With the advent of effective and intensive chemotherapy, we are able to achieve better response rates as well as improved survival but the side effects remain a constraint. This article intends to discuss one of the side effects of chemotherapy i.e. neuropathy; culprit agents, mechanism and therapeutic strategies to manage it.
Desmoid tumor is a slow growing neoplasm with aggressive infiltration of adjacent tissue with very rare metastatic potential. We report a 35 years old female patient with desmoid tumor of the anterior abdominal wall who underwent primary resection followed by mesh pasty. Patient had a past history of abdominal surgery in form of caesarean section, and after 5 years of surgery, she presented with a lump over right hypochondrium since last one year. Patient was assessed before surgery by clinical evaluation, abdominal ultrasound, computerized axial tomography scanning (CT scan), magnetic resonance imaging (MRI), and histopathology and immunohistochemistry report.Patient was operated with wide local excision of rectus abdominis muscle mass with meshplasty under general anaesthesia. After all, histology in this case revealed a desmoid tumor with negative β-Catenin report of operated tissue. In view of the negative surgical margins, patient has been put on regular follow...
CoQ10 tissue levels. CoQ10 therapy has no serious side effects in humans and new formulations have been developed that increase CoQ10 absorption and tissue distribution. CoQ10 has a role in carcinoma breast, cervix, lung, prostate, melanoma, cancer chemotherapy and cancer related fatigue. Future trends involving CoQ10 in many cancers needs more clinical trials for better understanding of CoQ10 efficacy.. Oral CoQ10 administration can correct CoQ10 deficiency since it increases CoQ10 tissue levels. CoQ10 therapy has no serious side effects in humans and new formulations have been developed that increase CoQ10 absorption and tissue distribution. CoQ10 has a role in carcinoma breast, cervix, lung, prostate, melanoma, cancer chemotherapy and cancer related fatigue. Future trends involving CoQ10 in many cancers needs more clinical trials for better understanding of CoQ10...
Intensity modulated radiation therapy (IMRT) is a technique to deliver a highly conformal radiation dose distribution, that too with wide spectrum ranging from conventional IMRT, through Volumetric Modulated Arc Therapy (VMAT) to most advanced form called Dense Angularly Sampled and Sparse Intensity Modulated Radiation Therapy (DASSIM-RT). The article intends to overview the current status of the technology....
Primary involvement of vulva or breast by non-hodgkin lymphoma (NHL) is known to occur uncommonly. Only 24 cases of NHL vulva and around 250 cases of NHL breast alone have been reported, so far; but none with simultaneous involvement of the two sites together. We report the first case having both sites involved in a 35 year old Indian female.
Chronomodulated therapy or chronotherapy has gained popularity, beyond a fancy term, as a novel and logical method to exploit the best, by administering anti-cancer treatment at an optimal timing according to circadian rhythms of their anti-cancer action and/or repair mechanism of cancer & normal cells. Understanding of chronobiology and the results of clinical studies back up this new concept. Chronotherapy seems to have all the potential to become tomorrow’s accepted, refined oncology practice without adding much to the cost of existing...
Head and neck cancer forms the major chunk of cancer patients in developing country like India. About 2/3rd of the patients present in locally advanced stage in which the cure rates are low. Concomitant chemoradiation with platinum compounds is the standard treatment for such patients as it offers organ and function preservation with better quality of life. MACH-NC update (2009) shows that concomitant chemoradiation provides an absolute survival benefit of 6.5% at 5 years. Many chemotherapeutic agents including 5-FU, taxanes and biologically targeted therapy have been investigated in an effort to maximize the locoregional and survival in locally advanced head and neck cancer. Oral chemotherapeutic agent gives the ease of self medication on daily basis without the need for hospital admission and intravenous infusion. Theoretically daily administration of oral chemotherapy agent mimics the continous infusion of a parenteral agent. Since infusional 5-FU along with Radical RT has achieved a complete response rate of 68% for 5-FU arm versus 56% for placebo arm (p=0.04) with the overall median survival of 33 months for 5-FU versus 25 months for placebo arm, Capecitabine (analog of 5-FU) in low doses have been used in concomitant setting for locally advanced head and neck cancer. Overall response rate observed has been 33-89% with manageable toxicity and near total patient compliance. The maximally tolerated dose to be given daily during radiation therapy is 500 mg/m2 b.i.d. Lower dose doses of 250-350 mg/m2 have also been used in concomitant with lesser toxicity and greater...
Cancer cells have a multitude of mechanisms to avoid and suppress immunity. Normal cells when exposed to chemical carcinogens, irradiation and certain viruses get transformed to cancer cells which can grow indefinitely. These cells have decreased requirements for growth factors; do not undergo apoptosis resulting in malignancy. The tumor cells have various antigens which are responsible for the generation of immune responses towards that particular tumor. There are two types of tumor antigens; tumors specific transplantation antigens (TSTAs) and tumor associated transplantation antigens (TATAs). The TSTAs are specific to tumor, result from mutations which alter the cellular proteins while TATAs may be proteins present in or during some stages of fetal development but not expressed or expressed at low levels in normal adult cells. Adoptive T-cell therapy involves the ex vivo cultivation of T cells with activity against a specific target cancer antigen to increase the frequency of these T cells to achieve therapeutic levels and then infuse them back into the patient. Oncolytic viruses selectively infect, replicate in, and kill tumor cells with no or limited impact on normal tissues which means that tumor cells have surface receptors to bind the virus. Monoclonal antibodies (mAbs) are immunoglobulins derived from a single clone of B cells, act by targeting an antigen which acts a ligand of receptor involved in signal transduction within the...
Our objective is to review the current articles pertaining to multimodality treatment that surround the management of retromolar trigone (RMT) cancer patients. RMT tumors constitute a small minority of all oral cancers. Majority of these patients present with locally advanced stage and its treatment is challenging. Good oncologic outcomes can be achieved by advocating an aggressive surgical approach in combination with post operative radiation therapy. In this literature review we intend to discuss locally advanced trigone cancer and its outcome after the completion of the multimodality...
IMPACT OF CHRONOMODULATED RADIOTHERAPY ON ACUTE SKIN TOXICITY IN CHEST WALL IRRADIATED BREAST CANCER PATIENTS – A SINGLE INSTITUTION ANALYSIS.
Abstract: We explored the possible association between the timing of delivery of radiation and the grade of skin reaction that develops in breast cancer patients receiving chest wall irradiation as adjuvant treatment after modified radical mastectomy. Invasive breast cancer patients, registered during the period of January 2013 – December 2014, who had undergone modified radical mastectomy followed by chest wall irradiation, were eligible for inclusion to the study. All the patients received chest wall external beam radiotherapy (EBRT) to a dose of 50 Gy in 25 fractions, one fraction a day, five days a week, delivered as tangential opposed pair, from a Cobalt 60 teletherapy source. Patients were stratified based on whether they received EBRT in the morning (between 8 am – 11 am) or in the evening between (5 pm – 8 pm). The clinicopathological characteristics of patients in both the arms were relatively well balanced. The incidence of higher grade of skin reaction (grade 3 or 4) was 22.5 % compared to 35.7 % in the morning and evening arms respectively, which was statistically significant (p = 0.039). The time to development of Grade 3 or 4 toxicity was 4.44 weeks compared to 4.11 weeks in the morning and evening arms respectively, suggesting that higher toxicity developed earlier in the patients receiving EBRT in the evening, though not statistically significant (p =...