Ibrahim Awad | Mansoura University (original) (raw)

Papers by Ibrahim Awad

Cancer Therapy & Oncology International Journal, 2016

The potential impact of radiotherapy on male fertility depends mainly on the total radiotherapy d... more The potential impact of radiotherapy on male fertility depends mainly on the total radiotherapy dose, tumor location, treatment volume, fractionation schedule, pre-treatment fertility status, and post-treatment survival of type-A spermatogonia. Very low doses of direct testicular radiation could cause damage to the germinal epithelium. Doses above 0.8Gy result in azoospermia and doses below 0.8Gy give rise to oligospermia, with complete recovery (return to pre-irradiation sperm concentration), within 9-18 months following 1Gy or less, 30 months for 2-3Gy and 5 years or more for doses of 4Gy and above. Leydig cells are more resistant to damage from radiotherapy than the germinal epithelium. Direct testicular irradiation of 20Gy, in 10 fractions, could increase the LH levels, with a decrease in serum testosterone level. Scattered testicular irradiation is more common. Unlike the majority of normal tissues, radiation doses to the germinal epithelium of the testis given in fractionated courses cause more gonadal damage than single doses. scattered testicular doses of 0.2-0.7, 0.7-1.2, and more than 1.2Gy can cause transient oligospermia, transient azoospermia and prolonged azoospermia respectively. Leydig cell function is usually preserved with scattered doses up to 20Gy in prepubertal boys and 30Gy in sexually mature men. If the hypothalamic-pituitary axis falls within the radiation fields, the patient is at risk of developing hypopituitarism with subsequent long-term gonadotrophin deficiency in 30-60% of cases receiving high dose radiation (50-70Gy) as in pituitary tumor and nasopharyngeal carcinoma.

Benha Medical Journal, 2021

Objective: To investigate the toxicity of prone position in whole breast radiotherapy after breas... more Objective: To investigate the toxicity of prone position in whole breast radiotherapy after breast conserving surgery (BCS) in breast cancer patients with large pendulous breasts. Patient and methods: Thirty patients (stage I-II) with large pendulous breast were simulated in both supine and prone positions. Target volumes and organs at risk were contoured on CT images. For each patient, the two planes were calculated and dose volume histograms were compared. The prescribed dose was 40 Gy in 15 fractions over 3 weeks to whole breast with 6-10 MV photon followed by 10 Gy in 5 fractions over one week boost to the tumor bed. The selection of treatment position was based on best target coverage and optimal sparing of organs at risk. Results: Among 30 patients, 13 patients (43.3%) were treated in the prone position, while the remaining 17 patients (56.7%) were treated in supine position. Higher grades of acute dermatitis were significantly reported in supine position (p=0.01).Grades 1 and 2 chronic radiation dermatitis were more in supine position, but no statistically significant difference (p=0.41). Grade I radiation pneumonitis was developed in 2 patients (14.3%) in supine group which was not significantly different (p=0.49). No cardiac symptoms were noted among both groups. Grade I lymphedema was noted in (11.8%) in supine group versus (23.1%) in prone group (p=0.6). Conclusion: Prone position is a suitable alternative to supine position in large pendulous breast with accepted toxicity profile.

Middle East Journal of Cancer, 2021

Background: The objective of this study was to compare the dosimetric outcome of plans with more ... more Background: The objective of this study was to compare the dosimetric outcome of plans with more fields to those with fewer ones for breast cancer patients. Method: Twenty-three breast cancer patients were examined in this experimental study. Two groups of these patients were planned by treatment planning system. The number of beams was changed for each group, and the dosimetric parameters were calculated. The dose volume histogram (DVH) and the statistical analyses were performed for the two plans of all patients. Results: The DVH for the planning target volume (PTV) of the two techniques was estimated. Optimized plans were carried out to ensure that 95 % of the target volume takes 95 % of the dose. Based on the statistical analysis, the best coverage of dose had no relationship with the number of beams because the P-value of V105 %, V95 %,V110 %, D mean, D max, CI, HI, and D5% were 0.9537, 0.9152, 0.3446, 0.8156, 0.9516, 0.7888, 0.2127, and 0.7282, respectively. The Mean ±SEM for ...

