Abstract Background: Surgery is commonly favored in the management of oral cancer but radiotherapy may be essential because of the size or location of the tumor. Refusal of radiotherapy by patients is an important issue, which must be taken into consideration during treatment planning. This study assessed prevalence and correlates of radiotherapy refusal among oral cancer patients. Methods: Data was analyzed for 47, 174 oral cancer cases in the Surveillance, Epidemiology and End Results (SEER) database during 1988–2008. Point estimates were calculated overall and by selected socio-demographic and clinical characteristics. A multivariate logistic regression model was fitted to determine predictors of radiotherapy refusal. Results: The overall prevalence of refusal of radiotherapy was 2.31%. Factors associated with increased likelihood of refusal of radiotherapy included age ± 45 years (adjusted odds ratio, aOR=2.48; P=0.031); gingival/floor of mouth tumors (aOR=1.32; P=0.010); receipt of surgery (aOR=1.21; P=0.04). Conversely, protective factors included being married (aOR=0.59; P<0.001); non-Hispanic blacks (aOR=0.53; P=0.001); involvement of paired structures (aOR=0.61; P<0.001) as well as multiple tumors (aOR=0.75; P=0.021). Sex was not a significant predictor on multivariate analysis. Conclusion: Prevalence of refusal of radiotherapy among oral cancer patients is relatively low and is significantly associated with age, marital status, as well as location, extent and severity of disease. Clinicians may anticipate patients likely to refuse radiotherapy and develop patient-tailored counseling considering the benefits and risks of proposed treatment. Final treatment decision must however take into consideration the wishes of the fully informed patient.
Keywords: oral cancer; malignancy; tumor; radiation; disparities; informed consent

Abstract The aim of the study was to evaluate the feasibility of a longitudinal non-invasive monitoring of rat pancreatic ductal adenocarcinoma (PDAC) using microCTscans (μCT). The identification of the pancreatic gland on (μCT) was performed at first using contrast products (Fenestra LC and VC, v/v) at a dosage of 0.5 ml/Kg of body weight. Then orthotopic PDAC developed in adult Lewis rat was detected and monitored. In vivo μCT measurement of tumor was compared to actual size ex vivo in 12 rats. Gemcitabine treatment of PDAC was monitored at two week intervals until defined endpoints (liver metastasis or ascitis) in 10 rats versus 10 controls. μCT had a 100% positive predictive value in the detection of orthotropic PDAC. Regression analysis showed a linear correlation between ex vivo and in vivo μCT tumor measurements. Longitudinal evaluation of tumor progression showed a reduction in tumor growth (P<0.05 at 8 weeks) and a slightly prolonged survival (P=0.15) under gemcitabine treatment. In conclusion μCT appears to be a cost-effective mean for preclinical study of PDAC saving time, animals, while respecting animal welfare. It could be considered as an efficient tool in anticancer drug research and development.
Keywords: microCT; orthotopic tumor model; pancreatic adenocarcinoma; rat

Abstract In order to analyze detailed anthropometric characterisation for risk of breast cancer (BC) in premenopausal Uruguayan women, a case-control study was carried out at the Pereira Rossell Women’s Hospital, Montevideo, where 253 incident BC cases and 497 frequency-matched healthy controls were interviewed on menstrual and reproductive story, and a series of body measurements were performed to calculate body composition and somatotype. Odds ratio (OR’s) coefficients were taken as estimates of relative risk derived from unconditional logistic regression. Results show a positive association for the fat fraction (OR for highest quartile =4.19, 95% CI (95% Confidence Interval) 2.70-6.50) as well as for the fat-to-muscle ratio (OR=4.68, 95% CI 2.98-7.36). Muscle fraction was inversely associated with risk (OR=0.53 95% CI 0.36-0.78). High endomorphism was the only somatotype variable associated to the disease risk (OR=1.69, 95% CI 1.13-2.54), however, losing its association when fat amount was included in the regression model. Stratified analyses by body mass index (BMI) levels, bone weight, age groups and number of live births also showed risk increases for the highest fat fractions, displaying significant linear trends. Albeit most of the literature reports a putative slight protective effect for a high BMI in premenopausal women, our results suggest that fat fraction, amount and distribution might play a role as predisposing factors for premenopausal BC.
Keywords: anthropometry; body composition; breast cancer; epidemiology; fat; muscle; nutrition; risk factors; somatotype

