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Background: stereotactic radiosurgery has emerged as an established treatment modality of intracranial tumors. It is used as an alternative to surgery or to supplement subtotal surgical resection of locally invasive tumors. aim of the Work: To demonstrate the efficacy and safety of stereotactic radiosurgery in treatment of benign meningiomas. Patients and Methods: twenty-six patients with 28 benign meningiomas were prospectively treated with 6-MV modified linac (Photon Knife) in a non-randomize clinical study. Mean age was 54 years (± 10.5, range: 25 to 75 years). Dose was given in single or multiple fractions depending on tumor location. Winston-Lutz test for accuracy of isocentre localization was performed in all cases. Regular clinical and radiological follow up was carried out. Results: The mean tumor volume was 16.3 cc (± 9.64, range: 1.85-32.56cc). Mean tumor edge dose was 17 Gy (± 2.9, range: (13 to 24Gy). All patients tolerated the treatment well. The follow up period ranged between 11 months and 42 months (mean: 28 ± 8.15 months). Clinical improvement occurred in 10.5%, deterioration occurred in 10.5%, whereas 79% remained stable. Radiological tumor control was achieved in 89.5%, while 10.5% of tumors continued to grow. Conclusion: stereotactic radiosurgery provided high rates of tumor growth control, often with tumor regression, and low morbidity rates in patients with benign intracranial meningiomas. It is a useful treatment modality which can supplement subtotal surgical resection of sizable benign meningiomas or can be used as an alternative to surgery for recurrent tumors, for patients who have severe systemic illness or those who refuse to have open surgery.

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Aims: To assess the safety and efficacy of chemo-radiotherapy before radical surgery in locally advanced gastric and gastroesophageal adenocarcinoma. Study Design: This was a prospective phase Ⅱ single arm study. Place and Duration of Study: Department of Clinical Oncology and Nuclear Medicine, Mansoura University Hospital, Mansoura, Egypt, between May 2017 and June 2019. Methodology: Patients with pathologically proven gastric or gastroesophageal junction adenocarcinoma are included. They received one cycle of induction chemotherapy paclitaxel-carboplatin, [paclitaxel dose of 175 mg/m2, carboplatin dose of (AUC: 5)], followed by CCRT [RT 45 Gy over 25 fractions over 5 weeks concurrent with weekly paclitaxel at a dose of 50 mg/m2, carboplatin at a dose of (AUC: 2)], followed by surgery and 2 cycles of paclitaxel-carboplatin for responders. Results: The study included 24 patients. Most of the patients were diagnosed at stage III (83.3%). There were no major side effects of the induction chemotherapy cycle. There were no reported grade 3 or 4 toxicities for the CCRT. Only two patients suffered from late radiation toxicities (distal esophageal stenosis). Pathological complete response was achieved in seven patients (31.8%). Twenty-two patients had surgical resection with a 95% resection margin zero. The median follow-up time was 22.5 months. The median progression-free survival (PFS) and overall survival (OS) were 23, 23.5 months, respectively. Conclusion: The preliminary data suggested good efficacy of the studied treatment design with acceptable adverse-event rates, however a larger multicentric phase 3 trial with a longer follow-up duration is recommended.