Emir Abdelkader University of Islamic Sciences

Introduction/Background Brachytherapy boost plays a fundamental role in the therapeutic approach of patients with locally advanced cervical carcinoma, As there is no consensus on fractionation scheme for high dose rate brachytherapy treatment. The aim of our study was to report the oncological and toxicity results of two fractionation schemes Methodology This is a retrospective study performed in a Department of radiotherapy at EHSO Emir Abdelkader in Oran - Algeria, including 149 patients treated between January 2014 and December 2019.All patients received concomitant chemo radiotherapy at a dose of 46 Gy, followed by HDR uterovaginal brachytherapy with two different fractionations: 19.5Gy in 03 fractions (group1), and the 25Gy in 5 fractions (group2). Results The 6.5Gyx3 regimen was used in 95 patients (64%), and the 5GyX5 regimen was used in 54 patients (36%).The median follow-up was 41.72 months, the median EQD2 (α/β=10) of D90 HR-CTV was 77.52 Gy for group 1 and 77.85 Gy for group 2. The mean EQD2 (α/β=3) of D2cc of the bladder in group 1 and 2 was 74.84 Gy and 81.6 Gy (p=0.000), and the mean EQD2 (α/β=3) of D2cc of the rectum in group 1 and 2 was 68.52Gy and 68.86 Gy respectively (p=0.123). The 5-year recurrence-free survival for group 1 was 87.9±3.7% and 93.3±3.7% for group 2 (p=0.377), while the 5-year overall survival for group 1 was 76.8±4.7% and 74.6±9% for group 2 (p=0.563), with a non-significant difference between the 2 groups. Grade 3 urinary toxicity for group 1 and 2 was 12.1%/16.1% (p=0.096), and 7.9%/12.5% for grade 3 digestive toxicity (p=0.776). Conclusion The two irradiation regimens used in HDR uterovaginal brachytherapy in 3 or 5 fractions give similar oncological results with a comparable late toxicity. Disclosures HR CTV= high-risk clinical target volumeEQD2= Equivalent dose in 2Gy fractions

Introduction/Background Adenocarcinoma accounts for 10–25% of malignant cervical cancer cases. Several authors have reported that their prognosis is less favourable than squamous cell carcinomas. The aim of our study is to determine the clinical, therapeutic and prognostic aspects of adenocarcinoma of cervical cancer. Methodology This is a retrospective study of 59 patients with adenocarcinoma of the uterine cervix treated at the Emir Abdelkader University Hospital Establishment of Oncology in Oran between January 2014 and December 2020. Results The average age of the patients was 55.9 years.metrorrhagia was the most frequent symptomatology finding in 57.62% with an average time of consultation of 7.4 months.the majority of patients were anemic in 62.7% of cases. According to the Figo 2018 classification the majority of patients were classified as stage IB (39%), stage III (37.3%), stage IIB (13.6%), stage IA (5%) and IVA (3.4%). Radiological lymph node involvement (ADP≥1cm) represented 34% of cases and the mean radiological tumour size was 47mm.56% of the patients underwent surgery and 44% of the patients were treated with exclusive concomitant radiochemotherapy with or without uterovaginal brachytherapy. Mean follow-up was 43.12 months. The progression free survival (PFS), disease free survival (DFS), and overall survival (OS) at 5 years was 86.4%, 53.9%, 61.7% respectively. In univariate analysis, Figo III-IV stage, tumour size greater than 5cm, presence of anaemia, radiological lymph node involvement, absence of surgery and brachytherapy are unfavourable prognostic factors for overall survival with a statistically significant p <0.05. Conclusion Adenocarcinomas of the uterine cervix are particular histopathological entities with a poor prognosis requiring more aggressive oncological treatment. Disclosures key words: Cervical cancer- adenocarcinoma-pronostic

