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Uterine cervix carcinoma: pathologic characteristics, treatment and follow-up evaluation
Amouzegar Hashemi F,Esmati E,Kalaghchi B
Tehran University Medical Journal , 2008,
Abstract: Background: Carcinoma of the uterine cervix is the sixth most common malignant neoplasm in women. Early stage diagnosis of uterine cervix carcinoma increases the cure rate of disease. Radiotherapy, with or without concurrent chemotherapy, is one of the most effective treatment modality in cervical carcinoma. After radiotherapy, accurate and regular follow-up results in early diagnosis and effective treatment of recurrence. The aim of this study is the assessment of the pathologic characteristics, setting and indications for postoperative radiotherapy and outcome of patients at the last follow-up.Methods: In this retrospective study, we evaluated 346 cases of cervical carcinoma had received radiotherapy in radiation oncology department of the Cancer Institute of Imam Khomeini Hospital, Tehran, Iran, from 1995 to 2001.Results: The age of the study group ranged from 26 to 78 years (mean=50.5, SD=11). Of these patients, 30.4% were in the early stage and 69.6% had advanced stage disease. Squamous cell carcinoma comprised 92.2% of the cases and 6.4% adenocarcinoma. Radical radiotherapy was the most frequent radiotherapy setting and adjuvant radiotherapy (post-op) was the second. A considerable number of patients did not come back for follow-up, and 43.7% were followed for a short time.Conclusion: Accurate presurgical clinical staging and surgical treatment by an expert gynecologic oncologist can reduce expose the patients to risks of two modality treatments (surgery and radiotherapy). According to our results, patients do not pay enough attention to disease follow-up. An acceptable training plan with emphasis on regular follow-up, is recommended.
An eight-year study of the Thyroid cancer cases treated in Tehran Cancer Institute’s radiation-oncology Department
Amouzegar Hashemi F,Haddad P,Sajjadi M
Iranian Journal of Nuclear Medicine , 2001,
Abstract: A retrospective study was undertaken to examine the thyroid cancer cases referred for external radiotherapy to our department during the period of 1991-99. Within this period, a total of 33 patients had been treated by irradiation for thyroid cancer or its metastases and these cases were evaluated for age, sex, pathology and type of surgery. The reason of patients’ referral for external radiotherapy (The main aim of our study) was tumor extensive infiltration of the neck soft tissue and/or lymph nodes in 21 cases (64%), and tumor metastasis in 12 cases (36%). Twenty-one patients came back for follow-up, who were all symptom-free 12-18 months after irradiation.
Effects of monotherapy versus combination therapy on overall and disease-free survival in high-grade astrocytoma
Amouzegar Hashemi F.,Hashemi E.,Haddad P.,Kazemian A.
Tehran University Medical Journal , 2007,
Abstract: Background: The standard treatment for high-grade astrocytoma (grades 3 and 4) is surgery followed by radiotherapy (post-op RT). Adjuvant chemotherapy increases disease-free survival (DFS) and overall survival (OS). There are several drugs used for this purpose, each of which have shown benefits and shortcomings. The superiority of combination therapies such as PVC (procarbazine, CCNU and vincristine) over single agents such as BCNU (carmustine) and CCNU (lumostin) has not been definitively established. Single agent CCNU could be a very convenient treatment, as it only involves oral prescription every six weeks. Thus, in this study, we compare CCNU alone with PCV to establish any potential superiority with regard to DFS and OS."nMethods: From 2003-2006, patients with high-grade astrocytoma who had undergone surgery and radiotherapy in the Cancer Institute of Imam Khomeini Hospital, Tehran, Iran, were randomized to CCNU alone or PCV. Chemotherapy was repeated every six weeks for six cycles. Six weeks after the end of sixth cycle, a CT scan was performed. New neurologic signs and symptoms or increases in the previous signs and symptoms and/or new masses in imaging and/or growth of the residual tumor (> 25%) and/or enhancement of any inactive mass from the previous imaging was considered a recurrence. DFS was considered to be the duration from the end of RT to the date of recurrence or last follow-up. OS was taken as the duration from the end of RT to date of death or last follow-up."nResults: After informed consent, of the 70 patients included in this study, 38 were treated with PCV and 32 were treated with CCNU. The mean age was 44 years, ranging from 16 to 78 years, and 51 of the patients were male. Nineteen patients had grade 3 anaplastic astrocytoma and 51 patients had grade 4 glioblastoma multiforme. There were no significant differences with regard to patient age, gender and pathology between the CCNU and PCV groups. DFS and OS were 26 and 27 months, respectively, in the CCNU group and 29 and 34 months, respectively, in the PCV group. By log-rank test, the difference between CCNU and PCV was not statistically significant with regard to the length of DFS and OS."nConclusion: Although no significant differences were found, a trend toward better survival could be seen in patients treated with PCV. Further studies with more patients and longer follow-up are needed to definitively resolve this issue.
