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ISSN (Online): 2454-1680

OncoExpert

INTERNATIONAL JOURNAL OF INTEGRATED ONCOLOGY

An Official Publication Of Society Of Pharmaceutical Science & Research
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1.

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 =...

Vipin George Kuriakose, Krishnanannair Jayakumar, Aravindh Anand, Anand Radha Krishnan, Divya Somasekharan

Dr. Vipin George Kuriakose, Department of Radiotherapy and Oncology, Government Medical College, Thiruvananthapuram INDIA

DOI:

1-7

1634

833

0

1.

A RETROSPECTIVE ANALYSIS OF PALLIATIVE SURGICAL PROCEDURES FOR ADVANCED MALIGNANCIES IN A PRIVATE TERTIARY CANCER CARE CENTER.

Palliative surgery is an important, yet understudied aspect of palliative care. The present article emphasizes the diversity of palliative surgical procedures performed at a private tertiary cancer care center in India and the need of the multidisciplinary approach towards it. Though the overall morbidity and mortality is high, a significant number of cancer patients are alleviated from their symptoms and have a better quality of life, even in those with an anticipated short...

Ashwin Anand Kallianpur, Harbans Bansal

Ashwin Anand Kallianpur Department of Surgical Oncology, Indus Superspeciality Hospital, Mohali, Punjab (INDIA)

DOI:

01-10

748

273

0

6.

PRIMARY NON-HODGKIN LYMPHOMA OF LIVER: AN UNUSUAL PRESENTATION AND REVIEW OF ITS MANAGEMENT.

 Primary Non-Hodgkin lymphoma (NHL) of liver is a very rare malignancy. Here, we report a case of 26 years old man who presented with right upper abdomen pain and lump, reduced appetite and progressive weakness of 4 month’s duration. Liver functions were deranged but serology was negative for viral markers and α Fetoprotein was within normal range. Ultrasonography and Computed Tomography scan of the abdomen revealed large nodule in right lobe of the liver. USG guided biopsy of liver mass and fluorescence in situ hybridization for CD markers established diagnosis of primary NHL of liver. Extensive investigations including X-ray of chest, whole-body positron-emission tomography scan and bone marrow biopsy showed no involve­ment of mediastinum, spleen, bone marrow or any other organ or lymph nodes significantly. Having B symptoms disease was staged IVB, the patient has been treated with 6 cycles of R-CHOP regimen (Rituximab/Cyclophosphamide–Doxorubicin–Vincristine–Prednisolone) followed by 2 courses of CHOP every three weekly. Response has been excellent and patient is asymptomatic as of now. This case highlights that primary hepatic lymphoma should be considered in the differential diagnosis of space-occupying liver lesions in presence of normal levels of...

Mukesh Kumar Bharti, Sudhakar Singh

Dr. Mukesh Kumar Bharti Assistant Professor, Dept of Radiotherapy & Oncology DMCH Laheriasarai, Darbhanga, Bihar

DOI:

35-39

1309

769

0

2.

OUTCOMES OF LOCALLY ADVANCED RETROMOLAR TRIGONE CANCERS TREATED WITH A MULTIMODALITY APPROACH

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...

Ashwin A Kallianpur, Vinod Nimbran, Romeeta Trehan, Shweta Mittal

Dr Ashwin A Kallianpur Senior Consultant, Department of Surgical Oncology, Indus Superspeciality Hospital, Mohali, INDIA

DOI:

8-14

2366

735

0

2.

MIXED GERM CELL TUMOR OF OVARY AND MAYER ROKITANSKY KUSTNER HAUSER SYNDROME: AN UNUSUAL COMBINATION!

Germ cell tumor of ovary in young female is most common ovarian neoplasm but represent less than three percent of all ovarian malignancies in females. Mixed germ cell tumor is a variant of germ cell tumors and its presentation with Mayer Rokitansky Kustner Hauser Syndrome, which represents the most common type of utero-vaginal agenesis, is very unusual. However, for patients with primary amenorrhea, Mayer Rokitansky Kustner Hauser syndrome is the second common cause. We describe an interesting, uncommon and unexpected case in a young Indian female patient with primary amenorrhea due to this syndrome coexisting with mixed germ cell...

Rajiv Gandhi K, Surendra Kumar Saini, Jitesh Sarvaiya, Mitanshu Sharma, Dhara Kacha

Department of Radiotherapy & Oncology, M P Shah Medical College & Associated G G Govt. Hospital, Jamnagar, Gujarat (INDIA)

DOI:

11-13

613

297

0

5.

UNUSUAL PRESENTATION OF NON-HODGKIN LYMPHOMA: VULVA GROWTH AND BREAST MASS IN THE SAME PATIENT

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.

