Background and objective We report our experiences with Intraoperative radiation therapy (IORT) among breast cancer (BC) patients in our region. Methods All patients who received radical IORT from April 2014 on to March 2020 were included in the study. Patient selection criteria included: Age equal or older than 45 years old; All cases of invasive carcinomas (in cases of lobular carcinomas only with MRI and confirmation); Patients who were 45–50 years old with a tumor size of 0–2 cm, 50–55 years old with a tumor size of < 2.5 cm, and those who were ≥ 55 years old with a tumor size of < 3 cm; Invasive tumors only with a negative margin; Negative nodal status (exception in patients with micrometastasis); A positive estrogen receptor status. Primary endpoints included death and recurrence which were assessed using the Kaplan–Meier method. Results Overall, 252 patients entered the study. Mean (SD) age of patients was 56.43 ± 7.79 years. In total, 32.9% of patients had a family history of BC. Mean (SD) tumor size was 1.56 ± 0.55 cm. Mean (IQR) follow-up of patients was 36.3 ± 18.7 months. Overall, 8 patients (3.1%) experienced recurrence in follow-up visits (disease-free-survival of 96.1%), among which four (1.5%) were local recurrence, two (0.8%) were regional recurrence and two patients (0.8%) had metastasis. Median (IQR) time to recurrence was 46 (22, 53.7) months among the eight patient who had recurrence. Overall, one patient died due to metastasis in our series. Eleven patients (4.3%) with DCIS in our study received IORT. All these patients had free margins in histopathology examination and none experienced recurrence. Conclusion Inhere we reported our experience with the use of IORT in a region where facilities for IORT are limited using our modified criteria for patient selection.
Introduction: Pancreatic leiomyosarcoma is a rare tumor and its clinical course and treatment is not well described. Case Presentation: This paper reports on a 57-year-old male, who presented epigastric pain and had a 12-cm pancreatic tail leiomyosarcoma. He received adjuvant radiotherapy after complete tumor resection. He developed local recurrence 11 months later and received no further treatment. He died after 3 months. Conclusions:The literature search revealed that pancreatic leiomyosarcoma has a variable clinical course and behavior.
10.30699/jambs.30.141.333 Background & Objective: The lack of breast cancer screening in young women leads to late disease diagnosis and worse outcomes in this age group. This study was designed to evaluate clinicopathological features and long-term outcomes of young breast cancer women in south of Iran. Materials & Methods: This is a retrospective study of breast cancer patients who were pathologically diagnosed during 2005 to 2017. Data from 284 breast cancer patients aged 40 years or younger were included in this study. Demographic, clinicopathological properties as well as treatment modalities including type of surgery, adjuvant radiotherapy, and adjuvant or neoadjuvant chemotherapy were recorded and analyzed.Results: Median age of the patients was 36 (range 23-40) years. After a median follow-up of 68 months, 21 patients had died due to the disease, 59 patients were alive with the disease, and 204 patients were alive without the disease. The univariate COX regression demonstrated that the disease -free survival (DFS) was significantly low in patients who had undergone breast conservation surgery (BCS) and also patients with higher stages, estrogen/progesterone-negative and human epidermal growth factor receptor 2-positive (ER-/PR-/HER2+) status. Low overall survival (OS) was also significantly associated with stage. According to multivariate COX regression, BCS, stages II, III and also young age were independent predictive factors for low DFS. Conclusion:Given the aggressive features and worse outcome of young breast cancer patients, treatment remains tough and screening seems to be required at young age. Further studies are required to find best management and therapeutic protocols for these patients.
There is no study about IORT effects on non-breast cancer Iranian patients in the medical literature. →What this article adds:Our results showed the effect of IORT, which is used for primary and local recurrence control of non-breast cancer patients for the first time in Iran.
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