E. Kaushik, Ankush Nayyar, Tejeshwar Singh Jugpal, A. Thakur
Malignant lymphoma of the thyroid gland is a rare entity, and the frequency of T-cell lymphoma is even rarer. We present a case of malignant T-cell lymphoma of the thyroid gland that developed in a 73-year-old woman. The patient with a history of Hashimoto's thyroiditis presented to us with the chief complaint of rapidly increasing neck swelling and breathing difficulty. Computed tomography (CT) of the neck showed a large thyroid gland with marked mass effect on the airway and the surrounding structures and was extending into the superior mediastinum. Cytology gave a diagnosis of Bethesda Category VI, positive for malignancy lymphoma. The diagnosis was confirmed on histopathological examination and immunohistochemical examination. Further, positron emission tomography CT scan ruled out any involvement beyond the locoregional region and hence suggested thyroid lymphoma as the primary disease.
{"title":"CD8-positive T-cell lymphoma of the thyroid: A rare case","authors":"E. Kaushik, Ankush Nayyar, Tejeshwar Singh Jugpal, A. Thakur","doi":"10.4103/oji.oji_1_23","DOIUrl":"https://doi.org/10.4103/oji.oji_1_23","url":null,"abstract":"Malignant lymphoma of the thyroid gland is a rare entity, and the frequency of T-cell lymphoma is even rarer. We present a case of malignant T-cell lymphoma of the thyroid gland that developed in a 73-year-old woman. The patient with a history of Hashimoto's thyroiditis presented to us with the chief complaint of rapidly increasing neck swelling and breathing difficulty. Computed tomography (CT) of the neck showed a large thyroid gland with marked mass effect on the airway and the surrounding structures and was extending into the superior mediastinum. Cytology gave a diagnosis of Bethesda Category VI, positive for malignancy lymphoma. The diagnosis was confirmed on histopathological examination and immunohistochemical examination. Further, positron emission tomography CT scan ruled out any involvement beyond the locoregional region and hence suggested thyroid lymphoma as the primary disease.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121713275","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}
Setu Shah, Isha Shah, N. Dash, V. Shivhare, Ankita Parikh
Sebaceous gland malignancies represent one of the rare and potentially aggressive types of skin neoplasms arising from the sebaceous gland's epithelium. Sebaceous carcinoma of nasal location is an extremely rare site of presentation as well as a rare cutaneous malignancy. Herein, we present a case of a 50-year-old female with sebaceous carcinoma of the nose that came to our hospital with a mass in her left nasal cavity and was operated as well as received adjuvant therapy for the same. The patient is doing well at 24 months of follow-up without any evidence of disease recurrence or residual. We discuss the clinical, pathological, radiological findings, and management of the same. Careful clinical history, histopathological examination, and radiologic findings are all important for the correct diagnosis of sebaceous carcinoma of the nasal cavity. Since there is no standard treatment available for this tumor, one needs to be aware about the treatment options available.