Introduction/Background Cervical cancer is a preoccupant problem of public health in Algeria, because its frequency and especially its mortality. The objective of our study is to determine epidemiological, clinical and therapeutic aspect of cervical cancer in west of Algeria. Methodology This is a retrospective study that took place in the radiotherapy department of EHSO of Emir Abdelkader in Oran in the period from 1st January 2015 to 31st December 2018. The number of patients included in the study is 409. Results The average age was 56.49 ± 0.6 years old with extreme of 24 years and 93 years. Genital bleeding is the dominant reason for consultation found in 81% of cases, most patients are grand multiparous, 76% of women have four or more children. 28% of women were anaemic at diagnosis with haemoglobin <12g/dl. Almost all patient (78% of cases) presented with an cervix bourgeon a or ulcerate bourgeon. The most represented histological type was squamous cell carcinoma in 88.3% of cases and adenocarcinoma was represented by 37 cases (9%), the average radiological tumour size is 43.7 mm of which 64% of cases were greater than 4 cm. According to the Figo2009 classification, stage IIB represents 55.2% of cases followed by stage IB (25% of cases), stage IV (8.1% of cases), stage III (5.1%), and stage IA (1.9% of cases), the average consultation time is 6.11 months. 4 therapeutic arms were used for the treatment of patients, radiotherapy used in 89.8% of cases, followed by surgery used in 54.3% of patients, brachytherapy in 52.5% of cases, and finally chemotherapy, of which 51.4% of women benefited. Conclusion Cervical cancer is the third leading cause of mortality after breast cancer and colorectal cancer in Algeria. Despite efforts for an early detection program by cervico-vaginal smear, patients arrived in locally advanced stage, and consult doctors late. Disclosures Cervical cancer, Radiotherapy

Introduction/Background Radiotherapy remains an important part of the therapeutic strategy for brain metastases, improving symptoms and prolonging survival in these patients. The aim of our study is to present our experience in the treatment of brain metastases of mammary origin by radiotherapy at the EHSO Emir Abdelkader of Oran. Methodology We retrospectively reviewed the records of 17 patients out of a total of 82 patients treated with palliative encephalic irradiation during the year 2020. Results In terms of frequency, primary breast cancer was second (20.7%) after lung cancer 65.9%. The median age of the patients was 49 years [40–67 years], brain metastases were metachronous in 88.2% of the patients (n=15) and synchronous in 11.8% (n=2). The diagnosis of brain metastases was made radiologically in 82.4% of cases and by biopsy-exeresis in 17.6% of cases. The number of metastases was multiple in 76.5% of cases and single in 23.5% of cases and their location was in 23.5% of cases (n=4) supratentorial, 5.9% (n=1) subtentorial and 70.63% (n=12) supratentorial and subtentorial 76.5% of the patients had a Karnofsky index greater than 70%. Seven patients (41.2%) were RPA I, 35.3% RPAII and 23.5% RPAIII. The brain radiation doses delivered were 18Gray in three sessions and 20Gray in five sessions in 70.6% and 29.4% of cases respectively. With a median follow-up of 13 months (4–33 months) we recorded 13 cerebral relapses (76.5%) and 12 deaths (70.6%). At two years, relapse-free survival was 23.5% and overall survival 28.2%. Conclusion Without treatment, brain metastases lead to death within two months. They often respond well to radiotherapy, which reduces brain signs and improves patient comfort and survival. Disclosures brain metastases, Radiotherapy, Gray, overall survival

Background The most prevalent subtype of breast cancer (BC) is luminal hormonal-positive breast cancer. The neoadjuvant chemotherapy regimens have side effects, emphasizing the need to identify new startegies.Objective Analyze the complete pathologic response (pCR) rate and overall response in a low-risk hormone-positive subset of patients receiving neoadjuvant hormone treatment (NAHT) with or without Palbociclib (a CDK4/CDK6 inhibitor) to boost NAHT effectiveness.Materials and methodsBased on the upfront 21-gene Oncotype DX or low-risk Breast Recurrence Score assay (RS™), the SAFIA trial is designed as a prospective multicenter international, double-blind neoadjuvant phase-III trial that selects operable with luminal BC patients that are HER2-negative for the induction hormonal therapy with Fulvestrant 500 mg ± Goserelin (F/G) followed by randomization of responding patients to palbociclib versus placebo. The pCR rate served as the study’s main outcome, while the secondary endpoint was a clinical benefit.ResultsOf the 354 patients enrolled, 253 initially responded and were randomized to either F/G fulvestrant with palbociclib or placebo. Two hundred twenty-nine were eligible for the evaluation of the pathologic response. No statistically significant changes were observed in the pCR rates for the patients treated with the F/G therapy with placebo or palbociclib (7% versus 2%, respectively) per the Chevallier classification (Class1 + Class2) (p = 0.1464) and 3% versus 10% assessed per Sataloff Classification (TA, NA/NB) (p = 0.3108). Palbociclib did not increase the rate of complete pathological response.Conclusion Neoadjuvant hormonal therapy is feasible in a selected population with a low RS score of < 31Clinical trialNCT03447132.

