Tanta | Egypt
Specialties: Clinical Oncology
Dr. Nehal Mohammed Elmashad is a Consultant of Clinical Oncology, works as Associate Professor of Clinical Oncology, Department of Clinical Oncology. Tanta University School of Medicine; Egypt. Tel +2 01094420401
Dr. Elmashad is a member of ESHNO (Egyptian Society of Head and Neck Oncology) since 2009, Egyptian Society of Hematology Oncology since 2009, and The Egyptian Cancer Society since 2002 with different medical professionals, scientists, professors, nurses and others to provide relevant and accurate information on the prevention, early diagnosis, treatment, and palliation of cancer.
Dr. Elmashad is an experienced researcher whose primary interests include clinical trials in HCC, gastro intestinal breast, lung cancers and palliative care. She participates in many national and international clinical trials in the area.
Dr. Elmashad is a recipient of many awards; including a project from Competitive Excellence Project of Egyptian Higher Education Institutions since 2014 and she serve as President of the executive teams of the outputs of the training in (Genetic Signature center for fostering next generation translational cancer research). This is a clear mission to facilitate research and training in miRNA in cancer patients. Also she shares an award from Implementation of Internal Quality Assurance System. Project code: B / TAN /3/02 (178 500 LE) Quality Assurance & Accreditation Project (QAAP), Projects Management Unit (PMU), Ministry of Higher Education, Arab Republic of Egypt, Second Cycle, May, 2005.
Dr Elmashad serves as Head of Crisis Management Unit at Faculty of Medicine, Tanta University, Egypt since 2012.Dr Elmashad works as Professional Trainer of Trainers TOT at National Center of Faculty and Leadership development, International Board of Certified Trainers (IBCT)/NCFLD. This Certified since 30-12-2012. She studied Total Quality Management (TQM) Diploma Canadian International Academy for Advanced Studies2013 and European International College Hospital Management Diploma 2014.
Dr Elmashad shares in Strategic Plan , reviewing Job Description Book for all workers at Faculty of Medicine and its hospital, The Self-Study at Faculty of Medicine, Share in Organizational structure Building for all workers at Faculty of Medicine and its hospital, Tanta University and Internal Quality assurance Peer reviewer of the new program (Malaysian) at Faculty of Medicine, Tanta University. She serves as Director of out patients Clinic of Tanta University Hospital since 07/06/2014 till 06/06/2016
Primary Affiliation: Tanta University - Tanta , Egypt
PubMed Central Citations
1PubMed Central Citations
Asian Pac J Cancer Prev. 2015;16(4):1657-63.
Asian Pacific journal of Cancer Prevention
Background: Early diagnosis of hepatocellular carcinoma (HCC) is the most important step in successful treatment. However, it is usually rare due to the lack of a highly sensitive specific biomarker so that the HCC is usually fatal within few months after diagnosis. The aim of this work was to study the role of plasma nuclear factor kappa B (NF-ĸB) and serum peroxiredoxin 3 (PRDX3) as diagnostic biomarkers for early detection of HCC in a high-risk population. Materials and Methods: Plasma nuclear factor kappa B level (NF-ĸB) and serum peroxiredoxin 3 (PRDX3) levels were measured using enzyme linked immunosorbent assay (ELISA), in addition to alpha-fetoprotein (AFP) in 72 cirrhotic patients, 64 patients with HCC and 29 healthy controls. Results: NF-ĸB and PRDX3 were significantly elevated in the HCC group in relation to the others. Higher area under curve (AUC) of 0.854 (for PRDX3) and 0.825 (for NF-ĸB) with sensitivity of 86.3% and 84.4% and specificity of 75.8% and 75.4% respectively, were found compared to AUC of alpha-fetoprotein (AFP) (0.65) with sensitivity of 72.4% and specificity of 64.3%. Conclusions: NF-ĸB and PRDX3 may serve as early and sensitive biomarkers for early detection of HCC facilitating improved management. The role of nuclear factor kappa B (NF-ĸB) as a target for treatment of liver fibrosis and HCC must be widely evaluated.