Research in Oncology, 2017

Background: Pancreatic carcinoma has the worst prognosis of all gastrointestinal solid tumors. On... more Background: Pancreatic carcinoma has the worst prognosis of all gastrointestinal solid tumors. Only 15-20% of cases present at a resectable stage and the rate of local recurrence is high. Aim: To assess tolerability and efficacy of adjuvant chemo-radiotherapy (CRT) for pancreatic carcinoma compared to chemotherapy (CTH) alone. Methods: This was a prospective study with historical control group. The intervention group involved patients who underwent a 3-phases protocol following Whipple surgery. In the first phase, weekly gemcitabine was administered at a dose of 1 gm/m 2 for 3 weeks. The second was a CRT phase whereas capecitabine (800 mg/m 2) used twice daily for 5-6 weeks concurrent with 3 dimensional conformal radiotherapy. Finally, the maintenance phase in which gemcitabine administered at a dose of 1 gm/m 2 weekly for 3 weeks with 1 week rest for 3 cycles. The historical group included patients who received gemcitabine only within the preceding 2 years. Results: From 50 patients with pancreatic cancer in the intervention group, 41 completed the treatment protocol versus 40 patients in the control group. The estimated median disease-free survival was 15 months in the CRT group versus 10 months in the CTH group, and the estimated mean was 19.4 versus 13.2 (p = 0.041). The estimated median overall survival was not reached in both treatment arms. The estimated mean overall survival was 27.9 months in the CRT group compared to 19.2 months in the CTH group (p = 0.023). The relapse rate was 29% in the CRT group versus 65% in the CTH group (p= 0.001). CRT was associated with more toxicity which was tolerated with no interruption of treatment. Conclusions: Adjuvant gemcitabine before and after capecitabine concurrent with 3D conformal radiotherapy was tolerated with better survival and local control in pancreatic cancer patients.

Mansoura Medical Journal, 1992

Background: Inoperable non-metastatic pancreatic cancer is a great challenge because the median s... more Background: Inoperable non-metastatic pancreatic cancer is a great challenge because the median survival is generally less than 1 year and the impact of standard therapies is so limited. All patients should be considered for protocol-based therapy. The aim of this study is to determine the tolerability and efficacy of Gemcitabine concurrent with 3D conformal radiotherapy for locally advanced, unresectable, non-metastatic pancreatic cancer. Methods: Thirty three patients received the following protocol in 3 phases; induction phase: Weekly Gemcitabine at a dose of 1,000 mg/m2 over 30 minutes infusion for 7 weeks, chemoradiotherapy phase: Gemcitabine 600 mg/m2 weekly for 5 weeks concurrent with 3 dimensional (3D) conformal radiotherapy for a total dose of 50.4 Gy in 28 fractions in 5.5 weeks, 5 days per week, and maintenance phase: Gemcitabine at a dose of 1,000 mg/m2 weekly for 3 weeks with 1 week rest between 2 cycles. Results: Forty eight patients with locally advanced unresectable ...

JOURNAL OF ADVANCES IN PHYSICS, 2017

Hypofractionated radiotherapy (HFRT) in breast cancer treatment regimen (40 Grey /15 fractions/3 ... more Hypofractionated radiotherapy (HFRT) in breast cancer treatment regimen (40 Grey /15 fractions/3 weeks) is more convenient for patients, especially those coming from remote areas to radiotherapy facilities and for healthcare providers, than conventional fractionation (50 Gy/25 fractions/5weeks). So the effectof radiotherapy interruption on treatment outcome (loco-regional control (LRC)& overall survival (OS)) during hypofractionated schedule is the issue of our study.Materials and Methods: We studied retrospectively 174 female patients with breast cancer who received PORT at the Clinical Oncology & Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Egypt, from January-2012 to December-2016. We determined the treatment outcome (OS&LRC) from the follow-up (FU) of the studied patients, as the patient still survived or died, and recurrence till now occurred or not, and were estimated with the Kaplan-Meier (K-M) method and Logrank test, respectively. Then we calculate...

