Abstract Introduction Xerostomia is an imminent complication of head and neck radiotherapy best assessed subjectively. This study aimed to evaluate the effects of sparing parotid glands with intensity-modulated radiation therapy (IMRT) on subjective xerostomia scores in patients with locoregionally advanced head and neck cancer. Subjects and Methods This is a prospective longitudinal study conducted in an outpatient department setting. A total of 43 patients with head and neck cancer were planned with IMRT as per the ICRU 62 (International Commission on Radiation Units and Measurement Report 62). The constraints to ipsilateral and contralateral parotid glands were 35 and 25 Gy, respectively. Treatment plan was assessed for doses to 100, 67, 50, and 33% volume of individual parotid glands. Patients were subjectively assessed using the Amosson’s Questionnaire and graded as per Eisbruch’s xerostomia Radiation Therapy Oncology Group scores. Dose volume histogram (DVH) was plotted and correlated with grades of xerostomia postradiation at 1, 3, 6, 9 and 12 months follow-ups. Statistical analysis was performed suing SPSS version 16, chi-square test, and one-way analysis of variance test. Results No statistically significant correlation between mean dose of radiation, volume of the parotid glands, and grades of xerostomia was noted postradiation. A statistically significant improvement in grades of xerostomia between 3 and 6 months (p = 0.0), 3 and 9 months (p = 0.020), 6 and 9 months (p = 0.009), 6 and 12 months (p = 0.05), and 9 and 12 months (p = 0.00) was noted. Recovery in grades was noted at 9 months. Conclusion There is no statistically significant direct correlation between DVH of the parotid glands and grades of xerostomia, although recovery in grades was statistically significant at 9 months.
{"title":"Does Dose Volume Histogram of Parotid Glands Correlate with Xerostomia Radiation Therapy Oncology Group Scores in Locoregionally Advanced Head and Neck Cancer Patients Treated with Intensity-Modulated Radiation Therapy?","authors":"S. Goel, R. Bhutani, V. Bansal, R. Goel","doi":"10.1055/s-0040-1718978","DOIUrl":"https://doi.org/10.1055/s-0040-1718978","url":null,"abstract":"Abstract Introduction Xerostomia is an imminent complication of head and neck radiotherapy best assessed subjectively. This study aimed to evaluate the effects of sparing parotid glands with intensity-modulated radiation therapy (IMRT) on subjective xerostomia scores in patients with locoregionally advanced head and neck cancer. Subjects and Methods This is a prospective longitudinal study conducted in an outpatient department setting. A total of 43 patients with head and neck cancer were planned with IMRT as per the ICRU 62 (International Commission on Radiation Units and Measurement Report 62). The constraints to ipsilateral and contralateral parotid glands were 35 and 25 Gy, respectively. Treatment plan was assessed for doses to 100, 67, 50, and 33% volume of individual parotid glands. Patients were subjectively assessed using the Amosson’s Questionnaire and graded as per Eisbruch’s xerostomia Radiation Therapy Oncology Group scores. Dose volume histogram (DVH) was plotted and correlated with grades of xerostomia postradiation at 1, 3, 6, 9 and 12 months follow-ups. Statistical analysis was performed suing SPSS version 16, chi-square test, and one-way analysis of variance test. Results No statistically significant correlation between mean dose of radiation, volume of the parotid glands, and grades of xerostomia was noted postradiation. A statistically significant improvement in grades of xerostomia between 3 and 6 months (p = 0.0), 3 and 9 months (p = 0.020), 6 and 9 months (p = 0.009), 6 and 12 months (p = 0.05), and 9 and 12 months (p = 0.00) was noted. Recovery in grades was noted at 9 months. Conclusion There is no statistically significant direct correlation between DVH of the parotid glands and grades of xerostomia, although recovery in grades was statistically significant at 9 months.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"07 1","pages":"118 - 125"},"PeriodicalIF":0.0,"publicationDate":"2020-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1718978","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45154474","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}
Felix Menkiti, C. Ukah, K. Adelusola, I. Ezejiofor