The design of efficient communication protocols for wireless sensor networks has aroused great interest in the research community, especially in the face of the limited energy of sensor nodes and the frequent change in network topology. Routing remains a challenging problem in wireless communications, as deploying or replacing sensor nodes in hazardous environments is difficult. Many studies have been devoted to alleviate certain limitations, such as clustering to maintain network connectivity, injecting heterogeneity to avoid the rapid death of nodes, or incorporating evolution-based optimization methods to find the best network configuration. This work combined heterogeneity and swarm-based optimization to efficiently balance energy consumption between nodes to increase network reliability. Specifically, this work employed the binary particle swarm optimizer and the binary artificial bees colony optimizer to find approximately the optimal set of cluster heads (CHs) with their optimal number. Based on the probabilistic principle of the heterogeneous protocols: SEP, EDEEC, and BEENISH, a new refined formulation of CHs selection using swarm optimization is proposed. The swarm flight is guided towards the best CHs with an objective function representing a good balance between the initial and residual energy of nodes. Compared to the standard heterogeneous protocols SEP, EDEEC, and BEENISH, the developed protocols significantly perform better in terms of stability (FND), the round of half nodes' death (HND), the network lifetime (LND), and energy saving. Indeed, the BABC-SEP was found 31,66% better than SEP in terms of remaining energy percentage, and CHs selection in EDEEC and BEENISH using BABC improved them by more than 20% in the percentage of remaining energy.

In the Covid-19 outbreak, the teacher should have the performance to be able to deal with the problems, opportunities, and challenges they face during distance learning. A phenomenological qualitative research method was used in this research to explore the identity of the Arabic language teacher at MIN 04 West Kotawaringin represented by their performance in the daily learning process. The data of this study were obtained from the analysis of interviews, observations and documentation. Interviews were conducted with two Arabic language teachers at MIN 04, students and the principal as the informants. The results showed that the teacher's performance could be seen from; the responsibilities in carrying out the task as a representation of their identity as an Arabic teacher who deal the problems and conditions about the learning facilities, enjoyable technique of teaching and learning, adapt to the use of digital-based media, take different learning resources, and take the initiative to use the most accessible and affordable methods. It was in line with the theory of teacher identity by Anne Graham and Renata Phelps that the teacher should be able to overcome the obstacles faced by both problems from students and infrastructure. This research could be a reference so that teachers can represent their performance, not only as a responsibility but also as a teacher's identity. Furthermore, this research hopefully can examine quantitatively regarding the identity of Arabic teacher in Central Kalimantan.

PURPOSE Luminal, human epidermal growth factor receptor 2–negative breast cancer represents the most common subtype of breast malignancies. Neoadjuvant strategies of operable breast cancer are mostly based on chemotherapy, whereas it is not completely understood which patients might benefit from neoadjuvant hormone therapy (NAHT). MATERIALS AND METHODS The SAFIA trial is a prospective multicenter, international, double-blind, neoadjuvant phase III trial, using upfront 21-gene Oncotype DX Breast Recurrence Score assay (recurrence score [RS] < 31) to select operable luminal human epidermal growth factor receptor 2–negative patients, for induction hormonal therapy HT (fulvestrant 500 mg with or without goserelin) before randomly assigning responding patients to fulvestrant 500 mg (with or without goserelin) plus either palbociclib (cyclin-dependent kinase 4/6 inhibitor) or placebo. The objectives of this interim analysis were to assess the feasibility of upfront RS determination on core biopsies in the Middle-East and North Africa region and evaluate the efficacy of induction NAHT in patients with an RS < 31. RESULTS At the time of this interim analysis, 258 patients with relative risk were accrued, including 202 patients (RS < 31% to 78.3%) treated with induction NAHT and 182 patients evaluable so far for response. The feasibility of performing the Oncotype DX assays on core biopsy specimens was optimal in 96.4% of cases. Overall, 93.4% of patients showed hormone sensitivity and no difference in NAHT efficacy was noticed between RS 0-10, 11-25, and 26-30. Interestingly, patients with high RS (26-30) showed a trend toward a higher major response rate ( P = .05). CONCLUSION The upfront 21-gene assay performed on biopsies is feasible in our population and has allowed us to select patients with high hormone sensitivity (RS < 31). This approach could be an alternative to upfront surgery without significant risk of progression, particularly during pandemic times.