Asian Pac J Cancer Prev, 16 (2), 613-619
Asian Pacific Journal of Cancer Prevention, Vol 16, 2015
Background: Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Insulin-like growth factor-1 (IGF-1) levels reflect hepatic function and are inversely correlated with the severity of background chronic liver disease. Objective: This study evaluated whether basal serum IGF-1 levels can predict prognosis of HCC patients according to different risks of disease progression. Materials and Methods: A total of 89 patients with hepatocellular carcinoma (HCC) were recruited in 3 groups: Group I, 30 HCC patients receiving sorafinib; Group II, 30 HCC patients with best supportive care; and Group III include 29 patients undergoing transcatheter arterial chemoembolization (TACE). All patients were investigated for serum levels of AST, ALP, Bb, Cr, BUN, AFP and IGF-I. Results: Patients with disease control had significantly higher baseline IGF-1 levels 210 (185-232.5) ng/mL (p value<0.01) than did patients without disease control. Low basal IGF-1 levels were associated with advanced HCC, such as multiple tumors and advanced stage, and low IGF-1 levels predicted shorter TTP and overall survival in patients treated with TACE. Conclusions: The levels of serum IGF-1, expressed as continuous values, may be helpful for accurately assessing hepatic function and the prognostic stratification of patients with HCC. Keywords: Hepatocellular carcinoma - IGF-1 - prognosis - serum factors
Alexandria Journal of Medicine
Rectal cancer is associated with a high risk of metastases and local recurrence; local recurrence rates after surgical treatment being up to 32% (1). Local recurrence is directly related to incomplete tumor resection (2, 3) and also related to the circumferential safety of resection (4, 5). An accurate local staging at the time of initial diagnosis is therefore very important. Aim The aim of this study is to use MRI in comparing the morphologic features of rectal cancer before and after 6 weeks of chemo irradiation treatment and to correlate the post treatment MRI appearances with the histological findings in resected tumors. Material and methods 68 patients with histopathologically proven rectal adenocarcinoma received standardized 5-week chemo radiation therapy and subjected to MRI before and after treatment for clinical staging. A correlation between pathological response and MRI findings was done. Result Sixty-eight patients with adenocarcinoma rectal cancer were included in the study. Preoperative MRI examination was performed. All patients subsequently underwent operation. The mean time lag between the MRI study and operation was 16.8 days. After preoperative chemo-radiotherapy, MRI findings showed that, there is a significant shift toward downstaging. 16/59 (23.5%) patients achieved down-staging from clinical stage III (before therapy) to stage II after therapy (P = 0.001) by achieving both tumor (T) downsizing and lymph node downstaging. MR images obtained after radiation therapy with concomitant chemotherapy have (100%) sensitivity, (78.7%) specificity, (100%) NPV in the differentiation of T1–2/T3–4 tumors with MRI, accuracy 80.9% with agreement 70.58% and 100% accuracy for node staging. Conclusion High resolution pre treatment MRI of the rectum has a high predictive value of treatment outcome either for neoadjuvant treatment or surgery.
G.J.O Issue ,16 2014
Gulf Journal of Oncology
Purpose: Cancer is a complex subject to write about. Decision-making regarding adjuvant therapy in patients with high risk stage II colon cancer is among the most challenging in oncology. The aim of this study is to clarify the magnitude of the risk-to-benefit ratio with adjuvant therapy in high risk patients with stage II colon cancer. Patients and Methods: Between January 2006 to January 2011, 162 patients with pathologically documented stage II colon cancer presented to Clinical Oncology Department, Tanta University Hospital, were randomly distributed into two groups to received adjuvant chemotherapy regimens after curative resection. The first group (80 patients) received Capecitabine 1250 mg / m2 twice daily for 14 days every 21 days for 6 cycles & the second group (82 patients) received FOLFOX4 (Oxaliplatin 85mg/m2 D1 and D15 plus de Gramont regimen) for 6 cycles . All patients in both groups were assessed for disease-free survival (DFS) and overall survival (OS) as regards to chemotherapy regimen and high risk factors. Multiple logistic regression analysis was used to calculate adjusted odds ratios of event by treatment propensity score matching to minimize selection bias for high risk factors as regards to DFS. Tolerability and safety were assessed for all study population in both groups. Results: Three- year DFS rates were 73% and 87% in the Capecitabine and Folfox4 groups respectively (Hazard ratio (HR) =2.051, 95%Cl (1.13-3.721), P-value= 0.018). Three year OS rates were 87% and 93% in the Capecitabine and Folfox4 groups, respectively (P-value=0.26); corresponding 5-year OS rates for patients with stage II disease were 34% and 93% (HR=2.555, 95%Cl(1.276-5.119) , P-value=0.008) in the Capecitabine and Folfox4 groups, respectively. Statistical significant differences for 5-year DFS and OS with lymph node sampling > 12 lymph nodes in favor Folfox4 group (HR=0.172, 95%Cl(0.0080-0.370), P-value=<0.001)& (HR=0.087, 95%Cl(0.028-0.268), P-value=0.001) respectively. Twenty patients (25%) and 10 patients (12.2%) showed disease recurrence in Capecitabine and FOLFOX4 treatment groups respectively with significant P. value = 0.036. For mortality, 12 patients (15%) and 6 patients (7.3%) in Capecitabine and FOLFOX4 treatment groups respectively with insignificant P. value= 0.120. Multivariate analysis for all study population stated that the only significant risk factor was the inadequate lymph node sampling as regards to relapse (HR= 0.244, 95% CI (0.094-0.631), P-value=0.004) in stage II colon cancer. Diarrhea and peripheral sensory neuropathy (PSN) were the most pronounced side effects in FOLFOX4 treatment arm versus Hand-foot syndrome in Capecitabine treatment arm. Conclusion: This study has demonstrated that patients with microscopic disease do behave more like stage III colon cancer patients; our data suggest that we must analyze tumors at this level if at all possible and those patients with <12 lymph nodes resection should received adjuvant chemotherapy in favor of FOLFOX4 regimen with significant improvement in DFS which can be translated into an OS benefit.