{"title":"Nasal sebaceous carcinoma: A case treated at a tertiary care center","authors":"Setu Shah, Isha Shah, N. Dash, V. Shivhare, Ankita Parikh","doi":"10.4103/oji.oji_9_23","DOIUrl":"https://doi.org/10.4103/oji.oji_9_23","url":null,"abstract":"Sebaceous gland malignancies represent one of the rare and potentially aggressive types of skin neoplasms arising from the sebaceous gland's epithelium. Sebaceous carcinoma of nasal location is an extremely rare site of presentation as well as a rare cutaneous malignancy. Herein, we present a case of a 50-year-old female with sebaceous carcinoma of the nose that came to our hospital with a mass in her left nasal cavity and was operated as well as received adjuvant therapy for the same. The patient is doing well at 24 months of follow-up without any evidence of disease recurrence or residual. We discuss the clinical, pathological, radiological findings, and management of the same. Careful clinical history, histopathological examination, and radiologic findings are all important for the correct diagnosis of sebaceous carcinoma of the nasal cavity. Since there is no standard treatment available for this tumor, one needs to be aware about the treatment options available.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124374816","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}
D. Das, S. Das Majumdar, S. Barik, Pritinanda Mishra, G. Parida, Anupama Muraleedharan, D. Parida, Mukund Sable, R. Patel, M. Shahin
A burned-out tumor of the testis is a rare clinical entity. It usually regresses spontaneously without any treatment and presents as metastasis to the retroperitoneum, mediastinum, cervical region, lungs, and liver. Clinical examination and ultrasound of the testis are pivotal to raising suspicion for the diagnosis of the burned-out tumor. Here, we report a case of a 23-year-old male who presented to us with a complaint of swelling on the left side of the neck. Biopsy from the neck mass suggested metastatic malignant mixed germ cell tumor, consistent with yolk sac tumor and embryonal carcinoma. The whole-body fluorodeoxyglucose-positron emission tomography-computed tomography suggested conglomerated left neck mass and retroperitoneal lymph node enlargement. Ultrasound of the scrotum suggested heterogeneously hypoechoic echotexture with few foci of microcalcification in the right testes. He underwent a right high inguinal orchidectomy, which showed no evidence of the tumor. The patient received four cycles of chemotherapy with bleomycin, etoposide, and a cisplatin-based combination regimen with a favorable response to the therapy. In view of residual viable disease and raised tumor markers, the patient received second-line chemotherapy with paclitaxel, ifosfamide, and carboplatin.
{"title":"Burned-out testicular tumor presenting as cervical and retroperitoneal lymphadenopathy","authors":"D. Das, S. Das Majumdar, S. Barik, Pritinanda Mishra, G. Parida, Anupama Muraleedharan, D. Parida, Mukund Sable, R. Patel, M. Shahin","doi":"10.4103/oji.oji_5_23","DOIUrl":"https://doi.org/10.4103/oji.oji_5_23","url":null,"abstract":"A burned-out tumor of the testis is a rare clinical entity. It usually regresses spontaneously without any treatment and presents as metastasis to the retroperitoneum, mediastinum, cervical region, lungs, and liver. Clinical examination and ultrasound of the testis are pivotal to raising suspicion for the diagnosis of the burned-out tumor. Here, we report a case of a 23-year-old male who presented to us with a complaint of swelling on the left side of the neck. Biopsy from the neck mass suggested metastatic malignant mixed germ cell tumor, consistent with yolk sac tumor and embryonal carcinoma. The whole-body fluorodeoxyglucose-positron emission tomography-computed tomography suggested conglomerated left neck mass and retroperitoneal lymph node enlargement. Ultrasound of the scrotum suggested heterogeneously hypoechoic echotexture with few foci of microcalcification in the right testes. He underwent a right high inguinal orchidectomy, which showed no evidence of the tumor. The patient received four cycles of chemotherapy with bleomycin, etoposide, and a cisplatin-based combination regimen with a favorable response to the therapy. In view of residual viable disease and raised tumor markers, the patient received second-line chemotherapy with paclitaxel, ifosfamide, and carboplatin.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123812971","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}
Debadutta Senapati, Sudhansu Mishra, Sanjib Mishra, Tapaprakash Behera
Xanthogranulomatous hypophysitis (XGH) is an inflammatory disease of the pituitary gland that has clinical presentation and radiologic features similar to a neoplastic lesion. We report a rare case of XGH in an elderly male of 61-year-old age presenting with features of a pituitary macroadenoma with apoplexy. Clinical features and radiologic findings can be confusing and misleading. Surgical resection is the preferred method for treatment and establishing the final diagnosis from biopsy. Attention should be paid to the management of hypopituitarism and diabetes insipidus. Preoperative diagnosis is difficult and a high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.
