S. Chanda, Dipjyoti Das, Sajal Sen, Dr Venkata Pradeep Babu Koyyala, Sanjeev K Gupta
The highest cancer incidence and mortality are observed in the northeastern states of India including Assam. The cancer treatment centers in Assam are located only at the state headquarters. Therefore, patients have to travel a long distance, incurring a good number of out-of-pocket expenses. Considering the severity of the issue, the Tata Trusts, in collaboration with the Government of Assam, established the Assam Cancer Care Foundation and developed the distributed cancer care model with a vision to develop cancer institutions to deliver equitable and affordable care closer to the patient’s homes. This is a four-level model. L1 facility is an apex center providing all sophisticated forms of cancer care services including clinical research. L2 facilities developed in Dibrugarh, Silchar, Barpeta, Dhubri, and Diphu provide basic comprehensive oncology services. L3 facilities are being established in Sivasagar, Tinsukia, Nagaon, Nalbari, Golaghat, Goalpara, Tezpur, Darrang, Lakhimpur, Jorhat, and Kokrajhar. These centers will provide diagnostic services to at-risk populations and day-care services for cancer patients. L4 level includes community interventions: preventive health packages delivered at the community level. Seven hospitals at Barpeta, Dibrugarh, Tezpur, Lakhimpur, Jorhat, Kokrajhar, and Darrang are functional since 28 April 2022. The rest are at different stages of development. Up to August 2023, 2,78,344 people were screened for common cancers where 211 were confirmed for cancers. During the same time, 31,005 patients were registered, and 18,319 chemotherapy sessions and 62,160 radiation therapy sessions were delivered across the 7 hospitals under government schemes resulting in no financial burden to patients. This intervention by Tata Trusts addresses the barriers of affordability, accessibility, and availability and is replicable to any geography of interest.
{"title":"Equitable and affordable cancer program in Assam: An initiative of Tata trusts and Government of Assam","authors":"S. Chanda, Dipjyoti Das, Sajal Sen, Dr Venkata Pradeep Babu Koyyala, Sanjeev K Gupta","doi":"10.25259/asjo_31_2023","DOIUrl":"https://doi.org/10.25259/asjo_31_2023","url":null,"abstract":"\u0000\u0000The highest cancer incidence and mortality are observed in the northeastern states of India including Assam. The cancer treatment centers in Assam are located only at the state headquarters. Therefore, patients have to travel a long distance, incurring a good number of out-of-pocket expenses. Considering the severity of the issue, the Tata Trusts, in collaboration with the Government of Assam, established the Assam Cancer Care Foundation and developed the distributed cancer care model with a vision to develop cancer institutions to deliver equitable and affordable care closer to the patient’s homes.\u0000\u0000\u0000\u0000This is a four-level model. L1 facility is an apex center providing all sophisticated forms of cancer care services including clinical research. L2 facilities developed in Dibrugarh, Silchar, Barpeta, Dhubri, and Diphu provide basic comprehensive oncology services. L3 facilities are being established in Sivasagar, Tinsukia, Nagaon, Nalbari, Golaghat, Goalpara, Tezpur, Darrang, Lakhimpur, Jorhat, and Kokrajhar. These centers will provide diagnostic services to at-risk populations and day-care services for cancer patients. L4 level includes community interventions: preventive health packages delivered at the community level.\u0000\u0000\u0000\u0000Seven hospitals at Barpeta, Dibrugarh, Tezpur, Lakhimpur, Jorhat, Kokrajhar, and Darrang are functional since 28 April 2022. The rest are at different stages of development. Up to August 2023, 2,78,344 people were screened for common cancers where 211 were confirmed for cancers. During the same time, 31,005 patients were registered, and 18,319 chemotherapy sessions and 62,160 radiation therapy sessions were delivered across the 7 hospitals under government schemes resulting in no financial burden to patients.\u0000\u0000\u0000\u0000This intervention by Tata Trusts addresses the barriers of affordability, accessibility, and availability and is replicable to any geography of interest.\u0000","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141804421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15DOI: 10.25259/asjo-2023-7-(466)
Madhurima Ponmar, H. Srinivasan, Naina Simon, Daniel Beno, L. Joseph, R. John, D. Boddu, L. Mathew, A. J. Prabhu
The vast majority of BCOR (BCL6 corepressor) sarcomas occur in the pediatric population and include different clinico-pathologic entities. This study evaluates morphology, immunohistochemistry and clinical outcome in pediatric BCOR sarcomas. Children, aged ≤ 18yrs, diagnosed to have translocation negative Ewing-like sarcoma, clear cell sarcoma of the kidney and primitive myxoid mesenchymal tumor of infancy, over a period of five years were included. Immunohistochemical staining for BCOR antibody was done and the cases with BCOR overexpression were subjected to a further immunopanel comprising of special AT-rich sequence-binding protein 2 (SATB2), Transducin-Like enhancer of split-1 (TLE1), Cyclin D1 and NKX2.2. The clinical outcome of patients with BCOR overexpression was assessed. BCOR overexpression was seen in 16/42 cases; Five were primary soft tissue tumors, three were primary bone tumors, seven were clear cell sarcoma of the kidney and one primary renal sarcoma. The median age of this group was 3.5 years (range 2–18 years) with male predominance (75%). All the BCOR positive tumors showed statistically significant morphological and immunohistochemical overlap. 4/16 did not take treatment at our center. Of the 12 who received treatment, 8 are in Complete Remission 1 (CR1). The mean event-free survival (EFS) and overall survival (OS) were 51.89 months (95% CI: 37.36-66.42) and 62.08 months (95% confidence interval (CI): 52.85-71.30) respectively. BCOR sarcomas did not show any statistically significant histological and immunohistochemical differences, thus reiterating the morphologic continuum of these clinically distinct tumors.
