Search results for: Nouri Keltoum

Authors: Alireza Jafarzadeh, Bahram Amu-Oqhli Tabrizi, Hadi Khayat Nouri, Arash Khaki

Abstract:

30 head of adult Vistar rats were chosen to evaluate the chronic narcotic effects of crack on some biochemical parameters. The rats weighted approximately 200 to 250 g. They were divided into 5 groups of 6 and were housed in identical condition in terms of food and ambience. Rats were maintained at 12 hours light and 12 hours darkness. Rats were injected 7.8 mg/kg BW crack intraperitoneally. The groups one to four received daily medication for one to four weeks respectively. The control groups were injected identical dose of saline. The blood was taken from control and test groups then serum was separated from. Serum biochemical parameters of amylase, lipase, triglycerides, cholesterol, HDL, LDL, VLDL, protein and albumin were measured by diagnostic kits. Serum protein and albumin levels did not show statistically significant changes. Serum lipase and amylase showed significant changes both of which were increased. The serum levels of cholesterol, LDL and HDL demonstrated no significant changes. Triglycerides values showed a significant increase in serum. Serum VLDL in groups 3 and 4 exhibited significant changes compare to other groups.

Keywords: albumin, amylase, cholesterol, crack, HDL, LDL, lipase, protein, rat, triglycerides, VLDL

Procedia PDF Downloads 664

Authors: Ali Olfati, Parichehr Nouri

Abstract:

Objective: In this study, we have investigated for the first time in the literature the efficacy of riboflavin [VB2] in preventing uterus As₂O₃ damage. Methods: Rats received 40 μg LHRHa for estrus synchronization. 48 pregnant Wistar rats were included. Four groups were formed with 7 rats in each group: Sham, 1.5 mg arsenic trioxide (As₂O₃/L) alone or in combination with VB2 [20 and 40 mg/L] in drinking water [for 21 days continuously]. Similar to maternal generation treatment, the F1-female generation was also arranged [for 35 days continuously until puberty]. Results: Data indicated that As₂O₃ reduced body weight and feed intake (p<0.05). Furthermore, the serum malondialdehyde levels in the As₂O₃ group were significantly higher than that of the control group (p<0.05). At the same time, total antioxidative status and the activities of glutathione peroxidase, superoxide dismutase, and catalase were reduced (p<0.05). Meanwhile, As₂O₃ remarkably increased the production of inflammatory markers [interleukin 6 and C-reactive protein](p<0.05). As₂O₃ administration induced uterus apoptosis-related genes by upregulating caspase-3, iNOS, and Bax genes and downregulating Bcl-2 gene of pubertal F1-female rats (p<0.05). Conclusion: Our observation indicated that VB2 therapy is potentially an effective strategy to modifying the detrimental effects of As₂O₃ in pubertal F1-female rats via suppresses oxidative damages.

Keywords: As₂O₃, inflammation, puberty, vitamin B2

Procedia PDF Downloads 118

Authors: Nouri, K., Ghassem Alaskari, M., K., Amiri Hazaveh, A., Nabi Bidhendi, M.

Abstract:

Pore pressure is one on the key Petrophysical parameter in exploration discussion and survey on hydrocarbon reservoir. Determination of pore pressure in various levels of drilling and integrity of drilling mud and high pressure zones in order to restrict blow-out and following damages are significant. The pore pressure is obtained by seismic and well logging data. In this study the pore pressure and over burden pressure through the matrix stress and Tarzaqi equation and other related formulas are calculated. By making a comparison on variation of density log in over normal pressure zones with change of sonic impedance under influence of compressional, shear, and Stonely waves, the correlation level of sonic impedance with density log is studied. The level of correlation and variation trend is recorded in sonic impedance under influence Stonely wave with density log that key factor in recording of over burden pressure and pore pressure in Tarzaqi equation is high. The transition time is in divert relation with porosity and fluid type in the formation and as a consequence to the pore pressure. The density log is a key factor in determination of pore pressure therefore sonic impedance under Stonley wave is denotes well the identification of high pressure besides other used factors.