{"title":"Xanthogranulomatous hypophysitis masquerading as pituitary macroadenoma","authors":"Debadutta Senapati, Sudhansu Mishra, Sanjib Mishra, Tapaprakash Behera","doi":"10.4103/oji.oji_11_23","DOIUrl":"https://doi.org/10.4103/oji.oji_11_23","url":null,"abstract":"Xanthogranulomatous hypophysitis (XGH) is an inflammatory disease of the pituitary gland that has clinical presentation and radiologic features similar to a neoplastic lesion. We report a rare case of XGH in an elderly male of 61-year-old age presenting with features of a pituitary macroadenoma with apoplexy. Clinical features and radiologic findings can be confusing and misleading. Surgical resection is the preferred method for treatment and establishing the final diagnosis from biopsy. Attention should be paid to the management of hypopituitarism and diabetes insipidus. Preoperative diagnosis is difficult and a high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133839236","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}
A. Ray, N. Kalita, N. Mahanta, A. Ali, Madhav Kashyap
Background: Trastuzumab (Herceptin) is used in human epidermal growth factor receptor-2 (HER2)-positive breast cancer patients either alone or in combination with various chemotherapeutic agents in the neoadjuvant, adjuvant as well as palliative settings. Cardiotoxicity remains an issue of concern with the use of trastuzumab which may be enhanced with the prior use of anthracycline-based chemotherapeutic agents. Aim: This prospective study was conducted with the aim of identifying the occurrence of cardiotoxicity in patients receiving trastuzumab with or without a history of prior use of anthracycline-based chemotherapy. Materials and Methods: The study was conducted over a period of 1½ years. All the HER2-positive breast cancer patients who received trastuzumab-based therapy in adjuvant as well as maintenance settings and the cardiotoxicity in terms of drop in left ventricular ejection fraction (LVEF) from the lower limit of normal range were evaluated. A significant drop is defined when LVEF drop is >10%. Cardiotoxicity was compared between those who received prior anthracycline-based chemotherapy versus nonanthracycline-based chemotherapy. Results: A total of 62 HER2-positive breast cancer patients who fulfilled the inclusion and exclusion criteria were enrolled for analysis. Thirty-two patients received prior anthracycline-based chemotherapy and 30 patients received nonanthracycline-based chemotherapy. A significant drop in LVEF of >10% was found in 20 out of 62 patients (32.3%). This significant drop in LVEF was found more in those patients who received prior anthracycline-based chemotherapy (n = 15) versus who did not receive prior anthracycline-based chemotherapy (n = 5) (46.9% vs. 16.7%; P = 0.0109). Conclusion: Trastuzumab-induced cardiotoxicity (LVEF drop >10%) is higher among breast cancer patients who received prior anthracycline-based chemotherapy as compared to those who did not receive prior anthracycline. This clinically significant drop in LVEF warranted an interruption in the treatment till stabilization and improvement of the cardiac function.
背景:曲妥珠单抗(赫赛汀)用于人表皮生长因子受体2 (HER2)阳性乳腺癌患者，可单独使用或与各种化疗药物联合使用，用于新辅助、辅助和姑息治疗。心脏毒性仍然是使用曲妥珠单抗的一个值得关注的问题，这可能会因先前使用蒽环类化疗药物而增强。目的:这项前瞻性研究的目的是确定接受曲妥珠单抗治疗的患者是否有蒽环类药物化疗史。材料与方法:本研究历时1年半。所有接受以曲妥珠单抗为基础的辅助和维持治疗的her2阳性乳腺癌患者以及左心室射血分数(LVEF)从正常范围下限下降的心脏毒性进行了评估。当LVEF下降>10%时为显著下降。比较先前接受蒽环类药物化疗与非蒽环类药物化疗的患者的心脏毒性。结果:共纳入62例符合纳入和排除标准的her2阳性乳腺癌患者进行分析。32例患者先前接受了蒽环类药物化疗，30例患者接受了非蒽环类药物化疗。62例患者中有20例(32.3%)LVEF显著下降>10%。先前接受过蒽环类药物化疗的患者(n = 15)与未接受蒽环类药物化疗的患者(n = 5)相比，LVEF的显著下降更为明显(46.9% vs. 16.7%;P = 0.0109)。结论:曲妥珠单抗诱导的心脏毒性(LVEF下降>10%)在先前接受过蒽环类药物化疗的乳腺癌患者中高于先前未接受蒽环类药物化疗的患者。这种临床上显著的LVEF下降需要中断治疗，直到心功能稳定和改善。
