ackground: Women with breast cancer are at increased risk for the development of osteoporosis and skeletal fractures, as consequences of aromatase inhibition or chemotherapy-induced ovarian failure. We investigated the effect of adjuvant chemotherapy on biochemical markers of bone formation and resorption as well as on bone mineral density (BMD) of non-metastatic breast cancer (NMBC) postmenopausal Egyptian women. Methods: We followed 100 newly diagnosed women with T1-3 N0-2 M0 breast cancer, who had a mean age (±SD) of 55.06±8.78 year, before and after receiving 6-cycles of CAF chemotherapy treatment protocol. All participant women were subjected to blood biochemical analysis for determining serum levels of: erythrocyte sedimentation rate, calcium, alkaline phosphatase (ALP), bone specific alkaline phosphatase (S.ALP), Osteocalcin, carboxytelopeptide of collagen type I (CTx-I), 25-Hydroxyvitamin D, Parathyroid Hormone (PTH) and tumor marker CA15-3. Segmental and total BMD were also investigated using Dual X-ray Absorptiometry technique. Results: We found ALP, S.ALP, and CTx-I levels were significantly lower (p<0.001), while PTH levels to be significantly higher for all women after chemotherapy as compared to their initial state before chemotherapy. Both segmental and total BMD, and consequently T- and Z-Scores after chemotherapy were significantly (p<0.01) lower than their levels before chemotherapy. We developed prediction mathematical formulae for spine, pelvis and total BMD for all women before and after chemotherapy. Conclusions: Adjuvant chemotherapy is responsible for decreasing both biochemical markers of bone formation and resorption as well as for decreasing segmental and total BMD in NMBC postmenopausal Egyptian women. We believe the mathematical formulae developed on basis of the two individual variables Age and BMI can be useful for assisting the clinician to frequently monitor bone health status of breast cancer patients in similar conditions.

Angiogenesis, the growth of new blood vessels from the existing vasculature, and is maintained in adult tissues by the balanced presence of both angiogenic inducers and inhibitors in the tissue milieu. When inducers predominate, vascular endothelial cells (VECs) become activated and in this activated VECs, distinct cell signaling pathways are initiated providing the specificity of anti-angiogenic therapies to the tumor vasculature. VEC apoptosis has been well documented in regressing vessels, and it has been shown that, in addition to activating the VECs, some inducers such as vascular endothelial growth factor also up-regulate Fas expression, thus sensitizing the cell to apoptotic stimuli. Endogenous angiogenesis inhibitors, such as thrombospondin-1(TSP-1) and pigment epithelium-derived factor (PEDF), stimulate signaling cascades within the VECs and also induce the expression of Fas ligand in activated VECs. Therefore, when inhibitors predominate, the apoptotic cascade is initiated ,thus anti-angiogenic therapies can target the inducer supply or directly target the VECs. Although clinical studies suggest that anti-angiogenic therapies may prove to be most effective when used in combination with traditional therapies.

Background: To assess feasibility of sparing the neural stem cell compartment (NSC), hippocampus, and limbic circuit during partial brain radiotherapy (PBRT) for pediatric intracranial tumors. Methods: Treatment plans were generated for the following pediatric intracranial tumors: low and high grade gliomas, low grade brainstem glioma, optic nerve glioma, hypothalamic glioma, localized ependymoma, skull base sarcoma, central nervous system (CNS) germinoma (involved field radiotherapy [IFRT] and whole ventricular radiotherapy [WVRT] ), and craniopharyngioma. For each pathology, standard intensity-modulated radiotherapy (IMRT) plans were generated using helical tomotherapy, as well as IMRT plans which spared limbic circuit, hippocampus, and NSC. Biologically equivalent dose for late effects (BEDlate effects) was generated for limbic circuit, hippocampus, and NSC. Percent reduction in mean, maximum, and minimum physical dose and BED was calculated between plans. Results: We reduced mean physical dose and BEDlate effects to these critical structures by 44% and 47.9% respectively (range 5.4-78.8% and 7-80.3%). Greatest benefits in relative dose reduction were seen in high grade hemispheric glioma cases; least relative dose reduction was seen in WVRT cases. Dosimetric coverage of treatment target (PTV) was equivalent in all cases as assessed by D95 and V100 metrics. Integral dose to uninvolved brain was reduced by mean of 7.6% (range -19.3% to +0.3%) in sparing plans. Conclusions: It is possible to spare limbic circuit, NSC, and hippocampus during PBRT for primary pediatric intracranial tumors using helical tomotherapy. This approach reduces integral dose delivered to uninvolved normal brain and may reduce late cognitive sequelae of cranial radiotherapy.

Over the past decade, high-risk of Human papilloma virus (HPV) impair of immune function, Interlukine-6 (IL-6) is proinflammatory cytokines promotes the growth cervical cancer through Signal transducer and activator of transcription 3 (STAT3) dependent mechanisms. Current study was designed the circulating cytokine level, Tissue biopsy mRNA gene expression by RT-PCR of IL-6, similarly the expression of STAT3 and pSTAT3 from 100 patients of pre cancer and cancer of the uterine cervix compare with 16 controls were studied. Whereas In the precancerous group have 54.4%, 43.9% 56.1% and 68.4%. In cervical cancer 79.1%, 72.1%, 72.1%, 27.9%and 83.7% the difference of two groups was significant correlation. It is interesting that the pattern of the investigated parameters indicates the difference in the pathological grade of precancerous and cervical cancer patients.