Keywords: pore pressure, stonely wave, density log, sonic impedance, high pressure zone

Procedia PDF Downloads 358

Authors: Seyed Hossein Iranmanesh, Hassan Nouri, Seyed Reza Iranmanesh

Abstract:

In the dynamic and complex landscape of today’s business, organizations often face challenges in impactful decision-making across multi-project settings. To efficiently allocate resources, coordinate tasks, and optimize project outcomes, establishing robust decision-making processes is essential. Furthermore, the increasing importance of information systems and their integration within organizational workflows introduces an additional layer of complexity. This research proposes the use of blockchain technology as a suitable solution to enhance decision-making in multi-project environments, particularly within the realm of information systems. The conceptual framework in this study comprises four independent variables and one dependent variable. The identified independent variables for the targeted research include: Blockchain Layer in Integrated Systems, Quality of Generated Information ,User Satisfaction with Integrated Systems and Utilization of Integrated Systems. The project’s performance, considered as the dependent variable and moderated by organizational policies and procedures, reflects the impact of blockchain technology adoption on organizational effectiveness1. The results highlight the significant influence of blockchain implementation on organizational performance.

Keywords: multi-project environments, decision support systems, information systems, blockchain technology, decentralized systems.

Procedia PDF Downloads 7

Authors: Latifa Hamoudi-Belarbi, L'Hadi Nouri, Khaled Belkacemi

Abstract:

The effect of three methods of drying (traditional drying, freeze-drying and spray-drying) on the survival of concentrated cultures of Geotrichum fragrans and Wickerhamomyces anomalus was studied. The survival of yeast cultures was initially compared immediately after freeze-drying using HES 12%(w/v)+Sucrose 7% (w/v) as protectant, traditional drying in dry rice cakes and finally spray-drying with whey proteins. The survival of G. fragrans and W. anomalus was studied during 4 months of storage at 4°C and 25°C, in the darkness, under vacuum and at 0% relative humidity. The results demonstrated that high survival was obtained using traditional method of preservation in rice cakes (60% for G. fragrans and 65% for W. anomalus) and freeze-drying in (68% for G. fragrans and 74% for W. anomalus). However, poor survival was obtained by spray-drying method in whey protein with 20% for G. fragrans and 29% for W. anomalus. During storage at 25°C, yeast cultures of G. fragrans and W. anomalus preserved by traditional and freeze-drying methods showed no significant loss of viable cells up to 3 months of storage. Spray-dried yeast cultures had the greatest loss of viable count during the 4 months of storage at 25°C. During storage at 4°C, preservation of yeasts cultures using traditional method of preservation provided better survival than freeze-drying. This study demonstrated the effectiveness of the traditional method to preserve yeasts cultures compared to the high cost methods like freeze-drying and spray-drying.

Keywords: freeze-drying, traditional drying, spray drying, yeasts

Procedia PDF Downloads 457

Authors: H. Nouri, S. Chavoshi Borujeni, S. Anderson, S. Beecham, P. Sutton

Abstract:

The potential risk of salt leaching through wastewater irrigation is of concern for most local governments and city councils. Despite the necessity of salinity monitoring and management in urban greenery, most attention has been on agricultural fields. This study was defined to investigate the capability and feasibility of monitoring and predicting soil salinity using near sensing and remote sensing approaches using EM38 surveys, and high-resolution multispectral image of WorldView3. Veale Gardens within the Adelaide Parklands was selected as the experimental site. The results of the near sensing investigation were validated by testing soil salinity samples in the laboratory. Over 30 band combinations forming salinity indices were tested using image processing techniques. The outcomes of the remote sensing and near sensing approaches were compared to examine whether remotely sensed salinity indicators could map and predict the spatial variation of soil salinity through a potential statistical model. Statistical analysis was undertaken using the Stata 13 statistical package on over 52,000 points. Several regression models were fitted to the data, and the mixed effect modelling was selected the most appropriate one as it takes to account the systematic observation-specific unobserved heterogeneity. Results showed that SAVI (Soil Adjusted Vegetation Index) was the only salinity index that could be considered as a predictor for soil salinity but further investigation is needed. However, near sensing was found as a rapid, practical and realistically accurate approach for salinity mapping of heterogeneous urban vegetation.