{"title":"BCOR overexpression in pediatric sarcomas- a morphologic continuum of mixed round and spindle cell tumors","authors":"Madhurima Ponmar, H. Srinivasan, Naina Simon, Daniel Beno, L. Joseph, R. John, D. Boddu, L. Mathew, A. J. Prabhu","doi":"10.25259/asjo-2023-7-(466)","DOIUrl":"https://doi.org/10.25259/asjo-2023-7-(466)","url":null,"abstract":"\u0000\u0000The vast majority of BCOR (BCL6 corepressor) sarcomas occur in the pediatric population and include different clinico-pathologic entities. This study evaluates morphology, immunohistochemistry and clinical outcome in pediatric BCOR sarcomas.\u0000\u0000\u0000\u0000Children, aged ≤ 18yrs, diagnosed to have translocation negative Ewing-like sarcoma, clear cell sarcoma of the kidney and primitive myxoid mesenchymal tumor of infancy, over a period of five years were included. Immunohistochemical staining for BCOR antibody was done and the cases with BCOR overexpression were subjected to a further immunopanel comprising of special AT-rich sequence-binding protein 2 (SATB2), Transducin-Like enhancer of split-1 (TLE1), Cyclin D1 and NKX2.2. The clinical outcome of patients with BCOR overexpression was assessed.\u0000\u0000\u0000\u0000BCOR overexpression was seen in 16/42 cases; Five were primary soft tissue tumors, three were primary bone tumors, seven were clear cell sarcoma of the kidney and one primary renal sarcoma. The median age of this group was 3.5 years (range 2–18 years) with male predominance (75%). All the BCOR positive tumors showed statistically significant morphological and immunohistochemical overlap. 4/16 did not take treatment at our center. Of the 12 who received treatment, 8 are in Complete Remission 1 (CR1). The mean event-free survival (EFS) and overall survival (OS) were 51.89 months (95% CI: 37.36-66.42) and 62.08 months (95% confidence interval (CI): 52.85-71.30) respectively.\u0000\u0000\u0000\u0000BCOR sarcomas did not show any statistically significant histological and immunohistochemical differences, thus reiterating the morphologic continuum of these clinically distinct tumors.\u0000","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"23 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aathirai Mahendiran, M. Potharaju, Sanjay Chandrasekhar
The aim of this study is to evaluate swallowing dysfunction at baseline (before radiotherapy), at one month and three months post-radiotherapy and to assess time taken for these parameters to come back to normal in head and neck cancer patients. Total 30 patients who received radiotherapy for head and neck cancer, either as inpatients or outpatients, at Apollo Speciality Hospital, Chennai from June 2022 and May 2023 (1 year). Laryngeal sensation and pharyngeal swallowing before radiotherapy, at one month and three months post-radiotherapy assessed using penetration aspiration scale (PAS Scale), bolus residue scale (BRS Scale) and subjective assessment using eating assessment tool-10 (EAT-10) questionnaire and assess time it take to come to normal The EAT-10,PAS and BRS scores were analysed by multivariate analysis. All these scores showed a definite improvement from baseline (Before Radiotherapy) to three months Post-RT. Further more our study predicts the hazard ratio, through which the exact percentage and number of days of one variable compared with other variable, to come back to normal can be predicted. EAT-10 scores showed the influence of age and RT dose. More the age and higher the dose more time is taken for the scores to return back to normal. In PAS and BRS males took a longer time for the scores to come back to normal, whereas patients with >60 years of age (categorical) and every year increase in age (Continuous) took a longer time to return back to normal of PAS and BRS scores respectively. It is possible to predict the number of days it takes for the EAT-10, PAS and BRS score to return back to normal. So that we can initiate preventive measures like swallowing exercises, nutritional advise and Ryles tube insertion at the earliest for those who may develop swallowing complications, to enhance the quality of life for these patients.
