Cancer Research, Statistics, and Treatment最新文献

{"title":"Epidemiological studies of risk factors could aid in designing risk stratification tools","authors":"K Devaraja","doi":"10.4103/crst.crst_276_23","DOIUrl":"https://doi.org/10.4103/crst.crst_276_23","url":null,"abstract":"The latest issue of Cancer Research, Statistics and Treatment contained an interesting article by Michaelraj et al., an epidemiological study on risk factors of head-and-neck squamous cell carcinoma (HNSCC) in south India.[1] I would like to discuss some of the crucial findings of this study and their implications in developing risk stratification models and beyond. This study cross-sectionally analyzed the epidemiological profile of 150 consecutive patients with primary treatment-naïve HNSCC recruited over three years at a tertiary care hospital in Tamil Nadu.[1] As seen in most of the other regions of India, the most common primary site of HNSCC was the oral cavity (40.7%) in this cohort.[2] There were three times more men than women among the diagnosed cases, and only just about a quarter of the study cohort had no exposure to smoking, tobacco chewing, or alcohol (27.3%). Although there existed a significant variability among the men and women regarding the distribution of these risk factors, as per Table 4 in the paper,[1] more than half the men with HNSCC had exposure to multiple risk factors. Furthermore, 66.7% of the overall cohort had exposure to at least one tobacco product. These observations of Michaelraj et al.[1] align with the existing consensus, as they suggest a possible etiopathological role of these known carcinogenic elements, particularly tobacco, the exposure to which is significantly higher among men than women.[3] In Table 5,[1] the authors analyzed the proportional distribution of risk factors in different age groups and found it statistically significant by two-way ANOVA. This table also showed that 91.8% (100/109) of patients with HNSCC exposed to a known risk factor(s) were aged between 41 and 70 years, and only a few patients in the exposed group were outside this range. Additionally, the distribution of all these risk factors (including various combinations of these factors) was seen to peak around the sixth decade of life. Lastly, the patients in the sixth decade of life or older had a higher degree of exposure to multiple risk factors than those in the fifth decade or younger, who had either one risk factor or no exposure at all. All these findings suggest that the putative role of tobacco and alcohol in the carcinogenesis of HNSCC seems to be more relevant in older adults, in their fourth, fifth, and sixth decades of life than in the younger population, a notion that has also been supported by other recent studies.[4] While the relative risk attributable to these known carcinogens is not always predictable, it is understandable that the risk increases with an increase in the duration and severity of exposure to these factors.[5] By these observations, the elderly male with a long-standing use of tobacco, with or without alcohol, would seem to have a higher risk of developing HNSCC, which includes oral cancer. Accordingly, these groups of people, if targeted, would be more likely to benefit from screening programs a","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135784764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Footprints on the sands of time","authors":"M. Dilan Davis","doi":"10.4103/crst.crst_247_23","DOIUrl":"https://doi.org/10.4103/crst.crst_247_23","url":null,"abstract":"While deciding whether to pursue a doctorate of medicine (DM) in Medical Oncology, I talked to numerous people. Most had limited knowledge, some mentioned the potential for significant earnings, others spoke of the emotional toll caused due to the nature of the field, and there were discussions about interdepartmental interference. However, one conversation that particularly stands out is the one I had with a close friend of mine from the United States of America (USA). Dr. DJ Shah left India after completing his Bachelor of Medicine, Bachelor of Surgery (MBBS), to pursue a residency in Internal Medicine in the USA. After finishing his residency, he planned to specialize in Pulmonary Medicine and Critical Care. He explained that he chose critical care because many of the patients he saw were acutely ill. They would either recover and not return, or their condition would deteriorate, and they would pass away. In the latter scenario, an emotional attachment might not be as strong, considering most patients in the intensive care unit (ICU) are intubated, hindering verbal communication, a critical element in forming deep connections. Conversely, he pointed out that oncology presents a different dynamic. Patients you would meet would most likely not be acutely sick, but in a state of shock due to a serious diagnosis. In this field, you would console them, treat them, and accompany them on their journey. Over time, they may be cured or gradually move toward the end of their life. In the latter situation, the experience could be emotionally taxing, both for the family and the treating