Indian journal of cancer最新文献

Abstract: Myeloid sarcoma (MS) refers to an extramedullary collection of immature cells of granulocytic series and occurs either in isolation or in association with myeloid malignancies, particularly acute myeloid leukemia (AML). We report a 16-year old girl with AML who was treated at our hospital with standard "7 + 3" induction chemotherapy and achieved morphological remission. She developed a small nodule below her right eyelid at day 10 of first consolidation chemotherapy with high-dose cytarabine. Eyelid lesion increased in size despite oral antibiotics. Peripheral blood did not show any blasts. However, bone marrow examination was consistent with relapsed AML. She was treated with salvage chemotherapy followed by allogeneic stem cell transplant. However, her disease relapsed 2 months later and she died. This is the first case of eyelid MS from India in which eyelid MS developed during chemotherapy for AML and heralded the subsequent disease relapse. Eyelid MS could be a sinister manifestation of AML. Literature regarding eyelid MS is discussed in brief.

Abstract: Glomus tympanicum is a hypervascular, benign neoplasm with a slow rate of growth. The incidence of this pathology is higher in females than in males and mainly occurs in the fifth to sixth decade of life. Pulsatile tinnitus and hearing loss are the main clinical features. We present the case of a 70-year-old female patient who was admitted to the otolaryngology service with a 1-month history of epistaxis and equilibrium disorder that caused a ground-level fall.

Background: Succinate dehydrogenase (SDH) deficient gastrointestinal stromal tumor (GIST) is the most common type of wild type GIST characterized by lack of mutations in proto-oncogene receptor tyrosine kinase (KIT) or platelet-derived growth factor receptor alpha (PDFGR alpha) pathways. It has a unique predilection for females and young adults, with a relatively indolent prognosis and varied treatment modalities. Data regarding SDH GIST from the Indian subcontinent is sparse.

Materials and methods: This is a retrospective study of patients with SDH deficient GIST, who presented to the GIST clinic in a tertiary care center in India from 2016-2022. 9 out of 120 GIST patients were SDH deficient. All patients were discussed in GIST tumor board and pathologies were re-reviewed by a dedicated GIST pathologist. Data was collected retrospectively from prospectively maintained database.

Results: There were nine patients with median age of 48 years (range 15-63), of which there were 5 males (n = 5, 55.5%). Eight patients (n = 8, 88.8%) had primary in stomach, one had duodenal GIST. In stomach, body was the most common location (n = 6,75%). 3 out of 9 patients (n = 3, 33.3%) had multifocal disease. 8 out of 9 (88.8%) had metastasis at presentation. Most common site of metastasis was liver (7 out of 8, 87.5%) Lymph node involvement was present in 4 out of 9 patients (44.4%). One patient had classical Carneys triad at presentation. 8 out of 9 (88.8%) had epithelioid morphology and 1 (11.1%) had mixed epithelioid-spindle picture. 5 out of 9 (55.5%) patients had germline SDH mutations. Out of nine patients, one was put on observation post surgery and therapy was given for eight patients (n = 8,88.8%). Response to imatinib was very poor, 3 out of 5 patients (60%) had response with sunitinib, three were started on regorafenib out of which one had partial response and one patient had partial response with temozolomide. Median overall survival was NR- not reached (95% CI 12.96-NR).

Conclusion: SDH deficient GIST is a unique subtype of gastrointestinal stromal tumor with distinct clinic-pathological features, diagnostic modalities, therapeutic strategies, and genetic implications as compared to C-kit/PDGFR-alpha mutated GIST.

Background: Human papillomavirus (HPV) is a leading cause of cancer worldwide. In India, cancer of the cervix is ranked as the second and the first most frequent cancer for women in the state of Himachal Pradesh. The HPV vaccine has the potential to prevent cancers, but vaccine uptake has been low in India due to a lack of awareness, cultural acceptance, and non inclusion in the national immunization program. With the introduction of the indigenous vaccine, 'Cervavac', by the Government of India, a school based intervention can prove to be a cost effective and successful strategy in promoting the uptake of the HPV vaccine.

Methods: The current pilot study aimed to determine the impact of an educational intervention on HPV and HPV vaccine knowledge and the acceptability of the HPV vaccine among teachers who are parents of children aged 9 19 years in Shimla, a town in the North Western Himalayas. Twenty three teachers' participated in the pilot intervention. A paired 't' test was used to find out the difference in HPV and HPV vaccine knowledge and HPV vaccine acceptability in pre and post intervention conditions.

Results: The results revealed that there was a significant increase in knowledge of HPV (t = 6.97), knowledge of vaccine, and an increase in the acceptability in general (t = 2.78), HPV vaccination knowledge (t = 6.99), and HPV vaccine acceptability (t = 11.76) scores among the participants.

Conclusion: This study highlights the importance of HPV knowledge and awareness in improving vaccine acceptability, suggesting a tailored approach that engages the target population in vaccination decisions to augment uptake.