Abstract Introduction HIV (human immunodeficiency virus)-associated immunodeficiency is the single most important acquired immunodeficiency in humans, underlying several diseases. The presence of HIV infection may be unsuspected or undetected in tissues due to latency or failure of the consulting physician to document it on the requisition form. HIV-1p24 protein is a component of the HIV particle capsid that can be exploited serologically and immunohistochemically to detect the presence of HIV infection. This study aimed to assess the usefulness of HIV-1 p24 immunohistochemistry in detecting the presence of HIV infection in histopathology tissues in a resource-challenged setting. Materials and Methods HIV-1p24 immunohistochemical expression was evaluated in 59 cases from the archives of both Nnamdi Azikiwe University Teaching Hospital (NAUTH) and Pathocon Specialist Clinic and Research Institute over a 10-year period. Pathology consult forms of all clinically and morphologically suspected cases of Kaposi sarcoma and their blocks were retrieved, recut, and reviewed using hematoxylin and eosin, and then subjected to HIV-1p24 immunohistochemical staining. Results Of the 59 cases, 38 expressed p24, whereas 21 were negative. Fifteen of the positive cases had no prior documented evidence of HIV infection. Five cases with clinically known statuses, four positive and one negative, were found to be negative and positive, respectively, following HIV-1p24 immunohistochemical staining, probably due to usage of ELISA (enzyme-linked immunosorbent assay) detection kit only and long term antiretroviral therapy. HIV infection was commoner in the third and fourth decades of life. Conclusion HIV-1p24 is a useful low-cost immunohistochemical marker in detecting the presence of HIV infection in histopathology specimens, even in previously unsuspected cases.
{"title":"The Usefulness of HIV-1p24 in Detecting the Presence of HIV Infection in Histopathology Tissue Specimens","authors":"Felix Menkiti, C. Ukah, K. Adelusola, I. Ezejiofor","doi":"10.1055/s-0040-1718979","DOIUrl":"https://doi.org/10.1055/s-0040-1718979","url":null,"abstract":"Abstract Introduction HIV (human immunodeficiency virus)-associated immunodeficiency is the single most important acquired immunodeficiency in humans, underlying several diseases. The presence of HIV infection may be unsuspected or undetected in tissues due to latency or failure of the consulting physician to document it on the requisition form. HIV-1p24 protein is a component of the HIV particle capsid that can be exploited serologically and immunohistochemically to detect the presence of HIV infection. This study aimed to assess the usefulness of HIV-1 p24 immunohistochemistry in detecting the presence of HIV infection in histopathology tissues in a resource-challenged setting. Materials and Methods HIV-1p24 immunohistochemical expression was evaluated in 59 cases from the archives of both Nnamdi Azikiwe University Teaching Hospital (NAUTH) and Pathocon Specialist Clinic and Research Institute over a 10-year period. Pathology consult forms of all clinically and morphologically suspected cases of Kaposi sarcoma and their blocks were retrieved, recut, and reviewed using hematoxylin and eosin, and then subjected to HIV-1p24 immunohistochemical staining. Results Of the 59 cases, 38 expressed p24, whereas 21 were negative. Fifteen of the positive cases had no prior documented evidence of HIV infection. Five cases with clinically known statuses, four positive and one negative, were found to be negative and positive, respectively, following HIV-1p24 immunohistochemical staining, probably due to usage of ELISA (enzyme-linked immunosorbent assay) detection kit only and long term antiretroviral therapy. HIV infection was commoner in the third and fourth decades of life. Conclusion HIV-1p24 is a useful low-cost immunohistochemical marker in detecting the presence of HIV infection in histopathology specimens, even in previously unsuspected cases.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"7 1","pages":"40 - 44"},"PeriodicalIF":0.0,"publicationDate":"2020-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1718979","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49100494","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}