{"title":"Cardiotoxicity in breast cancer patients receiving trastuzumab with or without prior anthracycline-based chemotherapy: A prospective study from a tertiary cancer institute at Guwahati, India","authors":"A. Ray, N. Kalita, N. Mahanta, A. Ali, Madhav Kashyap","doi":"10.4103/oji.oji_31_22","DOIUrl":"https://doi.org/10.4103/oji.oji_31_22","url":null,"abstract":"Background: Trastuzumab (Herceptin) is used in human epidermal growth factor receptor-2 (HER2)-positive breast cancer patients either alone or in combination with various chemotherapeutic agents in the neoadjuvant, adjuvant as well as palliative settings. Cardiotoxicity remains an issue of concern with the use of trastuzumab which may be enhanced with the prior use of anthracycline-based chemotherapeutic agents. Aim: This prospective study was conducted with the aim of identifying the occurrence of cardiotoxicity in patients receiving trastuzumab with or without a history of prior use of anthracycline-based chemotherapy. Materials and Methods: The study was conducted over a period of 1½ years. All the HER2-positive breast cancer patients who received trastuzumab-based therapy in adjuvant as well as maintenance settings and the cardiotoxicity in terms of drop in left ventricular ejection fraction (LVEF) from the lower limit of normal range were evaluated. A significant drop is defined when LVEF drop is >10%. Cardiotoxicity was compared between those who received prior anthracycline-based chemotherapy versus nonanthracycline-based chemotherapy. Results: A total of 62 HER2-positive breast cancer patients who fulfilled the inclusion and exclusion criteria were enrolled for analysis. Thirty-two patients received prior anthracycline-based chemotherapy and 30 patients received nonanthracycline-based chemotherapy. A significant drop in LVEF of >10% was found in 20 out of 62 patients (32.3%). This significant drop in LVEF was found more in those patients who received prior anthracycline-based chemotherapy (n = 15) versus who did not receive prior anthracycline-based chemotherapy (n = 5) (46.9% vs. 16.7%; P = 0.0109). Conclusion: Trastuzumab-induced cardiotoxicity (LVEF drop >10%) is higher among breast cancer patients who received prior anthracycline-based chemotherapy as compared to those who did not receive prior anthracycline. This clinically significant drop in LVEF warranted an interruption in the treatment till stabilization and improvement of the cardiac function.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121292019","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}
Phyllodes tumor (PT) constitutes <1% of breast tumors. Malignancy usually arises from the stromal component forming homologous or heterologous elements such as chondrosarcoma, liposarcoma, fibrosarcoma, osteosarcoma, or rhabdomyosarcoma. Rarely, carcinoma can arise from the epithelial cells within the PT. Rarer is the occurrence of collision tumor of malignant phyllodes and carcinoma in the breast which lacks the exact incidence since only few cases are reported in the literature. This is another such rare case of synchronous collision tumor of malignant phyllodes having chondrosarcomatous and osteosarcomatous differentiation associated with invasive and in situ ductal carcinoma having metastatic carcinomatous deposits in axillary lymph nodes in a 43-year-old female. Hence, extensive sampling of the gross specimen is crucial in diagnosing the collision tumors which are not detected either in breast imaging studies or during the surgery. Since malignant PT usually spreads through a hematogenous route, it has to be treated by wide local excision or simple mastectomy without the axillary lymph node dissection. If a PT is associated with carcinoma, the patient management and prognosis depend on the stage of the carcinoma.