JOURNAL OF ADVANCES IN PHYSICS, 2019

Purpose: To evaluate the biologic differences in treatment plans with different number of beams o... more Purpose: To evaluate the biologic differences in treatment plans with different number of beams on 3D conformal radiotherapy for breast cancer patients, and compute the percent of probability to tumor control and complication of normal tissue probability using matlap program. Then determine the optimum plan through these values.

Journal of Cancer Therapy, 2014

Purpose: To assess the response rate, duration of response and prognostic factors affecting respo... more Purpose: To assess the response rate, duration of response and prognostic factors affecting response after low-dose involved-field radiotherapy in patients with relapsed low-grade B-cell non-Hodgkin lymphoma. Patients and Methods: Forty-four patients were included. Patients were treated with a total dose of 4 Gy (2 × 2 Gy) using 6-15 Mv photon or electron beam. Results: most patients were above age of 60 years (59%) with male predominance. Follicular lymphoma was the most common pathological type; bulky disease (>5 cm) was presented in 61.4%. Patients who received only 2 regimens were 63.7% and 31.8% had >2 involved sites. No treatment related toxicity was observed. The overall response rate was 88.7%; complete response was reached in 59.1% and stable disease in 6.8%, progressive disease in 4.5%. Median time to local progression was 33 months (95% CI 23.70-42.29); 2-year local progression free survival was 78%. Response rate was found to be dependent on age, number of involved sites and lymph node size but independent on sex, pathological type, number of prior regimens, LDH level and time since diagnosis. Conclusion: Short-course-low dose palliative radiotherapy (2 × 2 Gy) affords an attractive option for treatment of relapsed low-grade non-Hodgkin's lymphoma due to high response rates. However, these results had to be confirmed in a larger number of patients.

Journal of the Egyptian National Cancer Institute, 2009

Radiotherapy became an important component in the treatment of brain gliomas either high grade or... more Radiotherapy became an important component in the treatment of brain gliomas either high grade or low grade. This study was conducted to evaluate the efficacy and safety of the three-dimensional conformal radiotherapy and compare this results with two-dimensional conventional radiotherapy in patients with brain gliomas. Sixty patients with histologically proven brain gliomas between November 2007 and december 2009, were enrolled in this study. They were 25 with low grade and 35 with high grade, treated in our department according to a three-dimensional conformal radiotherapy; patients received a total irradiation dose of 54-60 GY, 2 GY/day, 5 days/week, were enrolled prospectively (arm I). The patients under study were compared to 120 patients (44 low grade and 76 high grade) who received irradiation with 2 D-conventional radiotherapy and were served as a retrospective study (arm II). The overall survival and progression free survival times were estimated using Kaplan-Meier method a...