Abstract Follicular thyroid carcinoma is the second most common cancer of the thyroid, which usually presents as a solitary thyroid nodule. Diagnosis of follicular thyroid cancer involving the appendicular skeleton is very rare. In this paper, we report a case of a 65-year-old woman who previously underwent partial lobectomy of the left thyroid gland, and who consequently presented with a 2-year history of gradually enlarging left arm mass. Initial whole-body bone imaging revealed a large osteolytic lesion in the humerus. An MRI (magnetic resonance imaging) of the left arm showed a heterogeneously enhancing, encapsulated, soft tissue mass with humeral involvement, and the initial impression was osteosarcoma versus fibrosarcoma. Biopsy reading of the humeral mass was morphologically compatible with a well-differentiated metastatic thyroid carcinoma. She subsequently underwent right lobectomy where histopathology showed Hashimoto’s thyroiditis. A slide review was requested and the biopsy of the humeral mass revealed adenocarcinoma with follicular architecture, compatible with a metastatic thyroid carcinoma. Meanwhile, the findings on the right thyroid lobe revealed a multinodular colloid adenomatous goiter with hyperplastic features in a background of Hashimoto’s thyroiditis. This report demonstrated a rare presentation of follicular thyroid carcinoma metastasizing to the humerus that can be confused with primary bone tumors, both clinically and radiologically. Early diagnosis and a high index of suspicion is foremost for immediate and appropriate management.
{"title":"Follicular Thyroid Carcinoma Presenting as a Humeral Mass: A Rare Case Presentation","authors":"M. Mendoza, A. R. Hernandez, M. San Juan","doi":"10.1055/s-0040-1715763","DOIUrl":"https://doi.org/10.1055/s-0040-1715763","url":null,"abstract":"Abstract Follicular thyroid carcinoma is the second most common cancer of the thyroid, which usually presents as a solitary thyroid nodule. Diagnosis of follicular thyroid cancer involving the appendicular skeleton is very rare. In this paper, we report a case of a 65-year-old woman who previously underwent partial lobectomy of the left thyroid gland, and who consequently presented with a 2-year history of gradually enlarging left arm mass. Initial whole-body bone imaging revealed a large osteolytic lesion in the humerus. An MRI (magnetic resonance imaging) of the left arm showed a heterogeneously enhancing, encapsulated, soft tissue mass with humeral involvement, and the initial impression was osteosarcoma versus fibrosarcoma. Biopsy reading of the humeral mass was morphologically compatible with a well-differentiated metastatic thyroid carcinoma. She subsequently underwent right lobectomy where histopathology showed Hashimoto’s thyroiditis. A slide review was requested and the biopsy of the humeral mass revealed adenocarcinoma with follicular architecture, compatible with a metastatic thyroid carcinoma. Meanwhile, the findings on the right thyroid lobe revealed a multinodular colloid adenomatous goiter with hyperplastic features in a background of Hashimoto’s thyroiditis. This report demonstrated a rare presentation of follicular thyroid carcinoma metastasizing to the humerus that can be confused with primary bone tumors, both clinically and radiologically. Early diagnosis and a high index of suspicion is foremost for immediate and appropriate management.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"06 1","pages":"149 - 151"},"PeriodicalIF":0.0,"publicationDate":"2020-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1715763","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45813908","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}
Abstract Acute promyelocytic leukemia (APML) is a subtype of acute myeloid leukemia. The condition is clinically marked by anemia, fatigue, weakness, frequent infections, and fever associated with easy bleeding and coagulopathy. The diagnosis is made through bone marrow aspiration exhibiting increased promyelocytes and test for PML-RARα fusion gene. There has been remarkable progress in the treatment of APML in the past few decades with the induction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). This has also brought down mortality and relapse rates considerably. Similarly, nearly 90% patients are able to live disease free for about 10 years. However, there are certain hindrances to these treatments majorly due to side effects, relapses, and limited periods of remission associated with ATRA and ATO. Here, a freshly diagnosed case of APML is being reported. The patient was diagnosed in leading medical centers of Aligarh and New Delhi and only treated with blood transfusions in the absence of an established line of treatment in 1982. The patient has completed 37 years long survival without any sign of the disease and any adverse effect. This approach could be considered as an add-on medical therapy for APML.
