Indian journal of cancer最新文献

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Role of adaptive radiotherapy during concomitant chemoradiotherapy for limited-stage small-cell lung cancer. 局限期小细胞肺癌化疗期间适应性放疗的作用
IF 0.9 4区 医学
Indian journal of cancer Pub Date : 2024-07-13 DOI: 10.4103/ijc.IJC_578_20
Beyza Sirin Ozdemir, Ali A Yavuz
{"title":"Role of adaptive radiotherapy during concomitant chemoradiotherapy for limited-stage small-cell lung cancer.","authors":"Beyza Sirin Ozdemir, Ali A Yavuz","doi":"10.4103/ijc.IJC_578_20","DOIUrl":"10.4103/ijc.IJC_578_20","url":null,"abstract":"<p><strong>Background: </strong>Tumor shrinkage is frequently observed during conventionally fractionated chemoradiotherapy for limited-stage small-cell lung cancer (SCLC). The specific goals of this study are to evaluate the gross tumor volume (GTV) changes due to treatment-induced tumor reduction during the course of radiotherapy (RT) and to examine its potential use in adaptive radiotherapy (ART) for tumor dose escalation or normal tissue sparing in patients with SCLC.</p><p><strong>Materials and methods: </strong>A total of 10 patients with SCLC eligible for chemoradiotherapy underwent computed tomography (CT) scan after Fractions 13 and 23 (at nominal doses of 23.4 Gy and 41.4 Gy, respectively). The GTV was delineated on the repeat CT scans, and two treatment plans were generated with or without adaptation to tumor shrinkage during RT for each patient. Dosimetric and volumetric analyses were performed.</p><p><strong>Results: </strong>The average GTV reduction observed over 13 fractions was 58.5% (range: 13.2%-92.3%; P < 0.001) and over 23 fractions was 70% (range: 36.9%-84.5%; P < 0.001). Compared with the plan without adaptation, ART resulted in mean lung dose relative decreases of 8.7%, mean lung volume receiving ≥20 Gy relative decreases of 5%, mean lung volume receiving ≥5Gy relative decreases of 10%, mean medulla spinalis dose relative decreases of 21 cGy, mean esophagus volume receiving ≥50 Gy relative decreases of 19%, and mean heart volume receiving ≥42 Gy relative decreases of 13%. The benefits of ART were the greatest for tumor volumes ≥30 cm 3 and are directly dependent on GTV reduction during treatment.</p><p><strong>Conclusion: </strong>ART for SCLC achieved a significant benefit in terms of organ at risk (OAR) and dose escalation.</p>","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introduction of HPV vaccine in universal immunization programme of India: A step in the right direction for the elimination of cervical cancer. 印度在全民免疫计划中引入 HPV 疫苗:朝着消除宫颈癌的正确方向迈出了一步。
IF 0.9 4区 医学
Indian journal of cancer Pub Date : 2024-07-13 DOI: 10.4103/ijc.ijc_26_23
Md Abu Bashar, Imran A Khan
{"title":"Introduction of HPV vaccine in universal immunization programme of India: A step in the right direction for the elimination of cervical cancer.","authors":"Md Abu Bashar, Imran A Khan","doi":"10.4103/ijc.ijc_26_23","DOIUrl":"10.4103/ijc.ijc_26_23","url":null,"abstract":"","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of quality of life in head and neck cancer patients visiting the Palliative Care outpatient department in a tertiary care oncology centre in India. 印度一家三级肿瘤治疗中心姑息治疗门诊部的头颈部癌症患者生活质量评估。
IF 0.9 4区 医学
Indian journal of cancer Pub Date : 2024-07-13 DOI: 10.4103/ijc.IJC_1247_20
Abhity Gulia, Nishkarsh Gupta, Prateek Sharma, Vinod Kumar, Rajeev Kumar, Seema Mishra, Sushma Bhatnagar
{"title":"Assessment of quality of life in head and neck cancer patients visiting the Palliative Care outpatient department in a tertiary care oncology centre in India.","authors":"Abhity Gulia, Nishkarsh Gupta, Prateek Sharma, Vinod Kumar, Rajeev Kumar, Seema Mishra, Sushma Bhatnagar","doi":"10.4103/ijc.IJC_1247_20","DOIUrl":"10.4103/ijc.IJC_1247_20","url":null,"abstract":"<p><strong>Background: </strong>Patients with head and neck cancers (HNCs) are at an increased risk of developing functional symptoms associated with eating, speaking, and breathing along with symptoms caused by a fungating tumour (e.g., cosmetic change, malodor, and bleeding). These may substantially reduce their physical functioning and quality of life (QoL). This observational study aimed to find out the QoL in patients with HNC in a tertiary care oncology centre.