{"title":"Synchronous collision tumor of malignant phyllodes and invasive ductal carcinoma","authors":"U. Pai, A. Kavalakat, Nikita Thomas","doi":"10.4103/oji.oji_11_22","DOIUrl":"https://doi.org/10.4103/oji.oji_11_22","url":null,"abstract":"Phyllodes tumor (PT) constitutes <1% of breast tumors. Malignancy usually arises from the stromal component forming homologous or heterologous elements such as chondrosarcoma, liposarcoma, fibrosarcoma, osteosarcoma, or rhabdomyosarcoma. Rarely, carcinoma can arise from the epithelial cells within the PT. Rarer is the occurrence of collision tumor of malignant phyllodes and carcinoma in the breast which lacks the exact incidence since only few cases are reported in the literature. This is another such rare case of synchronous collision tumor of malignant phyllodes having chondrosarcomatous and osteosarcomatous differentiation associated with invasive and in situ ductal carcinoma having metastatic carcinomatous deposits in axillary lymph nodes in a 43-year-old female. Hence, extensive sampling of the gross specimen is crucial in diagnosing the collision tumors which are not detected either in breast imaging studies or during the surgery. Since malignant PT usually spreads through a hematogenous route, it has to be treated by wide local excision or simple mastectomy without the axillary lymph node dissection. If a PT is associated with carcinoma, the patient management and prognosis depend on the stage of the carcinoma.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122177608","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}
M. Nagarajan, R. Banu, Ananthakrishnan Radha, Sasikala Saranya
Background: Head-and-neck cancers are one of the most common cancers in the Indian subcontinent. The rising incidence of human papillomavirus (HPV), especially in oropharyngeal cancers is likely to increase the burden by many folds. Hence, we decided to study the incidence of HPV in oropharyngeal carcinoma and its characteristics. Materials and Methods: Patients with primary squamous cell carcinoma (SCC) of the oropharynx registered in our hospital between September 2018 and July 2020 were included in the study after obtaining informed consent. A total of 60 patients were included in the study. The evaluation of HPV status was done by immunohistochemistry for p16 expression. Results: The median age of presentation was 60 years (range: 38–85 years). Fifty-four patients were male and six patients were female. The incidence of HPV in oropharyngeal carcinoma was 21.7% (n = 13). There was no difference seen when we compare HPV-positive patients with HPV-negative patients as well as with the entire study population for the demographic characteristics such as age (P = 0.569), gender (P = 0.754), smoker (P = 0.368), history of alcohol consumption (P = 0.558), and history of tobacco chewing (P = 0.781). We did not find any association between HPV-positive and HPV-negative patients with anatomical subsites (P = 0.369), tumor stage (P = 0.397), and nodal stage (P = 0.592). HPV-positive oropharyngeal SCC (OPSCC) patients presented more at early stage as compared to HPV-negative patients (P = 0.005). HPV-positive patients had higher incidence of histological poor differentiation than HPV-negative patients (P = 0.024). Conclusion: The study highlighted the incidence of HPV (21.7%) among OPSCC patients using p16 expression. HPV-positive patients have propensity for early stage of presentation and histological poor differentiation. The demographic characteristics and anatomical subsites of OPSCC had no impact on HPV status.