Journal of the Egyptian National Cancer Institute (2013) 25, 199–207
Journal of the Egyptian National Cancer Institute
Abstract Background and aim: Breast cancers (BCs) involve the left side (LS) more than the right side (RS). Among the Egyptians, neither BC laterality nor its association with demographic factors, tumor locations, treatments and outcomes were previously reported. Patients and methods: Laterality was analyzed among 5459 BCs from the Gharbiah populationbased cancer registry covering >5% of the Egyptian population. Cox proportional model was used to assess the independent effect of stage, ER, and laterality on overall survival (OS). Results: In Egypt, BCs involve LS more than RS with LS-to-RS ratio (LRR) of 1.16. LS predominance was evident among men and women and both younger (<45 years) and older patients. HER2 over-expression and ductal cancers were significantly more in RSBCs while lobular cancers were significantly more in LSBCs. There were no significant differences in localization within the breast between LSBCs and RSBCs (p= 0.51). LS predominance was noticed across all subgroups except in patients with HER2 positive tumors (LRR = 0.63; p= 0.02). OS was significantly better in stage II and ER positive tumors than stage III and ER negative tumors. Despite OS of LSBCs being generally lower than RSBCs, this was not statistically significant. The significant impact of stage on OS was lost in LSBCs. Conclusions: Among Egyptian patients, the left breast is at greater risk of cancer than the right one. Despite right-sided tumors seemed more aggressive, Left-sided ones tend to confer worse survival than right-sided tumors.
Life Sci J 2013;10(4):373-379] (ISSN: 1097-8135)
Life Science Journal
Background: Oxaliplatin, an effective antineoplastic agent against colorectal tumors, can cause severe peripheral neurotoxicity, which seriously limits its clinical application. To date, there is no effective treatment for this complication. Alpha lipoic acid (ALA) been shown to be an effective in the treatment of diabetic distal sensorymotor neuropathy. The aim of this study was to evaluate the effects of ALA on preventing oxaliplatin-induced neurotoxicity in patients with colorectal tumors. Methods: In this study, Forty-nine patients with colorectal cancer were treated with Oxaliplatin, Leucovorin and Fluorouracil Regimen (FOLFOX4 protocol). The patients were randomly divided into two groups, the experimental group (24 patients) and control group (25 patients). The experimental group received ALA, while no neuroprotective agents were applied in the control group. The incidence rates and classification of neurotoxicity in the two groups were evaluated and the differences between the two groups were examined. Furthermore, the effect of ALA on neuronal electrophysiological parameters was also examined. Results: The grade of neurotoxicity in the experimental group was significantly lower than in the control group (P<0.05, Mann-Whitney U test) after two, four and six cycles of chemotherapy. Interference of daily activity was significantly lower in the ALA group than in the control group. In addition, the evaluation of motor and sensory nerve conductions showed significantly improvement in ALA group compared to the control group. The rate of increment of conduction velocity in ALA group is greater in the sensory nerve than in the motor nerve compared to the control group (p<0.001). Conclusion: The data suggested that ALA could reduce the grade of oxaliplatininduced neurotoxicity and was an effective neuroprotective agent against oxaliplatin-induced high-grade neurotoxicity in patients with colorectal tumors.
Egyptian Liver Journal 2012, 2:96–102
Egyptian Liver Journal
Introduction The management of hypersplenism in patients with advanced cirrhosis is a controversial issue as surgical splenectomy has high perioperative morbidity and mortality rates. Partial splenic embolization (PSE) and low-dose splenic irradiation (LDSI) are alternative procedures available in Egypt. The aim of this prospective controlled study was to compare (PSE) versus (LDSI) for ablation of the spleen as a treatment of hypersplenism in patients with advanced cirrhosis. Patients and methods Seventy-one cirrhotic patients were diagnosed by liver function tests, international normalization ratio, complete blood picture, bone marrow examination and abdominal ultrasonography. They were divided into three groups. Group I included 26 patients treated with (LDSI), group II included 25 patients treated with (PSE) and group III included 20 patients who received conventional therapy including blood transfusion and represented as control group and represented control group; we followed up these patients for 6 months. Results The LDSI group showed a steady progressive increase in all CBC elements. A significant increase in platelets was observed by week 2, whereas the values of haemoglobin and white blood cells increased within the first month. These increases were observed by the first week in the PSE group, reached a peak in the second week, and then decreased gradually but were still significantly higher than the pretreatment and control levels. Both procedures were well tolerated by the patients but more complications were reported with PSE. Both LDSI and PSE did not affect liver functions. Conclusion Both LDSI and PSE are safe and effective methods for the treatment of hypersplenism in decompensated cirrhosis. They induce an improvement in cytopenia and splenomegaly. The rapid onset and the higher efficacy of PSE should be weighed against the wide safety and moderate efficacy of radiation.