Keywords: WorldView3, remote sensing, EM38, near sensing, urban green spaces, green smart cities

Procedia PDF Downloads 129

Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf

Abstract:

Enacted tasks are typically remembered better than when the same task materials are only verbally encoded, a robust finding referred to as the enactment effect. It has been assumed that enactment effect is independent of object presence but the size of enactment effect can be increased by providing objects at study phase in adults. To clarify the issues in children, free recall and cued recall performance of action phrases with or without using real objects were compared in 410 school-aged children from four age groups (8, 10, 12 and 14 years old). In this study, subjects were instructed to learn a series of action phrases under three encoding conditions, participants listened to verbal action phrases (VTs), performed the phrases (SPTs: subject-performed tasks), and observed the experimenter perform the phrases (EPTs: experimenter-performed tasks). Then, free recall and cued recall memory tests were administrated. The results revealed that the real object compared with imaginary objects improved recall performance in SPTs and EPTs, but more so in VTs. It was also found that the object presence was not necessary for the occurrence of the enactment effect but it was changed the size of enactment effect in all age groups. The size of enactment effect was more pronounced for imaginary objects than the real object in both free recall and cued recall memory tests in children. It was discussed that SPTs and EPTs deferentially facilitate item-specific and relation information processing and providing the objects can moderate the processing underlying the encoding conditions.

Keywords: action memory, enactment effect, item-specific processing, object, relational processing, school-aged children

Procedia PDF Downloads 212

Authors: Arezou Rezazadeh, Nasrin Omidvar, Hassan Eini-Zinab, Mahmoud Ghazi-Tabatabaie, Reza Majdzadeh, Saeid Ghavamzadeh, Sakineh Nouri-Saeidlou

Abstract:

Dietary pattern analysis method can reflect more information about the nutritional etiology of chronic diseases such as obesity. The aim of this study was to determine the relationship between major dietary patterns and anthropometric measures in men and women living in the city of Urmia. In this cross-sectional study, 723 participants (427 women and 296 men), aged 20–64 in Urmia city were selected from all four zones of Urmia city, in the north-west of Iran. Anthropometrics (weight, height, waist and hip circumference) were measured with standard methods. Body Mass Index (BMI) was calculated by dividing weight (in kilograms) by the square of height (in meter). Dietary intake information was collected by a semi-quantitative food frequency questionnaire in the last year. Dietary patterns were determined using principal component analysis. The relationship between dietary patterns and obesity was analyzed by logistic regression. Three major dietary patterns (DPs) were identified that were named ‘Traditional Higher SES (THS)’, ‘Traditional Low SES (TLS)’ and ‘Transitional’. THS DP was positively and Transitional DP was negatively associated with BMI and waist circumference (W.C), however, after adjusting for confounding variables (age, gender, ethnicity, energy intake, physical activity and SES), the associations were not significant. The TLS was not significantly associated with BMI, but after adjusting for confounders, a significant positive association was detected with W.C and Waist to hip ratio (WHR). Findings showed that both traditional patterns were positively and the western type transitional pattern was reversely associated with anthropometric indices. But this relationship was highly affected by demographic, socioeconomic and energy input and output determinants. The results indicate the inevitable effect of environmental factors on the relationship between dietary patterns and anthropometric indices.

Keywords: anthropometric indices, dietary pattern, Iran, North-west

Procedia PDF Downloads 129

Authors: Al-Nouri Doha Mostfa, Al-Khalifa Abdulrahman Salih

Abstract:

The effects of long-term supplementation with different dietary omega-6/omega-3 (ω-6/ω-3) polyunsaturated fatty acid (PUFAs) ratios on the bone marrow fatty acids level, plasma biomarkers of bone metabolism, and minerals content in bone were evaluated in rabbits. Weanling male and female New Zealand white rabbits were randomly assigned to five groups and fed ad libitum for 100 days on diets containing 70 g/kg different dietary oils which providing the following ω-6/ω-3 ratios: soy bean oil (SBO control, 8.68), sesame oil (SO, 21.75), fish oil (FO, 0.39), DHA algae oil (DHA, 0.63), and DHA and ARA algae oils (DHA/ARA, 0.68). The bone marrow arachidonic (ARA), eicosapentaenoic (EPA), and docosahexaenoic (DHA) fatty acid levels were significantly influenced by and reflected the dietary ω-6/ω-3 ratios fed to rabbits. Rabbits fed on the FO diet maintained a lower ω-6/ω-3 ratio and a higher EPA and DHA levels, those fed on the DHA/ARA diet maintained a lower ω-6/ω-3 ratio and a higher ARA level, while those fed on the SO diet maintained a higher ω-6/ω-3 ratio and a lower ARA level. Plasma alkaline phosphatase (ALP) activity was significantly higher in male and female rabbits fed the DHA/ARA diet compared with those fed the control, SO, FO, or DHA diets. There was a significant main effect of dietary treatment on femur calcium (Ca), phosphorous (P), magnesium (Mg), and zinc (Zn) contents in both genders. This study confirmed that different dietary oil sources with varying ω-6/ω-3 ratios significantly altered the fatty acids level of bone marrow. In addition, the significant elevation in minerals content and the maintenance of optimal Ca/P ratio in bone of DHA/ARA and DHA fed groups beside the significant elevation in ALP activity in the DHA/ARA fed group proved that marine algae oils may be promising dietary sources for promoting bone mineralization and formation, thus improving bone mass during the growth stage.

