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Corticosteroid-Induced Multifocal and Extensive Lipomatosis: A Case Report

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Open Journal of Pathology 2011年第1期1卷 1-3页

作者： Ilham Bouaddi Hanan Rkain Fadoua Allali Nazik Allali Najia Hajjaj-hassouni 不详

Introduction: Corticosteroid-induced lipomatosis are uncommon situation. We report a case of an extensive lipomatosis in a rheumatoid arthritis patient, who received a long term steroid therapy. Case report: A 49-year-old rheumatoid arthritis woman, who received for two years a mean dose of 15 mg/ day of prednisone equivalent, was admitted to the hospital for a six months history of progressive abdominal distension and dyspnea. Physical exam revealed typical symptoms of Cushing’s syndrome and an important increase of abdominal volume. Lipomatosis diagnosis with mesenteric, mediastinal, retroperitoneal and epidural localizations, was rapidly confirmed by sonography and computed tomography (CT) exams. Management was based on corticosteroid reduction as well as use of hygiene and dietary measures. Therapeutic efficacy was noted on a clinical basis within one year. Discussion: lipomatosis occurs as a less known complication of long-term steroid therapy. Its localizations are numerous. Epidural and mediastinal lipomatosis are more frequent than mesenteric or retroperitoneal ones. Most frequently asymptomatic, lipomatosis could sometimes be revealed by false symptoms. Medical treatment including corticosteroid with drawal or reduction and calorie restriction, can lead to clinical improvement. Surgery is reseved in advanced forms with serious complications.

关键词： Lipomatosis Mesenteric Retroperitoneal Mediastinal Epidural Corticosteroids

Informational Needs in Women Undergoing Multifraction High Dose-Rate Brachytherapy for Cervical Cancer: A Prospective Qualitative Study

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Journal of Cancer Therapy 2022年第5期13卷 291-303页

作者： Kenza Benali Tayeb Kebdani Khalid hassouni Hanan El Kacemi Sanaa El Majjaoui Noureddine Benjaafar Department of Radiation Oncology National Institute of Oncology Rabat Morocco Faculty of Medicine Mohammed V University Rabat Morocco

Objective: To identify the informational needs of Moroccan women receiving intracavitary brachytherapy for locally advanced cervical cancer as part of a process to develop guidelines for quality patient-centered care. Methodology: A prospective, qualitative study with a phenomenological approach was carried out at the Brachytherapy unit of the National Institute of Oncology in Rabat, Morocco. Purposive sampling was used to recruit 31 patients undergoing high dose-rate brachytherapy for cervical cancer from July 2020 to August 2020. Semi-structured, one-to-one interviews were conducted by a female radiation oncologist in Arabic, guided by a theme list. The interviews were translated and a thematic analysis was performed. Results: Data saturation was achieved having interviewing 31 participants, aged 27 - 70 years. Findings on patients’ informational needs were the overarching theme and form the focus of this article. The informational needs included: providing patients with disease- and treatment-related information in their home language;adequate information concerning pre-treatment preparation, possible side-effects, and sexual intercourse;and providing patients with informative material adapted to their needs as standard procedure. Conclusion: This study has identified unmet women’s informational needs during brachytherapy for cervical cancer. Providing patients with sufficient and understandable information, adequate preparation before the procedure, more sensitive support during the procedure, and debriefing afterward could lessen feelings of fear and anxiety towards treatment delivery. Guidelines with a patient-centered approach could thus be developed to be used as a tool to assist members of multidisciplinary teams in providing quality care to this group of women.

关键词： Brachytherapy Cervical Cancer Informational Needs Qualitative Study

Retrospective Study of Tuberculosis in the Province of Kenitra (Morocco)

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Advances in Infectious Diseases 2020年第3期10卷 181-187页

作者： Bouhaddioui Bouchra Brik Kamal hassouni Taoufik Ayoub Fouad Bejja Fadia Bengueddour Rachid Regional Center of the Trades of the Education and Training Department of Life Sciences and Earth Kenitra Morocco Regional Center of the Trades of the Education and Training Department of Life Sciences and Earth Meknes Morocco Regional Center of the Trades of the Education and Training Department of Informatics Kenitra Morocco Service Networks of Health Institutions hospital Idrissi Kenitra Morocco Laboratory of Biology and Health Department of Biology University Ibn Tofail Kenitra Morocco

