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Background: Colorectal cancer ranks as the third most prevalent cancer type globally. In addition to surgery, chemotherapy, and radiation therapy, being the foremost efficacious and all-encompassing treatment modalities for cancer, pelvic chemoradiotherapy is known to precipitate adverse effects, notably intestinal inflammation. This study delves into assessing the impact of curcumin on the prophylaxis and amelioration of chemoradiotherapy-induced enterocolitis in colorectal cancer patients. Method: This randomized study encompassed 44 colorectal cancer patients undergoing standard pelvic chemoradiotherapy, allocated to either curcumin treatment (22 patients) or placebo (22 patients) groups. Patients were administered oral curcumin capsules at a daily dosage of 500 mg commencing one week before baseline and extending throughout the standard treatment regimen, adhering to the same schedule. Subsequently, patients were subjected to biweekly evaluations encompassing demographics, clinical characteristics, and manifestations of enterocolitis, with statistical analysis employing Mann-Whitney and chi-square tests. A significance threshold of P < 0.05 was employed in the study for statistical significance. Results: The incidence of complications exhibited no statistically significant disparity between the two cohorts across diverse disease stages. Furthermore, there were no discernible discrepancies in the manifestation of varying grades of intestinal complications between the curcumin-treated and placebo groups. Predominantly, both groups experienced the most pronounced side-effects during the initial two weeks of treatment. Additionally, there was no statistically significant distinction in the prevalence of adverse drug reactions between the two groups, with figures standing at 31% versus 40% (P = 0.17). Conclusion: Even though 500 mg/day of curcumin over a six-week duration did not engender a statistically significant reduction in the adverse effects of chemoradiotherapy, it was well-tolerated and deemed safe in this patient cohort. [ABSTRACT FROM AUTHOR]

Background: Patients undergoing head-and-neck radiotherapy are susceptible to Candida colonization and infection. This study aimed to identify oral Candida species type (ST), colony count (CC), and oropharyngeal candidiasis (OPC) in head-and-neck cancer patients, undergoing radiotherapy, before and 2 weeks after radiation. Materials and Methods: In this quasi-experimental study, head-and-neck cancer patients undergoing radiotherapy (up to 6000 cGy) were recruited. Samples were taken before and 2 weeks after radiation therapy (RT). CC was assigned using Sabouraud dextrose agar culture medium and morphological studies were performed to confirm OPC. For identification, polymerase chain reaction-restriction fragment length polymorphism was performed. Data were analyzed using Chi-square-test and kappa coefficient. P < 0.05 was considered statistically significant. Results: Twenty-one of 33 patients were Candida positive. The detected fungal species included Candida albicans (60%), Candida tropicalis (22%), Candida glabrata (9%), and other species (9%). Following RT, OPC and CC changed significantly (P = 0.003 and P = 0.001, respectively), whereas ST did not significantly change (P = 0.081). Two new species (Candida krusei and Candida parapsilosis) were detected after the intervention. The OPC, CC, and ST changes after RT were not significantly related to malignancy site or radiation dose (P > 0.05). Conclusion: The present study showed that OPC, CC, and ST were not related to the malignancy site. Following RT, OPC and CC changed significantly, while ST showed no significant change. The radiation dose and malignancy site had no effects on the OPC, CC, or ST alterations following RT. [ABSTRACT FROM AUTHOR]

Background: This study aimed to optimize efficiency in Monte Carlo (MC) simulation using sensitivity analysis of a beam model. Methods: The BEAMnrc-based model of 6 MV beam of a Siemens Primus linac was developed. For sensitivity analysis, the effect of the electron source, treatment head, and virtual phantom specifications on calculated percent depth dose (PDD) and lateral dose profiles was evaluated. Results: The optimum mean energy (E) and the full width at half maximum (FWHM) of the intensity distribution of the electron beam were calculated as 6.7 MeV and 3 mm, respectively. Increasing E from 6.1 to 6.7 MeV, increased the PDD in the fall-off region by 4.70% and decreased the lateral profile by 8.76%. Changing the FWHM had a significant effect on the buildup region of PDD and the horns and out-of-field regions of the lateral profile. Increasing the collimators opening by 0.5 mm, PDD increased by 2.13% and the central and penumbra regions of profiles decreased by 1.98% and 11.40% respectively. Collimator properties such as thickness and density were effective in changing the penumbra (11.32% for 0.25 cm increment) and the out-of-field (22.82% for 3 g/cm3) regions of the lateral profiles. Conclusion: Analysis of a 6 MV model showed that PDD profiles were more sensitive to changes in energy than to FWHM of the electron source. The lateral profiles were sensitive to E, FWHM, and collimator opening. The density of the collimator affected only the out-of-field region of lateral profiles. The findings of this study may be used to make benchmarking of an MC beam model more efficient. [ABSTRACT FROM AUTHOR]

