvement was pyriform sinus (47.5%). The twoyear OS rate was 29%. The two-year PFS was 22%. In the univariate analysis, N0-1 vs. N 2-3 and stage 2 vs. stage 3-4 were significant predictors of OS. In addition, distant metastasis had almost a significant association with lower OS. Conclusion: The outcome of locally advanced HPC was not promising using 3DCRT alone. It is necessary to implement dramatic changes in the management of these patients to achieve better outcomes. [ABSTRACT FROM AUTHOR]

Background: Glioblastoma is one of the most radioresistant cancers. It is suggested that combination of radiotherapy with other cancer treatment modalities may increase control of tumor. Temozolomide (TMZ) is one of the most known drugs for glioblastoma. It has shown that TMZ via induction of mutation and cell death can kill glioma cells. Objective: In the current study, we aimed to show possible radiosensitization effect of TMZ for glioma cells. In addition, results compared to response of normal fibroblast cells to TMZ and irradiation. Material and Methods: This is in vitro study for evaluation of the effect of TMZ and irradiation on high grade glioma cells and normal fibroblasts. The human fibroblast and glioma cells were cultured as monolayer. The cells were treated with 2000 µM TMZ, which was equal drug dose for IC50%. In addition, irradiation was done with 5Gy gamma rays. The formation of colony was observed following irradiation, treatment with TMZ, and combination both of them. Results: The formation of colony for both glioma and fibroblast cells showed a reduction following irradiation or treatment with TMZ. Irradiation showed more toxicity compared to TMZ for glioma cells, but not fibroblast cells. Combination of TMZ and irradiation showed a significant reduction in the colony formation compared to irradiation or TMZ treatment alone. Conclusion: This study showed that TMZ increases sensitivity of both glioma and fibroblast cells to ionizing radiation. [ABSTRACT FROM AUTHOR]