Sameh Hashem - Academia.edu (original) (raw)

Papers by Sameh Hashem

Journal of Medical …, Jan 1, 2012

Hematology/Oncology and Stem Cell Therapy, 2011

Embryonal tumor with abundant neuropil and true rosettes: a report of three cases of a rare tumor, with an unusual case showing rhabdomyoblastic and melanocytic differentiation

Neuropathology, Dec 1, 2011

AbstractEmbryonal tumor with abundant neuropil and true rosettes (ETANTR) is an increasingly reco... more AbstractEmbryonal tumor with abundant neuropil and true rosettes (ETANTR) is an increasingly recognized entity that belongs to the family of embryonal tumors of the CNS. The authors present three cases of this rare tumor that were encountered at King Hussein Cancer Center, Amman, Jordan. Discussion of the clinicopathological findings is presented along with a recent literature review. Sixteen-, 57- and 30-month-old children presented with tumors located in the pineal gland, the right fronto- parieto-temporal region and the cerebellum, respectively. The findings of hypocellular neuropil as well as the characteristic ependymoblastic rosettes were seen. In addition the third case showed an abnormal combination of patterns including melanocytic and rhabdomyoblastic differentiation. The tumors stained positively for synaptophysin in the neuropil and small cell component, while the ependymoblastic rosettes stained for vimentin only. Epithelial membrane antigen and CD99 were negative in all components. One of the cases showed tetraploidy of chromosome 2. All cases exhibited an aggressive course. This is a rare and recently recognized tumor with dismal outcome, and reporting of additional new cases should help in gaining more knowledge about it.

Management strategies for isolated recurrence in early-stage gastric cancer

The role of radio-protective agents in the era of Intensity Modulated Radiotherapy

Hepatocellular Carcinoma

This handbook will enable radiation oncologists to appropriately and confidently select and delin... more This handbook will enable radiation oncologists to appropriately and confidently select and delineate tumor volumes/fields for conformal radiation therapy, including intensity-modulated radiation therapy (IMRT), in patients with commonly encountered cancers. The orientation of this handbook is entirely practical, in that the focus is on the illustration of clinical target volume (CTV) delineation for each major malignancy. Each chapter provides guidelines and concise knowledge on treatment planning and CTV selection, explains how the anatomy of lymphatic drainage shapes target volume selection, and presents detailed illustrations of delineations, slice by slice, on planning CT images. While the emphasis is on target volume delineation for three-dimensional conformal therapy and IMRT, information is also provided on conventional radiation therapy field setup and planning for certain malignancies for which IMRT is not currently suitable.

Neoadjuvant versus adjuvant chemoradiation for rectal cancer: Experience at king Hussein cancer Center

Changing trends of down staging,sphincter preservation and complete pathological response over 8 years in locally advanced rectal cancer

Discovery medicine, 2010

Hepatocellular carcinoma (HCC) is the most common primary liver cancer in adults and it is freque... more Hepatocellular carcinoma (HCC) is the most common primary liver cancer in adults and it is frequently associated with cirrhosis. Surgical resection or orthotopic liver transplantation can be curative but only 30-40% of patients may benefit from curative radical treatment. Stereotactic body radiation therapy (SBRT) has emerged as a promising non-invasive therapy for patients with unresectable HCC and it may potentially serve as a bridging therapy for patients awaiting transplantation. There are a limited number of clinical trials examining the use of SBRT in patients with HCC and very good local tumor control and acceptable toxicities have been reported. This article provides an overview on the use of SBRT in the management of HCC.

Hematology/Oncology and Stem Cell Therapy, 2011

Practical Radiation Oncology, 2014

Purpose: To standardize upper abdominal normal organ contouring guidelines for Radiation Therapy ... more Purpose: To standardize upper abdominal normal organ contouring guidelines for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials: Twelve expert radiation oncologists contoured the liver, esophagus, gastroesophageal junction (GEJ), stomach, duodenum, and common bile duct (CBD), and reviewed and edited 33 additional normal organ and blood vessel contours on an anonymized patient computed tomography (CT) dataset. Contours were overlaid and compared for agreement using MATLAB (MathWorks, Natick, MA). S95 contours, defined as the binomial distribution to generate 95% group consensus contours, and normal organ contouring definitions were generated and reviewed by the panel.

