mohamed farouk Akl | Mansoura University (original) (raw)

Papers by mohamed farouk Akl

Journal of Cancer and Tumor International, 2017

Background: Medulloblastomas are the most common infratentorial malignant brain tumors with an in... more Background: Medulloblastomas are the most common infratentorial malignant brain tumors with an incidence rate of 0.5 in 100.000 typically arising in childhood at age 5-9 years. Aim of Work: Exploring the epidemiological characteristics, treatment outcome and prognostic factors of medulloblastoma patients whom were referred to Mansoura Clinical Oncology &Nuclear Medicine Department for adjuvant treatment through the period from Jan. 1997 to Dec. 2011 inclusive. Patients and Methods: Sixty-Two patients records were in harmony with the eligibility criteria. Males were slightly larger in number [33 cases (53%)]. The majority of the cases were of pediatric age (42 patient representing 68%). Complete resection was possible in only 31 cases (50%).The classic type was the commonest [36 cases (58%)]. The majority were of the of M0 stage [52 cases (84%)] and of high risk category [37 cases (60%)]. Median dose to posterior fossa was 52.5 Gray (range, 43-56 Gray). The Chemotherapy was administrated in forty-seven patients (75.8%). The toxicity of treatment were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 3.0). Results: Adjuvant Radiotherapy was generally well tolerated. The median overall survival time and median progression – free survival were 90 & 72 months respectively. Relapse was reported in 28 2 patients (45.16%).M staging, extensiveness of resection, hydrocephalus at presentation and time elapsed till radiotherapy all affected significantly the prognosis. Conclusion: In conclusion, this study highlights the effect of stage, completeness of surgery, and early initiation of adjuvant radiotherapy on the outcome.

The Egyptian Journal of Hospital Medicine

Background: Papillary thyroid cancer (PTC) represents most of cases of differentiated thyroid can... more Background: Papillary thyroid cancer (PTC) represents most of cases of differentiated thyroid cancers. Thyroidectomy followed by radioactive iodine (RAI) remnant ablation represent the cornerstone management of many intermediate and high-risk patients according to American Thyroid Association (ATA). Objective: This study aimed to evaluate the outcome of different used I 131 ablation doses (80, 100 and 120 mCi) in intermediate and high-risk patients in our hospital and to analyze the predictors affecting RAI failure. Besides, survival analysis was conducted as a secondary objective of the study. Patients and Methods: This was a retrospective study conducted on 63 patients diagnosed as PTC at our hospital from January 2015 till February 2020. Our study involved only PTC pathology, mean age of 40.6 ± 13.4 years at diagnosis, and intermediate-and high-risk patients according to ATA initial risk stratification system, 2015. Results: Among the 63 patients included in this study (17 males and 46 females), 41 were classified as intermediaterisk, while 22 were classified as high-risk based on the ATA guideline. Overall RAI ablation success, in both groups, was observed in 43/63 (68.25%) patients. Moreover, it was achieved in 31/41 (75.6%) of intermediate-risk patients and in 12/22 (54.5%) high-risk patients. Pre-ablation stimulated Tg >1ng/ml was statistically significant negative predictor of ablation failure [P-value < 0.001, odd`s ratio 61.5, 95% CI (10.8-51.5)]. Conclusion: There was no statistically significant difference between success rates of I 131 doses in intermediate-and high-risk groups. However, the failure rates were more after 120 mCi due to the associated more aggressive underlying disease, especially higher-risk patients so higher RAI activities are recommended for this risk group.

$Research paper thumbnail of Hypofractionated beam radiotherapy for localized prostate cancer$

Strahlentherapie und Onkologie, 2016

Aim This article gives an overview on the current status of hypofractionated radiotherapy in the ... more Aim This article gives an overview on the current status of hypofractionated radiotherapy in the treatment of prostate cancer with a special focus on the applicability in routine use. Methods Based on a recently published systematic review the German Society of Radiation Oncology (DEGRO) expert panel added additional information that has become available since then and assessed the validity of the information on outcome parameters especially with respect to long-term toxicity and long-term disease control. Results Several large-scale trials on moderate hypofractionation with single doses from 2.4-3.4 Gy have recently finished recruiting or have published first results suggestive of equivalent outcomes although there might be a trend for increased short-term and possibly even long-term tox

Nephrology Dialysis Transplantation, 2017

Middle East Journal of Cancer, 2020

Background: We aimed to achieve full tumor control during every fraction with head and neck cance... more Background: We aimed to achieve full tumor control during every fraction with head and neck cancer patients using 3DCRT treatment technique. Methods: We divided 16head and neck cancer patients into two groups to deliver radiotherapy doses of 66Gy and70Gy. We applied 3DCRT plan as a forward IMRT plan for each patient with coplanar beams arrangement technique designed with angles of (0o, 60o, 90o, 180o (or around 175o and 185o), 270o and 300o).We assessed the plans according to DVHs and satisfactory dose distributions. Results: Based on the overall evaluation of the two groups (16 cases), we achieved an accepted dose distribution for PTVs and OARs dose; simulating IMRT inverse plans dose distribution. Conclusion: Using such a mono-isocenteric plan, we were able to achieve perfect uniform dose distribution for PTVs up to 70Gy while sparing critical organs. This template could be used in countries with no access to forward IMRT planning.