Hematology/Oncology and Stem Cell Therapy, 2012

Whether it is possible to reduce the intensity of treatment in early (stage I or II) Hodgkin lymp... more Whether it is possible to reduce the intensity of treatment in early (stage I or II) Hodgkin lymphoma with a favorable prognosis remains unclear. Therefore, we conducted this randomized trial, comparing two treatment groups consisting of a combination chemotherapy regimen of two different intensities followed by involved-field radiation therapy at two different dose levels. Prospective, randomized, in patients referred to the Department Of Clinical Oncology And Nuclear Medicine. Ninety-eight patients with histologically proven early-stage Hodgkin lymphoma with a favorable prognosis were enrolled in this study between January 2008 and June 2010. They were randomly assigned in one of two treatment arms: arm I received four cycles of ABVD (adriamycin, belomycin, vinblastine, dacarbazine) followed by 30 Gy of involved-field radiation therapy; arm II received two cycles of ABVD followed by 20 Gy of involved-field radiation therapy. During the follow-up period, the 2-year relapse-free survival rates were 96% and 95% in arm I and arm II, respectively (P=.8), while the 2-year overall survival rates were 98% and 95% in arm I and arm II, respectively (P=.16). acute toxicity affected 54% of patients treated with four cycles of ABVD, who had grade III or IV toxicity, as compared with 30% of those receiving two cycles (P<.02). The rates of acute toxicity (grade III or IV) were also higher among patients treated with 30 Gy of involved-field radiation therapy than among those receiving 20 Gy (16% vs. 2.5%, P<.03) . In patients with early-stage Hodgkin lymphoma and a favorable prognosis, treatment with two cycles of aBVD followed by 20 Gy of involved-field radiation therapy was as effective as, and less toxic than, four cycles of ABVD followed by 30 Gy of involved-field radiation therapy.

Hepato-gastroenterology

This study aims to define the clinicopathologic criteria of primary gastric lymphoma in view of M... more This study aims to define the clinicopathologic criteria of primary gastric lymphoma in view of MALT concept and to present the outcome after different treatment modalities. Seventy-six cases of primary gastric lymphoma treated between January 1980 and December 2001 were reviewed. All tissue specimens (endoscopic or surgically resected) were re-examined. Tumors were staged according to Ann Arbor staging system and the Musshoff modification (IE in 30.3%, IIE in 39.4% and IIIE in 30.3%). Sixty patients underwent gastrectomy (partial or total) with postoperative chemotherapy for 32 patients. Sixteen patients were treated by chemotherapy only. The mean follow-up period was 15 years (range, 6 months to 21 years). Primary gastric lymphoma represented 69.1% of cases of gastrointestinal lymphoma and 16.2% of all gastric malignancy. The mean age was 45 years and male to female ratio was 2.3:1. Epigastric pain was the commonest symptom (in 88.2%). Ulcer-like lesions were the commonest (65.8%)...

Journal of Cancer Therapy, 2014

Cancer Therapy & Oncology International Journal, 2016

The potential impact of radiotherapy on male fertility depends mainly on the total radiotherapy d... more The potential impact of radiotherapy on male fertility depends mainly on the total radiotherapy dose, tumor location, treatment volume, fractionation schedule, pre-treatment fertility status, and post-treatment survival of type-A spermatogonia. Very low doses of direct testicular radiation could cause damage to the germinal epithelium. Doses above 0.8Gy result in azoospermia and doses below 0.8Gy give rise to oligospermia, with complete recovery (return to pre-irradiation sperm concentration), within 9-18 months following 1Gy or less, 30 months for 2-3Gy and 5 years or more for doses of 4Gy and above. Leydig cells are more resistant to damage from radiotherapy than the germinal epithelium. Direct testicular irradiation of 20Gy, in 10 fractions, could increase the LH levels, with a decrease in serum testosterone level. Scattered testicular irradiation is more common. Unlike the majority of normal tissues, radiation doses to the germinal epithelium of the testis given in fractionated courses cause more gonadal damage than single doses. scattered testicular doses of 0.2-0.7, 0.7-1.2, and more than 1.2Gy can cause transient oligospermia, transient azoospermia and prolonged azoospermia respectively. Leydig cell function is usually preserved with scattered doses up to 20Gy in prepubertal boys and 30Gy in sexually mature men. If the hypothalamic-pituitary axis falls within the radiation fields, the patient is at risk of developing hypopituitarism with subsequent long-term gonadotrophin deficiency in 30-60% of cases receiving high dose radiation (50-70Gy) as in pituitary tumor and nasopharyngeal carcinoma.

