Abstract Introduction Complementary and alternate medicine (CAM) use is highly prevalent among Indian cancer patients. However, such studies from the perspective of Indian patients with breast cancer (BC) are lacking. Objective The aim of this study was to evaluate the incidence of CAM use and its impact on the presentation of patients with BC. Materials and Methods This retrospective study was performed in the Department of Radiation Oncology over a period of 6 months (January to June 2019) and involved review of hospital-record of 229 newly-diagnosed patients with BC. Univariate and multivariate binary logistic regression analysis was done to evaluate the association of CAM use with the BC stage and various clinicodemographic variables. Results Of 229 patients, 96 (41.92%) used CAM. The CAM use was significantly associated with rural residence (odds ratio [OR]: 4.092; 95% confidence interval [CI]: 2.27–7.35), illiteracy (OR: 6.417; 95% CI: 1.83–22.45), delayed presentation by 3 to 6 (OR: 12.964; 95% CI: 2.94–57.00) and more than 6 months (OR: 40.667; 95% CI: 9.26–178.46), and advanced stage at diagnosis (OR: 10.786; 95% CI: 5.15–22.58). Similarly, advanced stage at diagnosis was significantly associated with rural residence (OR: 2.78; 95% CI: 1.59–4.84), illiteracy (OR: 7.20; 95% CI: 1.86–22.79,), and delayed presentation by 3 to 6 (OR: 6.41; 95% CI: 2.81–14.61) and more than 6 months (OR: 17.55; 95% CI: 7.26–42.45). Conclusions CAM use was highly prevalent among the patients with BC and significantly associated with advanced stage at diagnosis. Moreover, both CAM use and advanced stage at diagnosis were significantly associated with rural residence, low educational status, and delayed presentation.
Background: India is experiencing a rapid health transition with a rising burden of NCDs (Non-Communicable Diseases) causing significant morbidity and mortality, both in rural and urban population, with considerable loss in potentially productive years (age 35-64 years) of life.So, a systematic review of published studies was done to understand the pattern of NCDs risk factors in India.Methods: The Medline and Cochrane library database were searched.Any prospective or retrospective study, both quantitative and qualitative published since 2008 were included.Data were extracted independently and quality assessment was conducted on standard risk factor definition (WHO STEPs strategy), epidemiological estimates, study design, study population characteristics and assessment methods.Of the 132 published articles screened, 14 studies met the inclusion criteria and were included in the review.Results: Prevalence of overweight and obesity ranged from 2.4 to 33.1% and 2.2 to 77.5% respectively.Tobacco chewing, smoking and alcohol consumption were found to range widely between 12.15-54.9%,4.1-81.5% and 7.9-38.93%respectively.Diabetes known to be one of the important predictive risk factor, ranged between 3.7-26.72%while high BP estimates varied from 5.7 to 48.3%.Conclusions: Risk factors of non-communicable diseases are quite prevalent in Indian population.Risk factor control along with early diagnosis and treatment is highly warranted to get a grasp over NCDs.
Background: Cancer treatment induced bone loss has been retrospectively studied as a distinct entity in gynaecological cancers. Amongst gynaecological cancers, cervical cancer is the leading cause of mortality and morbidity, majorly in developing countries. Concurrent chemoradiation (CCRT) is considered as the standard of care in managing these patients. The present research was undertaken to study the impact of pelvic irradiation on bone mineral density (BMD) in cervical cancer patients visiting Radiation Oncology Department in tertiary care teaching hospital situated in the central India. A total of 60 patients with histologically proven cervical cancer Method: were studied over a period of 2 years from October 2020 to September 2022. Most common histological type was squamous Results: cell carcinoma (95.00%). Stage IIIB (33.33%) was the most frequently FIGO stage. Maximum patients received radical RT (91.67%) through 2- eld technique (86.67%). At 3- and 6-months follow-up, none of the patients developed fracture. Overall, there was statistically signicant decrease in BMD (T-Score) of lumbar spine and femur neck between baseline and 3- and 6-months follow up (p<0.05). The decrease in BMD reached statistically signicant level in 41–50 years (p=0.001), and 51–60 years age groups (p<0.0001). Also, the decrease in BMD reached statistically signicant level in BMI <18.5 kg/m2 (p<0.0001), 18.5–24.9 kg/m2 (p=0.006), and ≥25 kg/m2 (p=0.033). The decrease in BMD reached statistically signicant level in patients with (p<0.0001), and without menopause (p=0.004). However, the decrease was greater in patients with menopause. Findings Conclusion: suggest that patients with cervical cancer undergoing RT have signicant reduction in mean BMD. Proportion of patients with osteopenia and osteoporosis increases with time.
A BSTRACT Background: In India, majority of the patients with head-and-neck cancers are diagnosed in the locally advanced stage. The aim of this study was to compare the efficacy and safety of paclitaxel versus cisplatin with concurrent radiotherapy (RT) in patients with locally advanced head-and-neck squamous cell carcinomas (LAHNSCCs). Materials and Methods: This was an open-label, randomized study involving 100 patients with LAHNSCC who were randomly divided into two groups: the first group received paclitaxel (Tax, n = 50, 30 mg/m 2 /week for 7 weeks) and the second group received cisplatin (Cis, n = 50; 40 mg/m 2 /week for 7 weeks). Both the groups received concurrent RT in a total dose of 66.6 Gy in 37 fractions of 5 days/week over a period of 7.5 weeks. Results: The complete (46% vs. 36%) and partial (40% vs. 50%) response rates in the Tax + RT group and Cis + RT group were not significantly different (both P > 0.05). Cis + RT resulted in significantly greater Grade I adverse events (AEs) ( P < 0.05). While, Grade II, III, and IV AEs were significantly greater with Tax + RT (all P < 0.05). Overall analysis revealed that the use of Cis + RT was associated with a significantly greater number of patients who were free from AEs ( P < 0.05). Conclusions: Tax + RT and Cis + RT were equi-efficacious in patients with LAHNSCC. However, Cis + RT had a better safety profile.