oncologist, as a personal connection would have been forged during the long journey. He shared a story of a friend at MD Anderson Cancer Center, renowned for cancer treatment in the USA. This friend often struggled with the realization that even at a world-class hospital with exceptional resources, there were cases where treatment fell short, and all that could be done was inform the patient that their time was limited. Despite various perspectives, I ultimately chose to pursue oncology for my DM course. The initial transition was challenging, and I was adapting to a new hospital, environment, and a diverse set of patients. However, I gradually acclimated and found my place. After a month at the Tata Memorial Hospital (TMH, Parel, Mumbai, India), I received the unexpected news that my next two months would be spent at the Advanced Center for Treatment, Research and Education in Cancer (ACTREC) in Kharghar (Navi Mumbai), approximately 35 km from TMH. This facility had a distinct atmosphere, located away from the city’s hustle, offering patients with cancer a serene campus with green spaces and the peace they deserved. They had a building named “Asha Niwas,” which was home to patients with cancer and their families who came for treatment from all over India. During my exploration, I stumbled upon an inauguration stone bearing a name I was familiar with. The name was found in","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135698960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors’ reply to Jobanputra, Chauhan and Trivedi, and Devaraja","authors":"Minu J. Michaelraj, Sivasamy Ramasamy, Fenwick A. E. Rodriguez","doi":"10.4103/crst.crst_278_23","DOIUrl":"https://doi.org/10.4103/crst.crst_278_23","url":null,"abstract":"We thank Jobanputra,[1] Chauhan and Trivedi,[2] and Devaraja[3] for showing interest in our manuscript, published in the previous issue of the Cancer, Research, Statistics and Treatment journal.[4] The prime objective of our study was to unravel the genetics of head-and-neck squamous cell carcinoma (HNSCC) with special emphasis on the human papillomavirus (HPV). Demographic analysis was performed meticulously as a part of our primary study. As our research was mainly focused on the HPV status of the patient samples, we included only crucial and extensively reported risk factors in our questionnaire (tobacco consumption, smoking, and alcohol). HPV status was identified from the collected patients’ tissue samples in our laboratory as the HPV status of the patients was not available in the medical records. Thus, obtaining information on the HPV status from the patient’s general report would be more informative and would have enabled a wider analysis. HPV testing was performed on all the tissue samples collected, and it was not restricted to a particular subset of cancers, such as oropharyngeal cancers. The results obtained delineated HPV positivity in the oropharyngeal region. Though the sample collection was performed from a single center, we had multiple patients from diverse regions of western Tamil Nadu (Coimbatore, Erode, Salem, Tirupur, Nilgiris, and Dharmapuri). Certain ethical constraints, a limited number of patients reporting to the hospital due to the COVID-19 pandemic, and the unwillingness of the patients to participate in the study were the reasons for not including a larger sample size from diverse centers across Tamil Nadu. Measures are being taken to collect samples from other hospitals and tertiary centers to conduct a large cohort study. In conclusion, we will take the readers’ comments into consideration in the work being continued in our laboratory. Financial support and sponsorship This study was supported by Rashtriya Uchchatar Shiksha Abhiyan (RUSA) under the Bharathiar Cancer and Theranostics Research Center (BCTRC) Scheme. Conflicts of interest There are no conflicts of interest.","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135700101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors’ reply Mondal et al. and Nagpal et al.","authors":"R.A Sunil, Sanjeet Kumar Mandal, Nithin Bhaskar Valuvil","doi":"10.4103/crst.crst_286_23","DOIUrl":"https://doi.org/10.4103/crst.crst_286_23","url":null,"abstract":"We thank Mondal et al.[1] and Nagpal et al.[2] for their critical comments on our article, “Gated radiation therapy for patients with breast cancer to reduce the dose to the lung and heart: A comparative cross-sectional study.”[3] The deep inspiratory breath-hold (DIBH) technique reduces radiation dose to the heart in patients with left-sided breast cancer. Many devices are commercially available to conduct treatment via the DIBH technique, like Real-time Position Management Gating solutions from Varian systems and Active Breath Controller (ABC) from Elekta systems. Treatment with ABC involves a mouthpiece that cannot be reused. Thus, before subjecting patients to the DIBH technique-based treatment, we trained the patients with a spirometer to assess if they could hold their breath until two balls were raised in the spirometer. Only then, eligible patients underwent the radiation planning computed tomography simulation scan. In their study, Nagpal et al. measured the cardiac distances from the chest wall as a predictor of percentage reduction in dose to the heart. Irrespective of the distances, if patients can hold their breath, they should be given the benefit of treatment with the DIBH technique rather than the free-breathing technique.