Benha Medical Journal, 2021

Objective: To investigate the toxicity of prone position in whole breast radiotherapy after breas... more Objective: To investigate the toxicity of prone position in whole breast radiotherapy after breast conserving surgery (BCS) in breast cancer patients with large pendulous breasts. Patient and methods: Thirty patients (stage I-II) with large pendulous breast were simulated in both supine and prone positions. Target volumes and organs at risk were contoured on CT images. For each patient, the two planes were calculated and dose volume histograms were compared. The prescribed dose was 40 Gy in 15 fractions over 3 weeks to whole breast with 6-10 MV photon followed by 10 Gy in 5 fractions over one week boost to the tumor bed. The selection of treatment position was based on best target coverage and optimal sparing of organs at risk. Results: Among 30 patients, 13 patients (43.3%) were treated in the prone position, while the remaining 17 patients (56.7%) were treated in supine position. Higher grades of acute dermatitis were significantly reported in supine position (p=0.01).Grades 1 and 2 chronic radiation dermatitis were more in supine position, but no statistically significant difference (p=0.41). Grade I radiation pneumonitis was developed in 2 patients (14.3%) in supine group which was not significantly different (p=0.49). No cardiac symptoms were noted among both groups. Grade I lymphedema was noted in (11.8%) in supine group versus (23.1%) in prone group (p=0.6). Conclusion: Prone position is a suitable alternative to supine position in large pendulous breast with accepted toxicity profile.

Middle East Journal of Cancer, 2021

Background: The objective of this study was to compare the dosimetric outcome of plans with more ... more Background: The objective of this study was to compare the dosimetric outcome of plans with more fields to those with fewer ones for breast cancer patients. Method: Twenty-three breast cancer patients were examined in this experimental study. Two groups of these patients were planned by treatment planning system. The number of beams was changed for each group, and the dosimetric parameters were calculated. The dose volume histogram (DVH) and the statistical analyses were performed for the two plans of all patients. Results: The DVH for the planning target volume (PTV) of the two techniques was estimated. Optimized plans were carried out to ensure that 95 % of the target volume takes 95 % of the dose. Based on the statistical analysis, the best coverage of dose had no relationship with the number of beams because the P-value of V105 %, V95 %,V110 %, D mean, D max, CI, HI, and D5% were 0.9537, 0.9152, 0.3446, 0.8156, 0.9516, 0.7888, 0.2127, and 0.7282, respectively. The Mean ±SEM for ...

Research in Oncology, 2017

Background: Pancreatic carcinoma has the worst prognosis of all gastrointestinal solid tumors. On... more Background: Pancreatic carcinoma has the worst prognosis of all gastrointestinal solid tumors. Only 15-20% of cases present at a resectable stage and the rate of local recurrence is high. Aim: To assess tolerability and efficacy of adjuvant chemo-radiotherapy (CRT) for pancreatic carcinoma compared to chemotherapy (CTH) alone. Methods: This was a prospective study with historical control group. The intervention group involved patients who underwent a 3-phases protocol following Whipple surgery. In the first phase, weekly gemcitabine was administered at a dose of 1 gm/m 2 for 3 weeks. The second was a CRT phase whereas capecitabine (800 mg/m 2) used twice daily for 5-6 weeks concurrent with 3 dimensional conformal radiotherapy. Finally, the maintenance phase in which gemcitabine administered at a dose of 1 gm/m 2 weekly for 3 weeks with 1 week rest for 3 cycles. The historical group included patients who received gemcitabine only within the preceding 2 years. Results: From 50 patients with pancreatic cancer in the intervention group, 41 completed the treatment protocol versus 40 patients in the control group. The estimated median disease-free survival was 15 months in the CRT group versus 10 months in the CTH group, and the estimated mean was 19.4 versus 13.2 (p = 0.041). The estimated median overall survival was not reached in both treatment arms. The estimated mean overall survival was 27.9 months in the CRT group compared to 19.2 months in the CTH group (p = 0.023). The relapse rate was 29% in the CRT group versus 65% in the CTH group (p= 0.001). CRT was associated with more toxicity which was tolerated with no interruption of treatment. Conclusions: Adjuvant gemcitabine before and after capecitabine concurrent with 3D conformal radiotherapy was tolerated with better survival and local control in pancreatic cancer patients.