e16141 Background: RAS testing is essential for treatment selection in metastatic colorectal cancer (mCRC), as anti-EGFR treatment is indicated only in patients with wild-type (WT) RAS. MORE-RAS was a multicenter, multicountry, observational, ambispective (retrospective + prospective) study designed to evaluate RAS mutation status among patients with mCRC in the Middle East and North Africa (MENA) region. Results of the retrospective study over a prior 2-year period have been previously presented. Here, we report on the prospective evaluation of testing practices in newly diagnosed patients from the same centers. Methods: Five countries (Algeria, Egypt, KSA, Kuwait, Lebanon) enrolled patients between Dec 2014 and Feb 2019. Patients with a new diagnosis of histologically proven mCRC, at least 1 measurable lesion per RECIST criteria, and tissue availability for biomarker analysis were included; those with co-existing malignancies or life expectancy < 6 months were excluded. The primary endpoint was evaluation of the rate of RAS mutation in newly diagnosed patients. Follow-up was for 2 years. Results: 500 patients (mean age 54.6 years; 58% female) were included; 96.4% had Stage 4 disease. Primary tumor sites were sigmoidal colon: 33.4%; rectum: 29.6%; ascending colon: 18.4%; descending colon: 11.4%; transverse colon: 5.2%; and unknown: 1.4%. Most frequent sites of metastasis were liver: 43.4%, lung: 16.0%, and peritoneum: 10.1%. Overall, 407 pts (81.4%; 95% CI, 78%–85%) received prescription for RAS testing. RAS WT was found in 58.4% and mutant in 41.6%; the test was inconclusive in 1 pt. Non-prescription was attributed to test unavailability and medical or financial reasons. The distribution of mutations was KRAS: 85%, NRAS: 4.9%, and not available: 10.1%. Predictors of RAS testing prescription were older age, primary tumor localization in ascending colon, and high tumor grade. Knowledge of RAS status resulted in the addition of bevacizumab or anti-EGFR therapy in 20.4% and 21.2% of pts, respectively at Visit 1 (baseline). Conclusions: RAS testing is now routinely prescribed for newly diagnosed mCRC in the MENA region and can change therapy patterns. The RAS mutation rate in this region differs from that in Western countries.

Background NA chemotherapy (CT) +/- anti-Her2 treatment of operable breast cancer (BC) is considered a standard option in the management of BC. However, pathologic complete response (pCR) rates with CT in HR+/Her2- BC are usually low: 7% (Luminal A) to 16% (Luminal B). Alternatively, NA endocrine therapy (ET) has not been established as a standard treatment because of low pCRs. Methods This is a multicenter phase III, 3rd generation NA trial performed in 34 centers and 7 countries of Middle-East and North Africa (MENA Region). The objective is to investigate the potential role of adding Palbociclib to ET (Fulvestrant +/- Goserelin) compared to ET alone as NA therapy of HR+/Her2- operable BC sensitive to ET. The primary endpoint is pCR with the hypothesis that the addition of Palbociclib would increase the pCR rate from 5% to 15%. Clinical/radiological response, conservative surgery rate, safety, disease-free and OS are secondary endpoints. Exploratory endpoints encompass biomarker serial analysis of liquid biopsies with Quantum Optic and DNA methylation technologies. Results A total of 400 pre and post-menopausal pts with stage II and IIIA are planned to be recruited. Oncotype DX is performed upfront in order to eliminate CT candidates. All pts with a recurrence score (RS) < 31 are treated with Fulvestrant (500 mg Day (d.) 1, 14, 28 then q. 28 d. (+/- Goserelin 3.6 mg q.28 d.) for 4 months. Pts with responding/stable disease are then randomized in double blind fashion to Fulvestrant (+/- Goserelin) with either Palbociclib 125mg po daily 3 weeks/4 or placebo. Four additional cycles are delivered before surgery The trial was initiated in 2018. As of April 2019, 196 patients have been enrolled. The majority of them (60%) are pre/peri menopausal. The mean age is 50.5 years (range: 25-83). RS of < 31 was reported in 75% of cases. So far, 96 pts have completed the induction ET and were randomized to ET with or without Palbociclib. End of accrual is expected by end of 2019. Conclusions SAFIA trial aims to evaluate whether or not the addition of a CDK 4/6 inhibitor to pts sensitive to ET would validate a neo-adjuvant strategy without CT in luminal operable BC. Clinical trial identification NCT03447132. Legal entity responsible for the study International Cancer Research Group (ICRG). Funding Pfizer, AstraZeneca and Genomic Health. Disclosure All authors have declared no conflicts of interest.

