Partial frequency of radiation pneumonitis and its association with the energy and treatment technique in patients with breast cancer, Isfahan, Iran.

BACKGROUND: Breast cancer is the most common type of cancer among women, and the second cause of cancer mortality after pulmonary cancer in this gender. Radiotherapy is one of the major treatments, which locally controls the disease and prohibits in recurrency. Radiation pneumonitis is one of the radiotherapy complications, which usually occurs within 1.5-3 months after radiotherapy. As there is no precise estimation concerning this complication in Isfahan, partial frequency of radiation pneumonitis and its association with the energy and treatment technique in patients with breast cancer were evaluated. MATERIALS AND METHODS: This was an analytic cross-sectional study performed in 2010 in university referral center. A total of 382 patients with breast cancer, undergone surgery and referred for radiotherapy entered the study. A posterior and anterior and lateral X-Rays were taken as control images before starting radiotherapy and all X-Rays were repeated after 3-4 months post radiotherapy. The occurrence of radiotherapy pneumonitis was evaluated by the same radiologist. Data were analyzed through SPSS version 20. RESULTS: Out of 382 patients undergone breast conservative surgery (BCS) or modified radical mastectomy (MRM), and radiotherapy, 60 patients had pneumonitis of whom 6 patients underwent BCS and were treated by tangential field (three cases by Co 60 and three cases by PH 9). The rest of radiotherapy pneumonitis patients (n = 54) underwent MRM of whom, 42 cases were treated by one-field and 12 by two-field treatment techniques. CONCLUSION: Incidence of radiotherapy pneumonitis was different with respect to the adopted technique (one-field, two-field and tangential) (P = 0.023), with the highest association with two-field radiotherapy.

Topical silver sulfadiazine for the prevention of acute dermatitis during irradiation for breast cancer.

PURPOSE: This study aimed to evaluate the effectiveness of topical silver sulfadiazine (SSD) in preventing acute radiation dermatitis in women receiving radiotherapy for breast cancer. METHODS: A randomized controlled clinical trial was conducted on patients with breast cancer referred for radiotherapy after treatment with mastectomy and chemotherapy. The patients were randomized into the intervention (n = 51) and control (n = 51) groups and were instructed on general skin care during radiotherapy. The intervention group received SSD cream 1%, three times a day, 3 days a week, for 5 weeks during radiotherapy and one week thereafter. A blinded observer assessed the severity of dermatitis weekly (for 6 weeks) and graded it from 0 to 4 according to the Radiation Therapy Oncology Group criteria. RESULTS: The two groups were similar in baseline characteristics. Two patients in the control group discontinued the radiotherapy course because of severe skin injuries (grades 3 and 4). The intervention group encountered significantly less severe dermatitis during radiotherapy compared to the controls. The total score of skin injury was also lower in the intervention group compared with controls (5.49 ± 1.02 vs. 7.21 ± 1.76, p < 0.001). A multivariate analysis found that the use of SSD cream (p < 0.001) and flat chest wall anatomy (p = 0.008) were significantly associated with a decreased skin injury. CONCLUSIONS: SSD cream reduced the severity of radiation-induced skin injury compared with general skin care alone. Further studies in patients with other types of cancer and also comparing SSD cream with other topical agents are warranted.

Association between the high risk occupations and bladder cancer in Iran: a case-control study.

OBJECTIVES: The objective of this work was to identify the high-risk occupations in Iran and to re-inspect occupations that were related to bladder cancer. MATERIALS AND METHODS: In the study, 300 patients suffering from bladder cancer and 500 control individuals were interviewed. Demographic information, occupational history, and history of exposure to chemical compounds such as aromatic amines for each participant were collected. ORs and 95% CIs were calculated using unconditional logistic regression for each occupation. RESULTS: There was a significantly increased risk of bladder cancer among truck and bus drivers (OR = 11.3), skilled agricultural, forestry and fishery workers (OR = 6.0), metal industry workers (OR = 6.0), domestic housekeepers (OR = 5.9), and construction workers (OR = 3.8). CONCLUSIONS: The study showed a strong correlation between truck and bus drivers, skilled agricultural, forestry and fishery workers, metal industry workers, domestic housekeepers, as well as construction workers and the increased risk of bladder cancer in these occupations.