[4] In their study, Ferdinand et al., observed the correlation between the heart volume and maximum heart depth in the field as a predictor of cardiac dose reduction via the DIBH technique.[5] Many studies have reported different predictors for cardiac-sparing radiation techniques worldwide. Sardaro et al.[6] estimated that a 1 Gy increase in the mean heart dose equates to a 4% increase in the risk of late heart disease, and Darby et al.[7] estimated that a 1 Gy increase in the mean heart dose causes a 7.4% increase in the rate of major coronary events, like myocardial infarction or death from ischemic heart disease. Chakraborty et al. estimated that the disability-adjusted life years averted would be 622.53 if all Indian patients with left-sided breast cancer (estimated 61,272.65/year) were treated with DIBH. The incremental cost-effectiveness ratio was $4132.90 per disability-adjusted life year, which was 2.11 times the Indian per-capita gross domestic product (2016–2017: $1957.11). Thus, Chakraborty et al. demonstrated that DIBH is cost-effective in developing nations, where cardiac illness is the most prevalent non-communicable disease.[8] Though the mean heart dose of 4.50 ± 0.96 Gy was slightly higher with DIBH in our study[3] compared to other studies, we saw a significant decrease in the mean dose of the heart compared to the free breathing technique. Nevertheless, we would like to continue to give this benefit of DIBH technique-based radiation therapy to all patients with left-sided breast cancer in our institute. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135700464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors’ reply to Kapoor and Mahajan, Fazal et al., and Gupta and Rangarajan","authors":"Ruchika Thukral, Ajat S. Arora, Tapas Dora","doi":"10.4103/crst.crst_282_23","DOIUrl":"https://doi.org/10.4103/crst.crst_282_23","url":null,"abstract":"We thank Kapoor and Mahajan,[1] Fazal et al.,[2] and Gupta and Rangarajan[3] for their keen interest, valuable appreciation, and insightful comments on our article, “Artificial intelligence-based prediction of oral mucositis in patients with head-and-neck cancer: A prospective observational study utilizing a thermographic approach.”[4] We agree with Fazal et al.[1] that, when assessing oral mucositis, it is imperative to give due consideration to the patient’s clinical history and conduct a thorough physical examination. These aspects hold paramount importance in the evaluation process. At the Homi Bhabha Cancer Hospital, Tata Memorial Center, Sangrur, India, we maintain patient records both in the electronic medical record (EMR) system and physical files, while also conducting regular patient examinations. We completely acknowledge the validity of the comment by Fazal et al.[1] that doctors invest significant time in evaluating medical images, and the automation of thermal image processing with the help of artificial intelligence would reduce computational time.[5,6] In the future, more efforts should be made to improve the computational algorithms for larger datasets. We agree with the comments by Kapoor and Mahajan[2] that radiation-induced mucositis takes a minimum of 5–14 days to evolve, and thus, the data acquisition must be done within that specific time slot. Thermal imaging of patients with head-and-neck cancer was conducted over a four-week period as part of a preliminary (pilot) study. Our study[4] was cross-sectional, but thermal data were acquired every week; hence, in many cases, the thermal data were possibly from the same patient in consecutive weeks, but we did not document the data (details) on a weekly basis, which could have provided better clarity to the thermal data. Obtaining real-time data is an extremely time-consuming process, given the concurrent focus on uninterrupted treatment for patients with head-and-neck cancer during the data acquisition phase. The aim of our study[4] was to check the predictability of artificial intelligence-based thermal imaging for oral mucositis. We did not document the clinical aspects. To clarify, we included all cases that received a curative radical radiation dose of 70 Gy; we did not include any patients who received palliative radiotherapy. We agreed with the observation of Gupta and Rangarajan[3] that a larger sample size could have made the deep learning method more sensitive.