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Background:Germ cell tumors are neoplasms that originate from multi potential germ cells and can be intra or extra gonadal. According to pathologic classification, they have different subtypes. They account for 3% of pediatric malignancies and most commonly happen in children before the age of 15 years old. Epidemiologic evidence about pediatric germ cell tumors is scant in our region.Objectives:The aim of current study was to determine demographic characteristics, recurrence and survival rate of germ cell tumor patients under the age of 21 years.Patients and Methods:During a 10-year period (1996 - 2006), 106 patients under the age of 21 years suffering from germ cell tumor were admitted to our centers. We extracted the data needed for our study from patients’ medical records in the hospitals.Results:Thirty seven boys and 69 girls with a mean age of 8.4 ± 7.8 years were included. Most tumors were diagnosed before the age of one year (37%). The most common pathologic subtype was mature teratoma (44%). Ovary (35%) was the most common primary site. Surgery plus chemotherapy were used to treat 54 patients and BEP was the most common chemotherapy regimen. Metastasis and recurrent tumor were seen in 22% and 8% of cases, respectively. Four-year overall survival was 89%.Conclusions:Our study showed that demographic characteristics of GCT patients in our population are similar to patients of other geographic regions in the world. Primary tumor site, histologic subtype and metastasis were significant prognostic factors for survival.

Background: The current first-line treatment of locally advanced head and neck carcinoma (LAHNC) is concurrent chemoradiation with three-weekly cisplatin 100 mg/m 2 . However, prescribing cisplatin at this dose increases the treatment toxicity, which may compromise the treatment results. An alternative schedule is weekly 40 mg/m 2 cisplatin.Aim: To compare the acute hematologic and renal toxicities of these two regimens.Methods: This randomized clinical trial included 77 LAHNC patients who were allocated to a high dose (100 mg/m 2 every 3 weeks) or low dose (40 mg/m 2 weekly) cisplatin group concurrent with radiotherapy. Hematologic and renal indices were measured weekly during chemoradiation. Results:The average age of patients was 55.3 years. Overall, 71.4% of patients were treated in a definitive setting. The incidence of severe hematologic events was not significantly different. However, the average estimated glomerular filtration rate (eGFR) was significantly greater in the three-weekly group (67.85 vs. 58.57% mL/min per 1.73 m 2 ; P-value = .02). Cumulative cisplatin dose of ≥240 mg/m 2 was significantly greater in the weekly group. Totally, treatment breaks occurred in 40.3% of patients due to treatment toxicity. Treatment interruption was primarily due to neutropenia in the three-weekly and renal dysfunction and thrombocytopenia in the weekly group.Conclusions: Severe acute hematologic toxicities were comparable for three-weekly and weekly groups. The decrease in eGFR through treatment was more significant with weekly cisplatin. Further follow-up, however, is needed to confirm its impact on delayed renal function.

Background:Evidences about survival of the patients with head and neck squamous cell carsinoma (HNSCC) have been scant in our region.Objectives:The aim of current study was to determine clinico-pathological and treatment-related factors, influencing outcome of these patients.Patients and Methods:We have reviewed all patients with a new diagnosis of HNSCC admitted between 2008 and 2014 in “Jorjani Cancer Center”, Tehran, Iran. Overall survival (OS) and event free survival (EFS) of the patients, and their relation with demographic and clinico-pathological factors have been analyzed.Results:Among 119 included patients, 90 were male and 29 were female with mean age of 58 years. Larynx was the most common primary tumor site (55% of all patients). With a median follow-up period of 28 months, OS and EFS of the study patients was 61.2% and 52.4%, respectively. Tumor stage was the only parameter has significantly influenced the patients’ OS. Patients with normal BMIs had significantly higher mean EFS compared with patients with bellow or above normal BMIs. Surgical treatment modalities have resulted in the same prognosis as non-surgical approaches.Conclusions:Our study seems to be the first that investigated outcome of Iranian patients with head and neck cancer and its influencing factors.