{"title":"Acute Promyelocytic Leukemia: 37 Years Long Ongoing Survival in a de novo Patient with Metal-Based Ayurvedic Treatment","authors":"B. Prakash, S. Prakash, S. Tiwari","doi":"10.1055/s-0040-1715765","DOIUrl":"https://doi.org/10.1055/s-0040-1715765","url":null,"abstract":"Abstract Acute promyelocytic leukemia (APML) is a subtype of acute myeloid leukemia. The condition is clinically marked by anemia, fatigue, weakness, frequent infections, and fever associated with easy bleeding and coagulopathy. The diagnosis is made through bone marrow aspiration exhibiting increased promyelocytes and test for PML-RARα fusion gene. There has been remarkable progress in the treatment of APML in the past few decades with the induction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). This has also brought down mortality and relapse rates considerably. Similarly, nearly 90% patients are able to live disease free for about 10 years. However, there are certain hindrances to these treatments majorly due to side effects, relapses, and limited periods of remission associated with ATRA and ATO. Here, a freshly diagnosed case of APML is being reported. The patient was diagnosed in leading medical centers of Aligarh and New Delhi and only treated with blood transfusions in the absence of an established line of treatment in 1982. The patient has completed 37 years long survival without any sign of the disease and any adverse effect. This approach could be considered as an add-on medical therapy for APML.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"06 1","pages":"147 - 148"},"PeriodicalIF":0.0,"publicationDate":"2020-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1715765","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41898599","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}
G. Mittal, M. Agarwal, Anmol Agarwal, R. Garg, A. Rathi, Pratiksha Dwivedi
Abstract Maxillary sinus carcinoma is a rare neoplasm, with incidence of 0.2 to 0.8% of all systemic malignancies. Patients are diagnosed in the advanced stage when there is orbital invasion with abnormal ocular signs and symptoms. The standard treatment of maxillary sinus carcinoma is en bloc radical maxillectomy along with orbital exenteration, followed by postoperative adjuvant therapy. Orbital exenteration is used when the malignancy extends to the orbit in case of squamous/basal cell carcinoma. The aim of the current review is to provide an insight into the management of advanced maxillary carcinoma with orbital involvement in a 42-year-old male.
{"title":"Locally Advanced Carcinoma of Maxillary Sinus with Orbital Involvement","authors":"G. Mittal, M. Agarwal, Anmol Agarwal, R. Garg, A. Rathi, Pratiksha Dwivedi","doi":"10.1055/s-0040-1714308","DOIUrl":"https://doi.org/10.1055/s-0040-1714308","url":null,"abstract":"Abstract Maxillary sinus carcinoma is a rare neoplasm, with incidence of 0.2 to 0.8% of all systemic malignancies. Patients are diagnosed in the advanced stage when there is orbital invasion with abnormal ocular signs and symptoms. The standard treatment of maxillary sinus carcinoma is en bloc radical maxillectomy along with orbital exenteration, followed by postoperative adjuvant therapy. Orbital exenteration is used when the malignancy extends to the orbit in case of squamous/basal cell carcinoma. The aim of the current review is to provide an insight into the management of advanced maxillary carcinoma with orbital involvement in a 42-year-old male.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"7 1","pages":"08 - 12"},"PeriodicalIF":0.0,"publicationDate":"2020-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1714308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48097029","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}
Abstract Introduction Gastric cancer (GC) is the third leading cause of cancer death, with most patients diagnosed at a later stage, with distant metastasis at the time of presentation, contributing to poor prognosis. GC has been associated with nonspecific clinical presentations, which cause a time delay for patients to seek for medical advice. This study aims to identify the clinicopathological features of GC patients and correlate time delay of the diagnosis to the staging of the disease. Materials and Methods This is a single-center retrospective study of GC patients diagnosed from January 2012 to December 2018. All relevant data of GC patient diagnosed during this time period were extracted from the patients’ case notes. Results A total of 69 GC patients were included in this study, with male preponderance and mean age of 62 years old. The top three symptoms presented are dyspepsia or ingestion (47.8%), weight loss (43.5%), and nausea or vomiting (33.3%). The mean time delay was 3.7 months. Patients presented with weight loss have a significantly longer average time delay of 4.88 months. Most tumor lesion was found at the distal stomach (43.5%), while 74.5% tested negative for Helicobacter pylori. Most patients were diagnosed at Stage IV (52.6%) and Stage III (36.8%) of the disease, with poorly differentiated (67.7%) histological features which have poor prognosis. Discussion and Conclusion No evidence of specific symptom or combination of symptoms predicts higher risk of GC. Regardless of the number of symptoms presented or the time delay, most GC patients were diagnosed at later stage of the disease. The study shows the importance of GC screening in Malaysia to ensure early detection, even before a symptom presented.