Tuberculosis is a ubiquitous and contagious infectious disease caused by Mycobacterium tuberculosis (Koch’s bacillus). Morocco considers tuberculosis a strategic priority, mobilizing human and material resources to fight it. The objective was to describe the distribution of the disease socio-economic and geographic factors in the province of Kenitra. This was a transverse descriptive retrospective study of 1005 cases of intra- and extra-pulmonary tuberculosis carried out from January 1, 2017, to December 31, 2017, in tuberculosis and respiratory disease screening and treatment center. This study was based on the use of the files of tuberculosis patients who were diagnosed and treated at the center. The parameters studied are age, sex, municipality and place of residence. Genexpert techniques to differentiate between positive and negative microscopic tuberculosis were used. The results showed that the average age of Tuberculosis patients is 36.95 years, the minimum age is 12 months, and the oldest is 87 years old. The 30 - 44 age group is the most affected by 42%, followed by that of 15 - 29 years (29%), the oldest 75 - 90 are the least affected. The survey also revealed that men and Inactive people are more affected by the disease with infection rates of 60.95% and 39% respectively, followed by women 38.8%, the employees (35%), then students 16%. In rural areas, we recorded a rate of 58.26% ahead of cities 41.73%. This study has shown that the determinants of tuberculosis are manifold and relate mainly to unfavorable socioeconomic conditions, linked to poverty, population growth, human migration, which explains the incidence of the disease from the point of socio-economic view.

关键词： Tuberculosis Risk Factors Kenitra Morocco

Sarcomatoid Carcinoma of the Mandible: A Case Report and Literature Review

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Journal of Cancer Therapy 2022年第6期13卷 323-330页

作者： Kenza Benali Tayeb Kebdani Khalid hassouni Sanaa El Majjaoui Hanan El Kacemi Noureddine Benjaafar Department of Radiation Oncology National Institute of Oncology Rabat Morocco Faculty of Medicine Mohammed V University Rabat Morocco

Background: Sarcomatoid carcinoma is a rare biphasic malignancy with an epithelial and mesenchymal component. Given its histological particularity, the diagnosis of this tumor still represents a challenge for pathologists and surgeons. Sarcomatoid carcinoma of the mandible is a very rare and aggressive entity. To date, only sporadic cases have been reported in the literature. Aim: To report a rare case of aggressive mandibular sarcomatoid carcinoma treated with radical surgery and adjuvant chemoradiation, and discuss the related literature. Case Report: We introduce a rare case of mandibular sarcomatoid carcinoma occurring in a 34-year-old woman. Treatment consisted of radical surgery and re-excision for positive margins, adjuvant radiation therapy (66 Gy in 33 fractions in simultaneous integrated boost delivered using Volumetric Modulated Arc Therapy) and Cisplatin-based concurrent chemotherapy. The tumor displayed aggressive behavior and high metastatic potential, causing tumour recurrence and extensive lung metastasis. Conclusion: Sarcomatoid carcinoma of the mandible is an extremely rare malignant entity, with a high tendency for local recurrence, distant metastasis. Treatment involves radical surgery and adjuvant chemoradiation, although the outcome and prognosis might be poor.

关键词： Sarcomatoid Carcinoma Mandible Adjuvant Chemoradiation VMAT

Experiences of Women Receiving Multifraction High Dose-Rate Brachytherapy for Cervical Cancer: A Prospective Qualitative Study

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Journal of Cancer Therapy 2022年第6期13卷 311-322页

Objective: The aim of this study was to establish cervical cancer patients’ expectations and experiences during high dose-rate (HDR) intracavitary brachytherapy procedure, as part of a process to develop guidelines for quality patient-centered care. Methodology: A prospective, qualitative study with a descriptive phenomenological approach was used. Purposive sampling was carried out to recruit 31 women undergoing HDR brachytherapy for cervical cancer from June to August 2020 at the National Institute of Oncology in Rabat. Semi-structured, one-to-one interviews guided by a theme list were conducted by a female radiation oncologist in Arabic before, during and after treatment. The following aspects were discussed: expectations, experiences in the waiting room, in the treatment room, and suggestions for improvement. Data was transcribed, translated and thematic analysis performed. Results: Most of the patients felt unprepared and did not have a clear understanding of brachytherapy. Brachytherapy was a difficult experience causing fear and anxiety throughout treatment. Most women dreaded the procedure, before receiving the first treatment and even after having had one. Pain was a major problem for the participants. Some women compared this pain to childbirth, a process they preferred to brachytherapy. Patients agreed that the preventative medication received was not efficient to relieve the pain. Despite these negative experiences, patients were left with a positive outlook. Dialogue with the healthcare professionals, support from their family and fellow patients, envisaged outcomes and desires to heal were used to cope, whilst faith and spirituality gave them strength to endure the procedure. Conclusion: Women undergoing uterovaginal brachytherapy for cervical cancer experience pain and emotional distress. Providing patients with adequate information, more sensitive support during the procedure and debriefing afterwards could lessen feelings of fear and anxiety. Our fi