Mansoura Medical Journal, 1992

Background: Inoperable non-metastatic pancreatic cancer is a great challenge because the median s... more Background: Inoperable non-metastatic pancreatic cancer is a great challenge because the median survival is generally less than 1 year and the impact of standard therapies is so limited. All patients should be considered for protocol-based therapy. The aim of this study is to determine the tolerability and efficacy of Gemcitabine concurrent with 3D conformal radiotherapy for locally advanced, unresectable, non-metastatic pancreatic cancer. Methods: Thirty three patients received the following protocol in 3 phases; induction phase: Weekly Gemcitabine at a dose of 1,000 mg/m2 over 30 minutes infusion for 7 weeks, chemoradiotherapy phase: Gemcitabine 600 mg/m2 weekly for 5 weeks concurrent with 3 dimensional (3D) conformal radiotherapy for a total dose of 50.4 Gy in 28 fractions in 5.5 weeks, 5 days per week, and maintenance phase: Gemcitabine at a dose of 1,000 mg/m2 weekly for 3 weeks with 1 week rest between 2 cycles. Results: Forty eight patients with locally advanced unresectable ...

JOURNAL OF ADVANCES IN PHYSICS, 2017

Hypofractionated radiotherapy (HFRT) in breast cancer treatment regimen (40 Grey /15 fractions/3 ... more Hypofractionated radiotherapy (HFRT) in breast cancer treatment regimen (40 Grey /15 fractions/3 weeks) is more convenient for patients, especially those coming from remote areas to radiotherapy facilities and for healthcare providers, than conventional fractionation (50 Gy/25 fractions/5weeks). So the effectof radiotherapy interruption on treatment outcome (loco-regional control (LRC)& overall survival (OS)) during hypofractionated schedule is the issue of our study.Materials and Methods: We studied retrospectively 174 female patients with breast cancer who received PORT at the Clinical Oncology & Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Egypt, from January-2012 to December-2016. We determined the treatment outcome (OS&LRC) from the follow-up (FU) of the studied patients, as the patient still survived or died, and recurrence till now occurred or not, and were estimated with the Kaplan-Meier (K-M) method and Logrank test, respectively. Then we calculate...

JOURNAL OF ADVANCES IN PHYSICS, 2019

Purpose: To evaluate the biologic differences in treatment plans with different number of beams o... more Purpose: To evaluate the biologic differences in treatment plans with different number of beams on 3D conformal radiotherapy for breast cancer patients, and compute the percent of probability to tumor control and complication of normal tissue probability using matlap program. Then determine the optimum plan through these values.

Journal of Cancer Therapy, 2014

Purpose: To assess the response rate, duration of response and prognostic factors affecting respo... more Purpose: To assess the response rate, duration of response and prognostic factors affecting response after low-dose involved-field radiotherapy in patients with relapsed low-grade B-cell non-Hodgkin lymphoma. Patients and Methods: Forty-four patients were included. Patients were treated with a total dose of 4 Gy (2 × 2 Gy) using 6-15 Mv photon or electron beam. Results: most patients were above age of 60 years (59%) with male predominance. Follicular lymphoma was the most common pathological type; bulky disease (>5 cm) was presented in 61.4%. Patients who received only 2 regimens were 63.7% and 31.8% had >2 involved sites. No treatment related toxicity was observed. The overall response rate was 88.7%; complete response was reached in 59.1% and stable disease in 6.8%, progressive disease in 4.5%. Median time to local progression was 33 months (95% CI 23.70-42.29); 2-year local progression free survival was 78%. Response rate was found to be dependent on age, number of involved sites and lymph node size but independent on sex, pathological type, number of prior regimens, LDH level and time since diagnosis. Conclusion: Short-course-low dose palliative radiotherapy (2 × 2 Gy) affords an attractive option for treatment of relapsed low-grade non-Hodgkin's lymphoma due to high response rates. However, these results had to be confirmed in a larger number of patients.