Keywords: arachidonic (ARA), docosahexaenoic (DHA), eicosapentaenoic (EPA), growing rabbits

Procedia PDF Downloads 456

Authors: Hamideh Nouri, Sattar Chavoshi Borujeni

Abstract:

Grey infrastructure is an unavoidable part of urbanisation that is threatening the local microclimates. Sustainable urbanisation requires more green infrastructure in cities such as green roofs to minimise urbanisation impacts. The environmental, social and economic benefits of green roofs are widely deliberated. However, there is still a lack of assessment of the water management for green roofs. This paper aimed to assess the irrigation management of green roofs in a semi-arid region where blue water scarcity is one of the primary challenges in urban water management. To determine the appropriate water source and growing media for green roofs, an experiment was established at the University of South Australia, Australia. This study compared the performance of two growing media and three water sources on the drainage quality, medium weight and survival rate of potted Tussock grass (Poa labillardieral), an endemic plant to Australia and recommended for green roofs. Three irrigation sources were tap water, mixed of wastewater-stormwater, and rainwater. The growing media were natural sandy loam soil and Scoria - one of the most used commercial growing media for green roofs. The drainage quality of these media was tested by analysing leachate samples. Medium weight was measured before and after watering, and all pots were monitored for their survival rates. Results showed that although plant growing development was significantly higher in Scoria, the survival rate was lower. For all three water sources, EC and pH of the leachate were significantly lower from Scoria than the sandy loam soil. However, the mixed of wastewater-stormwater had the highest EC, and rainwater had the lowest EC. Results did not present a significant difference between pH of different water resources in the same media. Our experimental results found the scoria and rainwater as the best sources of medium and water for green roofs.

Keywords: green smart cities, urban water, green roofs, green walls, wastewater, stormwater

Procedia PDF Downloads 129

Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf

Abstract:

Studies of adults' episodic memory have found that enacted encoding not only improve recall performance but also retrieve faster during the recall period. The current study focused on exploring the temporal progression of different encoding conditions in younger and older school children. 204 students from two age group of 8 and 14 participated in this study. During the study phase, we studied action encoding in two forms; participants performed the phrases by themselves (SPT), and observed the performance of the experimenter (EPT), which were compared with verbal encoding; participants listened to verbal action phrases (VT). At test phase, we used immediate and delayed free recall tests. We observed significant differences in memory performance as function of age group, and encoding conditions in both immediate and delayed free recall tests. Moreover, temporal progression of recall was faster in older children when compared with younger ones. The interaction of age-group and encoding condition was only significant in delayed recall displaying that younger children performed better in EPT whereas older children outperformed in SPT. It was proposed that enactment effect in form of SPT enhances item-specific processing, whereas EPT improves relational information processing and this differential processes are responsible for the results achieved in younger and older children. The role of memory strategies and information processing methods in younger and older children were considered in this study. Moreover, the temporal progression of recall was faster in action encoding in the form of SPT and EPT compared with verbal encoding in both immediate and delayed free recall and size of enactment effect was constantly increased throughout the recall period. The results of the present study provide further evidence that the action memory is explained with an emphasis on the notion of information processing and strategic views. These results also reveal the temporal progression of recall as a new dimension of episodic memory in children.

Keywords: action memory, enactment effect, episodic memory, school-aged children, temporal progression

Procedia PDF Downloads 244

Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf, Kamal Kharazi

Abstract:

Research into long-term memory has demonstrated that the richness of the knowledge base cues in memory tasks improves retrieval process, which in turn influences learning and memory performance. The present research investigated the idea that adding cues connected to knowledge can affect memory performance in the context of action memory in children. In action memory studies, participants are instructed to learn a series of verb–object phrases as verbal learning and experience-based learning (learning by doing and learning by observation). It is well established that executing action phrases is a more memorable way to learn than verbally repeating the phrases, a finding called enactment effect. In the present study, a total of 410 students from four grade groups—2nd, 4th, 6th, and 8th—participated in this study. During the study, participants listened to verbal action phrases (VTs), performed the phrases (SPTs: subject-performed tasks), and observed the experimenter perform the phrases (EPTs: experimenter-performed tasks). During the test phase, cued recall test was administered. Semantic relational cues (i.e., well-integrated vs. poorly integrated items) were manipulated in the present study. In that, the participants were presented two lists of action phrases with high semantic integration between verb and noun, e.g., “write with the pen” and with low semantic integration between verb and noun, e.g., “pick up the glass”. Results revealed that experience-based learning had a better results than verbal learning for both well-integrated and poorly integrated items, though manipulations of semantic relational cues can moderate the enactment effect. In addition, children of different grade groups outperformed for well- than poorly integrated items, in flavour of older children. The results were discussed in relation to the effect of knowledge-based information in facilitating retrieval process in children.

Keywords: action memory, enactment effect, knowledge-based cues, school-aged children, semantic relational cues

Procedia PDF Downloads 249

Authors: Sakineh Nouri Saeidlou, Fatemeh Rezaiegoyjeloo, Parvin Ayremlou, Fariba Babaie

Abstract:

Introduction: Childhood overweight and obesity is a major public health problem in both developed and developing countries. Overweight and obesity in children may have severe consequences later in adolescence and adulthood. The aim of current study was to determine the prevalence trend of overweight and obesity in school-aged children from 2009 to 2011. Methods: The present study was a population-based study and conducted in three consecutive years, from 2009 to 2011. The study population included all of primary, secondary and high school children in rural and urban regions of West Azarbijan province in West-North of Iran. Body mass index (BMI), the ratio of weight to height squared [weight (kg)]/ [height (m)]2, was calculated to the nearest decimal place. Overweight and obesity were classified using CDC recommendations for age and sex: a BMI 85th–95th percentile was classified as overweight and a BMI>95th percentile was classified as obese. All statistical analyses were performed using the Excel Software. Descriptive statistics were used to characterize the sample in different time periods. The prevalence was calculated as the ratio of number present cases to a given population number in a given subgroup at a given time. Results: Overall, 165740, 145146 and 146203 school children were assessed at 2009, 2010 and 2011, respectively. Prevalence of overweight in primary school children among girls were 52.83, 86.93 and 116.36 and for boys were 57.07, 53.4 and 93.55 per 1000 person in 2009, 2010 and 2011 years ,respectively. The prevalence of obesity in secondary school children for girls were 22.26, 27.75 and 28.43 and 26.52, 25.72 and 35.85 for boys per 1000 person in 2009, 2010 and 2011, respectively, The highest prevalence of overweight was 77.58, 142.4 and 126.46 per 1000 person among primary, secondary and high school children, respectively, in 2011. The lowest prevalence of obesity was 12.52, 24.1 and 21.61 per 1000 person among primary, secondary and high school children, respectively, in 2009. Conclusion: However, the rapid increase in both obesity and overweight should have a special attention. Research on prevalence trend of overweight and obesity in children is poorly reported in Iran. So that, future studies need to follow-up on the associations between overweight and obesity with health outcomes when children develop and reach adolescence and adulthood.

Keywords: overweight, obesity, school children, prevalence trend, Iran

Procedia PDF Downloads 303

Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf, Kamal Kharrazi

Abstract:

When we teach, we have two critical elements at our disposal to help students: learning styles as well as testing styles. There are many different ways in which educators can effectively teach their students; verbal learning and experience-based learning. Lecture as a form of verbal learning style is a traditional arrangement in which teachers are more active and share information verbally with students. In experienced-based learning as the process of through, students learn actively through hands-on learning materials and observing teachers or others. Meanwhile, standard testing or assessment is the way to determine progress toward proficiency. Teachers and instructors mainly use essay (requires written responses), multiple choice questions (includes the correct answer and several incorrect answers as distractors), or open-ended questions (respondents answers it with own words). The current study focused on exploring an effective teaching style and testing methods as the function of age over school ages. In the present study, totally 410 participants were selected randomly from four grades (2ⁿᵈ, 4ᵗʰ, 6ᵗʰ, and 8ᵗʰ). Each subject was tested individually in one session lasting around 50 minutes. In learning tasks, the participants were presented three different instructions for learning materials (learning by doing, learning by observing, and learning by listening). Then, they were tested via different standard assessments as free recall, cued recall, and recognition tasks. The results revealed that generally students remember more of what they do and what they observe than what they hear. The age effect was more pronounced in learning by doing than in learning by observing, and learning by listening, becoming progressively stronger in the free-recall, cued-recall, and recognition tasks. The findings of this study indicated that learning by doing and free recall task is more age sensitive, suggesting that both of them are more strategic and more affected by developmental differences. Pedagogically, these results denoted that learning by modeling and engagement in program activities have the special role for learning. Moreover, the findings indicated that the multiple-choice questions can produce the best performance for school-aged children but is less age-sensitive. By contrast, the essay as essay can produce the lowest performance but is more age-sensitive. It will be very helpful for educators to know that what types of learning styles and test methods are most effective for students in each school grade.