关键词： Brachytherapy High Dose-Rate Cervical Cancer Qualitative Study Experiences

Evaluation of 3D-CRT and VMAT Radiotherapy Plans for Left Breast Cancer with Regional Lymph Nodes Irradiation

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Journal of Cancer Therapy 2023年第8期14卷 345-352页

作者： Houda Benmessaoud Hasnae Bouhia Halima Ahmut Sanaa El Majjaoui Hanane El Kacemi Khalid hassouni Tayeb Kebdani Department of Radiotherapy National Institute of Oncology of Rabat Faculty of Medicine and Pharmacy of Rabat Rabat Morocco

Introduction: Radiation therapy after breast surgery is an integral part of the treatment of early breast cancer. The goal of radiation therapy is to achieve the best possible coverage of the planning target volume (PTV), while reducing the dose to organs at risk (OARs) which are normal tissues whose sensitivity to irradiation could cause damage that can lead to modification of the treatment plan. In the last decade, radiation oncologist started to use the Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) for irradiating the breast, in order to achieve better dose distribution and target dose to the PTV and OAR. The aim of this study is to compare 2 external radiotherapy techniques (VMAT vs 3D) for patients with node-positive left breast cancer. Patients and Methods: We randomly selected 10 cases of postoperative radiotherapy for breast cancer in our hospital. The patients are all female, the average age was 45.4 years old, and the primary lesions are left breast. The ANOVA test was used to compare the mean difference between subgroups, and the p value Results: Dose volume histogram (DVH) was used to analyze each evaluation dose of clinical target volume (CTV) and organs at risk (OARs). Compared to 3DCRT plans, VMAT provided more uniform coverage to the breast and regional lymph nodes. The max point dose for tVMAT was lower on average (106.4% for VMAT versus 109% for 3DCRT). OAR sparing was improved with tVMAT, with a lower average V17Gy for the left lung (27.91% for VMAT versus 30.04% for 3DCRT, p and lower for V28Gy (13.75% for VMAT versus 22.34% for 3DCRT, p = 0.01). We also found a lower V35Gy for the heart on VMAT plan (p = 0.02). On the contrary, dose of contralateral breast was lower in 3DCRT than VMAT (0.59 Gy vs 3.65 Gy, p = 0.00). Conclusion: The both types of plans can meet the clinical dosimetry demands of postoperative radiotherapy for left breast cancer. The VMAT plan has a better conformity, but 3CDRT can provide a lo

关键词： Volumetric-Modulated arc Therapy 3D-Conformal Radiation Therapy Left Breast Cancer Target Volumes Treatment Plan

Malignant Peripheral Nerve Sheath Tumors of the Scalp: Case Report and Review of Literature

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International Journal of Clinical Medicine 2014年第15期5卷 916-920页

作者： Touria Bouhafa Abderahmann Elmazghi Hayat Baissel Hind El Fatmi Afaf Amarti Khalid hassouni Department of Pathology Université Sidi Mohammed Benabdellah CHU HASSAN II Fez Morocco Department of Radiotherapy Université Sidi Mohammed Benabdellah CHU HASSAN II Fez Morocco

Malignant peripheral nerve sheath tumors of the scalp are rare lesions of the nervous system. ?Only 16 cases have been reported to date. In this report, we present a case of a malignant peripheral nerve sheath tumor (MPNST) of the scalp and retrospectively analyze the clinical features, imaging findings, pathological features, and prognoses of these tumors.