本研究旨在评估头颈部癌症患者在放疗前、放疗后一个月和三个月的基线吞咽功能障碍，并评估这些参数恢复正常所需的时间。2022年6月至2023年5月（1年）期间，共有30名头颈部癌症患者在钦奈阿波罗专科医院接受了住院或门诊放疗。通过多变量分析，对放疗前、放疗后一个月和三个月的喉部感觉和咽部吞咽情况进行了评估，评估方法包括穿刺抽吸量表（PAS Scale）、栓剂残留量表（BRS Scale）和饮食评估工具-10（EAT-10）问卷的主观评估，以及评估恢复正常所需的时间。从基线（放疗前）到放疗后三个月，所有这些评分均有明显改善。此外，我们的研究还预测了危险比，通过危险比可以预测一个变量与其他变量相比恢复正常的确切百分比和天数。EAT-10 评分显示了年龄和 RT 剂量的影响。年龄越大、剂量越高，分数恢复正常所需的时间越长。在 PAS 和 BRS 中，男性患者的评分恢复正常所需的时间更长，而年龄大于 60 岁（分类）和年龄每增加一岁（连续）的患者的 PAS 和 BRS 评分恢复正常所需的时间分别更长。这样，我们就可以为可能出现吞咽并发症的患者尽早采取预防措施，如吞咽练习、营养建议和插入 Ryles 管，以提高这些患者的生活质量。
{"title":"Assessment of swallowing dysfunction using fees (flexible endoscopic evaluation of swallowing) in head and neck cancer patients undergoing radiotherapy","authors":"Aathirai Mahendiran, M. Potharaju, Sanjay Chandrasekhar","doi":"10.25259/asjo_26_2024","DOIUrl":"https://doi.org/10.25259/asjo_26_2024","url":null,"abstract":"\u0000\u0000The aim of this study is to evaluate swallowing dysfunction at baseline (before radiotherapy), at one month and three months post-radiotherapy and to assess time taken for these parameters to come back to normal in head and neck cancer patients.\u0000\u0000\u0000\u0000Total 30 patients who received radiotherapy for head and neck cancer, either as inpatients or outpatients, at Apollo Speciality Hospital, Chennai from June 2022 and May 2023 (1 year). Laryngeal sensation and pharyngeal swallowing before radiotherapy, at one month and three months post-radiotherapy assessed using penetration aspiration scale (PAS Scale), bolus residue scale (BRS Scale) and subjective assessment using eating assessment tool-10 (EAT-10) questionnaire and assess time it take to come to normal\u0000\u0000\u0000\u0000The EAT-10,PAS and BRS scores were analysed by multivariate analysis. All these scores showed a definite improvement from baseline (Before Radiotherapy) to three months Post-RT. Further more our study predicts the hazard ratio, through which the exact percentage and number of days of one variable compared with other variable, to come back to normal can be predicted. EAT-10 scores showed the influence of age and RT dose. More the age and higher the dose more time is taken for the scores to return back to normal. In PAS and BRS males took a longer time for the scores to come back to normal, whereas patients with >60 years of age (categorical) and every year increase in age (Continuous) took a longer time to return back to normal of PAS and BRS scores respectively.\u0000\u0000\u0000\u0000It is possible to predict the number of days it takes for the EAT-10, PAS and BRS score to return back to normal. So that we can initiate preventive measures like swallowing exercises, nutritional advise and Ryles tube insertion at the earliest for those who may develop swallowing complications, to enhance the quality of life for these patients.\u0000","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":" 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141675473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-27DOI: 10.25259/asjo-2022-54-(416)
R. Cahyanur, Nurjati Chairani Siregar, Agnes Stephanie Harahap, Joshua Kurnia Tandi, Clareta Vero Patricia Widya
Hodgkin lymphoma is a type of lymphoma that occurs due to mutations in B cells of the lymphatic system. Cases of lymphoma often have identical clinical manifestations with tuberculosis (TB), making the diagnosis difficult. Case of lymphoma coincidence with TB is rare, but can probably cause complexity in the diagnosis and treatment of patients. We report the case of a 20-year-old male patient who presented with symptoms of prolonged fever, enlarged lymph nodes, loss of weight, and weakness. The patient was treated with antituberculosis medication, but the symptoms did not improve. Several investigations were carried out on the patient. Lymph node biopsy showed scattered tumor cells consisting of mononuclear Hodgkin cells with several Reed–Sternberg cells. On the other hand, the bone marrow aspiration examination was positive for Mycobacterium tuberculosis. Reconsideration of confirmed diagnosis and repeated diagnostic process are required when there is a discrepancy in clinical features, radiological findings, or treatment responses.