{"title":"The Clinicopathological Features and Staging at Presentation of Gastric Cancer: A Single-Center Retrospective Study","authors":"S. Chong, S. Ang","doi":"10.1055/s-0040-1714307","DOIUrl":"https://doi.org/10.1055/s-0040-1714307","url":null,"abstract":"Abstract Introduction Gastric cancer (GC) is the third leading cause of cancer death, with most patients diagnosed at a later stage, with distant metastasis at the time of presentation, contributing to poor prognosis. GC has been associated with nonspecific clinical presentations, which cause a time delay for patients to seek for medical advice. This study aims to identify the clinicopathological features of GC patients and correlate time delay of the diagnosis to the staging of the disease. Materials and Methods This is a single-center retrospective study of GC patients diagnosed from January 2012 to December 2018. All relevant data of GC patient diagnosed during this time period were extracted from the patients’ case notes. Results A total of 69 GC patients were included in this study, with male preponderance and mean age of 62 years old. The top three symptoms presented are dyspepsia or ingestion (47.8%), weight loss (43.5%), and nausea or vomiting (33.3%). The mean time delay was 3.7 months. Patients presented with weight loss have a significantly longer average time delay of 4.88 months. Most tumor lesion was found at the distal stomach (43.5%), while 74.5% tested negative for Helicobacter pylori. Most patients were diagnosed at Stage IV (52.6%) and Stage III (36.8%) of the disease, with poorly differentiated (67.7%) histological features which have poor prognosis. Discussion and Conclusion No evidence of specific symptom or combination of symptoms predicts higher risk of GC. Regardless of the number of symptoms presented or the time delay, most GC patients were diagnosed at later stage of the disease. The study shows the importance of GC screening in Malaysia to ensure early detection, even before a symptom presented.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"06 1","pages":"120 - 126"},"PeriodicalIF":0.0,"publicationDate":"2020-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1714307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47744408","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}
Abstract Introduction Coronavirus disease 2019 (COVID-19) has become a world pandemic since early 2020. The complexity of handling multiple myeloma (MM) has increased substantially during this pandemic. The objective of this review is to know the current recommendation to manage MM in the COVID-19 era. Materials and Methods Electronic databases, including PubMed central and PubMed, were used to conduct a literature search. It was conducted on May 18, 2020, using the keywords “multiple myeloma” AND “COVID-19” AND “Prevalence OR Impact OR treatment OR prophylactic.” The included articles were review articles, recommendations, case reports or series, or population-based studies (cross-sectional, cohort, case-control, or interventional), and full-text if available. Results A total of 124 articles were identified through the search strategy. The two reviewers screened titles and abstracts of all articles. Most articles were excluded because of ineligible to the criteria. Ultimately, 18 articles were included in the final evaluation. MM patients might have higher risk to become severe COVID-19 if they got infected due to their immunocompromised condition. Due to the pandemic, precise treatment priorities should be made by considering its benefit and the risk of MM progression. For the young, especially healthy patients, the most effective therapy should be offered and tailored to the patient’s goal. Several MM societies have published the recommendation regarding the special stage of MM. Conclusion Myeloma societies in the world have released recommendations related to the management of myeloma patients. However, there is scarce of evidence to do the recommendation.
