Research Article
Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases
Md Ruhul Amin Bhuiyan*,
Farhana Hussain Sadia,
Ahammad Al Mamun Sweet,
Md Ershadul Haque,
Khandaker Md. Rezwan Bayzid,
AZM Sumsuzoha,
Aditi Paul Chowdhury,
Md Abdul Mannan
Issue:
Volume 9, Issue 1, April 2024
Pages:
1-10
Received:
10 April 2023
Accepted:
10 June 2023
Published:
8 January 2024
Abstract: Background: Brain metastases are secondary tumors that develop from primary malignant tumors located outside the central nervous system. It is the most common kind of intracranial tumor in adults. Brain metastases are treated with both decisive anticancer therapy and supportive care. Objective: To compare the efficacy of whole brain radiotherapy versus concurrent whole brain radiotherapy with Temozolomide in the treatment of brain metastases. Method: This quasi-experimental study was conducted in the department of Oncology in Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajganj among 68 patients from December 2018 to June 2020. Patients who attended the KYAMCH Oncology department during the study period and met the selection criteria were enrolled in the study. Results: In Arm A, the mean age was 56.15±10.14 years and in Arm B, the mean age was 54.06±10.24 years. Karnofsky Performance Status of most of the patients was 70 or above in both arms, which was 25 (73.50%) and 26 (76.50%) in Arm A and Arm B respectively. In Arm A, the most common primary tumor site was lung 17 (50%) and in Arm B, it was lung 18 (52.94%). In Arm A, the most common clinical feature was headache 21 (61.80%) and In Arm B, 20 (58.80%) patients too presented with headache. In Arm A, before treatment 5 (14.70%) patients had convulsion. In Arm B, before treatment 6 (17.60%) patients had convulsion. After treatment convulsion was found in 2 (5.90%) patients. The response was more in Arm B. The most common non- hematological toxicity was nausea, which developed in 17 (50%) patients in Arm A and 22 (64.70%) patients in Arm B. Though non- hematological toxicities were more in Arm B, it was not statistically significant. Thrombocytopenia was reported in 11 (32.35%) patients in Arm A and 20 (58.82%). In Arm A, CR was observed in 02 (05.90%) patients and in Arm B, CR was observed in 05 (14.70%) patients. Statistically significant radiological responses were achieved in the WBRT+TMZ arm compared to the WBRT alone arm. Adenocarcinoma overall response was achieved in 6 (17.64%) patients in Arm A and 12 (35.29%) patients in Arm B. Conclusion: After analyzing the result of the study it can be concluded that the efficacy of concurrent radiotherapy with Temozolomide is higher than that of radiotherapy alone in the treatment of brain metastases. The combined treatment protocol significantly improves the symptoms and signs with acceptable toxicity profile.
Abstract: Background: Brain metastases are secondary tumors that develop from primary malignant tumors located outside the central nervous system. It is the most common kind of intracranial tumor in adults. Brain metastases are treated with both decisive anticancer therapy and supportive care. Objective: To compare the efficacy of whole brain radiotherapy ve...
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Research Article
Pheochromocytoma Discovered Incidentally at the Sylvanus Olympio University Hospital in Lomé (Togo)
Djalogue Lihanimpo*,
Nemi Komi Dzidzonu,
Tchamdja Toyi,
Mossi Komi Edem,
Djagadou Kodjo Agbéko,
Balaka Abago,
Djibril Mohaman Awalou
Issue:
Volume 9, Issue 1, April 2024
Pages:
11-14
Received:
3 December 2023
Accepted:
2 January 2024
Published:
5 February 2024
Abstract: Introduction: The diagnosis of pheocytochroma is often late compared to the appearance of symptoms, sources of morbidity and even mortality. However, pheochromocytoma can be discovered incidentally during a pathology unrelated to the tumor. Case report: We report a case revealed by acute viral hepatitis B. It’s a young subject hospitalized in the internal medicine department of the Sylvanus OlympioTeaching Hospital in Lome. This is a 22-year-old patient, professional driver with no known pathological history, admitted for headache, muscle aches and asthenia associated with abdominal pain and postprandial vomiting in a febrile context. In admission, clinical examination revealed high blood pressure (BP=190/140mmHg), a deterioration in general condition, jaundice and painful hepatomegaly. The biological assessment revealed a cholestatic cytolysis syndrome (AST: 48.24N, ALT: 42.23N, PAL: 1.06N, Gamma GT: 3.84N, total bilirubin: 31.4N, direct bilirubin: 89, 6N). The serological assessment revealed acute viral hepatitis B (HbsAg positive and anti-Hbc antibodies type IgM positive, HIV and hepatitis C serologies negative). An abdominal ultrasound noted homogeneous hepatomegaly without dilatation of the portal trunk or bile ducts. Faced with this hypertension in a 22-year-old, secondary hypertension was considered and abdominal CT revealed a pheochromocytoma. Conclusion: Pheochromocytoma is not uncommon in our circles. It should always be considered in the present of high blood pressing in young subject.