[7] Real-time thermal data acquisition is a time-consuming process, and data acquisition is still ongoing. In the future, more efforts will be made to improve the computational algorithm on larger thermal datasets that contain images from patients with all grades of mucositis. We thank Gupta and Rangarajan[3] for their recommendations. We will go through the Medical Image Computing and Computer Assisted Intervention Society (MICCAI) and Checklist for Artificial Intelligence in Medical Imaging (CLAIM) checklists a","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135700838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational interventions to improve participation of communities in cancer screening programs","authors":"Gokul Sarveswaran, Prashant Mathur","doi":"10.4103/crst.crst_224_23","DOIUrl":"https://doi.org/10.4103/crst.crst_224_23","url":null,"abstract":"In Ain, France, a low-income, immigrant community with low literacy levels participated in a study by Balamou et al.[1] to evaluate the effects of an eight-week cancer educational intervention on the participants’ screening outcomes, cancer knowledge, and self-efficacy. The study highlighted the importance of targeted educational interventions for populations facing multiple socioeconomic and literacy-related barriers. Vulnerable populations, characterized by factors such as low education, low socioeconomic status, migration, and limited healthcare access, bear a disproportionate burden of cancer incidence and mortality. Additionally, these groups often engage in high-risk behaviors, including tobacco and alcohol use, obesity, physical inactivity, and inadequate consumption of fruits and vegetables, which further elevate their susceptibility to cancer.[2,3] The convergence of socioeconomic disadvantages and these risk factors amplify the vulnerability of these populations to cancer. The study by Balamou et al.[1] sheds light on a crucial topic, given the significant burden of cancer in India and other developing countries and the potential impact of educational interventions. In this editorial, we examine the role of cancer educational interventions in optimizing cancer screening activities, with a specific focus on India’s low literacy population, while referencing similar studies conducted globally to highlight best practices and potential strategies for implementation. Global impact of cancer Cancer is a significant global public health issue, representing the leading cause of death worldwide. In 2020 alone, it accounted for over 10 million deaths, comprising nearly one in six deaths.[4] India, with its vast population and diverse socioeconomic landscape, faces unique challenges in combating cancer. Low literacy rates prevalent among certain segments of the Indian population hinder effective cancer prevention and screening efforts. However, targeted cancer educational interventions present an opportunity to bridge this knowledge gap and empower individuals with the necessary information to make informed decisions. Low literacy rates in India India’s literacy rates have improved over the years, but a considerable portion of the population still faces literacy challenges. According to the National Statistical Office’s 2017–2018 report, the overall literacy rate in India was 77.7%.[5] However, this figure masks regional disparities, with some states reporting literacy rates as low as 66.4%.[6] This low literacy scenario poses a significant barrier to effective cancer prevention and screening initiatives. A study conducted by Tripathi et al.[7] examined the impact of low literacy on cancer knowledge and prevention behaviors in a rural Indian population. The study found that individuals with lower literacy levels had limited awareness of cancer symptoms, risk factors, and the importance of screening. This lack of knowledge contributed to delays in ","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"278 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135701138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a comprehensive head-and-neck oncological radiology (HNOR) consortium: Are we there yet?","authors":"T. Basu, A. Mahuvakar, A. Karpe","doi":"10.4103/crst.crst_53_23","DOIUrl":"https://doi.org/10.4103/crst.crst_53_23","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"113 1","pages":"148 - 149"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76115008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative imaging of perforators for breast reconstructive surgeries: The way forward","authors":"Amit Gupta, Sweety Gupta, A. Mondal","doi":"10.4103/crst.crst_38_23","DOIUrl":"https://doi.org/10.4103/crst.crst_38_23","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"158 1","pages":"153 - 154"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74325895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rezvilutamide in metastatic, hormone-sensitive prostate cancer","authors":"Akhil P Santhosh, A. Gogia","doi":"10.4103/crst.crst_316_22","DOIUrl":"https://doi.org/10.4103/crst.crst_316_22","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"69 1","pages":"172 - 173"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79373623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' reply to Bhargav and Mayilvaganan","authors":"S. Saha, V. Noronha, K. Prabhash","doi":"10.4103/crst.crst_78_23","DOIUrl":"https://doi.org/10.4103/crst.crst_78_23","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"62 1","pages":"171 - 172"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90098579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}