Keywords: experience-based learning, learning style, school-aged children, testing methods, verbal learning

Procedia PDF Downloads 169

Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

Abstract:

Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

Procedia PDF Downloads 98

Authors: Omar Nouri, Wafa Mnejja, Fatma Dhouib, Syrine Zouari, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Leila Farhat, Nejla Fourati, Jamel Daoud

Abstract:

Purpose and Objective: Intensity modulated radiation (IMRT) technique, associated with induction chemotherapy (IC) and/or concomitant chemotherapy (CC), is actually the recommended treatment modality for nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the therapeutic results and the patterns of relapse with this treatment protocol. Material and methods: A retrospective monocentric study of 145 patients with NPC treated between June 2016 and July 2021. All patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. The high-risk volume dose was 66.5 Gy in children. Survival analysis was performed according to the Kaplan-Meier method, and the Log-rank test was used to compare factors that may influence survival. Results: Median age was 48 years (11-80) with a sex ratio of 2.9. One hundred-twenty tumors (82.7%) were classified as stages III-IV according to the 2017 UICC TNM classification. Ten patients (6.9%) were metastatic at diagnosis. One hundred-thirty-five patient (93.1%) received IC, 104 of which (77%) were TPF-based (taxanes, cisplatin and 5 fluoro-uracil). One hundred-thirty-eight patient (95.2%) received CC, mostly cisplatin in 134 cases (97%). After a median follow-up of 50 months [22-82], 46 patients (31.7%) had a relapse: 12 (8.2%) experienced local and/or regional relapse after a median of 18 months [6-43], 29 (20%) experienced distant relapse after a median of 9 months [2-24] and 5 patients (3.4%) had both. Thirty-five patients (24.1%) died, including 5 (3.4%) from a cause other than their cancer. Three-year overall survival (OS), cancer specific survival, disease free survival, metastasis free survival and loco-regional free survival were respectively 78.1%, 81.3%, 67.8%, 74.5% and 88.1%. Anatomo-clinic factors predicting OS were age > 50 years (88.7 vs. 70.5%; p=0.004), diabetes history (81.2 vs. 66.7%; p=0.027), UICC N classification (100 vs. 95 vs. 77.5 vs. 68.8% respectively for N0, N1, N2 and N3; p=0.008), the practice of a lymph node biopsy (84.2 vs. 57%; p=0.05), and UICC TNM stages III-IV (93.8 vs. 73.6% respectively for stage I-II vs. III-IV; p=0.044). Therapeutic factors predicting OS were a number of CC courses (less than 4 courses: 65.8 vs. 86%; p=0.03, less than 5 courses: 71.5 vs. 89%; p=0.041), a weight loss > 10% during treatment (84.1 vs. 60.9%; p=0.021) and a total cumulative cisplatin dose, including IC and CC, < 380 mg/m² (64.4 vs. 87.6%; p=0.003). Radiotherapy delay and total duration did not significantly affect OS. No grade 3-4 late side effects were noted in the evaluable 127 patients (87.6%). The most common toxicity was dry mouth which was grade 2 in 47 cases (37%) and grade 1 in 55 cases (43.3%).Conclusion: IMRT for nasopharyngeal carcinoma granted a high loco-regional control rate for patients during the last five years. However, distant relapses remain frequent and conditionate the prognosis. We identified many anatomo-clinic and therapeutic prognosis factors. Therefore, high-risk patients require a more aggressive therapeutic approach, such as radiotherapy dose escalation or adding adjuvant chemotherapy.

Keywords: therapeutic results, prognostic factors, intensity-modulated radiotherapy, nasopharyngeal carcinoma

Procedia PDF Downloads 38