{"title":"Multiple Myeloma Management in COVID-19 Era","authors":"A. Kurniawan, D. A. Halim, N. Sutandyo","doi":"10.1055/s-0040-1716813","DOIUrl":"https://doi.org/10.1055/s-0040-1716813","url":null,"abstract":"Abstract Introduction Coronavirus disease 2019 (COVID-19) has become a world pandemic since early 2020. The complexity of handling multiple myeloma (MM) has increased substantially during this pandemic. The objective of this review is to know the current recommendation to manage MM in the COVID-19 era. Materials and Methods Electronic databases, including PubMed central and PubMed, were used to conduct a literature search. It was conducted on May 18, 2020, using the keywords “multiple myeloma” AND “COVID-19” AND “Prevalence OR Impact OR treatment OR prophylactic.” The included articles were review articles, recommendations, case reports or series, or population-based studies (cross-sectional, cohort, case-control, or interventional), and full-text if available. Results A total of 124 articles were identified through the search strategy. The two reviewers screened titles and abstracts of all articles. Most articles were excluded because of ineligible to the criteria. Ultimately, 18 articles were included in the final evaluation. MM patients might have higher risk to become severe COVID-19 if they got infected due to their immunocompromised condition. Due to the pandemic, precise treatment priorities should be made by considering its benefit and the risk of MM progression. For the young, especially healthy patients, the most effective therapy should be offered and tailored to the patient’s goal. Several MM societies have published the recommendation regarding the special stage of MM. Conclusion Myeloma societies in the world have released recommendations related to the management of myeloma patients. However, there is scarce of evidence to do the recommendation.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"7 1","pages":"01 - 07"},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1716813","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43597961","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}
Abstract Objective This work aimed to study the distribution of lymph nodal metastatic pattern in carcinoma gallbladder with multidetector computed tomography (CT). Materials and Methods A retrospective observational study was conducted including 80 patients with carcinoma gallbladder who underwent triple-phase CT angiography or single-phase contrast-enhanced CT scan of the abdomen between January 2019 and November 2019. Results In our study, 75 (93.7%) out of 80 cases showed metastasis to lymph nodes, with distribution as follows: periportal (69), peripancreatic (62), and aortocaval (47). The most common involved combination included all three lymph nodal groups (periportal, peripancreatic, and aortocaval), involving 40 (50%) cases. The combination of only periportal and peripancreatic lymph nodes was seen in 17 (21%) cases. Isolated periportal lymph nodes were seen in eight cases (10%) cases. The combination of only periportal and aortocaval lymph nodes was seen in four (5%) cases. Isolated peripancreatic lymph nodes were seen in three (3.7%) cases. The combination of periportal and aortocaval was seen in four (5%) cases followed by peripancreatic and aortocaval lymph nodes that was seen in two (2.5%) cases. Isolated aortocaval lymph nodes were seen in one (1.2%) case. Conclusion Periportal lymph nodes were the single most commonly involved station followed by peripancreatic and aortocaval lymph nodes. The combination of periportal, peripancreatic, and aortocaval lymph nodes was seen most commonly. The second most commonly involved combination was found to be periportal and peripancreatic lymph nodes followed by isolated periportal lymph nodes.