</p><p><strong>Methods: </strong>A prospective observational study was conducted in adult patients diagnosed with HNC. The patients were divided depending upon their disease extent into early, advanced, and very advanced local disease. The physical, cognitive, emotional, financial and social domains were assessed using a validated Hindi version of the European Organisation for Research and Treatment of cancer (EORTC)- QoL 30 and EORTC H&N 35 at baseline and 3 months.</p><p><strong>Results: </strong>A total of 100 patients were assessed with a mean age of 49.3 ± 12.4 years. Most of the patients had carcinoma buccal mucosa (42%) followed by carcinoma tongue (17%). The patients experienced difficulties with physical functioning and deterioration in emotional functioning. Pain and fatigue were the major problematic symptoms especially in advanced disease patients resulting in poor QoL. There was a significant improvement in various domains of QoL at 3 months follow-up in those with advanced disease. The fatigue scores at baseline and follow-up showed a positive correlation with other symptoms.</p><p><strong>Conclusion: </strong>Patients with HNC have a high symptom burden that leads to poor QoL. Appropriate palliative care interventions help to decrease symptom burden and prevent deterioration of their QoL in patients with HNC.</p>","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meta-analysis of the clinical efficacy and safety of T-DM1 in the treatment of HER2-positive breast cancer T-DM1治疗HER2阳性乳腺癌的临床疗效和安全性的荟萃分析
IF 1 4区 医学
Indian journal of cancer Pub Date : 2024-05-02 DOI: 10.4103/ijc.ijc_223_24
Furong Liu, Yuehua Li, Dinghua Yang, Li Tang, Qian Yang, Majiao Jiang, Leilei Tian, Jingjing An
{"title":"Meta-analysis of the clinical efficacy and safety of T-DM1 in the treatment of HER2-positive breast cancer","authors":"Furong Liu, Yuehua Li, Dinghua Yang, Li Tang, Qian Yang, Majiao Jiang, Leilei Tian, Jingjing An","doi":"10.4103/ijc.ijc_223_24","DOIUrl":"https://doi.org/10.4103/ijc.ijc_223_24","url":null,"abstract":"<p>This meta-analysis aims to comprehensively evaluate the efficacy and safety of T-DM1 in treating HER2-positive breast cancer, providing insights for clinical practice. We conducted a literature search in PubMed, Cochrane Library, and Embase databases up to September 2023, collecting randomized controlled trials and cohort studies on T-DM1 for HER2-positive breast cancer. Out of 316 initially retrieved articles, 12 studies meeting the quality and inclusion criteria were included after a rigorous screening process. We used RevMan 5.3 software for the meta-analysis, employing fixed or random-effect models. Odds ratios (RRs) and 95% confidence intervals (CIs) were calculated as effect size measures. We conducted sensitivity analyses and assessed publication bias to ensure the results’ stability and reliability. In seven studies, T-DM1 treatment significantly prolonged OS in patients with HER2-positive breast cancer [hazard ratio (HR) = 0.70, 95% CI: 0.64–0.77, <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">P</em> &lt; 0.01], and the effect was especially pronounced in patients with advanced disease (HR = 0.64, 95% CI: 0.54–0.76, <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">P</em> &lt; 0.001). Analysis of pCR rates did not show a significant difference (OR = 0.91, 95% CI: 0.48–1.73, <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">P</em> = 0.77). In five studies, ORR improved, but the difference between the two groups was not significant (OR = 1.16, 95% CI: 0.66–2.05, <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">P</em> = 0.61). Analysis of progression-free survival (PFS) showed a significant improvement in the experimental group relative to the control group (HR = 0.69, 95% CI: 0.57–0.84, <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">P</em> = 0.0003). Regarding the incidence of total adverse events, no significant difference was seen between the two groups (OR = 2.16, 95% CI: 0.98–4.79, <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">P</em> = 0.06), but for