Shadi S. Alkhayyat

Outcomes of Saudi Arabian Patients With Nasopharyngeal Cancer Treated With Primarily Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiotherapy

Purpose Nasopharyngeal cancer (NPC) is the most common head and neck cancer in Saudi Arabia. This study reports the locoregional disease control and survival outcomes in patients with NPC treated in King Abdulaziz University Hospital. Methods Patients treated for NPC between June 2007 and October 2014 were retrospectively reviewed. Demographic information, clinicopathologic variables, and chemotherapy data were collected and analyzed. Cumulative survival and disease control rates were calculated by Kaplan-Meier product-limit actuarial method. Results Thirty-nine patients with NPC were reviewed. Thirty-five (90%) patients received definitive radiotherapy (RT) and four (10%) had palliative RT. Mean prescribed dose for definitive RT was 68 Gy (range, 60 to 70.2 Gy), delivered with mean doses per fraction of 1.9 Gy (range, 1.8 to 2.1 Gy). After a median follow-up of 15 months (range, 1 to 84 months), 22 (63%) patients who underwent definitive RT were disease free and 13 (37%) were still with disease. During this period, seven (18%) patients died of the disease; five (13%) of them received definitive RT. After 2 years’ follow-up, the actuarial estimate rates were: 85.7% for local control, 91.4% for nodal control, and 85.7% for distant control. Conclusion Our study showed a disease with clinical behavior similar to what has been observed in East and Southeast Asia. Further it explored the neoadjuvant chemotherapy approach in treating NPC with results that are comparable to literature. However, little is known about the molecular pathogenesis of this disease in this region, and further research integrating clinical and molecular biomarkers is required.

Detection of rare single nucleotide variants affecting genes in the DNA repair pathways in hereditary breast cancer

Background Patients with hereditary breast cancer constitute a considerable fraction of overall breast cancer sufferers. The contribution of genetic factors to the development of breast cancer in the admixed and highly consanguineous population of the western region of Saudi Arabia is thought to be significant as the disease is early onset [1]. The current protocols of continuous clinical follow-up of relatives of such patients are costly and cause a burden on the usually over-stretched medical resources. Discovering the significant contribution of BRCA1/2 mutations to breast cancer susceptibility allowed for the design of genetic tests that allows the medical practitioner to focus the care for those who need it most. However, BRCA1/2 mutations do not account for all breast cancer susceptibility genes and there are other genetic factors, known and unknown that may play a role in the development of such disease.