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Background&Objective: The proper treatment for early-stage Hodgkin’s disease is controversial. The purpose of this study was to evaluate the therapeutic outcomes of various treatment strategies in supradiaphragmatic clinical early-stage Hodgkin’s disease. Materials&Methods: This retrospective study reviewed the medical records of 105 eligible patients (49 stage I, 59 stage II) who were treated at radiotherapy- oncology departments of Qaem and Omid hospitals in Mashhad (Iran) from April 1995 to April 2000. 26 patients had B symptoms and 5 had large mediastinal mass. Treatment of patients consisted of chemotherapy alone (43 cases), radiotherapy alone (46 cases, 40 mantle and 6 Total nodal irradiation) and combined modality (16 cases). Survival rates were calculated by Kaplan- Meier model. Log-rank test was used to compare the survival profile between groups. Results: The median age of patients was 25 years with a male to female ratio of 1.56: 1. In comparison with radiotherapy only group, Primary chemotherapy and combined modality groups had significantly more cases with unfavorable factors such as B symptoms, Large mediastinal mass, ESR>40 and stage II. For chemotherapy, combined modality and radiotherapy groups the 5-year progression free survival was 72.5%, 82.5% and 56.2% (P<0.05) and the 5-year disease specific survival was 82.9%, 91.6% and 82.5% respectively. Conclusion: Despite having more cases with unfavorable factors, patients who underwent chemotherapy or combined treatment had lower relapse rates compared to radiotherapy only group. However, there was not a significant difference in 5-year disease specific survival rates between these groups.

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Background & Objective: Surgery and /or radiotherapy are major local treatments for esophageal carcinoma. The results of radiotherapy alone have been unsatisfactory. The purpose of this study was to evaluate the treatment outcome of definitive chemoradiotherapy for patients with esophageal SCC.

 

Materials & Methods: This prospective histological descriptive study was done on 190 nonmetastatic esophageal SCC patients which received definitive chemoradiotherapy (55-64 Gy, Cisplatin 80-100 mg/m2 day 1-5FU 750-1000 mg/m2, 24h infusion days 1-4) with curative intent in cancer research center, Mashhad University of Medical Sciences between Jan 2000-Jan 2004. At least one course of chemotherapy was prescribed concurrently with radiotherapy.

 

Results: There were 99 male and 91female patients with the median age of 65 (range, 25-87). The median radiation dose prescribed was 60 Gy (range, 55-64) and median chemotherapy courses was 4 (range, 1-8). With a median follow-up time of 12 months (range, 3-60), one, two and three-year survival rates were 67.8%, 48.7% and 36.3% respectively and median survival was 22 months. Reduction of symptoms was shown in 84% of patients with dysphagia. 109 patients remained disease free with a median follow-up of 14 months (range, 3-60), among which 34 were followed more than 24 months. We found 81 cases (42.6%) with treatment failure during the follow-up (34 locoregional failure, 14 distant metastases, 33 distant metastases accompanied with locoreginal failure).

 

Conclusion: Although definitive chemoradiotherapy can result in long term disease free survival and even cure in a subset of patients with SCC of esophagus, locoregional failure and distant metastasis has remained the main causes of treatment failure.

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Background and Objective: Several organization such as AAPM (American Association of Physicist in Medicine), ACR (American College of Radiology), ACMP (American College of Medical Physics) and ESTRO (European Society for Therapeutic Radiology and Oncology) recommended the need for periodic quality control procedure in radiation oncology. One of the best methods for quality control is in vivo dosimetry, while radiotherapy is performed. The aim of this study was to design and optimiz a protocol for the quality control of radiation treatment of patients with head and neck malignancy. Materials and Methods: In this case series study midle line dose was measured in vivo in conjunction with portal imaging in 19 patients that were treated using a Co-60 unit, in August and December 2007. Distribution of entrance and exit dose was determined using two diodes, off axis ratios and portal imaging together with a user code written in MATLAB. User code was applied to convert optical intensity of portal film to optical density. Midline dose was calculated in one centimeter intervals using entrance and exit dose with the Huyskens algorithm method. Results: The midline dose was calculated in 165 points. The mean and standard deviation between measured and prescribed dose was about 4.27±3.61%. In 110 points (66.66%), the deviation was less than 5% (2.27±1.37), in 41 points (24.84%) the mean deviation was between 5 and 10% (6.51±1.2) and in 14 points (8.48%) mean deviation was more than 10% (13.37±2.34). The maximum and minimum deviations were found in center of the field (2.6±1.63) and 5cm away from center of the field (7.24±4.86) respectively. Maximum and minimum deviations correspond to the equivalent field of 14cm2 (5.08±3.53) and 8cm2 (2.95±2.13) respectively. Conclusion: This study showed that using a portal detector in conjunction with two diodes is a simple and accurate method for daily quality control in radiotherapy. The data is acquired in this way can be used for evaluating the accuracy of treatment steps including determination of output of a treatment machine, quality control of a treatment planning system and precision of calculations and patient setup.

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Background and Objective: Radiotherapy is a main therapeutic regiment in the treatment of head and neck cancers. Radiation not only eradicate cancer but it also cause damage to healthy surrounding tissues, giving rise to objective and subjective problems. This study was done to evaluate the subjective complications of post radiation in patients with head and neck cancer. Methods: This descriptive –analytic study was carried out on 45 patients with head and neck cancer (28 males and 17 females) whom were gone under radiotherapy in Rasht, Iran. Subjective complications evaluated before, during, 1 month and 3 months after radiotherapy. Persian version of LENT-SOMA questionnaire was used. Pain, xerostomia, dysphagia, trismus and dysgeusia were recorded for each subject. Results: 80% of subjects experienced Pain. In the study period, pain intensity, frequency and analgesic consumption were belonging to ear and throat. One month after post radiation, pain intensity, frequency and analgesic consumption belong to ear, throat, jaw, mouth and teeth which were significantly more than 3 months after radiotherapy (P<0.05). One month after post treatment, xerostomia, dysphagia, trismus and dysgeusia were significantly more than 3 months after radiotherapy (P<0.05). Pain in ear and jaw had significant correlation with radiation dosage (P<0.05). Conclusion: Intensity of subjective complains were aggravated and merge one month after radiotherapy and can be reduced to nearly the initial stage of treatment, three months after radiotherapy.

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Background and Objective: Valproic acid is used in the epilepsy, bipolar and migraine therapy. As a histone deacetylase inhibitor, Valproic acid has been recently under investigation in cancer treatment, either alone or in combination with either chemotherapy or radiotherapy. This study was done to determine the effect of Valproic acid and radiotherapy on viability of MCF-7 breast cancer cell line. Methods: In this descriptive - analytic study, MCF-7 cell line was obtained from the Iranian Pasteur Institute. The cells were treated and incubated by different concentrations of Valproic acid (1, 2, 4, 8, 16, 32, 64 and 128 mM) either alone or in combination with various dosages (0 .5, 2, 4, 6 and 8 Gray) of radiotherapy. After cell viability assay, using the Neutral red staining, the most nearest results to LD50 were selected. Cell viability was evaluated with trypan blue staining. Results: The most nearest concentrations of LD50 was doses of 2, 8 and 16 mM of valproic acid and dosage of Gray 4 of radiation. There was a significant dose-dependent correlation between reduction of cell viability with valproic acid concentration (P<0.05). Conclusion: Valproic acid, either alone or combination with radiotherapy caused a significant decline in the cell viability of MCF-7 breast cancer cell line.