The most important biological function of exosomes is their possible use as biomarkers in clinical diagnosis. Compared with biomarkers identified in conventional specimens such as serum or urine, exosomal biomarkers provide the highest amount of sensitivity and specificity, which can be attributed to their excellent stability. Exosomes, which harbor different types of proteins, nucleic acids and lipids, are present in almost all bodily fluids. The molecular constituents of exosomes, especially exosomal proteins and microRNAs (miRNAs), are promising as biomarkers in clinical diagnosis. This discovery that exosomes also contain messenger RNAs and miRNAs shows that they could be carriers of genetic information. Although the majority of RNAs found in exosomes are degraded RNA fragments with a length of <200 nucleotides, some full-length RNAs might be present that may affect protein production in the recipient cell. In addition, exosomal miRNAs have been found to be associated with certain diseases. Several studies have pointed out miRNA contents of circulating exosomes that are similar to those of originating cancer cells. In this review, the recent advances in circulating exosomal miRNAs as biomarkers in gastrointestinal cancers are discussed. These studies indicated that miRNAs can be detected in exosomes isolated from body fluids such as saliva, which suggests potential advantages of using exosomal miRNAs as noninvasive novel biomarkers.

Objective: A huge amount of the efforts made by health teams is dedicated to caring for cancer patients. This study has aimed to investigate the effect of self-care training on life expectancy and quality of life (QOL) in patients with gastrointestinal cancer who were under radiotherapy. Methods: In this clinical trial, 50 patients were selected using the block randomization method. The intervention was performed at Ayatollah Khansari Hospital in Arak, Iran. The patients in the intervention group received three sessions of face-to-face training. The data collection tools included Schneider's Life Expectancy Questionnaire and EORTC QOLQ-C30. Data were analyzed by SPSS version 23. Results: In the control group, 16 were male (64%) and 9 female (36%), and in the intervention group, 14 were male (56%) and 11 were female (44%). Before the intervention, the two groups were homogenous regarding all variables. After the intervention, the mean of QOL was 67 ± 22.62 in the intervention group and 56 ± 18.55 in the control group ( P < 0.05). In examining the different dimensions of QOL, improvement in all functional dimensions was observed in the intervention group. After the intervention, the mean score of life expectancy showed a significant difference ( P < 0.05) between the intervention group (39.52 ± 5.26) and the control group (31.6 ± 7.13). Conclusions: It was found that self-care training improved the QOL and life expectancy of patients with gastrointestinal cancer who were under radiotherapy. Therefore, self-care training is recommended to improve the QOL and the life expectancy of cancer patients.

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The aim of radiotherapy is to deliver the highest possible radiation dose to the tumor and the lowest radiation to normal tissues surrounding the tumor. In the present study, lymph nodes of the supraclavicular region were treated using two therapeutic techniques, namely photon technique (PT) and combinatory photon-electron technique (CPET). We recruited 50 patients with local lymph node metastasis. The photon energies were 6-15 MV. Furthermore, the electron beam energy was 18 MeV in CPET. The study findings revealed that the mean delivered dose to target volume was 41.12 ± 2.98Gy for PT and 44.56 ± 1.90Gy for CPET. The percentage of the target volume irradiated to 90% of the prescribed dose (V90) was calculated as 74.61% ± 9.30% and 82.06% ± 9.70% for PT and CPET, respectively. The mean dose delivered to the heart and lungs was not significantly different between the two groups. Furthermore, the maximum doses delivered to the spinal cord were 12.55Gy in PT and 8.89Gy in CPET. The mean doses delivered to the thyroid gland were 39.26 and 34.89Gy in PT and CPET. According to the study results, the maximum doses delivered to the spinal cord, head of the humerus bone, and thyroid were reduced significantly as measured the CPET technique. In contrast, no significant difference was observed regarding the dose delivered to the heart and lung. The dose delivered to the supraclavicular region determined by the CPET was significantly augmented. Furthermore, the coverage of the tumor mass was optimized using the new method.