霍奇金淋巴瘤是一种因淋巴系统 B 细胞变异而导致的淋巴瘤。淋巴瘤病例往往与肺结核（TB）有相同的临床表现，给诊断带来困难。淋巴瘤与肺结核并发的病例很少见，但可能会给患者的诊断和治疗带来复杂性。我们报告了一例 20 岁男性患者的病例，他出现了长期发热、淋巴结肿大、体重减轻和虚弱的症状。患者接受了抗结核药物治疗，但症状没有改善。对患者进行了多项检查。淋巴结活检显示，肿瘤细胞散在分布，由单核霍奇金细胞和一些里德-斯特恩伯格细胞组成。另一方面，骨髓穿刺检查显示结核分枝杆菌阳性。当临床特征、放射学检查结果或治疗反应不一致时，需要重新考虑确诊并重复诊断过程。
{"title":"Hodgkin lymphoma and bone marrow tuberculosis: A coincidence","authors":"R. Cahyanur, Nurjati Chairani Siregar, Agnes Stephanie Harahap, Joshua Kurnia Tandi, Clareta Vero Patricia Widya","doi":"10.25259/asjo-2022-54-(416)","DOIUrl":"https://doi.org/10.25259/asjo-2022-54-(416)","url":null,"abstract":"Hodgkin lymphoma is a type of lymphoma that occurs due to mutations in B cells of the lymphatic system. Cases of lymphoma often have identical clinical manifestations with tuberculosis (TB), making the diagnosis difficult. Case of lymphoma coincidence with TB is rare, but can probably cause complexity in the diagnosis and treatment of patients. We report the case of a 20-year-old male patient who presented with symptoms of prolonged fever, enlarged lymph nodes, loss of weight, and weakness. The patient was treated with antituberculosis medication, but the symptoms did not improve. Several investigations were carried out on the patient. Lymph node biopsy showed scattered tumor cells consisting of mononuclear Hodgkin cells with several Reed–Sternberg cells. On the other hand, the bone marrow aspiration examination was positive for Mycobacterium tuberculosis. Reconsideration of confirmed diagnosis and repeated diagnostic process are required when there is a discrepancy in clinical features, radiological findings, or treatment responses.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"157 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139153010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timeliness of care is crucial to optimize outcomes in lung cancer. In the Philippines, the causes of delays in lung cancer diagnosis and treatment have not yet been explored. We reviewed records of patients diagnosed with lung cancer in our institution between September 2017 and August 2019 after biopsy or resection of a pulmonary lesion. Time to specialist consultation, biopsy, cancer diagnosis, and treatment were measured and compared with standards set by the British Thoracic Society. Eighty patients were included in the analysis. The median time to pulmonology consult and biopsy was 5 and 18 days, respectively. Cancer diagnosis was made within 28 days for 48% of patients. Causes of delay include late pulmonology referral (21%), delayed biopsy (38%), need for repeat biopsy (24%), and performing outright resection (10%). Out of 25 patients who received systemic treatment, only four were treated within 28 days of their cancer diagnosis. Curative resection was delayed beyond 56 days for two out of four patients. Each step in the management of lung cancer is a potential cause for delay. This study revealed opportunities for improvement in multiple areas of care that can allow more patients to benefit from treatment.
{"title":"Barriers to timely lung cancer diagnosis and treatment in a Philippine tertiary hospital","authors":"Rich Ericson Chan King, Roland Reuben Bolos Angeles, Alfredo Viray Chua, Jorge Garcia Ignacio, Jubert Pasion Benedicto","doi":"10.25259/asjo-2022-72-(436)","DOIUrl":"https://doi.org/10.25259/asjo-2022-72-(436)","url":null,"abstract":"Timeliness of care is crucial to optimize outcomes in lung cancer. In the Philippines, the causes of delays in lung cancer diagnosis and treatment have not yet been explored. We reviewed records of patients diagnosed with lung cancer in our institution between September 2017 and August 2019 after biopsy or resection of a pulmonary lesion. Time to specialist consultation, biopsy, cancer diagnosis, and treatment were measured and compared with standards set by the British Thoracic Society. Eighty patients were included in the analysis. The median time to pulmonology consult and biopsy was 5 and 18 days, respectively. Cancer diagnosis was made within 28 days for 48% of patients. Causes of delay include late pulmonology referral (21%), delayed biopsy (38%), need for repeat biopsy (24%), and performing outright resection (10%). Out of 25 patients who received systemic treatment, only four were treated within 28 days of their cancer diagnosis. Curative resection was delayed beyond 56 days for two out of four patients. Each step in the management of lung cancer is a potential cause for delay. This study revealed opportunities for improvement in multiple areas of care that can allow more patients to benefit from treatment.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"50 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139162710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-17DOI: 10.25259/asjo-2022-62-(415)