Melanomas affecting the small bowel are usually metastasis from primary cutaneous lesions. A primary melanoma of the gastrointestinal tract is very rare with reported incidence of just 3%. We present a case of small bowel melanoma with liver metastases. Primary malignant melanoma of the small intestine is quite rare with only a few cases reported in literature. Like its cutaneous counterpart, intestinal melanomas too remains an aggressive disease with a poor prognosis. The overall survival of malignant melanoma affecting the GI tract is 4 to 6 months with a survival rate of less than 10% at 5 years.
ESTRO meets Asia 2019 S9 ensure correct clinical outcomes for stereotactic radiosurgery.To date, substantial work has been performed in identifying and quantifying suitable dosimeters for relative output factor (ROF) measurements including recent IAEA published recommendations.
Waiting lists are problems that plague all government radiation therapy centers across the country, leading to disease progression, and reduced treatment efficacy. No shows for appointments create artificial access issues, reduce revenues, waste staff time, and negatively affect patient care.A Retrospective analysis of 180 patients, who were given an appointment and were to be started for radiation therapy at the Department of Radiation Therapy and Oncology, at our institute from May 1, 2013 to July 31, 2013, was done. Patients were divided into two Groups; Group A (n = 104, 57.8%) that complied for treatment and Group B (n = 76, 42.2%) that did not comply for treatment on the scheduled date. The Group B ("no shows") patients were contacted telephonically and were evaluated for the primary reasons for their failure to comply for treatment through a preformed questionnaire.The mean age, gender distribution and patient's habitat in both the groups were comparable. On Group B analysis, the average waiting period for the appointment was 74 days; 31.4% had died within an average of 31 days; 37.1% said they were better; 10% said their condition was the same; 18.6% said their disease had progressed. Patients were also evaluated for various factors responsible for their not reporting for treatment at the institute.Better communication and constant reminders between patients and the departmental staff can go a long way in helping to curb the problem of no shows and mitigate the artificial access issues. This would lead to better patient care and better resource utilization.
Ranjith K.The objective of this study was to compare the efficacy, safety, pharmacokinetics, and immunogenicity of a proposed bevacizumab biosimilar (DRL_BZ) with the innovator Avastin (reference medicinal product [RMP]) in patients with nonresectable metastatic colorectal cancer (mCRC) over a period of 9 months and advanced nonsquamous non-small cell lung cancer (NSCLC) over 6 months. The study was planned as a randomized, double-blind trial. In part A, a total of 117 mCRC patients were intended to receive 5 mg/kg of bevacizumab every 2 weeks along with mFOLFOX6 chemotherapy for a maximum of 18 cycles. In part B, 60 NSCLC patients were to receive 15 mg/kg of bevacizumab every 3 weeks along with pemetrexed and carboplatin for the initial four cycles, followed by pemetrexed for another four cycles. The primary endpoint was the progression-free survival rate at 6 months (PFS6) in both subparts. The anticipated sample size was 106 evaluable mCRC patients to achieve 85% statistical power for concluding noninferiority with a margin of half the difference (18.8%) between DRL_BZ and Avastin, along with a pilot study involving 60 evaluable NSCLC patients. Safety comparison included assessing adverse events (AEs), infusion reactions, and lab abnormalities. Immunogenicity comparison involved the incidence of antidrug antibodies (ADAs) and neutralizing antibodies (NAbs). Pharmacokinetic comparison was planned after the first and fourth dosing cycles of treatment in 24 NSCLC patients. The PFS6 for mCRC patients treated with DRL_BZ and RMP was 57.8% and 50% respectively, with a difference in efficacy of 7.8 (-8.7, 23.7). The PFS9 was 31.1% and 22.9%, with a difference of 8.2% (-6.9%, 22.9%). The objective response rate (ORR) for DRL_BZ and RMP was 28.8% and 22.4%, while the disease control rate (DCR) was 44.2% and 37.9% respectively. For NSCLC patients, the PFS6 was 44% and 45%, showing a difference of -1.0 (-4.2, 22.1). The ORR was 41.4% and 48.1%, and the DCR was 62.1% and 63%. The frequency, type, and severity of AEs were similar in both indications. Blood levels during the first and fourth dosing cycles exhibited comparable values. All NSCLC patients tested negative for ADA, while no mCRC patients on DRL_BZ tested positive for ADA. Low incidences of ADA (8%) and NAbs (4.0%) were reported in patients on RMP. Overall, the efficacy, safety, immunogenicity, and pharmacokinetic parameters of DRL_BZ and RMP were found to be comparable. Clinical Trial Registration For BZ-01-002: CTRI/2016/01/006481.
Neoplasms of the kidney are most commonly adenocarcinomas. Carcinomas of the renal pelvis and ureter are rare, accounting for only 4% of all urothelial cancers. Squamous cell carcinoma (SCC) of renal pelvis and ureter are very rare and account for 6-15% of all renal tumors of which transitional carcinomas constitute the majority followed by adenocarcinoma and SCC. Renal SCC (RSCC) is a rare malignancy of the upper urinary tract characteristically presenting with advanced stage, the reported incidence being 1.4% of all renal malignancies. Very few cases have been reported in the literature. Most patients have a history of chronic urolithiasis, renal infection or abuse of analgesics. This tumor is aggressive in nature and usually has a poor prognosis. We report two cases of RSCC one with characteristic history of chronic pyelonephritis and one without characteristic etiologic factors. These cases have been reported due to their extreme rarity and also highlight the silent presentation of these tumors and the need to keep
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