Evaluation of Pharmacotherapeutic Choices in Brain Cancer Patients

AIM: The aim of the study is to evaluate various parameters that contribute in the choice of therapy, which includes the severity of cancer state in patient, the efficacy of opted choice, the limitations of the opted choice, impact of the opted therapy and the risk of recurrence of cancer after complete treatment. OBJECTIVE: To determine the aptness of the choice of pharmacotherapy opted. To study the limitations of opted pharmacotherapy in patients. To study variability in choices of pharmacotherapy in different patients. To evaluate the efficacy of treatment provided. To determine the risk of recurrence of cancer post treatment in patients. Management of pre-existing medical conditions. BACKGROUND: The choice of pharmacotherapy to be adopted for treatment of cancer depends on various factors – patient factors like type of cancer, progression rate of cancer, stage of cancer, patient compliance in therapy, economics, outcomes of therapy, risks, etc. Along with cancer medications, supportive treatment is also to be provided to alleviate other symptoms of patients that may arise due to use of drugs. METHODOLOGY: A retrospective cohort study was carried out at BasavatarakamIndo-American Cancer Hospital and Research Institute for a duration of 6 months. 199 patients of Brain Cancer were evaluated over a time period of 5 years (2013 to 2017). The parameters included in the evaluation are: Tumour parameters. Clinical and pathological responses. Medical management variations. Survival through time. RESULTS: Success rate of the choice of pharmacotherapy opted depends mainly on the absence of recurrence or relapse. When surgery alone done, either partial or total excision of tumor leads to life-threatening side effects like perilesional edema, increased ICP or residual lesions. CT or RT when done alone leads to changes in QOL of patients either due to depression or other psychological damage and can also lead to mutations of other organ cells leading to increased chances of other cancers. CONCLUSION: Patients diagnosed with stage III or stage IV brain cancer are often at a high risk of relapse. The aptness of the therapy depends mainly on the choice of therapy. When the choice of therapy was evaluated, Temozolamide was the choice of drug for 90% of the patients with Brain cancer. Certain protocols with different chemotherapeutic agents were opted for when brain tumor was accompanied with metastases from distant organs or if infection was present (E.g. Ewing’s Sarcoma, Lung Consolidation, etc). Chemotherapy or Radiation therapy alone, are not successful and require either Surgery with Adjuvant CT or RT has proven to have high rate of success. Keywords: Brain tumor, CT, RT, Surgery, Edema, Pharmacotherapy, mutations, choices, evaluation, determine, management, progression, symptoms, response, clinical, parameters, variation, survival.