Background: To describe three cases of radiation-induced lung injury (RILI) occurring outside the radiation field and to review clinical, radiologic, and histologic aspects of RILI outside the radiation field.

Methods: We present case reports of three men with a mean age of 57.6 years, who had received radiation therapy and concomitant chemotherapy for supraglottic and laryngeal carcinoma. A detailed clinical, radiological, and laboratory evaluation was carried out to confirm the diagnosis.

Results: All our three patients developed radiation pneumonitis about 4 to 8 weeks after the completion of radiotherapy. All the three patients received radiation in the neck region. The lung infiltrates had developed outside the radiation field. Computed tomography of the chest showed ground glass opacity in the lower lung zones. One patient had grade 2 radiation pneumonitis, while the other two had grade 1. Two patients had grade 1 radiation pneumonitis spontaneously resolved, while one patient was advised inhaled steroids, though he was lost to follow-up.

Conclusions: RILI may occur away from the site of irradiation due to immunological and non-dosimetric factors. It is important to diagnose RILI at the earliest as management would vary with the grade of RILI. Grade 1 RILI may resolve spontaneously.

Background: Consumption of tobacco products including smokeless tobacco is a public health problem. Measures of tobacco control along with promotion of tobacco cessation will have a great impact in reducing the burden tobacco-related diseases. The objectives of current paper were to create cancer awareness and understand predictors influencing use of smokeless tobacco among the public transport bus employees.

Methods: Around 4000 public transport bus employees in Mumbai were enrolled after obtaining written informed consent. They were randomized in four arms. Pretest and posttest were conducted to assess their knowledge attitudes and practices regarding tobacco use. Employees were given detailed health education regarding hazards of tobacco and were invited for oral cancer screening. The screen positive participants were referred to the nodal hospital for further management.

Results: 2118 (52.95%) employees enrolled consumed tobacco in smokeless forms. Only 174 (8.21%) tobacco users used smoking forms. Khaini was the most common form of tobacco used, followed by masheri/gul. The median frequency of use of different tobacco products varied from 2 to 4 per day. The mean age at initiation of tobacco was 25.76 ± 8.46 years. According to the results of the multivariate analysis, married men, above 40 years, bus driver, belonging to Hindu religion, consuming alcohol, and with no family member using tobacco use were at higher risk of being chronic tobacco users.

Conclusion: Awareness about hazards of tobacco and stringent laws against use of smokeless tobacco should be implemented to guard the employees from harmful effects of tobacco use.

Abstract: Glioneuronal tumors are a very rare type of central nervous system (CNS) tumors. Due to rarity, even literature is limited. There is inconsistency in literature with respect to prevalence in different age groups, sex predilection, and treatment. Diagnosis of diffuse glioneuronal tumors is based on both radiologic and histopathologic features. Radiologically, they are often large, ill-defined lesions. On immunohistochemistry, the are positive for glial fibrillary acidic protein (GFAP), OLIG2, S100, and synaptophysin and negative for IDH1. Recently, glioneuronal tumors are included in the 2016 World Health Organization (WHO) classification of CNS neoplasms; however, there are many cases of glioneuronal tumors with distinctive morphologic features that are still not formally included in any classification. Similarly, there is vast disparity between treatments in various literature reports, ranging from surgery to chemoradiation to craniospinal irradiation. Here, we are presenting a case of high-grade diffuse glioneuronal tumor in a 28-year-old male. We have described the radiologic and pathologic features in our case. He was treated with volumetric modulated arc technique (VMAT) radiotherapy and concurrent chemotherapy.

Background: Radiation therapy plays a critical role in head and neck cancer treatment, which can utilize artificial intelligence algorithms for automatic contour segmentation, treatment planning, and the selection of individual treatments. During the planning phase of radiation therapy, organs at risk (OARs), like the parotid gland, must be identified and mapped out to avoid unwanted side effects. Manual contouring of the parotid gland can be time-consuming and error-prone, causing interobserver variability. This study presents an algorithmic framework for the automated delineation of parotid glands using artificial intelligence and deep learning algorithms that interprets image sets to increase the precision and effectiveness of treatment planning, reduce the risk of side effects, and enhance treatment outcomes. Auto contouring increases the consistency and reproducibility of treatment plans and reduces the need for recontouring.

Methods: In this study, CT scans of 20 anonymized datasets were used. The slices were visualized with their corresponding contours. Further, the CT scans were preprocessed, and various image processing techniques were applied. The dataset generation process was automated, and the data were fed into the developed model. The U-Net architecture was used to create the model. The evaluation metrics used for the model were Accuracy, Precision, Recall, Loss, and Intersection Over Union (IOU).

Results: The proposed model gave a validation accuracy of auto contouring for the left contour to be ~97%. A validation accuracy for the right contour is ~96%.

Conclusions: The auto contouring of parotid glands proves to be a convenient and reliable framework that can be applied and used by radiation oncologists.