Yashpal Verma, Ashok K. Chauhan, Ramesh Sabharwal and Jagjeet Singh

Dr. Yashpal Verma, Medical Officer, Department of Radiotherapy, University of Health Sciences, Rohtak (INDIA). Contact no. +91-9416125026

DOI:

31-34

1766

871

0

4.

PRIMARY ANAPLASTIC LARGE CELL LYMPHOMA OF BONE: MANAGING THE MISCELLANEOUS!

Anaplastic large cell lymphoma (ALCL) represents 2 to 3% of non-Hodgkin lymphoma (NHL). Anaplastic lymphoma kinase negative (ALK-) subtype accounts for 15-50% of all ALCL. Primary bone involvement in lymphoma is uncommon and constitutes less than 1% of all lymphomas and 4-5% of all extranodal NHL. Hence extra-nodal primary bone involvement in ALCL is even rarer. We report the 14th case of primary ALCL in a 38 year old Indian female. Other than the uncommon site, there is no reason not to keep NHL as differential diagnosis, as the condition responds too well to standard...

Sulbha Mittal, Yashpal Verma, Ashok K. Chauhan, Paramjeet Kaur, Anil Khurana, Nupur Bansal

Medical Officer, Department of Radiotherapy, University of Health Sciences, Rohtak (INDIA)

DOI:

25-29

1512

894

0

1.

ASTROBLASTOMA: DOES IT REQUIRE DIFFERENT TREATMENT ?

Background- Astroblastoma is partially understood, poorly reported and rare in occurrence tumor with significant dilemma regarding cellular origin, diagnostic criteria, clinical behavior, and management protocol. Material and method– Thorough search of published English scientific literature was made with search word Astroblastoma through Google Search, PubMed, Research Gate and Cochrane Library till June 2018. The reports thus collected were examined for data regarding age, gender, location and laterality of disease, pathological grade, treatment received, and outcome of treatment. Results– Data of 161 patients was retrieved from 72 publications. Median age at presentation was 18 years. Females were affected much more frequently than males. Most common site of involvement was the frontal lobe. Laterality data was inconsistent and sparingly reported. Most common presenting complaint was headache followed by history of seizure. Surgery was performed in majority of patients-79.6% of the patients underwent a gross total resection, 45% (44 out of 98 reported) had a high-grade tumor. Sixty patients received adjuvant radiation with a median dose of 54 Gy (Range 20-72), mostly for high grade, residual or recurrent disease. Adjuvant chemotherapy was used in 25 patients. Median follow-up was 43 months (range 1-238). Median overall survival was 138 months. Patients with a higher-grade tumor had significantly worse overall survival. Conclusion- Astroblastoma is rare but known to have two distinct grades, with higher-grade tumors bearing significantly poor survival. Maximal safe surgery is the standard. Though there is lack of consensus, adjuvant radiotherapy with or without Temozolamide should be considered in view of high rates of local...

Dr. Yashpal Verma

Additional Senior Medical Officer, Department of Radiation Oncology, PGIMS, Rohtak (India)

DOI:

01-09

377

127

0

1.

CANCER CHRONOTHERAPY: THE RIGHT TIME TO HIT!

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...

Ashok Kumar Chauhan, Yashpal Verma and Ramesh Sabharwal

Dr Yashpal Verma, Medical Officer, Department of Radiotherapy, Post graduate institute of medical sciences, Rohtak (INDIA)

DOI:

1-7

2026

1033

0

3.

CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY: METHODS TO MEASURE

Peripheral neuropathy is a structural or functional abnormality of peripheral nerves giving rise to neuropathic symptoms. Neuropathic symptoms can be motor, sensory and autonomic or varied combination of these major categories. Chemotherapeutic agents frequently cause various neuropathic symptoms and signs depending upon culprit agent, its dose and duration. Chemotherapy-Induced Peripheral Neurotoxicity is a common, disabling and dose-limiting side-effect of cancer treatment and its assessment is difficult. Some patients complain of tingling, numbness and pain in distal extremities while others may also develop motor and autonomic symptoms. Some patients remain symptomatic even after discontinuation of offending drugs. Patients with chemotherapy induced neuropathy bear higher healthcare cost than cancer patients without neuropathy. As new chemotherapeutic agents are being developed it is important to measure chemotherapy induced peripheral neuropathy accurately so that it can be recognized at an earlier stage, the treatment can be modified appropriately and disease progression can be monitored. An added advantage would be a possibility of reliable comparison between neuropathic side effect of newer and older chemotherapeutic...

Ravi Uniyal

Senior Resident, Department of Neurology, SGPGI, Lucknow, INDIA

DOI:

15-23

1623

0

0

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