Background RAS mutational status is an essential criterion to guide first-line treatment in metastatic colorectal cancer (mCRC). MORE-RAS was a multicenter, multicountry, observational, ambispective (retrospective + prospective) study conducted in the Middle East and North Africa (MENA) region to assess RAS testing practices and tumor characteristics in newly diagnosed patients (pts) with mCRC. Results of the retrospective analysis are presented here. Methods Eligible pts included adults aged ≥18 with mCRC who had already initiated first-line therapy, had at least 1 post-baseline visit for disease evaluation, and had available survival data. Pts with incomplete and unavailable data or presence of other coexisting malignancies were excluded. Data from eligible pts were retrospectively analysed 2 years back from the day of patient consent. Results A total of 495 pts (median age: 57 y) were enrolled; majority were male (55.6%), with adenocarcinoma histology, stage IV disease (86.8%) and left-sided tumors (79%). Primary tumor site was sigmoid (40.9%), followed by rectal (26.1%), ascending (17.2%), descending (12.1%), and transverse (3.8%) colon. RAS testing was requested in 417 (78%) pts; reasons for not prescribing included test unavailability, financial/medical decision, or other. Testing samples were mostly paraffin-embedded (91.7%) primary tumors (92.5%); sequencing was the most common test method used. RAS testing found that 33.9% of tumors harbored mutations and 66.1% carried wild-type (WT) sequences. The most common mutation was KRAS (94.1%), occurring largely in Exon2-Codon12 (70.5%). RAS testing was typically prescribed after initiation of first-line treatment, significantly more in pts with stage IV disease (p < 0.005), resulted in addition of targeted therapy (41.8% anti EGFR, 30.2% anti VEGF) in WT mCRC, and significantly impacted treatment strategy of left-sided tumors (p = 0.037). Conclusions RAS testing for mCRC in the MENA region was often performed after first-line treatment. The dominance of WT RAS in this region is distinct from the mutational pattern reported in Western countries. Legal entity responsible for the study Amgen. Funding Amgen. Disclosure M. Oukkal: Advisory / Consultancy, Speaker Bureau / Expert testimony: Amgen; Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (self): Roche; Advisory / Consultancy: Novartis; Advisory / Consultancy: Pfizer; Speaker Bureau / Expert testimony: Bayer; Speaker Bureau / Expert testimony: Ipsen. H. Mahfouf: Advisory / Consultancy, Speaker Bureau / Expert testimony: Amgen; Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Advisory / Consultancy, Speaker Bureau / Expert testimony: Merck; Advisory / Consultancy, Speaker Bureau / Expert testimony: Bayer; Advisory / Consultancy: Ipsen. A. Ouamer: Full / Part-time employment: Amgen. L. Bashir: Full / Part-time employment: Amgen. All other authors have declared no conflicts of interest.

Colorectal cancer (CRC) is a complex and multifactorial disease, in which genetic and environmental factors both seem to play a part. Many epidemiological studies have explored the association between genetic polymorphisms of X-ray repair cross-complementing group 3 (XRCC3) (Thr241Met) and Xeroderma pigmentosum group D (XPD) lysine to glutamine at codon 751 (Lys751Gln) and risk of CRC in various populations; however, the results are controversial. We conducted this case-control study in a West Algerian population to assess the potential role of this genetic polymorphism on the risk of CRC in this population. Genomic DNA was extracted from blood samples collected from 129 sporadic CRC patients and 148 normal controls. The polymorphisms were determined by pyrosequencing technique. The distribution of XRCC3 Thr241Met and XPD Lys751Gln genotypes among controls did not differ significantly from those predicted by the Hardy-Weinberg distribution (p > 0.05). There were no significant differences in the genotypes distribution and allele frequencies between CRC patients and controls. A significant association was found between the combined heterozygous of XRCC3 and homozygous variant of XPD gene and CRC. This is the first study on DNA repair genetic polymorphisms in West Algerian population, and it suggests that the XRCC3 Thr241Met and XPD Lys751Gln polymorphisms may not be associated with the CRC risk in this population.

In this paper, a quantum!inspired differential evol ution algorithm for solving the N!queens problem is presented. The N!queens problem aims at placing N queens on an NxN chessboard, in such a way that no queen could capture any of the others. The proposed algorithm is a novel hybridization between differential evolution algorithms and quantum computing principles. Accordingly, differential evolution algorithms have been enhanced by the adoption of some quantum concepts such as quantum bits and states superposition. The use of the quantum interference has allowed this hybrid approach to have a remarkable efficiency and good results.