Background: Hand-foot syndrome (HFS) is a prevalent skin reaction to cytotoxic systemic therapy, mainly Capecitabine. The present study aimed to determine etiologies of HFS in addition to its prevention in colorectal cancer patients with Capecitabine-containing chemotherapy regimen. Method: In this randomized double-blinded study, we recruited 66 eligible patients. The first 33 patients received 25 mg captopril twice daily, while the other 33 were given two placebo tablets. Results: All the patients were assessable for safety and efficacy. Captopril demonstrated a favorable safety profile. The participants in the two groups did not have any significant differences in terms of the median age and the level of hemoglobin (P = 0.45, P = 0.06, respectively). However, the CEA tumor marker was significantly higher in those with HFS (P < 0.05). The incidence of HFS in men and women were 8 (18.6%) and 3 (13%) cases, respectively, and the patients' sex did not affect the incidence of this syndrome (P = 0.73). Furthermore, according to the stage of colorectal cancer, the difference between the two groups was significant (P < 0.05). Meanwhile, there were no significant differences concerning the grade of colorectal cancer (P = 0.2). Conclusion: The results herein revealed that administration of captopril in colorectal cancer patients with Capecitabine-containing chemotherapy regimen reduced the symptoms and incidence of HFS. On the other hand, CEA tumor marker and the stage of colorectal cancer were in correlation with incidence of HFS. [ABSTRACT FROM AUTHOR]

Background: Head-and-neck radiotherapy can change oral Candida species and cause candidiasis resistance to common antifungals by making the changes to the oral cavity environment. Voriconazole is a synthetic azole with extensive antifungal activity. The current study aimed at comparing the antifungal activity of fluconazole and voriconazole on Candida species isolated from the oral cavity of patients undergoing head-and-neck radiotherapy. Materials and Methods: The present in vitro study was performed on samples isolated from patients undergoing head-and-neck radiotherapy, before and during radiotherapy. After the identification of the species, the antifungal effect of fluconazole and voriconazole was determined by the microdilution method, and the minimum inhibitory concentration (MIC), the minimum fungicidal concentration, and the antifungal susceptibility of the isolated strains were also measured. The data were analyzed by the Chi-squared and then two-sided Fisher's exact tests. P < 0.05 was considered statistically significant. Results: The study findings showed no significant difference in the susceptibility of Candida albicans to voriconazole and fluconazole before and during radiotherapy. Before radiotherapy, both voriconazole and fluconazole had similar effects on Candida tropicalis, but after radiotherapy, voriconazole was less effective. However, both before and during radiotherapy, fluconazole had a greater antifungal effect than voriconazole on Candida glabrata strains. The MICs of voriconazole and fluconazole for both Candida parapsilosis and Candida krusei isolates were within the susceptible or dose-dependent range. Conclusion: The current study results showed that voriconazole was not more effective than fluconazole in the treatment of oral candidiasis in patients undergoing head-and-neck radiotherapy. [ABSTRACT FROM AUTHOR]

Background: Taste abnormalities are common among cancer patients after starting radiotherapy or chemotherapy. Considering the role of zinc and reports on its beneficial effects in taste perception, we evaluated the preventive effects of zinc sulfate on radiation‑induced taste alterations. Materials and Methods: In a randomized, placebo‑controlled trial, adult patients with head and neck cancers who were on schedule for radiotherapy, with or without chemotherapy, were allocated to receive zinc sulfate (50 mg, three times a day) or placebo; started with beginning of radiotherapy and continued for one month later. Taste acuity was determined by measuring detection and recognition thresholds for four taste qualities at baseline, at the end of radiotherapy, and a month later using the Henkin method. Results: Thirty‑five patients (mean age = 59.2 ± 16.5, 60% male) completed the trial. The two groups were similar at baseline. After radiotherapy, and one month later, there was a significant increase in taste perception threshold for bitter, salty, sweet, and sour tastes in the placebo group (P = 0.001). In those who received zinc, there was only slight increase in threshold for perception of the salty taste (P = 0.046). No relevant side effects due to zinc sulfate were reported. Conclusion: Zinc supplementation in head/neck cancer patients under radiotherapy can prevent radiation‑induced taste alterations. Further studies with longer follow‑ups and with different doses of zinc supplementation are warranted in this regard. [ABSTRACT FROM AUTHOR]

Background: Using three-dimensional conformal radiation treatment (3D-CRT) and helical tomotherapy (HT), this study examines and contrasts the dosage received by the mandible, maxilla, and teeth., Methods: Sixteen patients with head-and-neck cancer (H and NC) were the subject of treatment planning at the Seyyed Al-Shohada Hospital in Isfahan, Iran. This study examined target coverage quality, exposure of healthy tissue, and radiation delivery effectiveness., Results: In terms of a number of measures, including D 2% , D 50% , D mean , V 95% , conformity index (CI), and homogeneity index (HI) for the planning target volume (PTV) and D 2% , D 98% , D mean , V 95% , CI, and HI for the nodal PTV, HT showed considerable gains over 3D-CRT. The brainstem, D 1cc , and D 10cc received considerably lower maximum dosages in HT. Measurements of the right and left cochleas (D mean , V55, and D max ) revealed decreases in HT, with D mean revealing the most significant variations. The D mean and D max values for HT significantly decreased in constrictors as well. In terms of several HT-related indicators, the larynx, optic chiasm, optic nerves, oral cavity, mandible, thyroid, and parotid glands all showed considerable decreases., Conclusion: The findings of the comparison of the two treatment approaches revealed that the HT method was more than 50% more effective than the 3D-CRT method in sustaining organs at risk (OARs) and the target volume dose. In general, dosimetric coverage, homogeneity, conformity indices, and the absence of cold and hot patches showed that HT produced targets with greater accuracy than 3D-CRT. In addition, HT outperformed 3D-CRT in protecting important structures (OARs). HT as a result has the potential to be a more effective method of treatment for those with H and NC and involvement of regional lymph nodes., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Medical Signals & Sensors.)