{"title":"Lymph Nodal Metastatic Pattern in Carcinoma Gallbladder with Multidetector Computed Tomography: An Institutional Experience","authors":"G. Raj, Bhanupriya Singh, R. Raj, Ragini Singh","doi":"10.1055/s-0040-1714306","DOIUrl":"https://doi.org/10.1055/s-0040-1714306","url":null,"abstract":"Abstract Objective This work aimed to study the distribution of lymph nodal metastatic pattern in carcinoma gallbladder with multidetector computed tomography (CT). Materials and Methods A retrospective observational study was conducted including 80 patients with carcinoma gallbladder who underwent triple-phase CT angiography or single-phase contrast-enhanced CT scan of the abdomen between January 2019 and November 2019. Results In our study, 75 (93.7%) out of 80 cases showed metastasis to lymph nodes, with distribution as follows: periportal (69), peripancreatic (62), and aortocaval (47). The most common involved combination included all three lymph nodal groups (periportal, peripancreatic, and aortocaval), involving 40 (50%) cases. The combination of only periportal and peripancreatic lymph nodes was seen in 17 (21%) cases. Isolated periportal lymph nodes were seen in eight cases (10%) cases. The combination of only periportal and aortocaval lymph nodes was seen in four (5%) cases. Isolated peripancreatic lymph nodes were seen in three (3.7%) cases. The combination of periportal and aortocaval was seen in four (5%) cases followed by peripancreatic and aortocaval lymph nodes that was seen in two (2.5%) cases. Isolated aortocaval lymph nodes were seen in one (1.2%) case. Conclusion Periportal lymph nodes were the single most commonly involved station followed by peripancreatic and aortocaval lymph nodes. The combination of periportal, peripancreatic, and aortocaval lymph nodes was seen most commonly. The second most commonly involved combination was found to be periportal and peripancreatic lymph nodes followed by isolated periportal lymph nodes.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"7 1","pages":"22 - 27"},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1714306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47789522","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}
Abstract Pure primary squamous cell carcinoma (SCC) of the breast is a rare malignancy which constitutes < 0.1% of all primary invasive breast carcinomas. It is considered to be more aggressive compared with other infiltrating ductal cancers, and knowledge concerning treatment patterns and outcomes is limited. We treated a 50-year-old woman with SCC of left breast, having metastatic fixed axillary lymph nodes. The tumor was hormone receptor negative. Paclitaxel and carboplatin-based neoadjuvant chemotherapy was given with a good response, followed by modified radical mastectomy. Adjuvant radiotherapy was given to the chest and axilla in view of two lymph nodes positive for tumor out of 12. No local and systemic recurrence encountered in 1 year of follow-up. Surgery along with platinum and taxane-based chemotherapy and radiotherapy is an effective mode of treatment for SCC in other parts of the body. More data is necessary to formulate management guidelines, and further define if there is any role for systemic chemotherapy, radiation therapy, or hormonal blockade.
{"title":"Primary Squamous Cell Carcinoma of Breast Responsive to Platinum and Taxane-Based Chemotherapy: A Rare Entity and Review Literature","authors":"J. Pandey, Amar Kumar, A. Ranjan","doi":"10.1055/s-0040-1714309","DOIUrl":"https://doi.org/10.1055/s-0040-1714309","url":null,"abstract":"Abstract Pure primary squamous cell carcinoma (SCC) of the breast is a rare malignancy which constitutes < 0.1% of all primary invasive breast carcinomas. It is considered to be more aggressive compared with other infiltrating ductal cancers, and knowledge concerning treatment patterns and outcomes is limited. We treated a 50-year-old woman with SCC of left breast, having metastatic fixed axillary lymph nodes. The tumor was hormone receptor negative. Paclitaxel and carboplatin-based neoadjuvant chemotherapy was given with a good response, followed by modified radical mastectomy. Adjuvant radiotherapy was given to the chest and axilla in view of two lymph nodes positive for tumor out of 12. No local and systemic recurrence encountered in 1 year of follow-up. Surgery along with platinum and taxane-based chemotherapy and radiotherapy is an effective mode of treatment for SCC in other parts of the body. More data is necessary to formulate management guidelines, and further define if there is any role for systemic chemotherapy, radiation therapy, or hormonal blockade.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"06 1","pages":"116 - 119"},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1714309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48471629","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}