specific adverse events, such as leukopenia and neutropenia, the T-DM1 group demonstrated a significant reduction relative to the other treatment regimens. The results underscore the potential of T-DM1 in enhancing survival among patients with advanced HER2-positive breast cancer, yet they also highlight variability in effectiveness concerning pCR rate and ORR. The findings on adverse effects underscore the necessity of a balanced consideration of T-DM1’s risks and benefits. Future research should focus on a more detailed examination of responses in varied patient populations, long-term outcomes, and a thorough economic evaluation of T-DM1, along with an exploration into treatment resistance. This will provide a more nuanced understanding of T-DM1’s role in the treatment landscape of HER2-positive breast cancer.</p>","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140828712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is there a role of cytoreductive surgery with HIPEC in recurrent ovarian granulosa cell tumors? An Indian cancer center experience with review of literature 在复发性卵巢颗粒细胞瘤中使用细胞剥脱术(Cytoreductive surgery with HIPEC)是否有作用?印度一家癌症中心的经验及文献综述
IF 1 4区 医学
Indian journal of cancer Pub Date : 2024-05-02 DOI: 10.4103/ijc.ijc_1454_21
Mukurdipi Ray, Aarthi S. Jayraj, Kunal Dhall, Rambha Pandey, Suryanarayana V. S. Deo
{"title":"Is there a role of cytoreductive surgery with HIPEC in recurrent ovarian granulosa cell tumors? An Indian cancer center experience with review of literature","authors":"Mukurdipi Ray, Aarthi S. Jayraj, Kunal Dhall, Rambha Pandey, Suryanarayana V. S. Deo","doi":"10.4103/ijc.ijc_1454_21","DOIUrl":"https://doi.org/10.4103/ijc.ijc_1454_21","url":null,"abstract":"<h3>Background: </h3>\u0000<p>Granulosa cell tumors of the ovary represent the most common sex-cord stromal tumors. Though characterized by an indolent course and a good five-year survival rate, they tend to have late recurrences and subsequent poorer survival. The role of hyperthermic intraperitoneal chemotherapy (HIPEC) in women with recurrent granulosa cell tumors with peritoneal dissemination has not been well defined.</p>\u0000<h3>Methods: </h3>\u0000<p>All patients with adult or juvenile type granulosa cell tumors who underwent cytoreductive surgery with HIPEC with 70 mg/m<sup xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">2</sup> of cisplatin for 60 minutes over a period of four years were retrospectively evaluated. We also performed a review of the literature on similar cases reported.</p>\u0000<h3>Results: </h3>\u0000<p>We identified eight patients with recurrent adult granulosa cell tumors (AGCT) who fulfilled our inclusion criteria. The mean operative duration was 340 minutes, inclusive of the duration of HIPEC. Fifty percent of patients suffered from postoperative morbidity. Grade 4 morbidity was observed in one patient. At a median follow-up of 35 months, four patients experienced disease recurrence. The median disease-free survival was 10 months (range: 6–31 months) and the median overall survival was 11.5 months (range: 7–40 months).</p>\u0000<h3>Conclusion: </h3>\u0000<p>Cytoreductive surgery (CRS) and HIPEC provides a unique opportunity for treating peritoneal dissemination in patients with recurrent ovarian AGCTs. This procedure is well tolerated with acceptable morbidity. Prospective studies are warranted to further elucidate the efficacy of this novel therapeutic approach in recurrent ovarian granulosa cell tumors.</p>","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140828906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Concordance of breast cancer services in an urban tertiary care institute in India to EUSOMA guidelines: An audit of Indian breast cancer practices. 印度城市三级医疗机构乳腺癌服务与 EUSOMA 指南的一致性:印度乳腺癌治疗方法审计。
IF 1 4区 医学
Indian journal of cancer Pub Date : 2024-04-06 DOI: 10.4103/ijc.ijc_565_21
G. Kadayaprath, Sandhya Gupta, Neerja Gupta
