Background: Studies using safe natural products {Blue green ® tablet (Rhodiola rosea L. root dry extract; Eleutherococcus senticosus Maxim. root dry extract; Ginkgo biloba L. leaf dry extract; Klamath microalgae Aphanizomenon flos aquae (AFA) 50 mg)} showed its antiviral effect. As well as vitamin D3, linolenic acid, black seeds and honey. The aim of the study was to determine the efficacy of combination of these natural products and chloroquine in treatment of HCV patients refusing or unfit for combined Interferon and Ribavirin (INF/RBV) therapy or HCV patients who failed to achieve sustained virological response to INF/RBV. Methods: Patients with detectable HCV RNA with different stages of fibrosis and cirrhosis refusing or unfit for combined Interferon Ribavirin (INF/RBV) therapy or patients who failed to achieve sustained virological response to INF/RBV from April 2009 to March 2012 were included in this study. All the patients were treated first from coinfection as schistosomiasis and helicobacter pylori if present then received combination Blue green ® tablet-original natural company, Italy; 2 tablet/30 kg once daily; Vitamin D: 1000 IU/day; tablespoon filled with paste made of linolenic acid, black seeds powder and honey; and 250 mg chloroquine once daily for 10 days and then every 3 days through the duration of therapy.Results: 195 patients with chronic HCV were included; mean age 47.8 ± 9.03 years, 67.7% males. All patients have chronic hepatitis. 24 patients had cirrhosis. 82 (42.1%) achieved negative HCV RNA after 6 months of treatment. After 12 months of treatment, 107 (54.9%) patients had negative HCV RNA. 125 (64.3%) patients achieved ETR after 18 months of treatment. Moreover, 4/6 (66.6%) patients with combined HCV and HBV showed undetectable HBV after 3 months. Two out of 8 (25%) patients who failed to achieve SVR with previous (INF/RBV) have ETR. Conclusion:Combination of safe natural products (Blue green ® tablet, vitamin D3, linolenic acid, black seeds and honey) and chloroquine may have a role to achieve SVR in combination with recent direct acting antiviral drugs for HCV infection.

1075 Background: Breast cancer and HCV are two frequent diseases in Egypt. There is a considerable probability of concurrent affection. This concurrence creates a subpopulation which needs special evaluation and care. Methods: To evaluate a subset of Egyptian breast cancer patients receiving doxorubicin based adjuvant chemotherapy, with HCV seropositivity (Group 2) compared to HCV seronegative patients (Group 1). 102 breast cancer patients, planned to receive Doxorubicin based adjuvant chemotherapy, at the Oncology Department, Alexandria Faculty of Medicine, were recruited since June 2009. Pretreatment evaluation included serological testing for HCV. FAC adjuvant chemotherapy was given. Results: HCV seropositivity was detected in 52 cases. Two cases in Group 2 developed toxic hepatitis and discontinued treatment and follow up. The remaining 100 patients suffered comparable toxicities, except for more frequent SGOT and SGPT elevations in Group 2. Diarrhea was more frequent in Group 2. Treatment delays and dose reductions were more frequently observed in Group 2. The 24 month disease-free survival and relapse pattern were not significantly different between the two groups. Conclusions: Patients receiving chemotherapy should undergo screening for the virus. Most patients with HCV were able to tolerate chemotherapy and continue the initial chemotherapy plan, without significant change in the toxicity profile or the natural course of their malignancy. Dose or regimen adjustments may be of help to less tolerant patients. A preemptive 10% initial Doxorubicin dose reduction might reduce the frequency of severe toxicity. The assistance of a gastroenterologist in HCV positive breast cancer patients, planned for chemotherapy is important.

pts) (41.7%). Concomitant systemic chemotherapy (OT, CT or immunotherapy) was administered in only 41 pts (19.4%).Results: At analyses 104 pts (49.3%) were male and 107 (50.7%) female; the mean age was 79 years old (range 42-100). The majority of pts were elderly with 2 or more comorbidities (88% pts were aged > 70 years old). The mean KPS was 70 (range 40-90). After a mean follow-up of 14 months the median OS was 11 months. Overall, 74.5% pts completed RT at the prescribed dose, and 25.5 % interrupted it due to PD, clinical worsening or lost motivation. A clinical or radiological examination response was observed in 56% of pts (CR 24%, PR 32%), SD in 6%, PD in 17% pts, and in 21% it was not possible to evaluate the response. In pts receiving the prescribed dose the response rate was 75%, of them 40% had a CR. Patients that completed RT treatment had a higher survival rate compared to pts who interrupted it (median 14 mths vs 3 mths; p-value 0.0001). Moreover, KPS > 70, PTV < 250 cc, systemic therapy during RT treatment and clinical or radiological response were prognostic factors regarding OS (p-value < 0.05). RT delivered technique did not influence survival rate or local response, however pts treated with 3DCRT had higher rates of ! G2 acute or late toxicity (p-value < 0.067). G3 ! acute toxicity was observed in only 1.8% of pts. A late toxicity ! G3 was observed in 8 pts (4.7%).Conclusions: Weekly hypofractionated RT 36.75-42 Gy in 7-8 ff appears feasible in poor PS and elderly pts unfit of standard RT treatment with a good response rate of 75%. Total dose, KPS > 70, PTV < 259 cc, systemic therapy were prognostic factors regarding OS. IMRT-VMAT technique is recommended to be used to reduce G2 or higher toxicity.Legal entity responsible for the study: The authors.