Yamini Bachheti, V. Nautiyal, Mushtaq Ahmad
The early identification of breast cancer patients who will not respond to neoadjuvant chemotherapy is valuable for timely change in management strategies. Reliable clinical and pathological markers predictive of response to treatment have considerable potential for practical clinical use. Our longitudinal study aimed to assess clinical, pathological, and immunohistological factors predictive of chemotherapy response. Thirty Five patients of breast cancer underwent six cycles of Taxotere, Adriamycin, and Cyclophosphamide (TAC) based neoadjuvant chemotherapy (Docetaxel 75 mg/m2, Doxorubicin 50 mg/m2 or Epirubicin 100 mg/m2 and Cyclophosphamide 500 mg/m2) every three weeks followed by surgery. Histopathological response was assessed after surgery. At a follow up of 12 months, association between factors was tested with Fisher exact test, survival analysis was done with Kaplan Meier analysis and significance was tested by log rank test. Five patients out of 35 had pathological complete response (pCR). 14.8% of all T4 disease (P = 0.043) and 22.7% of all Estrogen receptor (ER) negative patients had pCR (P = 0.025). Among all patients showing pCR, four patients (80%) had Grade III tumors (P = 0.018) while all five patients had high Ki67 index (P = 0.032). At 12 months, the mean estimated overall survival came out to be 11.6 months. Mean estimated disease free survival was less for patients with pCR (7.2 months) vs. partial response (10.1 months) (P = 0.44). Our study concluded that tumors with larger size, higher stage, higher grade, ER negativity and higher proliferation index had better response to chemotherapy but these tumors also had a trend towards early relapse.
{"title":"Assessment of Predictive Factors for Response to Neoadjuvant Chemotherapy in Breast Cancer","authors":"Yamini Bachheti, V. Nautiyal, Mushtaq Ahmad","doi":"10.25259/asjo-2022-62-(415)","DOIUrl":"https://doi.org/10.25259/asjo-2022-62-(415)","url":null,"abstract":"\u0000The early identification of breast cancer patients who will not respond to neoadjuvant chemotherapy is valuable for timely change in management strategies. Reliable clinical and pathological markers predictive of response to treatment have considerable potential for practical clinical use. Our longitudinal study aimed to assess clinical, pathological, and immunohistological factors predictive of chemotherapy response.\u0000\u0000\u0000Thirty Five patients of breast cancer underwent six cycles of Taxotere, Adriamycin, and Cyclophosphamide (TAC) based neoadjuvant chemotherapy (Docetaxel 75 mg/m2, Doxorubicin 50 mg/m2 or Epirubicin 100 mg/m2 and Cyclophosphamide 500 mg/m2) every three weeks followed by surgery. Histopathological response was assessed after surgery. At a follow up of 12 months, association between factors was tested with Fisher exact test, survival analysis was done with Kaplan Meier analysis and significance was tested by log rank test.\u0000\u0000\u0000Five patients out of 35 had pathological complete response (pCR). 14.8% of all T4 disease (P = 0.043) and 22.7% of all Estrogen receptor (ER) negative patients had pCR (P = 0.025). Among all patients showing pCR, four patients (80%) had Grade III tumors (P = 0.018) while all five patients had high Ki67 index (P = 0.032). At 12 months, the mean estimated overall survival came out to be 11.6 months. Mean estimated disease free survival was less for patients with pCR (7.2 months) vs. partial response (10.1 months) (P = 0.44).\u0000\u0000\u0000Our study concluded that tumors with larger size, higher stage, higher grade, ER negativity and higher proliferation index had better response to chemotherapy but these tumors also had a trend towards early relapse.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"11 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138965761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mehdi Ferjaoui, Naourez Kolsi, E. Bergaoui, Maroua Naouar, M. Njima, Rachida Bouatay, A. Elkorbi, Khaled Harrathi, Jamel Koubaa
The aim of the study is to expose and highlight the clinical, imaging and therapeutic features of B-cell laryngeal lymphoma, with a brief review of literature. We report a rare case of B-cell laryngeal lymphoma A 42-year-old female was referred to the Otorhinolaryngology department for progressive dyspnea and dysphonia. Endoscopic examination and imaging reveals a supraglottis mass. The final diagnosis is a B-cell non-Hodgkin lymphoma of the supraglottis. Primary laryngeal lymphoma is a rare condition that should be considered in the differential diagnosis of a laryngeal mass, especially if it affects the supraglottic region. The diagnosis is difficult. Direct laryngoscopy with multiples and deep biopsies makes the diagnosis. The treatment and prognosis depend on the stage and grade of the lymphoma.