Hepatocellular Carcinoma

Target Volume Delineation and Field Setup, 2012

Brain Tumor Pathology, 2012

Brain stem gliomas (BSG) are rare tumors occurring predominantly in childhood. They are mostly of... more Brain stem gliomas (BSG) are rare tumors occurring predominantly in childhood. They are mostly of astrocytic origin and are divided into infiltrative versus circumscribed types, with different prognoses. The diagnosis is mainly based on MRI findings, and biopsy is rarely performed. This is a retrospective study of BSG with available biopsies diagnosed at our center over 6-year period. Fifteen cases were identified, with a predominance of females. The median age was 7 years, and the mean duration of symptoms was \6 weeks in 58.3 % (n = 7) of cases. MRI was typical of diffuse pontine gliomas in 64.3 % (n = 9) of cases. Radiotherapy was the commonest modality of treatment, and the median overall survival was 21.7 months. Twelve cases were consistent with infiltrative astrocytoma of various grades (2 grade II, 7 grade III and 3 grade IV). Entrapped normal neurons and mitosis were the commonest findings indicating infiltrative growth and high grade, respectively, and those correlated significantly with immunostaining for neurofilament protein and Ki-67 of C3 %. Overall survival correlated only with the duration of symptoms and tumor grade on biopsies. A limited panel of immunostains might be useful in undetermined cases to decide on the growth pattern and grade.

World Journal of Surgical Oncology, 2011

Lymph node metastasis from cutaneous squamous cell carcinoma is uncommon. The popliteal fossa is ... more Lymph node metastasis from cutaneous squamous cell carcinoma is uncommon. The popliteal fossa is rarely involved with metastasis. Popliteal lymph node dissection is uncommonly performed and not frequently discussed in the literature. We present a case of squamous cell carcinoma of the heel with popliteal and inguinal metastasis. This is followed by a description of the relevant anatomy of the popliteal fossa and the technique of popliteal lymphadenectomy.

Respiratory Medicine CME, 2011

A 22-year-old female patient, with synovial sarcoma of the left thigh, was treated with marginal ... more A 22-year-old female patient, with synovial sarcoma of the left thigh, was treated with marginal resection and adjuvant chemoradiotherapy. Two years later, she developed sub-pleural metastatic nodules that were resected. Follow-up chest CT-scans revealed small yet new left lower lobe sub-pleural nodules, which were observed closely. These lesions progressed over time and, 20 months later, the patient underwent pulmonary metastasectomy. Histopathology examination of the lung tissue showed changes consistent with a sarcoid-like reaction. There were no systemic manifestations of sarcoidosis. To date, there have been no reported cases of sarcoid-like reaction associated with synovial sarcoma. Reporting this case, therefore, may help to improve our overall understanding of the relationship between malignancy and sarcoid-like reactions in the lungs.

928 poster BIBLOMETRIC ANALYSIS OF CANCER NANOTECHNOLOGY RESEARCH: ARE RADIOTHERAPY-RELATED APPLICATIONS LAGGING BEHIND

Radiotherapy and Oncology, 2011

Radiotherapy and Oncology, 2011

Conclusions: During the last 3 decades many efforts have been made to improve advanced HNSCC pts ... more Conclusions: During the last 3 decades many efforts have been made to improve advanced HNSCC pts prognosis while keeping toxicity to an acceptable level. We recorded good clinical results with platin based ALT CTRT regimens in the first trials and investigated the activity of a radiosensitizer or a biologic agent to the same CTRT regimen with encouraging results despite worse toxicity.

