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Eldesoky I.,Childrens Cancer Hospital
Journal of applied clinical medical physics / American College of Medical Physics | Year: 2012

This work aimed at evaluating the performance of three different intensity-modulated radiotherapy (IMRT) treatment planning systems (TPSs)--KonRad, XiO and Prowess--for selected pediatric cases. For this study, 11 pediatric patients with different types of brain, orbit, head and neck cancer were selected. Clinical step-and-shoot IMRT treatment plans were designed for delivery on a Siemens ONCOR accelerator with 82-leaf multileaf collimators (MLCs). Plans were optimized to achieve the same clinical objectives by applying the same beam energy and the same number and direction of beams. The analysis of performance was based on isodose distributions, dose-volume histograms (DVHs) for planning target volume (PTV), the relevant organs at risk (OARs), as well as mean dose (Dmean), maximum dose (Dmax), 95% dose (D 95), volume of patient receiving 2 and 5 Gy, total number of segments, monitor units per segment (MU/Segment), and the number of MU/cGy. Treatment delivery time and conformation number were two other evaluation parameters that were considered in this study. Collectively, the Prowess and KonRad plans showed a significant reduction in the number of MUs that varied between 1.8% and 61.5% (p-value = 0.001) for the different cases, compared to XiO. This was reflected in shorter treatment delivery times. The percentage volumes of each patient receiving 2 Gy and 5 Gy were compared for the three TPSs. The general trend was that KonRad had the highest percentage volume, Prowess showed the lowest (p-value = 0.0001). The KonRad achieved better conformality than both of XiO and Prowess. Based on the present results, the three treatment planning systems were efficient in IMRT, yet XiO showed the lowest performance. The three TPSs achieved the treatment goals according to the internationally approved standards.


Elsherbini A.A.M.,Cairo University | El-Shahawy A.,Childrens Cancer Hospital
Journal of Nanomaterials | Year: 2013

Magnetic nanoparticles (MNPs) are being developed for a wide range of biomedical applications. In particular, hyperthermia involves heating the MNPs through exposure to an alternating magnetic field (AMF). These materials offer the potential for selectively by heating cancer tissue locally and at the cellular level. This may be a successful method if there are enough particles in a tumor possessing sufficiently high specific absorption rate (SAR) to deposit heat quickly while minimizing thermal damage to surrounding tissue. The current research aim is to study the influence of super paramagnetic iron oxides Fe 3O4 (SPIO) NPs concentration on the total heat energy dose and the rate of temperature change in AMF to induce hyperthermia in Ehrlich carcinoma cells implanted in female mice. The results demonstrated a linearly increasing trend between these two factors. © 2013 Alsayed A. M. Elsherbini and Ahmed El-Shahawy.


Zaghloul M.S.,Childrens Cancer Hospital
The Gulf journal of oncology | Year: 2012

Different craniospinal irradiation techniques are complex. The homogeneity of the dose to the target and the normal tissues at risk affect both the control rate and the level of adverse effects. Thirty one patients were treated with CSI in the supine position. Custom-made Styrofoam was tailored for each patient to straighten the convexity and concavity of the spinal axis allowing better dose distribution uniformity during CSI technique. In the first 6 patients, CT simulation were performed twice: one time with the patient lying directly on the vacuum mattress without the foam (the conventional way) and the second while lying on the foam. Dose distribution was calculated using a 3D conformal planning. The gap between the fields was determined using isodose alignment method. All treatment portals were verified during the first 3 treatment sessions and once weekly thereafter using either cone-beam or portal image device. Weekly feathering (shifting of the junction between the 2 adjacent radiation fields) was routinely performed. The 95% dose distribution had better coverage with the foam (p=0.042) while the hot volume of 110% and 105% dosage were significantly lesser than conventional technique (both p=0.028). The organs at risk received nearly similar radiation doses in the 2 positions. The CSI led to minimal immediate adverse effects that were reversible. Weight loss was experienced by 55% of patients. This modified technique of CSI is simple, ensuring better dose distribution to CSI target without increasing the dose to the surrounding organs at risk. It is tolerable and safe to apply.


Alfaar A.S.,Childrens Cancer Hospital
Telemedicine journal and e-health : the official journal of the American Telemedicine Association | Year: 2012

In developed countries, pharmacists play a crucial role in designing and implementing cancer treatments as part of a multidisciplinary oncology team. However, developing countries have a shortage of pharmacists, and their role is generally limited to dispensing and selling drugs. The aim of this study was to investigate the feasibility of providing clinical pharmacy educational activities via international teleconferencing to improve cancer care in developing countries. Meticulous preparation and intense promotion of the workshop were done in Egypt before the telepharmacy conferences began. Multiple connectivity tests were performed to resolve technical problems. Nine telepharmacy conferences were delivered during 3-h sessions that were held on three consecutive days. Talks were subsequently made available via Web streaming. Attendees were requested to complete a survey to measure their satisfaction with the sessions. The teleconference was attended by a total of 345 persons, and it was subsequently reviewed online via 456 log-in sessions from 10 countries. Technical issues (e.g., poor auditory quality) were resolved on the first day of the event. The rate of attendees' responses on the survey was 30.1%, and satisfaction with the event was generally good. Telecommunication is a relatively inexpensive approach that may improve pharmacy practices, especially those used to treat patients with cancer in developing countries. Special attention to patient-based telepharmacy education, including the use of cost-effective technology, should be considered.


Elsherbini A.A.M.,Cairo University | Saber M.,Cairo University | Aggag M.,Childrens Cancer Hospital | El-Shahawy A.,Childrens Cancer Hospital | Shokier H.A.A.,Cairo University
Magnetic Resonance Imaging | Year: 2011

Super paramagnetic iron oxide Fe3O4 nanoparticles prepared via photochemical reaction in pure form were used for inducing hyperthermia to treat subcutaneous Ehrlich carcinoma implanted in female mice. Our results indicate that the mean temperature profiles at the rectum, periphery of the tumor surface and at the center of the tumor during hyperthermia treatment increased gradually. The maximum temperature achieved in the tumor center was 47±1°C after 20 min with radiofrequency exposures at 25 kW. The acquired magnetic resonance images identified apoptotic cells in the center of the tumor which were exposed to magnetic resonance hyperthermia (MRH). Apoptotic cells presented as dark signal intensity in the T1-weighted images which were further confirmed by pathological examinations. Also, the results revealed that the tumor size in the all mice exposed to MRH is still as the same as before the treatment, but the rate of tumor growth was very slow by comparing with the growth rate of the control group. © 2011 Elsevier Inc.

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