{"title":"B-cell non-Hodgkin lymphoma of the larynx: Case report and review of literature","authors":"Mehdi Ferjaoui, Naourez Kolsi, E. Bergaoui, Maroua Naouar, M. Njima, Rachida Bouatay, A. Elkorbi, Khaled Harrathi, Jamel Koubaa","doi":"10.25259/asjo-2022-33","DOIUrl":"https://doi.org/10.25259/asjo-2022-33","url":null,"abstract":"\u0000The aim of the study is to expose and highlight the clinical, imaging and therapeutic features of B-cell laryngeal lymphoma, with a brief review of literature.\u0000\u0000\u0000We report a rare case of B-cell laryngeal lymphoma \u0000\u0000\u0000A 42-year-old female was referred to the Otorhinolaryngology department for progressive dyspnea and dysphonia. Endoscopic examination and imaging reveals a supraglottis mass. The final diagnosis is a B-cell non-Hodgkin lymphoma of the supraglottis.\u0000\u0000\u0000Primary laryngeal lymphoma is a rare condition that should be considered in the differential diagnosis of a laryngeal mass, especially if it affects the supraglottic region. The diagnosis is difficult. Direct laryngoscopy with multiples and deep biopsies makes the diagnosis. The treatment and prognosis depend on the stage and grade of the lymphoma.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"48 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138592079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-27DOI: 10.25259/asjo-2022-56-(412)
Banupriya Ramakrishnan, Geetha Sivaramalingam, B. Raghavan, J. Govindaraj, Sathyasree Viswanathan, Nidhi Umretiya
The purpose of the study is to evaluate the role of Standardized Uptake Value (SUV) and Apparent Diffusion Coefficient (ADC) values as a predictor of histologic grade and molecular subtype of breast malignancy and to evaluate the correlation of grade of malignancy with background parenchymal uptake, background parenchymal enhancement and fibroglandular tissue of the contralateral normal breast 53 patients with unilateral breast cancer were included in the study. Images from Computed Tomography (CT) and Positron Emission Tomography (PET) were analyzed measuring maximum SUV and background SUV from the contralateral normal breast by placing a single Region of interest (ROI). From Diffusion-weighted magnetic resonance imaging (DWI-MRI) images ADC values were calculated with b value 0–1200 s/mm2 and single ROI placed in an area corresponding to the ROI placed to obtain maximum SUV of the mass. Type of fibroglandular tissue and background parenchymal enhancement was categorized based on Breast Imaging-Reporting and Data System (BI-RADS)–lexicon on T1 weighted and Dynamic Contrast-Enhanced (DCE) images respectively. Necrotic and hemorrhagic areas within the mass were excluded in both positron emission tomography–computed tomography (PET-CT) and Magnetic resonance imaging (MRI) while calculating SUV and ADC. A positive correlation was found between grade and Mean SUVmax with higher values in grade 3 malignancy (11.41 ± 4.76) (p-value – 0.003). Statistically significant variation in SUVmax was seen among estrogen receptor/progesterone receptor (ER/PR) status with low values in ER/PR positive tumors (p-value < 0.05). There was significant correlation between the molecular subtypes with higher SUVmax in triple-negative tumors (12.27 ± 4.22) (p-value – 0.02). Significant variation in ADC values among different molecular subtypes was seen with higher values in human epidermal growth factor receptor (HER2)-Enriched tumors (1.032 ± 0.25) and low values in luminal A subtype (0.798 ± 0.13). Therefore, PET-CT and MRI can be used as a complementary imaging tool in assessing the aggressiveness and biological characteristics of tumors.