Journal of the Egyptian National Cancer Institute, 2009

Radiotherapy became an important component in the treatment of brain gliomas either high grade or... more Radiotherapy became an important component in the treatment of brain gliomas either high grade or low grade. This study was conducted to evaluate the efficacy and safety of the three-dimensional conformal radiotherapy and compare this results with two-dimensional conventional radiotherapy in patients with brain gliomas. Sixty patients with histologically proven brain gliomas between November 2007 and december 2009, were enrolled in this study. They were 25 with low grade and 35 with high grade, treated in our department according to a three-dimensional conformal radiotherapy; patients received a total irradiation dose of 54-60 GY, 2 GY/day, 5 days/week, were enrolled prospectively (arm I). The patients under study were compared to 120 patients (44 low grade and 76 high grade) who received irradiation with 2 D-conventional radiotherapy and were served as a retrospective study (arm II). The overall survival and progression free survival times were estimated using Kaplan-Meier method a...

Hematology/Oncology and Stem Cell Therapy, 2012

Whether it is possible to reduce the intensity of treatment in early (stage I or II) Hodgkin lymp... more Whether it is possible to reduce the intensity of treatment in early (stage I or II) Hodgkin lymphoma with a favorable prognosis remains unclear. Therefore, we conducted this randomized trial, comparing two treatment groups consisting of a combination chemotherapy regimen of two different intensities followed by involved-field radiation therapy at two different dose levels. Prospective, randomized, in patients referred to the Department Of Clinical Oncology And Nuclear Medicine. Ninety-eight patients with histologically proven early-stage Hodgkin lymphoma with a favorable prognosis were enrolled in this study between January 2008 and June 2010. They were randomly assigned in one of two treatment arms: arm I received four cycles of ABVD (adriamycin, belomycin, vinblastine, dacarbazine) followed by 30 Gy of involved-field radiation therapy; arm II received two cycles of ABVD followed by 20 Gy of involved-field radiation therapy. During the follow-up period, the 2-year relapse-free survival rates were 96% and 95% in arm I and arm II, respectively (P=.8), while the 2-year overall survival rates were 98% and 95% in arm I and arm II, respectively (P=.16). acute toxicity affected 54% of patients treated with four cycles of ABVD, who had grade III or IV toxicity, as compared with 30% of those receiving two cycles (P<.02). The rates of acute toxicity (grade III or IV) were also higher among patients treated with 30 Gy of involved-field radiation therapy than among those receiving 20 Gy (16% vs. 2.5%, P<.03) . In patients with early-stage Hodgkin lymphoma and a favorable prognosis, treatment with two cycles of aBVD followed by 20 Gy of involved-field radiation therapy was as effective as, and less toxic than, four cycles of ABVD followed by 30 Gy of involved-field radiation therapy.

Hepato-gastroenterology

This study aims to define the clinicopathologic criteria of primary gastric lymphoma in view of M... more This study aims to define the clinicopathologic criteria of primary gastric lymphoma in view of MALT concept and to present the outcome after different treatment modalities. Seventy-six cases of primary gastric lymphoma treated between January 1980 and December 2001 were reviewed. All tissue specimens (endoscopic or surgically resected) were re-examined. Tumors were staged according to Ann Arbor staging system and the Musshoff modification (IE in 30.3%, IIE in 39.4% and IIIE in 30.3%). Sixty patients underwent gastrectomy (partial or total) with postoperative chemotherapy for 32 patients. Sixteen patients were treated by chemotherapy only. The mean follow-up period was 15 years (range, 6 months to 21 years). Primary gastric lymphoma represented 69.1% of cases of gastrointestinal lymphoma and 16.2% of all gastric malignancy. The mean age was 45 years and male to female ratio was 2.3:1. Epigastric pain was the commonest symptom (in 88.2%). Ulcer-like lesions were the commonest (65.8%)...

Journal of Cancer Therapy, 2014