Medium dose rate brachytherapy for patients with cervical carcinoma; early result of a prospective study
Amouzegar Hashemi F,Zahedi F,Farhan F,Kalaghchi B
Tehran University Medical Journal , 2009,
Abstract: "nBackground: Treatment of cervical carcinoma is routinely performed with Low Dose Rate (LDR) brachytherapy, but Brachytherapy in our department is done with Medium Dose Rate (MDR) due to the technical characteristics of the machine available here. Thus we decided to evaluate the results of this treatment in our department in a prospective study. "nMethods: Between March 2006 and July 2008, 140 patients with histologic diagnosis of cervical carcinoma referred to Tehran Cancer Institute; were treated with external beam radiotherapy (44-64 Gy to whole pelvis) and MDR brachytherapy (8-30 Gy to Point A) with a dose rate of 2.2±0.3 Gy/h. "nResults: 121 patients were followed up for a median time of 18 months (range: 9-39 m). There were 11%(6/54) local recurrence for surgery and adjuvant radiotherapy group; 25%(16/65) for radical radiotherapy group, and 19%(23/121) for all patients. Rectal and bladder complications incidence for all patients were 10%(12/121) and 13%(16/121) respectively. High grade complication was shown only in one patient in radical radiotherapy group. In this study 3-years disease free survival and overall survival were 73% and 92% respectively, and disease stage (p=0.007) and overall treatment time (p=0.05) were the significant factors affecting disease free survival. "nConclusions: Results of this series suggest that the use of external beam radiotherapy and MDR brachytherapy with about 20% dose reduction in comparison with LDR can be an acceptable technique with regard to local control and complications.
Concurrent Chemoradiation With Weekly Gemcitabine and Cisplatin in Locally Advanced Cervical Cancer
Amouzegar Hashemi F,Hamed Akbari E,Kalaghchi B,Esmati E
Tehran University Medical Journal , 2011,
Abstract: Background: More than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard of treatment for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultaneously with radiation.Methods: Thirty Women with untreated invasive squamous-cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in Radiation Oncology department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty mg/m2 gemcitabine followed by 35 mg/m2 cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment.Results: The mean age of the participants was 58.13±11.83 (29-78) years. After 3 months of treatment, 73.3% had complete and 26.7% had partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients.Conclusion: According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation by gemcitabine in advanced cervical cancers.
Comparing the effects of conventional and hypofractionated radiotherapies on early skin toxicity and cosmetic outcomes after breast cancer conserving surgery
F Amouzegar Hashemi,B Kalaghchi,AR Sebzari,P Haddad
Tehran University Medical Journal , 2012,
Abstract: Background: The high number of breast cancer patients who receive radiation therapy after surgery has caused many to think about a shorter period of radiotherapy, which can significantly reduce the radiotherapy machine time, labor hours, and fewer patient visits. This study was designed to evaluate the acute skin effects and cosmetic outcomes of short course radiotherapy in early-stage breast cancer in comparison with the conventional treatment method.Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy by either receiving conventional treatment (dose: 50 Gy in 25 fractions) with subsequent electron boost or a short-course hypofractionated radiotherapy (dose: 42.5 Gy in 16 fractions) and a subsequent electron boost.Results: There were no skin changes during the first or the second week of treatment in the two groups. Cutaneous complications began after the third week as grade 1 skin toxicity after termination of the short-course radiotherapy but there were no difference in complication rate after four weeks of treatment. Six months and one year after treatment, there were no differences in terms of skin complications or cosmetic outcomes between the two groups.Conclusion: Although the use of a whole-breast irradiation with a hypofractionated schedule was associated with desirable outcomes, in term of skin toxicity and cosmetics, but longer follow-up periods with larger sample sizes are needed to confirm these results.
BRAIN ASTROCYTOMAS : A STUDY OF EPIDEMIOLOGICAL FINDINGS, TREATMENT RESULTS AND PROGNOSTIC FACTORS IN TEHRAN CANCER INSTITUTE'S RADIOTHERAPY PATIENTS
F. Amouzegar - Hashemi,P. Haddad,M. Sajjadi K.Dehshiri
Acta Medica Iranica , 1999,
Abstract: - Astrocytomas, including glioblastoma multiforme (GBM), arc the most common brain tumors. Post-operative radiotherapy plays an important rote in their treatment. Records of all patients with a pathologic diagnosis of astrocytoma referred for radiotherapy from 1987-1992 were reviewed and prognostic factors with regard to recurrences were analyzed."nDuring the study period, 162 astrocytoma patients were treated by radiation in our department. Malc-to~fcmalc ratio was 1.4:1. Tlic disease was most prevalent in the 3rd ami 4th decades of life. Most tumors were in cerebral hemispheres and grade IV. In nearly all patients only CT scan had been used for diagnosis, and total resection had been performed."nRadiation dose was mostly 5,000-5,500 cGy by standard fractionation. Follotv-up was available for 91 patients, and in these patients CCNU (tomustine) chemotherapy was prescribed for high-grade tumors. Tltrec-year local control was 77% . Grade, extent of surgery, and use of CCNU were statistically significant as prognostic factors. Also 4 GBM long-term survivors were found. Treatment of brain astrocytomas by radiation in our department was concluded to he reasonably successful.