{"title":"Concordance of breast cancer services in an urban tertiary care institute in India to EUSOMA guidelines: An audit of Indian breast cancer practices.","authors":"G. Kadayaprath, Sandhya Gupta, Neerja Gupta","doi":"10.4103/ijc.ijc_565_21","DOIUrl":"https://doi.org/10.4103/ijc.ijc_565_21","url":null,"abstract":"ABSTRACT\u0000The provision of breast cancer care tends to vary substantially from one breast unit to another. To provide state-of-the-art patient-centered care to women diagnosed with breast cancer, adoption and adherence to structured treatment algorithms, protocols, and international guidelines are essential. In this review, we endeavor to audit breast cancer care at our tertiary cancer center against published EUSOMA guidelines. This was a retrospective study with an observational design. All patients who completed recommended treatment for breast diseases at our institute from January 1, 2018 to December 31, 2018 were included and evaluated. Data were retrieved from patient e-prescriptions and medical records. Analysis was performed using Microsoft Office 2010 to measure how our practices compared to EUSOMA quality indicators (QIs). Clinical assessments, imaging, and preoperative work-up of breast cancer patients met EUSOMA standards. Prognostic and predictive characterization of tumors was performed in all cases. Surgical management of invasive cancer and ductal carcinoma in situ (DCIS) was in accordance with the guidelines. Adherence to postoperative radiation and adjuvant endocrine therapy was adequate. More mastectomies were performed in patients with invasive cancers measuring <3 cm. Overtreatment was avoided in every other subgroup. Adjuvant and neoadjuvant chemotherapy and targeted adjuvant therapy were adequately utilized unlike neoadjuvant targeted therapy. Minimal attrition was noted in patient follow-up. This extensive audit has set a benchmark for future annual audits and helped highlight areas where improvement of service delivery is needed.","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140735322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Plasmacytoid urothelial carcinoma - A clinicopathological case series of an aggressive variant of urothelial cancer. 浆细胞性尿路上皮癌--一种侵袭性尿路上皮癌变异的临床病理病例系列。
IF 0.9 4区 医学
Indian journal of cancer Pub Date : 2024-04-01 Epub Date: 2023-01-10 DOI: 10.4103/ijc.IJC_617_20
Pooja Kamlesh Gajaria, Santosh Menon, Ganesh Bakshi, Gagan Prakash, Amit Joshi, Vedang Murthy, Sangeeta B Desai
{"title":"Plasmacytoid urothelial carcinoma - A clinicopathological case series of an aggressive variant of urothelial cancer.","authors":"Pooja Kamlesh Gajaria, Santosh Menon, Ganesh Bakshi, Gagan Prakash, Amit Joshi, Vedang Murthy, Sangeeta B Desai","doi":"10.4103/ijc.IJC_617_20","DOIUrl":"10.4103/ijc.IJC_617_20","url":null,"abstract":"<p><strong>Background: </strong>Many new morphological variants of urothelial carcinoma of urinary bladder have been described in the literature, plasmacytoid/signet ring cell/diffuse variant being one of the rare amongst these. Till date, no case series has been reported from India, describing this variant.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed the clinicopathological data of 14 patients diagnosed at our center with plasmacytoid urothelial carcinoma.</p><p><strong>Results: </strong>Seven cases (50%) were pure forms while the remaining 50% of cases had a concurrent conventional urothelial carcinoma component. Immunohistochemistry was performed to rule out other mimickers of this variant. Treatment-related data were available for seven patients, while follow-up was available for nine cases.</p><p><strong>Conclusion: </strong>Overall, plasmacytoid variant of urothelial carcinoma is considered to be an aggressive tumor with poor prognosis.</p>","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10815013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical risk factors and Risk assessment model for Anastomotic leakage after Rectal cancer resection. 直肠癌切除术后吻合口漏的临床风险因素和风险评估模型
IF 0.9 4区 医学
Indian journal of cancer Pub Date : 2024-04-01 Epub Date: 2023-03-13 DOI: 10.4103/ijc.ijc_903_21
Rui Ding, Ming He, Hong Cen, Zheng Chen, Yonghui Su