{"title":"Incidence and characteristics of human papillomavirus-positive oropharyngeal cancers by p16 expression","authors":"M. Nagarajan, R. Banu, Ananthakrishnan Radha, Sasikala Saranya","doi":"10.4103/oji.oji_18_21","DOIUrl":"https://doi.org/10.4103/oji.oji_18_21","url":null,"abstract":"Background: Head-and-neck cancers are one of the most common cancers in the Indian subcontinent. The rising incidence of human papillomavirus (HPV), especially in oropharyngeal cancers is likely to increase the burden by many folds. Hence, we decided to study the incidence of HPV in oropharyngeal carcinoma and its characteristics. Materials and Methods: Patients with primary squamous cell carcinoma (SCC) of the oropharynx registered in our hospital between September 2018 and July 2020 were included in the study after obtaining informed consent. A total of 60 patients were included in the study. The evaluation of HPV status was done by immunohistochemistry for p16 expression. Results: The median age of presentation was 60 years (range: 38–85 years). Fifty-four patients were male and six patients were female. The incidence of HPV in oropharyngeal carcinoma was 21.7% (n = 13). There was no difference seen when we compare HPV-positive patients with HPV-negative patients as well as with the entire study population for the demographic characteristics such as age (P = 0.569), gender (P = 0.754), smoker (P = 0.368), history of alcohol consumption (P = 0.558), and history of tobacco chewing (P = 0.781). We did not find any association between HPV-positive and HPV-negative patients with anatomical subsites (P = 0.369), tumor stage (P = 0.397), and nodal stage (P = 0.592). HPV-positive oropharyngeal SCC (OPSCC) patients presented more at early stage as compared to HPV-negative patients (P = 0.005). HPV-positive patients had higher incidence of histological poor differentiation than HPV-negative patients (P = 0.024). Conclusion: The study highlighted the incidence of HPV (21.7%) among OPSCC patients using p16 expression. HPV-positive patients have propensity for early stage of presentation and histological poor differentiation. The demographic characteristics and anatomical subsites of OPSCC had no impact on HPV status.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134256939","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}
Sumana Choudhary, A. Saxena, Megha Bajaj, Ashima Thakur, Mayank Sonkar
Persistent chronic pain is the most common residual complaint in cancer survivors; its etiology being neoplastic process, postcancer treatment, or any other concurrent disorders. Growing concern about pain management in cancer survivors throws a mammoth challenge because more than 40% of cancer survivors now live longer than 10 years. Due to limited studies on persistent chronic pain in cancer survivors other than breast cancer, this enormous challenge remains in pain management in these cancer survivors. There are innumerable predictive factors for the development of persistent pain after cancer surgeries. It would be more prudent to concentrate on chronic pain mechanisms despite holding on to categorial risk factors and implanting them into patient outcomes. An effort should be made to a more holistic management of nociceptive and neuropathic pain in cancer survivor patients of Head and Neck, Prostate, and Lung carcinoma patients. In this article, we have tried to review the literature on managing chronic persistent pain in all cancer survivors, excluding carcinoma of the breast. In conclusion, we would like to emphasize that for an improved or excellent outcome of chronic persistent pain in cancer survivors, a holistic, multimodal approach encompassing pain relief techniques and pain relief strategies, relaxation exercises, cognitive behavioral therapy, and neuro-rehabilitative strategies would prove to be of immense help. A joint understanding between the pain management expert and the cancer survivors can result in beneficial outcomes.
{"title":"Persistent chronic pain in cancer survivors: An update and future directions","authors":"Sumana Choudhary, A. Saxena, Megha Bajaj, Ashima Thakur, Mayank Sonkar","doi":"10.4103/oji.oji_41_21","DOIUrl":"https://doi.org/10.4103/oji.oji_41_21","url":null,"abstract":"Persistent chronic pain is the most common residual complaint in cancer survivors; its etiology being neoplastic process, postcancer treatment, or any other concurrent disorders. Growing concern about pain management in cancer survivors throws a mammoth challenge because more than 40% of cancer survivors now live longer than 10 years. Due to limited studies on persistent chronic pain in cancer survivors other than breast cancer, this enormous challenge remains in pain management