Local recurrence after breast conserving surgery in breast cancer: a study in Cancer Institute, Tehran
Farnaz Amouzegar- Hashemi,Alireza Alaleh,Ali Kazemian,Peiman Haddad
Tehran University Medical Journal , 2010,
Abstract: "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Breast conservative therapy is associated with similar outcomes in comparison with mastectomy. The aim of this study is assessment of local recurrence rate and related risk factors in patients who have been treated with radiotherapy after conservative surgery for breast cancer."n"nMethods: This is a cohort study which data of all breast cancer patients who have visited in follow up clinic in radiation oncology department of cancer institute of Imam Khomeini Hospital complex in Tehran, Iran, during years 2007-2009 were collected. All of the patients were investigated for local recurrence and the possible risk factors."n"nResults: Two hundred and seventy seven patients have entered the study and all have followed for at least one year since data entry. Median follow-up time from the start of radiotherapy were 35 months (12-148 mo). We had seven cases (2.5%) with local recurrences (2.5%) which most of them occurred in first year after treatment. Because of low rate of recurrence none of the variables such as margin and nodal status has significant correlation with local recurrence which this should be due to small number of patient and short time of follow up."n"nConclusions: At median follow up of 35 months from the beginning of radiation therapy, local recurrence rate was 2.5% which is similar to the literature. We recommend to follow a larger group of patients for longer times to estimate recurrence risk after breast conservative therapy.
Chemoradiation in Nasopharyngeal Carcinoma: A 6-Year Experience in Tehran Cancer Institute
Bita Kalaghchi,Ali Kazemian,Farnaz Amouzegar Hashemi,Mehdi Aghili
Acta Medica Iranica , 2011,
Abstract: To determine the addition of value of neoadjuvant, concurrent and adjuvant chemotherapy to radiation in the treatment of nasopharyngeal carcinoma with regard to the overall survival (OS) and disease free survival (DFS) within a six year period in Tehran cancer institute. Files of all patients with nasopharyngeal carcinoma treated by radiotherapy with or without concurrent chemotherapy in a curative setting in Tehran cancer institute during the period of 1999-2005 were retrospectively reviewed.. A total of 103 patients with nasopharyngeal carcinoma had been treated during the study period with radiotherapy or chemoradiotherapy in our institute. There were 29 (28.2%) females and 74 (71.8%) males. The median age at the time of radiotherapy was 47 years old (range 9-75 years). The patients were followed 2 to 76 months with a median follow-up of 14 months. Time of first recurrence after treatment was 3-44 months with a median of 10 months.. Survival in 2 groups of patients treated with radiotherapy alone or chemoradiation did not have a significant difference (P>0.1). Two-year survival in patients treated with or without adjuvant chemotherapy and had local recurrence after treatment did not have significant difference (P>0.1). Two-year survival in patients with or without local recurrence after treatment did not have significant difference (P>0.1). A beneficial affect or a survival benefit of adjuvant/neoadjuvant chemotherapy and concurrent chemoradiation was not observed in Iranian patients.
Comparative Study on Application of Bimetallic Pt-Based Alloy Electrocatalysts in Advanced Chlor-Alkali Electrolysis  [PDF]
F Farzami, E Joudaki, S. J Hashemi
Engineering (ENG) , 2011, DOI: 10.4236/eng.2011.38102
Abstract: Application of an oxygen-depolarized cathode will contribute to energy saving in chlor-alkali electrolysis. For this purpose, the development of high-performance cathode with the best electrocatalyst is essential. Using bimetallic Pt-based alloy electrocatalysts including PtPd and PtAg carbon-supported in oxygen-depolarized cathode chlor-alkali cell has been shown to have the high cell performance. This study presents application of PtRu carbon supported electrocatalyst oxygen-depolarized cathode and performance comparison of cells with carbon-supported PtRu, PtPd and PtAg electrocatalysts cathodes using the same DSA-Cl2 anode. Results show that there are quite similarity between the effects of various factors on the caustic current efficiency (CCE) in a zero-gap oxygen-depolarized chlor-alkali cells employing carbon-supported PtPd, PtRu and PtAg electrocatalysts. Besides, it seems that the PtPd/C electrocatalyst cathode has relatively higher performance than the other cathodes with PtAg/C and PtRu/C electrocatalysts in zero-gap chlor-alkali cells.
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