{"title":"Role of SUV and ADC values as a predictors of grade and molecular subtypes of breast malignancy","authors":"Banupriya Ramakrishnan, Geetha Sivaramalingam, B. Raghavan, J. Govindaraj, Sathyasree Viswanathan, Nidhi Umretiya","doi":"10.25259/asjo-2022-56-(412)","DOIUrl":"https://doi.org/10.25259/asjo-2022-56-(412)","url":null,"abstract":"The purpose of the study is to evaluate the role of Standardized Uptake Value (SUV) and Apparent Diffusion Coefficient (ADC) values as a predictor of histologic grade and molecular subtype of breast malignancy and to evaluate the correlation of grade of malignancy with background parenchymal uptake, background parenchymal enhancement and fibroglandular tissue of the contralateral normal breast 53 patients with unilateral breast cancer were included in the study. Images from Computed Tomography (CT) and Positron Emission Tomography (PET) were analyzed measuring maximum SUV and background SUV from the contralateral normal breast by placing a single Region of interest (ROI). From Diffusion-weighted magnetic resonance imaging (DWI-MRI) images ADC values were calculated with b value 0–1200 s/mm2 and single ROI placed in an area corresponding to the ROI placed to obtain maximum SUV of the mass. Type of fibroglandular tissue and background parenchymal enhancement was categorized based on Breast Imaging-Reporting and Data System (BI-RADS)–lexicon on T1 weighted and Dynamic Contrast-Enhanced (DCE) images respectively. Necrotic and hemorrhagic areas within the mass were excluded in both positron emission tomography–computed tomography (PET-CT) and Magnetic resonance imaging (MRI) while calculating SUV and ADC. A positive correlation was found between grade and Mean SUVmax with higher values in grade 3 malignancy (11.41 ± 4.76) (p-value – 0.003). Statistically significant variation in SUVmax was seen among estrogen receptor/progesterone receptor (ER/PR) status with low values in ER/PR positive tumors (p-value < 0.05). There was significant correlation between the molecular subtypes with higher SUVmax in triple-negative tumors (12.27 ± 4.22) (p-value – 0.02). Significant variation in ADC values among different molecular subtypes was seen with higher values in human epidermal growth factor receptor (HER2)-Enriched tumors (1.032 ± 0.25) and low values in luminal A subtype (0.798 ± 0.13). Therefore, PET-CT and MRI can be used as a complementary imaging tool in assessing the aggressiveness and biological characteristics of tumors.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139231304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective Assessment of clinicopathological and bone marrow parameters in Myelodysplastic Syndrome (MDS) with monosomy 7 and deletion (del) 7q and their prognostic stratification. Material and Methods Retrospective observational study of MDS patients with monosomy 7 and deletion (del) 7q was conducted from January 2013 to August 2021. Demographic, clinical, and hematological variables were acquired apart from cytogenetic analysis and karyotyping. Prognostic International Prostate Symptom Score (IPSS) risk stratification was performed. Results 110 patients of MDS underwent cytogenetics study, 8 patients had monosomy 7, and 17 patients had del 7q. The median age group for both subsets was 51–54 years. Both groups showed male predominance. In monosomy 7 MDS, severe anemia was more profound (87%) in comparison to del 7q (53%). Absolute neutrophil count (ANC) of <800/cubic mm was found equally in both groups. 88% of both the subsets had platelet count <50 thousand/liter with higher Lactate Dehydrogenase (LDH) in the del 7q group (81.25%). About 50% of MDS cases with monosomy 7 and 37.5% of del 7q cases had excess blasts of > 5%. Based on the Revised International Prognostic Scoring System (IPSS-R), 75% of patients in both subsets had a high and very high-risk category. Progression to Acute myeloid leukemia (AML) was more common in monosomy 7 than in del 7q (23% vs 24 %). Conclusion Early age of presentation with predominance in men was noted in both the groups. The IPSS-R score was more valid in determining the risk category for predicting the course of these patients rather than considering cytogenetic type alone. However, more cases need to be analyzed to validate our findings.
{"title":"Clinicopathological profile of myelodysplastic syndrome (MDS) with monosomy 7 and deletion 7q: An institute experience","authors":"Sneha Kakoty, Anurag Saha, Torsha Jana, Paheli Maru, Jyoti Sawhney","doi":"10.25259/asjo-2022-59-(422)","DOIUrl":"https://doi.org/10.25259/asjo-2022-59-(422)","url":null,"abstract":"Objective Assessment of clinicopathological and bone marrow parameters in Myelodysplastic Syndrome (MDS) with monosomy 7 and deletion (del) 7q and their prognostic stratification. Material and Methods Retrospective observational study of MDS patients with monosomy 7 and deletion (del) 7q was conducted from January 2013 to August 2021. Demographic, clinical, and hematological variables were acquired apart from cytogenetic analysis and karyotyping. Prognostic International Prostate Symptom Score (IPSS) risk stratification was performed. Results 110 patients of MDS underwent cytogenetics study, 8 patients had monosomy 7, and 17 patients had del 7q. The median age group for both subsets was 51–54 years. Both groups showed male predominance. In monosomy 7 MDS, severe anemia was more profound (87%) in comparison to del 7q (53%). Absolute neutrophil count (ANC) of <800/cubic mm was found equally in both groups. 