关键词： Malignant Peripheral Nerve Sheath Tumors The Scalp Treatment

Impact of the COVID-19 Pandemic Lockdown on Radiotherapy Patients: A Retrospective Cohort Study

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Journal of Cancer Therapy 2022年第3期13卷 155-167页

作者： Kenza Benali Houda Benmessaoud Halima Ahmut Sanaa El Majjaoui Tayeb Kebdani Khalid hassouni Hanan El Kacemi Noureddine Benjaafar Department of Radiation Oncology National Institute of Oncology Rabat Morocco Faculty of Medicine Mohammed V University Rabat Morocco

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to the imposition of a strict nationwide lockdown, which has affected all aspects of healthcare, including the delivery of standard care to cancer patients. Objective: The aim of this study was to report the impact of the COVID-19 pandemic on patient attendance at a radiotherapy department during the lockdown period. Methods: This is a retrospective analysis of all patients planned for radiotherapy at the National Institute of Oncology in Rabat. Patient compliance to radiotherapy during the lockdown period was measured and compared with that during the same period in 2019. Data regarding age, sex, tumor site and treatment-related factors were analyzed and compared with those during the same period in 2019. Results: We included a total of 650 patients, 348 patients in Group A (control period) and 302 in Group B (lockdown period). Patients were aged between 30 and 70 years in about 85%, with a female predominance in both groups. The most common sites of occurrence of cancer were breast, female reproductive organs and the head and neck. A 13.2% reduction in the number of treated patients and a 16.9% reduction in the number of sessions was observed. There was a significant decrease in the proportion of breast cancers treated (P = 0.03). The proportion of patients receiving palliative radiotherapy increased significantly (P = 0.03), with a significant increase in the use of single-fraction palliative radiation therapy (P = 0.006). There was a significant difference in the compliance to radiotherapy during the lockdown period (92.3% versus 86.4%, P = 0.01);delays and interruptions were due to travel restrictions (58.5%) and fear of contamination (29.2%). No patient was tested positive for COVID-19 during radiotherapy during the study period. Conclusion: We observed a decrease in the number of treated patients during the lockdown despite our efforts to maintain the treatment routine. A significant decreas

关键词： Cancer COVID-19 Pandemic Lockdown Radiotherapy Compliance

The Experience of Pain and Anxiety in Cervical Cancer Patients Undergoing Multiple Fraction High-Dose Rate Brachytherapy: A Prospective Observational Study

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Journal of Cancer Therapy 2022年第7期13卷 405-416页

作者： Kenza Benali Mohammed Adnane Tazi Gael Kietga Tayeb Kebdani Khalid hassouni Sanaa El Majjaoui Hanan El Kacemi Noureddine Benjaafar Department of Radiation Oncology National Institute of Oncology Rabat Morocco Faculty of Medicine Mohammed V University Rabat Morocco Epidemiology Division Ministry of Health Rabat Morocco

Purpose: To evaluate the anxiety and pain levels of cervical cancer patients undergoing intracavitary multifraction high-dose rate (HDR) brachytherapy, as part of a process to develop guidelines for quality patient-centered care. Methods: Cervical cancer patients (n = 31) undergoingmultiple fraction HDR brachytherapy treatment at the National Institute of Oncology in Rabat (Morocco) completed ratings of pain and anxiety intensity using 11-point verbal analog scales, at 6 key time points over 2 brachytherapy insertion procedures and 4 brachytherapy fractions. Women were evaluated for psychological status at baseline before starting the brachytherapy process using the Hospital Anxiety and Depression Scale (HADS). Scores were grouped as follows: 0 - 7 = normal, 8 - 10 = borderline, 11 - 21 = abnormal. Factors that could affect anxiety levels such as education level, relationship status, number of pregnancies and prior surgical history were documented. Results: Between July and August 2020, 31 women with a median age of 49.6 years were evaluated (range: 27 - 70). The HADS score identified depression in 5 patients (16.1%) and anxiety in 12 patients (38.7%). Throughout both treatment procedures, anticipatory anxiety was reported, with a maximum intensity in the operating room during spinal anesthesia (3.23 ± 1.7) and during applicator insertion (2.97 ± 2.4). Moderate-to-severe anxiety scores were reported in 25.8% and 22.6% of patients respectively. Level of education showed a significant correlation with anxiety scores (p = 0.027). Pain increased significantly during the procedure (p ± 1.4) and applicator removal (4.74 ± 1.5) turned out to be the most painful parts of the procedure. No correlation was found between pain and anxiety levels. Conclusion: Intracavitary multifraction high-dose rate brachytherapy is associated with mild to moderate levels of pain and anxiety, although a subset of patients reported more severe symptoms and may require additional medical and psy

关键词： Cervical Cancer Brachytherapy High-Dose Rate Pain Anxiety