Journal of Radiotherapy in Practice, 2010

Middle Eastern and North African (MENA) clinical oncology physicians spend 10 years À on average ... more Middle Eastern and North African (MENA) clinical oncology physicians spend 10 years À on average À from the dawn of medical school to the conclusion of clinical training. Amidst this enduring journey, residents and fellows spare little time for research projects ensuring low ratio of trainees with peer-reviewed publications at the time of graduation.

Journal of Medical Imaging and Radiation Oncology, 2012

The objective of this article was to evaluate therapeutic outcomes of elderly patients with gliob... more The objective of this article was to evaluate therapeutic outcomes of elderly patients with glioblastoma multiforme (GBM) treated by surgery followed by combined modality therapy and compare achievable outcomes to those of a younger age population. Methods and Materials: Seventy-eight adult patients with histologically confirmed grade IV astrocytoma were treated at King Hussein Cancer Center (Amman, Jordan) between September 2004 and December 2008. Records were retrospectively reviewed and included 55 males and 23 females between 19 and 78 years of age (median age 50 years). This case series included 20 patients aged 60 years or older. All patients underwent craniotomy followed radiotherapy and concurrent or sequential temozolomide. The follow-up ranged from 1 to 56 months (median 9.4 months). Results: The median survival for the whole cohort was 13.8 months. The median survival for patients less than 60 years was 14.3 months and for patients 60 years or older was 12.3 months (P = 0.19). Among elderly patients, radical surgical resection (P = 0.002), concurrent delivery of chemoradiation (0.041) and radiotherapy dose Ն5400 cGy (P = 0.0001) conferred statistically significant improvements in overall survival. Conclusion: Management of GBM in elderly patients should include maximal surgical resection followed by radiotherapy and temozolomide whenever medically feasible. Outcomes comparable to those obtained in younger age groups can be expected. Our results indicate that concurrent chemoradiation is superior to sequential chemoradiation in these patients. Fig. 2. Kaplan-Meier survival curve for patients stratified according to age.

International Journal of Radiation Oncology*Biology*Physics, 2011

Journal of Medical …, Jan 1, 2012

Hematology/Oncology and Stem Cell Therapy, 2011

Embryonal tumor with abundant neuropil and true rosettes: a report of three cases of a rare tumor, with an unusual case showing rhabdomyoblastic and melanocytic differentiation

Neuropathology, Dec 1, 2011

AbstractEmbryonal tumor with abundant neuropil and true rosettes (ETANTR) is an increasingly reco... more AbstractEmbryonal tumor with abundant neuropil and true rosettes (ETANTR) is an increasingly recognized entity that belongs to the family of embryonal tumors of the CNS. The authors present three cases of this rare tumor that were encountered at King Hussein Cancer Center, Amman, Jordan. Discussion of the clinicopathological findings is presented along with a recent literature review. Sixteen-, 57- and 30-month-old children presented with tumors located in the pineal gland, the right fronto- parieto-temporal region and the cerebellum, respectively. The findings of hypocellular neuropil as well as the characteristic ependymoblastic rosettes were seen. In addition the third case showed an abnormal combination of patterns including melanocytic and rhabdomyoblastic differentiation. The tumors stained positively for synaptophysin in the neuropil and small cell component, while the ependymoblastic rosettes stained for vimentin only. Epithelial membrane antigen and CD99 were negative in all components. One of the cases showed tetraploidy of chromosome 2. All cases exhibited an aggressive course. This is a rare and recently recognized tumor with dismal outcome, and reporting of additional new cases should help in gaining more knowledge about it.