Asian Pacific Journal of Cancer Prevention : APJCP, 2021

Background: Lung cancer is one of the most frequently diagnosed malignancies. Human endogenous re... more Background: Lung cancer is one of the most frequently diagnosed malignancies. Human endogenous retrovirus-H long terminal repeat-associating protein 2 (HHLA2) is a recently discovered ligand of the B7 family. Blocking this immune checkpoint has become an important treatment option for lung cancer. Methods: The study includes 62 biopsy specimens either bronchoscopic or CT-guided biopsies diagnosed as lung cancer in Hospitals of Faculty of Medicine, Mansoura University, Egypt during the period from 2016 to 2020. Immunohistochemical Staining for HHLA2 and EGFR was performed. HHLA2 expression was assessed in different pathological types of lung Cancer, and it was correlated with other clinicopathologic parameters and patient prognosis. Results: We found a significant association between HHLA2 expression and metastasis. About 83% of patients presented with metastasis showed positive expression of HHLA2 compared to 44.4% in patients with no metastasis (p=0.02). Also, results show signific...

Background: Quality assurance for intensity modulated radiation therapy (IMRT) depends on the typ... more Background: Quality assurance for intensity modulated radiation therapy (IMRT) depends on the type of dosimetry system and its evaluation procedure. We can check both the intensity and distribution of each field as the required pretreatment verification with dosimetry systems. Method: Treatment verification for different plans (IMRT and RapidArc) applied on localized prostate cancer patients was done with electronic portal imager device (EPID), Delta4). The EPID used was Varian aS1000 mounted on Varian (TrueBeam) Linac with gamma criteria set to ΔD=3% and Δd=3mm. RapidArc plans were designed by arcs (179.0o CCW to 181.0o and 181.0o CW to 179.0o) under the same gamma criteria of (ΔD=3%, DTA=3mm and γ-index ≤1) while the threshold dose was 20%. Results: Evaluation analysis is passed for IMRT prostate plans with the area gamma ˂1.0 which equaled 99.1% (99.1% of the pixels had gamma˂1) within a tolerance of 95.0%, area gamma ˃0.8 (was equal to 2.1%) / area gamma ˃1.2 (was equal to 0.3%)...

Cardiovascular Disorder and Medicine

Objective: The aim of this work was to evaluate Multidetector Computed Tomography (MDCT) findings... more Objective: The aim of this work was to evaluate Multidetector Computed Tomography (MDCT) findings of hepatic manifestation in common malignant hematological disorders. Materials and Methods: This retrospective study included 300 patients with different types of malignant hematological disorders. They were 119 female and 181 male (mean age, 45.4 year; range, 5-70 years). The most common hematological disorder was Non-Hodgkin lymphoma (NHL) detected in 192/300 (64%) patients and then Hodgkin disease (HD) detected in 40/300 (13.3%) patients. All 300 patients had ultrasonography. Clinical evaluation and laboratory assessment were done for all patients. Whole body and triphasic abdominal CT scanning was performed on 64 MDCT systems. Results: MDCT scanning revealed hepatic affection in 82/192 of NHL. All these 82 cases revealed hepatomegaly and focal lesion detected in 36 cases. As regard Hodgkin disease (HD), hepatomegaly detected in 22/40 cases and focal lesion detected in 8/40 cases. H...

Asian Cardiovascular and Thoracic Annals

Background Cancer and pulmonary tuberculosis are major global health concerns and are associated ... more Background Cancer and pulmonary tuberculosis are major global health concerns and are associated with substantial morbidity and mortality. The association between active tuberculosis and subsequent cancer development has been investigated for many years. This study was planned to determine the prevalence of latent tuberculosis infection in patients with recently diagnosed bronchogenic carcinoma. Methods Sixty-four newly diagnosed primary lung cancer patients were enrolled. Diagnosis of latent tuberculosis infection was performed with QuantiFERON-TB Gold In-Tube tests, with exclusion of active tuberculosis. Results Latent tuberculosis infection was detected in 16 (25%) patients, and 8 (12.5%) had indeterminate results of the QuantiFERON-TB Gold In-Tube test. Being a current smoker was associated with a higher prevalence of latent tuberculosis ( p = 0.001). Comorbidities, tumor site, and histopathology were not associated with latent tuberculosis infection. Conclusions There is a cons...

