Background: Diarrhea is a well-recognized side effect associated with pelvic radia on; however, there is not any effec ve common treatment for radia on-induced diarrhea. A popular alterna ve is probio cs, which have been used in several gastrointes nal disorders. Probio cs are live microbial food supplements. Furthermore, honey is a puta ve nutri onal with a variety of health effects, including an bacterial, an oxidant, an-inflammatory and prebio c. The present study evaluated the effects of probio c with or without honey on radia on-induced diarrhea. Materials and Methods: Sixty-seven adult pa ents with pelvic cancer underwent radiotherapy for four weeks. They randomized to receive probio c (n = 22), probio c plus honey (n = 21) or placebo (n = 24) from one week before radiotherapy for five weeks. Diarrhea grade and stool consistency score were recorded weekly according to the Common Toxicity Criteria system and the Bristol scales, respec vely. Results: The results showed a decrease in the daily number of bowel movements (p = 0.003 and 0.006), diarrhea grade (p = 0.001 and 0.001) and the need for an diarrheal medica on (p = 0.021 and 0.041) also an increase in the stool consistency (p = 0.004 and 0.005) in pa ents who either used probio c or probio c plus honey (respec vely), these were significant in weeks 4 and 5 of treatment. Conclusion: Probio cs with or without honey can reduce the incidence of radia on-induced diarrhea and the need for an diarrheal medica on.

Background:Oral mucositis is a debilitating side effect of cancer treatment for which there is not much successful treatments at yet. We evaluated the effectiveness of topical morphine compared with a routine mouthwash in managing cancer treatment-induced mucositis.Materials and Methods:Thirty head and neck cancer patients with severe mucositis (World Health Organization Grade III or IV) were randomized into the morphine and magic mouthwash groups. Patients received morphine sulfate 2% or magic solution (contained magnesium aluminum hydroxide, viscous lidocaine, and diphenhydramine), 10 ml for every 3 h, six times a day, for 6 days. Both groups received same dietary and oral hygiene instructions and care. Mucositis was graded at baseline and every 3 days after treatment. Patients’ satisfaction and drug effect maintenance were also evaluated.Results:Twenty-eight patients (mean age of 49.5 ± 13.2 years, 63.3% female) completed the trial; 15 in the morphine group and 13 in the magic group. There was a decrease in mucositis severity in both of the morphine (P < 0.001) and magic (P = 0.049) groups. However, at the 6th day, more reduction was observed in mucositis severity in the morphine compared with magic group (P = 0.045). Drug effect maintenance was similar between the two groups, but patients in the morphine group were more satisfied by their treatments than those in the magic group (P = 0.008).Conclusions:Topical morphine is more effective and more satisfactory to patients than the magic mouthwash in reducing severity of cancer treatment-induced oral mucositis. More studies with larger sample size and longer follow-up are required in this regard.

Background:Peripheral neuropathy is one of the most important limitations of oxaliplatin base regimen, which is the standard for the treatment of colorectal cancer. Evidence has shown that Vitamin E may be protective in chemotherapy-induced peripheral neuropathy. The aim of this study is to evaluate the effect of Vitamin E administration on prevention of oxaliplatin-induced peripheral neuropathy in patients with colorectal cancer.Methods:This was a prospective randomized, controlled clinical trial. Patients with colorectal cancer and scheduled to receive oxaliplatin-based regimens were enrolled in this study. Enrolled patients were randomized into two groups. The first group received Vitamin E at a dose of 400 mg daily and the second group observed, until after the sixth course of the oxaliplatin regimen. For oxaliplatin-induced peripheral neuropathy assessment, we used the symptom experience diary questionnaire that completed at baseline and after the sixth course of chemotherapy. Only patients with a score of zero at baseline were eligible for this study.Results:Thirty-two patients were randomized to the Vitamin E group and 33 to the control group. There was no difference in the mean peripheral neuropathy score changes (after − before) between two groups, after sixth course of the oxaliplatin base regimen (mean difference [after − before] of Vitamin E group = 6.37 ± 2.85, control group = 6.57 ± 2.94; P = 0.78). Peripheral neuropathy scores were significantly increased after intervention compared with a base line in each group (P < 0.001).Conclusions:The results from this current trial demonstrate a lack of benefit for Vitamin E in preventing oxaliplatin-induced peripheral neuropathy.

Titanium (Ti) mesh plates are used as a bone replacement in brain tumor surgeries. In the case of radiotherapy, these plates might interfere with the beam path. The purpose of this study is to evaluate the effect of titanium mesh on the dose distribution of electron fields. Simulations were performed using Monte Carlo BEAMnrc and DOSXYZnrc codes for 6 and 10 MeV electron beams. In Monte Carlo simulation, the shape of the titanium mesh was simulated. The simulated titanium mesh was considered as the one which is used in head and neck surgery with a thickness of 0.055 cm. First, by simulation, the percentage depth dose was obtained while the titanium mesh was present, and these values were then compared with the depth dose of homogeneous phantom with no titanium mesh. In the experimental measurements, the values of depth dose with titanium mesh and without titanium mesh in various depths were measured. The experiments were performed using a RW3 phantom with GAFCHROMIC EBT2 film. The results of experimental measurements were compared with values of depth dose obtained by simulation. In Monte Carlo simulation, as well as experimental measurements, for the voxels immediately beyond the titanium mesh, the change of the dose were evaluated. For this purpose the ratio of the dose for the case with titanium to the case without titanium was calculated as a function of titanium depth. For the voxels before the titanium mesh there was always an increase of the dose up to 13% with respect to the same voxel with no titanium mesh. This is because of the increased back scattering effect of the titanium mesh. The results also showed that for the voxel right beyond the titanium mesh, there is an increased or decreased dose to soft tissues, depending on the depth of the titanium mesh. For the regions before the depth of maximum dose, there is an increase of the dose up to 10% compared to the dose of the same depth in homogeneous phantom. Beyond the depth of maximum dose, there was a 16% decrease in dose. For both 6 and 10 MeV, before the titanium mesh, there was always an increase in dose. If titanium mesh is placed in buildup region, it causes an increase of the dose and could lead to overdose of the adjacent tissue, whereas if titanium mesh is placed beyond the buildup region, it would lead to a decrease in dose compared to the homogenous tissue.PACS number: 87.53.Bn

Evidence to justify survival benefit of local therapy of the breast (LT) for breast cancer patients who are metastatic at presentation (MBC) is weak. The aim of this study is to evaluate the outcome of LT on survival in MBC patients. Patients who had received (1) radiotherapy, (2) surgery, (3) surgery and radiotherapy as LT, and (4) no LT in four groups of 25 were evaluated for 1-and 4-year cause-specific survival (CSS). One-and 4-year CSS in four groups were (1) 76% and 60%, (2) 84% and 56% (3) 80% and 52%, and (4) 48% and 16%, respectively. When controlling for age and site of metastasis as covariates, grouping significantly correlated with survival: F (3, 94): 2.93, P 0.04. Post hoc analysis revealed that the mean survival of group 2: (M 23.39, SE 2.53) was higher than group 4: (M 13.63, SE 2.52, P = 0.03). Surgery as a single modality LT for MBC may provide survival benefit.