88% of both the subsets had platelet count <50 thousand/liter with higher Lactate Dehydrogenase (LDH) in the del 7q group (81.25%). About 50% of MDS cases with monosomy 7 and 37.5% of del 7q cases had excess blasts of > 5%. Based on the Revised International Prognostic Scoring System (IPSS-R), 75% of patients in both subsets had a high and very high-risk category. Progression to Acute myeloid leukemia (AML) was more common in monosomy 7 than in del 7q (23% vs 24 %). Conclusion Early age of presentation with predominance in men was noted in both the groups. The IPSS-R score was more valid in determining the risk category for predicting the course of these patients rather than considering cytogenetic type alone. However, more cases need to be analyzed to validate our findings.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136078868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-04DOI: 10.25259/asjo-2022-69-(433)
Artem Rafaelian, Boris Martynov, Kseniia Chemodakova, Roman Martynov, Andrey Kholyavin, Garry Papayan, Dmitry Svistov
Objectives Stereotactic photodynamic therapy (sPDT) using 5-aminolaevulinic acid (5-ALA) as a cytotoxic photosensitizer may be a potentially prospective treatment option for malignant gliomas. Material and Methods We analyzed data from 10 patients with recurrent malignant gliomas of the brain who were treated with sPDT at the Department of Neurosurgery of the Military-Medical Academy S. M. Kirov, from 2020 to November 2021. Three patients were treated with sPDT again after 3, 7, and 15 months due to relapse. Results The median age of the patients was 55.5 years, range was 30–60 years, there were six men and four women. At the time of sPDT, 7 (70%) patients with recurrent tumors were diagnosed with glioblastomas (WHO grade IV), and 3 (30%) with anaplastic astrocytomas (WHO grade III). Tumors were without IDH mutation in 7 (70%) patients; MGMT gene expression status was evaluated in tumors in 9 (90%) patients. A 1p/19q co-deletion was not detected in any of the patients. The median tumor volume was 5.85 cm 3 (min. 3.2 cm 3 , max. 22.5 cm 3 ). We have found that the median recurrence-free period after sPDT in patients with anaplastic astrocytomas and glioblastomas was 435 and 195 days, respectively. Conclusion This result allows to consider sPDT as one of the perspective methods of treatment of patients with recurrent gliomas of high malignancy in cases when repeated open surgical intervention has high risks of new neurological deficit.
目的使用5-氨基乙酰丙酸(5-ALA)作为细胞毒性光敏剂的立体定向光动力疗法(sPDT)可能是恶性胶质瘤的一种潜在的前瞻性治疗选择。材料和方法我们分析了2020年至2021年11月在军事医学院s.m.基洛夫神经外科接受sPDT治疗的10例复发性脑恶性胶质瘤患者的数据。3例患者因复发分别于3、7、15个月后再次接受sPDT治疗。结果患者年龄中位数为55.5岁，年龄范围30 ~ 60岁，男性6例，女性4例。sPDT时，7例(70%)复发肿瘤患者诊断为胶质母细胞瘤(WHO分级IV级)，3例(30%)为间变性星形细胞瘤(WHO分级III级)。7例(70%)患者肿瘤无IDH突变;在9例(90%)患者的肿瘤中评估MGMT基因表达状态。在所有患者中未检测到1p/19q共缺失。肿瘤中位体积5.85 cm 3(最小3.2 cm 3)。22.5厘米3)。我们发现间变性星形细胞瘤和胶质母细胞瘤患者sPDT后的中位无复发期分别为435天和195天。结论sPDT可作为复发性高恶性胶质瘤患者的治疗方法之一，在反复开放手术干预有新神经功能缺损高风险的情况下。
{"title":"Photodynamic interstitial stereotactic therapy for recurrent malignant glioma","authors":"Artem Rafaelian, Boris Martynov, Kseniia Chemodakova, Roman Martynov, Andrey Kholyavin, Garry Papayan, Dmitry Svistov","doi":"10.25259/asjo-2022-69-(433)","DOIUrl":"https://doi.org/10.25259/asjo-2022-69-(433)","url":null,"abstract":"Objectives Stereotactic photodynamic therapy (sPDT) using 5-aminolaevulinic acid (5-ALA) as a cytotoxic photosensitizer may be a potentially prospective treatment option for malignant gliomas. Material and Methods We analyzed data from 10 patients with recurrent malignant gliomas of the brain who were treated with sPDT at the Department of Neurosurgery of the Military-Medical Academy S. M. Kirov, from 2020 to November 2021. Three patients were treated with sPDT again after 3, 7, and 15 months due to relapse. Results The median age of the patients was 55.5 years, range was 30–60 years, there were six men and four women. At the time of sPDT, 7 (70%) patients with recurrent tumors were diagnosed with glioblastomas (WHO grade IV), and 3 (30%) with anaplastic astrocytomas (WHO grade III). Tumors were without IDH mutation in 7 (70%) patients; MGMT gene expression status was evaluated in tumors in 9 (90%) patients. A 1p/19q co-deletion was not detected in any of the patients. The median tumor volume was 5.85 cm 3 (min. 3.2 cm 3 , max. 22.5 cm 3 ). We have found that the median recurrence-free period after sPDT in patients with anaplastic astrocytomas and glioblastomas was 435 and 195 days, respectively. Conclusion This result allows to consider sPDT as one of the perspective methods of treatment of patients with recurrent gliomas of high malignancy in cases when repeated open surgical intervention has high risks of new neurological deficit.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135644929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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