in these cancer survivors. There are innumerable predictive factors for the development of persistent pain after cancer surgeries. It would be more prudent to concentrate on chronic pain mechanisms despite holding on to categorial risk factors and implanting them into patient outcomes. An effort should be made to a more holistic management of nociceptive and neuropathic pain in cancer survivor patients of Head and Neck, Prostate, and Lung carcinoma patients. In this article, we have tried to review the literature on managing chronic persistent pain in all cancer survivors, excluding carcinoma of the breast. In conclusion, we would like to emphasize that for an improved or excellent outcome of chronic persistent pain in cancer survivors, a holistic, multimodal approach encompassing pain relief techniques and pain relief strategies, relaxation exercises, cognitive behavioral therapy, and neuro-rehabilitative strategies would prove to be of immense help. A joint understanding between the pain management expert and the cancer survivors can result in beneficial outcomes.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132673883","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}
Sudhir Palsaniya, S. Saini, A. Samar, S. Patni, A. Bapna
Background: Gallbladder cancer (GBC) has a high incidence rate in the Indo-Gangetic belt and is usually presented in the unresectable advanced or metastatic stage. In this study, we evaluated the response rate and toxicities of the gemcitabine plus capecitabine (GEM-CAP)-based combination chemotherapy in unresectable or metastatic GBC patients. Subjects and Methods: This was an investigator-initiated, single-arm, prospective study conducted on unresectable or metastatic GBC patients at Jaipur, India, for 1 year. All the patients received a GEM-CAP combination chemotherapy regimen which consisted of gemcitabine 1000 mg/m2 intravenously over 30 min on days 1 and 8 and capecitabine at 800 mg/m2 orally twice a day for 14 days, administered every 21 days. The response was evaluated in terms of overall response rate (ORR), tumor control rate (TCR), and progression-free survival (PFS). Both quantitative and qualitative toxicities were assessed. Results: A total of 35 patients were enrolled, of which 3 patients were excluded due to treatment interruption. The mean age of patients was 55 (32–80) years, with the majority being female (77.14%), having an ECOG score of 1 (71.43%), and with Stage IVB disease (77.14%). The ORR was 25%, TCR was 50%, and median PFS was 4 months. Major toxicities noted were Grade I and II hematological and nonhematological toxicities, which were managed adequately. Conclusion: The combination therapy of gemcitabine and capecitabine is reasonable, feasible, and well-tolerated approach for the treatment of unresectable advanced and metastatic GBC patients, a disease that had limited treatment options.
{"title":"An investigator-initiated study of gemcitabine and capecitabine in Indian patients with unresectable or metastatic gallbladder cancer","authors":"Sudhir Palsaniya, S. Saini, A. Samar, S. Patni, A. Bapna","doi":"10.4103/oji.oji_8_22","DOIUrl":"https://doi.org/10.4103/oji.oji_8_22","url":null,"abstract":"Background: Gallbladder cancer (GBC) has a high incidence rate in the Indo-Gangetic belt and is usually presented in the unresectable advanced or metastatic stage. In this study, we evaluated the response rate and toxicities of the gemcitabine plus capecitabine (GEM-CAP)-based combination chemotherapy in unresectable or metastatic GBC patients. Subjects and Methods: This was an investigator-initiated, single-arm, prospective study conducted on unresectable or metastatic GBC patients at Jaipur, India, for 1 year. All the patients received a GEM-CAP combination chemotherapy regimen which consisted of gemcitabine 1000 mg/m2 intravenously over 30 min on days 1 and 8 and capecitabine at 800 mg/m2 orally twice a day for 14 days, administered every 21 days. The response was evaluated in terms of overall response rate (ORR), tumor control rate (TCR), and progression-free survival (PFS). Both quantitative and qualitative toxicities were assessed. Results: A total of 35 patients were enrolled, of which 3 patients were excluded due to treatment interruption. The mean age of patients was 55 (32–80) years, with the majority being female (77.14%), having an ECOG score of 1 (71.43%), and with Stage IVB disease (77.14%). The ORR was 25%, TCR was 50%, and median PFS was 4 months. Major toxicities noted were Grade I and II hematological and nonhematological toxicities, which were managed adequately. Conclusion: The combination therapy of gemcitabine and capecitabine is reasonable, feasible, and well-tolerated approach for the treatment of unresectable advanced and metastatic GBC patients, a disease that had limited treatment options.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117184121","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}