{"title":"Clinical risk factors and Risk assessment model for Anastomotic leakage after Rectal cancer resection.","authors":"Rui Ding, Ming He, Hong Cen, Zheng Chen, Yonghui Su","doi":"10.4103/ijc.ijc_903_21","DOIUrl":"10.4103/ijc.ijc_903_21","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage (AL) is the most serious complication after rectal cancer surgery. Risk factors associated with AL have been documented in previous studies; however, the consensus is still lacking. In this retrospective study, we aimed to identify risk factors for AL after rectal cancer resection and to create an accurate and effective tool for predicting the risk of this complication.</p><p><strong>Methods: </strong>The study cohort comprised of 276 patients with rectal cancer who had undergone anterior resection between 2015 and 2020. Twenty-four selected variables were assessed by univariate and multivariate logistic regression analyses to identify independent risk factors of AL. A risk assessment model for predicting the risk of AL was established on the basis of the regression coefficients of each identified independent risk factor.</p><p><strong>Results: </strong>Anastomotic leakage occurred in 20 patients (7.2%, 20/276). Multivariate analysis identified the following variables as independent risk or protective factors of AL: perioperative ileus ( P < 0.001, odds ratio [OR] = 14.699), tumor size ≥5 cm ( P = 0.025, OR = 3.925), distance between tumor and anal verge <7.5 cm ( P = 0.045, OR = 3.512), obesity ( P = 0.032, OR = 7.256), and diverting stoma ( P = 0.008, OR = 0.143). A risk assessment model was constructed and patients were allocated to high-, medium-, and low-risk groups on the basis of risk model scores of 5-7, 2-4, and 0-1, respectively. The incidences of AL in these three groups were 61.5%, 11.9%, and 2.0%, respectively ( P < 0.001).</p><p><strong>Conclusions: </strong>Our risk assessment model accurately and effectively identified patients at high risk of AL and could be useful in aiding decision-making aimed at minimizing adverse outcomes associated with leakage.</p>","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A comparative study of the treatment outcome of moderately accelerated radiation fractionation (with concurrent chemotherapy in daily dosing) to conventional chemo-radiotherapy in locally advanced head and neck cancers: Supportive in a resource constrained environment. 中度加速放射分割(每日同时化疗)与常规放化疗治疗局部晚期头颈癌疗效的比较研究:在资源受限的环境中提供支持
IF 0.9 4区 医学
Indian journal of cancer Pub Date : 2024-04-01 Epub Date: 2023-05-15 DOI: 10.4103/ijc.IJC_155_21
Chhavi Arora, Neelam Sharma, Amul Kapoor, Tejas N Pandya
{"title":"A comparative study of the treatment outcome of moderately accelerated radiation fractionation (with concurrent chemotherapy in daily dosing) to conventional chemo-radiotherapy in locally advanced head and neck cancers: Supportive in a resource constrained environment.","authors":"Chhavi Arora, Neelam Sharma, Amul Kapoor, Tejas N Pandya","doi":"10.4103/ijc.IJC_155_21","DOIUrl":"10.4103/ijc.IJC_155_21","url":null,"abstract":"<p><strong>Background: </strong>In our country, head and neck cancers account for about a third of all cancers. Moreover, the patients typically present in advanced stages, which entails intensive multimodality therapy; but there is not much scope for improved survival outcomes. In view of this, a study was conducted to know the effects of treatment intensification, wherein moderately accelerated fractionation radiotherapy was given to patients presenting with advanced cancer of head and neck. This treatment was further intensified by accompanying radiation with concurrent cisplatin chemotherapy in daily doses. The control arm received the current standard therapy of conventional fractionation radiotherapy with weekly cisplatin chemotherapy.</p><p><strong>Methods: </strong>The primary objective of the study was to determine the prospect of tumor control (TC), disease-free survival (DFS), and overall survival (OS). The secondary objective was to study acute toxicity and late toxicity of the highest grade in both treatment groups. The study was conducted on a total of 60 patients who presented with locally advanced squamous cell carcinoma of the head and neck. The 30 patients in the control group received conventional fractionated radiotherapy (five fractions per week) with weekly cisplatin chemotherapy (40 mg/m 2 ), whereas the remaining 30 in the study group received moderately accelerated radiotherapy (six fractions per week with same treatment field) along with daily cisplatin chemotherapy (6 mg/m 2 ) with a reduction in treatment time by 1 week.