Purpose:To compare calculated tumour control probability (TCP) of the target(s) and normal tissue complication probability (NTCP) for Organs At Risk (OAR); lungs, heart, and contralateral breast using 3D conformal radiotherapy (3D-CRT) and intensity-modulated radiation therapy (IMRT) in patients with operable left breast cancer. Uncomplicated Tumour Control Probability (UTCP) was accordingly calculated. Patients and Methods: Sixty female patients with operable left breast cancer either post mastectomy or breast conservative surgery (BCS) underwent 3D-CRT and IMRT planning. Target coverage and target dose distribution as well as doses received by OAR (lungs, heart) were evaluated in both techniques. The TCP for target volumes, the NTCP for late excess cardiac mortality and radiation pneumonitis using Burman model. UTCP for each target was also calculated by subtracting the sum of NTCPs for OAR from TCP of the each target conclusion: UTCP was significantly better in the IMRT arm in both left breast & chest wall targets either IMC was included in the target or not .

Background: Lung cancer remains the most common primary tumor responsible for brain-metastases (BM) leading to 40%-50% of cases. BM from Non-Small Cell Lung Cancer (NSCLC) is associated with poor prognosis. Aim: This study aimed to analyze risk factors and treatment outcome of patients with NSCLC who developed BM, and also to identify which subgroup of these patients is associated with better survival outcome. Methods: This retrospective study included data of 714 patients with NSCLC presented to an Egyptian cancer center during the period between January 2006 and December 2012. Of them, 132 patients had clinical evidence of BM. results: The median time to development of BM (TTBM) was 6 months. Factors associated with longer TTBM were better Eastern Cooperative Oncology Group (ECOG) performance status score 1-2 (p = 0.004), early stages at presentation (stage I-II) (p < 0.0001), and administration of chemotherapy (p < 0.0001). Median OS (OS) from the time of development of BM was 5 months. Factors associated with longer OS were better performance status (ECOG 1-2) at development of BM (p <0.0001), controlled lung primary (p <0.0001), absence of extracranial metastases (p =0.019), the use of chemotherapy after development of BM (p <0.0001) and whole brain irradiation (p =0.001). Controlled lung primary and administration of chemotherapy were independent favorable prognostic factors associated with higher OS (p = 0.006 and 0.02, respectively). conclusion: After the development of BM; NSCLC patients with good performance status, controlled lung primary and without extracranial metastases have a better outcome.

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The aim of the current study is to focus on treatment response in patients with malignant pleural mesothelioma (mPm) treated with combination chemotherapy using cisplatin plus vinorelbine. Secondary endpoints included, toxicity, progression-free and overall survival. Patients and Methods: This prospective study included 26 patients with histologically proven unresectable mPm treated at Kasr El-Aini Center of Clinical Oncology and Nuclear medicine (NEmROCK) from march 2003 to August 2004. Patients were assigned to receive cisplatin 75mg/m 2 on day one and vinorelbine 25mg/m 2 on days one and 8 every three weeks. Results: All 26 patients had measurable disease and were assessed for response. Six patients had partial response (23%), 14 patients had stable disease (54%), and six patients had disease progression on therapy (23%). Toxicity was acceptable and no treatment-related deaths occurred. The median progression-free survival was 5.15 months and the median overall survival for was 10.3 months, with a 42.3% one-year survival. Conclusion: Cisplatin-vinorelbine combination is an effectve regimen for management of malignant pleural mesothelioma with a tolerable toxicity profile. Further studies with a larger number of patients is necessary.

Background: Postoperative radiotherapy in the management of breast cancer was proven to be effective in reducing local recurrence. The aim of this work was to compare between 2 dimensional (2D) and 3 dimensional conformal radiotherapy (3D-CRT) considering dose homogeneity inside the target volume(s) and doses received by the surrounding risk structures. Clinical outcome including tumor control, survival and toxicity of both techniques were also prospectively compared. Patients and Methods: Sixty female patients with left breast cancer following mastectomy or breast conservative surgery were included and each one had a 2D and 3D conformal planning. Both techniques were compared (physical study) for target volume coverage, dose homogeneity and doses received by the risk organs. For treatment (clinical study), only one technique was randomly applied. Patients were divided into group A including 30 patients who received treatment based on 2D planning and group B including 30 patients who received 3D-CRT. Results: The physical study revealed no significant difference between both techniques in coverage or dose homogeneity inside the left breast (or chest wall) or supraclavicular lymph nodes (SCLN). However, 3D-CRT demonstrated a better coverage inside the internal mammary nodes (IMN). Another significant result was sparing the left lung from receiving a dose of 20 Gy or more (V20Gy) in favor of the 3D conformal plan. The estimated excess relative risk of right breast cancer was less in 3D-CRT (1.68 ± 0.815 %) compared to 2D (2 ± 0.66 %), but the difference was not statistically significant. Clinically, at a median follow up period of 29.5 months, there was no significant difference between both arms in the loco-regional recurrence, survival, or toxicity. However, a statistically significant less reduction of cardiac ejection fraction (EF) measured by isotopic scanning was noticed with 3D-CRT (5.127 ± 4.8839% for 2D versus 2.363 ± 4.7562% for 3D, P = 0.013). Conclusion: 3D-CRT spared the left lung from receiving higher radiation dose during the post-operative radiotherapy with significant less reduction of cardiac EF. 3D-CRT should be offered for patients who are going to receive IMN irradiation for better coverage of the target volume.