Management strategies for isolated recurrence in early-stage gastric cancer

The role of radio-protective agents in the era of Intensity Modulated Radiotherapy

Hepatocellular Carcinoma

This handbook will enable radiation oncologists to appropriately and confidently select and delin... more This handbook will enable radiation oncologists to appropriately and confidently select and delineate tumor volumes/fields for conformal radiation therapy, including intensity-modulated radiation therapy (IMRT), in patients with commonly encountered cancers. The orientation of this handbook is entirely practical, in that the focus is on the illustration of clinical target volume (CTV) delineation for each major malignancy. Each chapter provides guidelines and concise knowledge on treatment planning and CTV selection, explains how the anatomy of lymphatic drainage shapes target volume selection, and presents detailed illustrations of delineations, slice by slice, on planning CT images. While the emphasis is on target volume delineation for three-dimensional conformal therapy and IMRT, information is also provided on conventional radiation therapy field setup and planning for certain malignancies for which IMRT is not currently suitable.

Neoadjuvant versus adjuvant chemoradiation for rectal cancer: Experience at king Hussein cancer Center

Changing trends of down staging,sphincter preservation and complete pathological response over 8 years in locally advanced rectal cancer

Discovery medicine, 2010

Hepatocellular carcinoma (HCC) is the most common primary liver cancer in adults and it is freque... more Hepatocellular carcinoma (HCC) is the most common primary liver cancer in adults and it is frequently associated with cirrhosis. Surgical resection or orthotopic liver transplantation can be curative but only 30-40% of patients may benefit from curative radical treatment. Stereotactic body radiation therapy (SBRT) has emerged as a promising non-invasive therapy for patients with unresectable HCC and it may potentially serve as a bridging therapy for patients awaiting transplantation. There are a limited number of clinical trials examining the use of SBRT in patients with HCC and very good local tumor control and acceptable toxicities have been reported. This article provides an overview on the use of SBRT in the management of HCC.

Hematology/Oncology and Stem Cell Therapy, 2011

Practical Radiation Oncology, 2014

Purpose: To standardize upper abdominal normal organ contouring guidelines for Radiation Therapy ... more Purpose: To standardize upper abdominal normal organ contouring guidelines for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials: Twelve expert radiation oncologists contoured the liver, esophagus, gastroesophageal junction (GEJ), stomach, duodenum, and common bile duct (CBD), and reviewed and edited 33 additional normal organ and blood vessel contours on an anonymized patient computed tomography (CT) dataset. Contours were overlaid and compared for agreement using MATLAB (MathWorks, Natick, MA). S95 contours, defined as the binomial distribution to generate 95% group consensus contours, and normal organ contouring definitions were generated and reviewed by the panel.

Hepatocellular Carcinoma

Target Volume Delineation and Field Setup, 2012

Brain Tumor Pathology, 2012

Brain stem gliomas (BSG) are rare tumors occurring predominantly in childhood. They are mostly of... more Brain stem gliomas (BSG) are rare tumors occurring predominantly in childhood. They are mostly of astrocytic origin and are divided into infiltrative versus circumscribed types, with different prognoses. The diagnosis is mainly based on MRI findings, and biopsy is rarely performed. This is a retrospective study of BSG with available biopsies diagnosed at our center over 6-year period. Fifteen cases were identified, with a predominance of females. The median age was 7 years, and the mean duration of symptoms was \6 weeks in 58.3 % (n = 7) of cases. MRI was typical of diffuse pontine gliomas in 64.3 % (n = 9) of cases. Radiotherapy was the commonest modality of treatment, and the median overall survival was 21.7 months. Twelve cases were consistent with infiltrative astrocytoma of various grades (2 grade II, 7 grade III and 3 grade IV). Entrapped normal neurons and mitosis were the commonest findings indicating infiltrative growth and high grade, respectively, and those correlated significantly with immunostaining for neurofilament protein and Ki-67 of C3 %. Overall survival correlated only with the duration of symptoms and tumor grade on biopsies. A limited panel of immunostains might be useful in undetermined cases to decide on the growth pattern and grade.