Abstract: Introduction: The diagnosis of pheocytochroma is often late compared to the appearance of symptoms, sources of morbidity and even mortality. However, pheochromocytoma can be discovered incidentally during a pathology unrelated to the tumor. Case report: We report a case revealed by acute viral hepatitis B. It’s a young subject hospitalized in the i...
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Research Article
CDA Formulations as Persuasive Good Cancer Drugs to Save Cancer Patients
Ming Cheng Liau*,
Christine Liau Craig,
Linda Liau Baker
Issue:
Volume 9, Issue 1, April 2024
Pages:
15-24
Received:
11 January 2024
Accepted:
22 January 2024
Published:
5 February 2024
Abstract: The objective of this study is to develop good cancer drugs to save cancer patients. Good cancer drugs are the drugs capable of inactivating abnormal methylation enzymes (MEs) to take out both cancer stem cells (CSCs) and cancer cells (CCs) by inducing these cells to undergo terminal differentiation, and to restore chemo-surveillance to save cancer patients. Bad cancer drugs are cytotoxic agents that can kill CCs but cannot affect CSCs, which can also destroy chemo-surveillance to contribute to the fatality of advanced cancer patients. Cell differentiation agent-2 (CDA-2) is a persuasive good cancer drug approved by the Chinese FDA. CDA-2 is a preparation of wound healing metabolites purified from urine, which can serve as a model for the development of CDA formulations as good cancer drugs. Wound healing metabolites active as differentiation inducers (DIs) and differentiation helper inducers (DHIs) are the active players of chemo-surveillance created by the nature as allosteric regulators of abnormal methylation enzymes (MEs). The elimination of abnormal MEs is very critical to the success of cancer therapy. Wound healing is a simple matter that comes naturally, because the nature creates chemo-surveillance to ensure perfection of wound healing. Cancer is the consequence of wound unhealing due to the collapse of chemo-surveillance. Cancer therapy can also be a simple matter, if the therapy follows wound healing process. PSCs and CSCs are cells with abnormal MEs, which are protected by drug resistance and anti-apoptosis mechanisms. PSCs are the cells involved in wound healing. Efficient induction of terminal differentiation of PSCs is very critical to the success of wound healing. Natural DIs and DHIs are the partners of PSCs and CSCs in wound healing, which can easily access to PSCs and CSCs. If wound is not healed, PSCs are forced to evolve into CSCs and then to progress to faster growing CCs. CCs display a high level of degradative enzymes to generate substrates for the syntheses of macro-molecules to support their faster growth. Natural DIs and DHIs may be rapidly degraded in CCs. A different set of unnatural DIs and DHIs may be necessary to achieve the induction of terminal differentiation of CCs. Thus, two sets of CDA formulations, one CDA-CSC with natural DIs and DHIs, and another CDA-CC with non-natural DIs and DHIs to accomplish induction of terminal differentiation of both CSCs and CCs to achieve effective therapy of cancer.
Abstract: The objective of this study is to develop good cancer drugs to save cancer patients. Good cancer drugs are the drugs capable of inactivating abnormal methylation enzymes (MEs) to take out both cancer stem cells (CSCs) and cancer cells (CCs) by inducing these cells to undergo terminal differentiation, and to restore chemo-surveillance to save cancer...
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