Abstract A group of bis(benzimidazol-2-yl) amines have been already evaluated for cytotoxicity in vitro to human colorectal cancer cell line HT-29, breast cancer cells MDA-MB-231 and normal spleen cells and two of them (B1 and B2) have been taken for the purposes of our present investigations. From the second group of compounds representing 1,3-disubstituted-2,3-dihydro-2-iminobenzimidazoles two substances (B3 and B4) have been chosen because of their most pronounced anti-proliferative effect to human colorectal cancer cell line HT-29, breast cancer cells MDA-MB-231 and normal spleen cells, using the in vitro proliferative MTS-test. It was important to estimate the cause for this suppressive activity of the compounds. We proposed that this could be due to their antioxidant capacity. The substances were examined for antioxidant activity against hydroxyl and peroxyl radicals, applying the HORAC and ORAC methods and showed considerable capacity. The scavenging capacity of B2 towards hydroxyl radicals is the highest, followed by B1. It was estimated that B2 has the greatest scavenger capacity of oxygen radicals, emitted by the examined cells followed in descending order by B1, B3 and B4. The observed differences can be considered as impact of their structure on the Me⁺²-helating activity and effective H-atom donation. A correlation was observed between the structure of the particular substance and the expressed antioxidant potential. The latter correlated also with the effect on the tested tumor cell lines. This result means that tumor cells are accompanied by a measurable emission of ROS which might be regulated by a proper application of antioxidants.
Keywords: aminobenzimidazoles; HORAC; ORAC; antioxidant activity; tumor cells

Abstract Objectives: To examine intra-observer reliability (IR) for lesion detection on contrast-enhanced breast magnetic resonance images (MRI) for screening women at high risk of breast cancer in single and joint double readings, without case selection. Methods: Contrast-enhanced breast MRIs were interpreted twice by the same independent reader and twice in joint readings. IR was assessed for lesion detection, normal MRI identification, mass, non-mass like enhancements (NMLE) and focus characterisation, and BI-RADS assessment. Results: MRI examinations for 124 breasts, 65 women (mean age 43.4y) were retrospectively reviewed with 110 lesions identified. Abnormal BIRADS (3-5) classifications were found for 52.3% in single readings and 58.5% in joint readings. Seven biopsies were performed for 4 histologically confirmed cancers. IR for BI-RADS classifications was good for single (0.63, 95% CI: 0.49-0.77), and joint readings (0.77, 95% CI: 0.61-0.93). IR for background parenchymal enhancement (BPE) was moderate across single (0.53, 95% CI: 0.40-0.65) and joint readings (0.44, 95% CI: 0.33-0.56). IR for BI-RADS category according to each enhancement was poor for single (0.27, 95% CI: 0.10-0.44), and higher for joint readings, (0.58, 95% CI: 0.43-0.72). Conclusions: IR in BI-RADS breast assessments or BI-RADS lesion assessments are better with joint reading in screening for women with high genetic risks, in particular for abnormal MRI (BI-RADS 3, 4 and 5).
Keywords: breast neoplasms; magnetic resonance imaging; genetic susceptibility; cancer screening; inter-observer variation

Abstract Meningiomas are common intracranial tumors which usually pursue a benign course. Extracranial metastases from meningiomas are very rare and the lung is the most common site. We report a 27 year old girl with an intracranial atypical meningioma with pulmonary metastasis which had been misdiagnosed as lung sequestration upon chest CT examination. She underwent subtotal surgical resection of the meningioma in 2006 and surgical removal of the lung metastasis in 2009. Then, the patient developed pleural, lung, periesophageal and diaphragmatic nodal metastases, despite only subtle increase of the intracranial residual meningioma. Therefore, she was treated by Doxil (pegylated liposomal doxorubicin) and bevacizumab with a progression of disease after three cycles and then with hydroxyurea for two months with a dimensional increase of metastatic lesions. After adding sorafenib to hydroxyurea the patient showed a further progression disease and finally died for respiratory insufficiency. Metastatic meningiomas have been rarely reported. Hydroxyurea is one of the most used drug in recurrent and metastatic meningiomas, despite modest results are obtained. Further chemotherapy strategies or biological agent must be investigated in clinical trials.
Keywords: metastatic meningioma; chemotherapeutic agents; doxorubicin; bevacizumab; hydroxyurea

Abstract Men with prostate cancer experience many challenges to their quality of life (QOL). While some of these challenges reflect the direct effects of the cancer, additional side-effects and symptoms are also associated with common treatments especially androgen deprivation therapy (ADT). While several studies have examined the effects of ADT on the QOL of men with prostate cancer, much of this research is between 10-20 years old and was conducted in North America or Europe. This study therefore examined the effects of ADT on QOL in prostate cancer patients (survivors) in the Southern hemisphere. The registries of two New Zealand based hospitals were sourced to identify men with prostate cancer who were using ADT for at least six months (ADT group, n=205) and those who had never used ADT (non-ADT group, n=143). Participants in both groups were mailed a letter of invitation, the WHOQOL-BREF and three facets of the WHOQOL-OLD QOL questionnaire. Response rates of 41% and 40% were obtained for the ADT and non-ADT groups, respectively. QOL scores were generally similar between the groups, with the exception of physical QOL, which was significantly lower in the ADT group. Such results suggest that cancer clinicians, allied health professionals and cancer researchers should not just concentrate on the physical effect of ADT on their survivors’ risk of developing osteoporosis, falls-related fracture and cardio-metabolic syndrome, but also devote time to ensure their survivors’ perception of their physical QOL is not compromised.
Keywords: cancer survivorship; cancer therapy; hormonal therapy; quality of life; prostate cancer