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Background:The literature is inconsistent for the role of neutrophil-to-lymphocyte ratio (NLR) obtained before neoadjuvant therapy (pre-NLR) in predicting pathological response to neoadjuvant chemoradiation (neoCRT) in patients with locally advanced rectal cancer (LARC). In the present cohort study, we explored the predictive role of pre-NLR in this setting. Methods: We prospectively included patients with LARC who were candidates for neoCRT at the Shohada-e-Hafte Tir Hospital (Tehran, Iran) between Mar 2018 and Feb 2020. The pre-NLR was obtained through a peripheral blood smear before CRT. We used the AJCC system for evaluating tumor regression grade (TRG). The TRGs were categorized into: response-group 1 (TRG 0-1 vs. 2-3), response-group 2 (TRG 0 vs. 1-3), and responsegroup 3 (TRG 0-2 vs. 3). We applied receiver operating characteristic (ROC) analysis to assess the predictive value of pre-NLR. Results: Of the 86 screened patients with rectal cancer, 30 patients who fulfilled the inclusion criteria were included in the study. In total, 63.3% were responsive, and 23.3% had complete pathologic response. Pre-NLR could not predict the pathologic response in response-group 1 (area under the ROC curve [AUC]: 0.45, 95%CI 0.23-0.66) and response-group 2 (AUC: 0.36, 95%CI 0.13-0.59). Nevertheless, it had a poor predictive value in response-group 3 (AUC: 0.55, CI%95 0.33-0.75) with an optimal NLR cutoff value of 2.94. Conclusions: Pre-NLR could not predict the pathological response to neoCRT in our cohort of patients with LARC.

To investigate whether excision repair cross complementing-group1 (ERCC1) expression status could serve as a bio-predictor of response to platinum-based induction chemotherapy for head and neck cancers (HNCs) patients with a diagnosis of epithelial HNC were studied retrospectively. Paraffin embedded tumor samples of the patients were analyzed by reverse transcription-polymerase chain reaction (RT-PCR) to determine ERCC1 expression status and its correlation with response to platinum-based induction chemotherapy was investigated. Of 44 included patients, 33 were male (75%) and 11 were female (25%) with a mean age of 53 years. Some 36% of patients whose tumor samples had high ERCC1 expression showed no response to induction chemotherapy. The value for patients with low ERCC1 expression was 9% and the difference was statistically significant (p=0.03). The ERCC1 expression state did not significantly vary between patient groups according to sex, age, primary tumor site, and tumor and node stage. Our study indicates that ERCC1 expression status detected by RT-PCR might serve as a bio-predictor of response to platinum-based induction chemotherapy for epithelial HNCs.

Background: Teleoncology refers to the use of telemedicine for remotely providing multiple specialized services in clinical oncology processes, including screening, diagnosis, treatment planning, consultation, supportive care, pathology, surgery, and follow-up services. Objectives: The aim of this study was to identify the required data elements and elicitation of requirements for developing a telemedicine system that aims at providing treatment plans for patients with breast cancer. Methods: In this study, the required data elements for the teleoncology system were identified through both the investigation of clinical guidelines and review of patients’ medical records. Identified data elements were determined by breast cancer specialists through the questionnaire. Besides, an interview method was applied to elicit the requirements of this system. Results: The identified data elements were categorized into 20 groups (e.g., clinical data, breast physical examinations, pathological results, tests, imaging results, etc.). From the 182 data elements included within the questionnaire, 125 were recognized to be necessary (n = 32, 100%). The lowest mean percentage were observed in magnesium blood test (Mg) (n = 21, 65.63%) and protein test (Pr) (n = 21, 65.63%). Other data elements with a minimum mean of 71.87% and a maximum mean of 100% were recognized necessary. In general, 2 major themes, 9 categories, and 45 related sub-categories were extracted from analyzing the findings of the interviews related to the system requirements. Conclusions: The findings of the present study can be used as a basis for developing teleoncology systems that aim at providing treatment plans for patients with breast cancer.