B. Reddy, Rashmi Shivananjappa, Geeta S.N, R. Tiwari
Abstract Introduction This study aimed to estimate the planning target volume (PTV) margin in lung tumors using 4D computed tomography (CT) scan and evaluate other factors that have an effect on tumor motion. Materials and Methods We recruited 43 biopsy-proven, newly diagnosed carcinoma lung patients who were treated with definitive intent from January 2017 to June 2018. The radiation dose was delivered using a 3D conformal radiation therapy (CRT)/intensity-modulated radiotherapy (IMRT)/volumetric modulated arc therapy (VMAT) plan to a dose of 6000 to 6600 cGy in 30 or more fractions to the whole primary. All patients underwent 4D CT scan on the Elekta machine where all the 10 phases of respiration in free breathing were recorded. These phases are fused with CT simulation images, on which gross tumor volume (GTV) and clinical target volume (CTV) are contoured in all phases of respiration. Following this, an internal target volume (ITV) was created by measuring tumor motion all the directions from the center of tumor and PTV was concluded. Results The mean ITV for tumor in all six directions, that is, in superior, inferior, anterior, posterior, medial and lateral directions was 0.9, 0.9, 0.8, 0.9, 0.8, and 0.9 cm, respectively. For coverage of tumor for 90% of patients, the margins required in superior, inferior, anterior, posterior, medial, and lateral directions were 1.3, 1.5, 1.5, 1.4, 1.5, and 1.3 cm, respectively. Other factors such as size of the tumor and location of the tumor did not significantly contribute to PTV changes in our study. Conclusion Mean ITV for tumor in all six directions summed up to be 0.8 cm, but there was significant movement in inferior direction for upper lobe tumors (0.9 cm) (p = 0.008), in medial direction for middle lobe tumors (0.8 cm) (p = 0.05), and in medial direction for lower lobe tumors (0.75 cm) (p = 0.005).
{"title":"Use of 4-Dimensional Cone Beam Computed Tomography Scan to Estimate the Planning Target Volume Margin in Lung Tumors","authors":"B. Reddy, Rashmi Shivananjappa, Geeta S.N, R. Tiwari","doi":"10.1055/s-0040-1714304","DOIUrl":"https://doi.org/10.1055/s-0040-1714304","url":null,"abstract":"Abstract Introduction This study aimed to estimate the planning target volume (PTV) margin in lung tumors using 4D computed tomography (CT) scan and evaluate other factors that have an effect on tumor motion. Materials and Methods We recruited 43 biopsy-proven, newly diagnosed carcinoma lung patients who were treated with definitive intent from January 2017 to June 2018. The radiation dose was delivered using a 3D conformal radiation therapy (CRT)/intensity-modulated radiotherapy (IMRT)/volumetric modulated arc therapy (VMAT) plan to a dose of 6000 to 6600 cGy in 30 or more fractions to the whole primary. All patients underwent 4D CT scan on the Elekta machine where all the 10 phases of respiration in free breathing were recorded. These phases are fused with CT simulation images, on which gross tumor volume (GTV) and clinical target volume (CTV) are contoured in all phases of respiration. Following this, an internal target volume (ITV) was created by measuring tumor motion all the directions from the center of tumor and PTV was concluded. Results The mean ITV for tumor in all six directions, that is, in superior, inferior, anterior, posterior, medial and lateral directions was 0.9, 0.9, 0.8, 0.9, 0.8, and 0.9 cm, respectively. For coverage of tumor for 90% of patients, the margins required in superior, inferior, anterior, posterior, medial, and lateral directions were 1.3, 1.5, 1.5, 1.4, 1.5, and 1.3 cm, respectively. Other factors such as size of the tumor and location of the tumor did not significantly contribute to PTV changes in our study. Conclusion Mean ITV for tumor in all six directions summed up to be 0.8 cm, but there was significant movement in inferior direction for upper lobe tumors (0.9 cm) (p = 0.008), in medial direction for middle lobe tumors (0.8 cm) (p = 0.05), and in medial direction for lower lobe tumors (0.75 cm) (p = 0.005).","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"06 1","pages":"127 - 133"},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1714304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49437261","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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