</p><p><strong>Results: </strong>The overall response to therapy assessed as TC, DFS, and OS was compared, and no statistically significant difference between the two treatment arms was observed. However, the mean overall treatment time was reduced in the study group to 45 days as compared with 49 days in the control group ( P = 0.001). The acute toxicities of xerostomia ( P = 0.057) and skin ( P = 0.052) and late toxicity of aspiration/laryngeal toxicity ( P = 0.002) were higher in grade and number in the study group with accelerated fractionation.</p><p><strong>Conclusions: </strong>Hence, the study results suggest that it is a feasible option to combine the therapeutic benefits of accelerated fractionation radiotherapy with concurrent chemotherapy in patients with locally advanced head and neck carcinomas. There is a significant decrease in the overall treatment time and a considerable reduction in the load on the resource-constrained healthcare system. It would be equitable to point out that higher grade of few toxicities in the acceleration arm are likely due to doses to organs at risk being intensified with accelerated fractionation, which can now be delivered in a controlled manner with the latest high precision techniques, resulting in improved toxicity profile and quality of life which is the way forward for future studies.</p>","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44943625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Brain metastasis of hepatocellular carcinoma- single center experience. 肝细胞癌脑转移的单中心经验
IF 0.9 4区 医学
Indian journal of cancer Pub Date : 2024-04-01 Epub Date: 2023-05-26 DOI: 10.4103/ijc.IJC_980_19
Samed Rahatli, Arzu Oguz, Zohrab Abduyev, Ozden Altundag
{"title":"Brain metastasis of hepatocellular carcinoma- single center experience.","authors":"Samed Rahatli, Arzu Oguz, Zohrab Abduyev, Ozden Altundag","doi":"10.4103/ijc.IJC_980_19","DOIUrl":"10.4103/ijc.IJC_980_19","url":null,"abstract":"<p><strong>Background: </strong>Although the most common intracranial neoplasm in the adult population is metastatic tumors, brain metastasis from hepatocellular carcnoma (HCC) are very rare. The aim of this study is to analyze patients with advanced HCC, in order to determine the incidence of brain metastasis and evaluate the clinicopathologic properties.</p><p><strong>Methods: </strong>The records of HCC patients treated in our university between 2011 and 2019 were reviewed retrospectively. Patient characteristics, symptoms, laboratory data, treatment modalities, and survival after both the diagnosis of HCC and detection of brain metastasis were recorded.</p><p><strong>Results: </strong>Of the 119 hepatocellular carcinoma patients, 34 had metastasis, 8 of which were to the brain. The median time elapsed between the diagnosis of HCC and brain metastasis was 14.6 months and the median overall survival after the detection of brain metastasis was 1.6 months. In 34 patients with metastasis, median survival was 26.2 months for those without brain metastasis, whereas it was 15.8 months for those with brain metastasis ( P = 0.460). The survival times after brain metastasis were 11.6 and 3.9 months for the two patients treated with regorafenib and sorafenib after the detection of brain metastasis, respectively.</p><p><strong>Conclusion: </strong>In this study, it was found that patients who were clinically eligible to receive tyrosine kinase inhibitors survived longer after the detection of brain metastasis. Our study shows that multidisciplinary evaluation of these patients is vital for treatment guidance, and survival outcomes can be improved with the advancements in surgical and radiotherapy techniques even in patients with poor prognosis.</p>","PeriodicalId":13505,"journal":{"name":"Indian journal of cancer","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41402910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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