Egyptian Journal of Radiology and Nuclear Medicine

Background: Different planning methods of IMRT planning techniques (IMRT (DMLC) and RapidArc) vs.... more Background: Different planning methods of IMRT planning techniques (IMRT (DMLC) and RapidArc) vs. stander techniques (three-dimensional radiation therapy (3DCRT)) will be evaluated for prostate cancer patients' planning and verification. Three groups of localized prostate cancer patients are planned and evaluated regarding DVHs and practical radiation dosimetry, and ten 3DCRT plans are assessed statistically for each patient. Results: Plan (7) with parameters of five equally weighted fields with angles of 0°, 45°, 90°, 270°, and 315°and energy of 15MV is the most suitable plan both for PTV coverage and for OAR sparing with a fewer number of fields and fewer number of gantry angles. IMRT complexity involves the requirement of long treatment times and additional effort for planning, safety checks, and quality control before the patient start the treatment and proceed. Conclusions: The selected plan also is more safe on patients up to 7400 cGy than other plans and is easier to be applied compared to IMRT and RapidArc plans, depending on patient geometry. IMRT radiation doses are more effective and can safely be delivered to PTV with little side effects compared with 3D conformal and conventional techniques. RapidArc has the advantage of re-optimizing and small arcs of variable parameters in dose delivery, taking into account the maximum speed of gantry and MLCs.

Journal of experimental therapeutics & oncology, 2018

Spontaneous regression (SR) of lymphoma is a rare phenomenon. While the precise mechanism of SR r... more Spontaneous regression (SR) of lymphoma is a rare phenomenon. While the precise mechanism of SR remains unknown, apoptosis may be associated with its process. Here, we present a case of a 52-year-old woman was admitted to our hospital with cough and orthopnea for 2 weeks. Multi-detector computed tomography of whole body showed anterior and middle mediastinal soft tissue mass with multiple adjacent malignant lymphadenopathy. The mediastinal mass invaded right atrium and pericardium. Another left subphrenic retro-pancreatic mass was detected. This mass surrounded upper pole of left kidney. Fine needle aspiration cytology was done and revealed lymphocytic smear with advised tru-cut biopsy. CT guided tru-cut was taken after 8 days. During CT guided technique; marked regression of left subphrenic mass was detected. Post-contrast MDCT scan was done and revealed partial response of the masses after 8 days. The partial regressive course of this disease suggests the effectiveness of fine nee...

Indian Journal of Surgical Oncology

BMC nephrology, Jan 4, 2018

Nephrotoxicity is a major hazard complicating the use of platinum based drugs (PBD), which can hi... more Nephrotoxicity is a major hazard complicating the use of platinum based drugs (PBD), which can hinder using higher doses protocols to maximize the therapeutic gain. Shortage of serum creatinine level as an accurate biomarker for acute kidney injuries (AKI) necessitates searching for novel biomarkers with better sensitivity and specificity in patients on PBD. In a prospective cohort design, 132 patients receiving PBD were selected for the study. AKI was diagnosed by continuous follow up of serum creatinine level according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines 2012. Serum creatinine and urinary biomarkers (KIM-1, NGAL and cystatin C) was measured in the day of treatment and for 3 days after PBD cycle. AKI occurred in 35 patients (26.52% of patients). KIM-1, Cystatin C, and NGAL showed significant increase in samples collected in the day of AKI in comparison to their corresponding basal levels (P < 0.0001). In addition, significant increase in urinary leve...

Journal of Cancer Therapy, 2018

Background and Objective: Osteosarcoma is a rare bone cancer with approximately 30%-35% of patien... more Background and Objective: Osteosarcoma is a rare bone cancer with approximately 30%-35% of patients who will relapse either systemically or locally, with the lung being the commonest site of relapse. The objective of this trial was to evaluate the efficacy of cyclophosphamide and etoposide, in treatment of metastatic osteosarcoma patients progressed after one or more chemotherapy lines, with the progression free survival and treatment response as the primary endpoints, while the secondary endpoints were overall survival and treatment toxicity. Patients and Methods: Twenty seven metastatic osteosarcoma patients were enrolled into this trial and received cyclophosphamide and etoposide chemotherapy. Cyclophosphamide was given at a dose of 500 mg/m 2 per day, I.V for 5 days and etoposide (100 mg/m 2 per day I.V for 5 days). Response was assessed after 3 cycles according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Chemotherapy Toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE). Results: The median overall survival time and progression-free survival were 12 months and 8 months, respectively. Four patients (14.8%) achieved partial response; 14 patients (51.9%) had stationary disease (SD); and 9 (33.3%) expressed tumor progression. Hematologic toxicity was the main toxicity. None of the patients had G4 or life threatening toxicities. Conclusion: The combination of cyclophosphamide and etoposide represents an efficient and tolerable treatment option for patients with metastatic osteosarcoma.