A. Rudresha, GH Abhilash, D. Lokanatha, M. Babu, K. Lokesh, L. Rajeev, S. Saldanha, L. Jacob, Amit Pandey, Priyesh Dubey, P. Babbar
Objective: The aim of this study was to evaluate if addition of metoclopramide to the triplet antiemetic therapy is superior to the triplet antiemetic therapy for prevention of delayed chemotherapy-induced nausea and vomiting. Materials and Methods: A randomized single-blind trial was performed on 200 chemotherapy-naïve breast cancer patients who have to receive anthracycline-based highly emetogenic chemotherapy (HEC). The patients were randomized to study arm (n = 100) and control arm (n = 100). Triplet antiemetic therapy (fosaprepitant on day 1, 5-HT3 antagonist on day 1, and dexamethasone for days 1–4) was used in both the arms and metoclopramide (day 1–5) was added to the study arm. Response to antiemetic prophylaxis was assessed in terms of “complete response (CR),” “only nausea,” and “both nausea and vomiting.” CR is defined as no nausea, no vomiting, and no rescue medication during the overall phase (days 1–5). Nausea/vomiting was detected by using the Visual Analog Scale and its impact on quality of life was determined by using the Functional Living Index Emesis (FLIE) score. Results: The demographical and clinical features were similar in both the groups. Majority of patients in both the arms presented with Eastern Cooperative Oncology Group PS 0, Stage III, and positive hormone receptor status. CR was observed more in the study arm than that of the control arm (51% vs. 37%; P = 0.046). The mean total FLIE score was 29.23 in the study arm and 31.16 in the control arm (P = 0.036). Conclusion: This study resulted in a significant CR and clinically relevant improvement in FLIE score for addition of metoclopramide to triple antiemetic prophylaxis. Therefore, a quadruple antiemetic combination including metoclopramide might be an antiemetic prophylaxis option for breast cancer patients receiving anthracycline-based HEC for better compliance to treatment.
{"title":"Addition of metoclopramide to triple antiemetic therapy towards prevention of anthracycline-based chemotherapy-induced nausea and vomiting in breast cancer patients","authors":"A. Rudresha, GH Abhilash, D. Lokanatha, M. Babu, K. Lokesh, L. Rajeev, S. Saldanha, L. Jacob, Amit Pandey, Priyesh Dubey, P. Babbar","doi":"10.4103/oji.oji_9_22","DOIUrl":"https://doi.org/10.4103/oji.oji_9_22","url":null,"abstract":"Objective: The aim of this study was to evaluate if addition of metoclopramide to the triplet antiemetic therapy is superior to the triplet antiemetic therapy for prevention of delayed chemotherapy-induced nausea and vomiting. Materials and Methods: A randomized single-blind trial was performed on 200 chemotherapy-naïve breast cancer patients who have to receive anthracycline-based highly emetogenic chemotherapy (HEC). The patients were randomized to study arm (n = 100) and control arm (n = 100). Triplet antiemetic therapy (fosaprepitant on day 1, 5-HT3 antagonist on day 1, and dexamethasone for days 1–4) was used in both the arms and metoclopramide (day 1–5) was added to the study arm. Response to antiemetic prophylaxis was assessed in terms of “complete response (CR),” “only nausea,” and “both nausea and vomiting.” CR is defined as no nausea, no vomiting, and no rescue medication during the overall phase (days 1–5). Nausea/vomiting was detected by using the Visual Analog Scale and its impact on quality of life was determined by using the Functional Living Index Emesis (FLIE) score. Results: The demographical and clinical features were similar in both the groups. Majority of patients in both the arms presented with Eastern Cooperative Oncology Group PS 0, Stage III, and positive hormone receptor status. CR was observed more in the study arm than that of the control arm (51% vs. 37%; P = 0.046). The mean total FLIE score was 29.23 in the study arm and 31.16 in the control arm (P = 0.036). Conclusion: This study resulted in a significant CR and clinically relevant improvement in FLIE score for addition of metoclopramide to triple antiemetic prophylaxis. Therefore, a quadruple antiemetic combination including metoclopramide might be an antiemetic prophylaxis option for breast cancer patients receiving anthracycline-based HEC for better compliance to treatment.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133731660","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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