Introduction: Evaluate the role of neoadjuvant chemoradiotherapy (CRT) followed by an additional cycle of chemotherapy and total mesorectal excision (TME) in patients with locally advanced rectal cancer on the rate of pathologic complete response ( pCR) and tumor downstaging, their impact on survival and evaluation of treatment related toxicity and surgical complications. Methods: This prospective phase II trial included 73 patients with histopathologically proven non metastatic rectal adenocarcinoma referred from or admitted at Surgical Oncology Department, Radiotherapy Department, South Egypt Cancer Institute, and Clinical Oncology Department, Assiut University, Egypt, from March 2012 to September 2013. Radiotherapy (1.8 Gy, 5 days a week over 5 weeks, total dose 50.4 Gy, 3 D conformational technique) was given in combination with intravenous oxaliplatin 50 mg/m2 once weekly for 5 weeks and oral capecitabine 825 mg/m2 twice daily on each day of radiation. After completion of CRT, patients received an additional cycle of chemotherapy consisted of oxaliplatin (130 mg/m2 on day 1) and capecitabine (825 mg/m2, twice per day from day 1 to day 14). Surgery was performed 6-8 weeks after completion of chemoradiotherapy. Results: Seventy patients (95.9%) underwent surgery. Postoperative pathologic assessment showed an overall downstaging rate of 78.1%, while 16 patients (21.9%) had stationary disease. Complete pathologic response was achieved in 11 patients (15.1%). No tumor progression has been observed. After median follow up period of 26 months (7-30 months), the 2-year overall survival (OS) was 88%, recurrence free survival was 88.7% and distant metastasis free survival was 93.9%. Lower pathologic tumor stage was significantly associated with better OS (P = .002) and recurrence-free survival (P = .001), while pathologic nodal stage and TRG had no significant difference in overall survival, recurrence free survival or distant metastasis free survival. Forty-one patients (56.2%) experienced grade 1-2 toxicity and 5 patients (6.8%) experienced grade 3 toxicity. Conclusion: Neoadjuvant CRT and one cycle of chemotherapy followed by TME is effective with pCR of 15.1% and overall downstaging rate of 78.1%. In addition to favorable toxicity profile (lower grade 3 and 4 toxic effects as 3 patients developed grade 3 diarrhea and 2 patients developed grade 3 hematological toxicity and lower rate of Grade 1 -2 diarrhea; 28.8%) and outcome.

Background: The major concern of health care professionals regarding the value of teaching self-care for management of acute side effects of radiation therapy of head and neck cancer (HNC) patients is the improvement of their clinical outcomes. Aim: This quasi-experimental randomized controlled study design aimed to evaluate the effect of self-care teaching module on radiation-induced acute side effects and clinical outcomes in HNC patient.

Introduction: Cerebral aneurysm coiling considers ideal treatment for intracranial aneurysms. Objective: to evaluate the effect of nursing interventions protocol on patients' clinical outcomes undergoing peri cerebral aneurysm coiling. Materials and methods: Quasi-experimental study conducted at the Neuro-psychiatry Center affiliated to Tanta University. A Convenience sample of 60 adult patients undergoing peri cerebral aneurysm coiling for the first time. Four tools used Tool I Patients Structured interview schedule. Tool II Glasgow Coma Scale. Tool III Numerical rating scale. Tool IV: Post aneurysmal patient assessment tools. Results: The present study shows that less than half of both study and control group age ranged from 41-60 years, also it shows that more than half of study group and approximately two third of control group were female. In addition, it reveals that there was improvement of post aneurysmal coiling nursing interventions protocol mean results which include that majority of study group post nursing interventions protocol and minority of control group post routine hospital care haven’t localized pain and neck stiffness, furthermore all patients of study group and less than two third of control group haven’t localized hematoma, Moreover majority of study group and less than one quarter of control group haven’t aneurysmal nausea.