World Journal of Surgical Oncology, 2011

Lymph node metastasis from cutaneous squamous cell carcinoma is uncommon. The popliteal fossa is ... more Lymph node metastasis from cutaneous squamous cell carcinoma is uncommon. The popliteal fossa is rarely involved with metastasis. Popliteal lymph node dissection is uncommonly performed and not frequently discussed in the literature. We present a case of squamous cell carcinoma of the heel with popliteal and inguinal metastasis. This is followed by a description of the relevant anatomy of the popliteal fossa and the technique of popliteal lymphadenectomy.

Respiratory Medicine CME, 2011

A 22-year-old female patient, with synovial sarcoma of the left thigh, was treated with marginal ... more A 22-year-old female patient, with synovial sarcoma of the left thigh, was treated with marginal resection and adjuvant chemoradiotherapy. Two years later, she developed sub-pleural metastatic nodules that were resected. Follow-up chest CT-scans revealed small yet new left lower lobe sub-pleural nodules, which were observed closely. These lesions progressed over time and, 20 months later, the patient underwent pulmonary metastasectomy. Histopathology examination of the lung tissue showed changes consistent with a sarcoid-like reaction. There were no systemic manifestations of sarcoidosis. To date, there have been no reported cases of sarcoid-like reaction associated with synovial sarcoma. Reporting this case, therefore, may help to improve our overall understanding of the relationship between malignancy and sarcoid-like reactions in the lungs.

928 poster BIBLOMETRIC ANALYSIS OF CANCER NANOTECHNOLOGY RESEARCH: ARE RADIOTHERAPY-RELATED APPLICATIONS LAGGING BEHIND

Radiotherapy and Oncology, 2011

Radiotherapy and Oncology, 2011

Conclusions: During the last 3 decades many efforts have been made to improve advanced HNSCC pts ... more Conclusions: During the last 3 decades many efforts have been made to improve advanced HNSCC pts prognosis while keeping toxicity to an acceptable level. We recorded good clinical results with platin based ALT CTRT regimens in the first trials and investigated the activity of a radiosensitizer or a biologic agent to the same CTRT regimen with encouraging results despite worse toxicity.

Journal of Radiotherapy in Practice, 2010

Middle Eastern and North African (MENA) clinical oncology physicians spend 10 years À on average ... more Middle Eastern and North African (MENA) clinical oncology physicians spend 10 years À on average À from the dawn of medical school to the conclusion of clinical training. Amidst this enduring journey, residents and fellows spare little time for research projects ensuring low ratio of trainees with peer-reviewed publications at the time of graduation.

Journal of Medical Imaging and Radiation Oncology, 2012

The objective of this article was to evaluate therapeutic outcomes of elderly patients with gliob... more The objective of this article was to evaluate therapeutic outcomes of elderly patients with glioblastoma multiforme (GBM) treated by surgery followed by combined modality therapy and compare achievable outcomes to those of a younger age population. Methods and Materials: Seventy-eight adult patients with histologically confirmed grade IV astrocytoma were treated at King Hussein Cancer Center (Amman, Jordan) between September 2004 and December 2008. Records were retrospectively reviewed and included 55 males and 23 females between 19 and 78 years of age (median age 50 years). This case series included 20 patients aged 60 years or older. All patients underwent craniotomy followed radiotherapy and concurrent or sequential temozolomide. The follow-up ranged from 1 to 56 months (median 9.4 months). Results: The median survival for the whole cohort was 13.8 months. The median survival for patients less than 60 years was 14.3 months and for patients 60 years or older was 12.3 months (P = 0.19). Among elderly patients, radical surgical resection (P = 0.002), concurrent delivery of chemoradiation (0.041) and radiotherapy dose Ն5400 cGy (P = 0.0001) conferred statistically significant improvements in overall survival. Conclusion: Management of GBM in elderly patients should include maximal surgical resection followed by radiotherapy and temozolomide whenever medically feasible. Outcomes comparable to those obtained in younger age groups can be expected. Our results indicate that concurrent chemoradiation is superior to sequential chemoradiation in these patients. Fig. 2. Kaplan-Meier survival curve for patients stratified according to age.

International Journal of Radiation Oncology*Biology*Physics, 2011