Journal of cancer research and therapeutics最新文献

Abstract: Oxaliplatin is a common drug used in the management of colorectal malignancies. Rare neurological side effects including amaurosis fugax, urinary retention, stroke, cranial nerve palsy, dysarthria, and dysphagia have been reported in the literature. Usually, such incidences are reported immediately after 1st dose of oxaliplatin infusion. We report a rare transient ischemic attack (TIA))-like side effects after 2nd dose of oxaliplatin infusion.

Purpose/objective: Endometrial carcinoma (EC) is the third most common gynecological malignancy in India. Recent PORTEC-3 analysis emphasized the role of central histopathological review. We aimed to retrospectively analyze the demographic and histopathological characteristics of EC patients treated at our institute and assess the impact of the central histopathological review on management and also analyze clinical outcomes in this cohort of patients.

Materials and methods: Data of 75 EC patients treated at our center between 2013 and 2022 were retrieved from our departmental archives. Patients were analyzed for demographic details, histopathological findings, details of surgery and histopathology (HPE), results of a review of HPE, adjuvant treatment details, and clinical outcomes. All patients with HPE outside of our institute were reviewed at our center prior to initiation of treatment. In cases of discordance, patients were discussed in the multidisciplinary tumor board for the final treatment decisions. Patients were staged as per International Federation of Gynaecology and Obstetrics 2018.

Result: The median age was 57 years (range: 37-74 years). Twenty-seven patients with HPE reported from the outside center were reviewed at our institute and changes were observed in 26 patients (96.3%). HPE review changes were observed in terms of histological grade, histological type, myometrial invasion, and lymph node involvement in five (18.5%), three (11.1%), seven (25.9%), and three (42.8%), respectively. HPE review leads to changes in the management of 19/26 patients. Stage distribution was I: II: III in 48 (64%): 9 (13.3%): 18 (24%) patients, respectively. The median external beam radiotherapy dose was 50 Gray (range: 45-50.4 Gray at 1.8-2 Gray per fraction). The median brachytherapy dose for patients treated with brachytherapy alone was 7 Gray each for three sessions and in combination with EBRT was 6 Gray each in two sessions. At a median follow-up of 51 months (range: 6-116 months), seven (9.3%) patients developed distant metastasis, two (2.7%) patients had local plus distant metastasis, and two (2.7%) patients had local recurrence. The overall survival and disease-free survival rates at 3 years were 93.5% and 86.7%, respectively.

Conclusion: EC patients treated at our center have excellent local control rates with a combination of external beam radiotherapy and brachytherapy. The central histopathological review may result in changes impacting patient management and should be routinely done prior to initiation of treatment in EC.

Abstract: Hepatocellular carcinoma (HCC) is much rarer in children and adolescents in comparison to adults with an incidence of 0.7/1,000,000 per year. Hepatitis B virus, a known carcinogen increases the chances of HCC at a young age. Very few case reports of HCC developing in HBV-positive male children have been published.We present a case of a 14-year-old Hepatitis B-positive boy who presented with abdominal distension and jaundice. Contrast enhanced computerized tomography (CECT) whole abdomen suggested a diagnosis of multinodular HCC with no evidence of metastasis on FDG PET-CECT. Histopathology with immunohistochemistry confirmed the diagnosis of moderately differentiated HCC.Clinical presentation of HCC in children is similar to adults. Viral hepatitis, metabolic disorders, and male gender increase the risk of HCC. In our case, boy never had any prior history of jaundice, abdominal pain/distension, or any other illness suggestive of liver dysfunction. When the boy was found to be HBV positive, his mother was also screened and turned out to be Hepatitis B virus positive. Histopathology along with a panel of immunohistochemical markers clinched the final diagnosis.

Abstract: Acute gastroenteritis is the most common clinical manifestation of Vibrio cholerae infection. Cases of non-O1 V. cholerae infections in cancer patients have been previously reported in the literature. To our best knowledge, this is a unique case of V. cholerae classical biotype, serovar Ogawa infection in a young female patient with gastric malignancy.

Introduction: Deep inspiratory breath hold is one of the techniques for reducing the heart doses for left breast cancers. This study was conducted to confirm use of physical parameters from DIBH simulation CT scan like DIBH amplitude alongside several novel parameters to predict the heart dose reduction.

Materials and methods: Segmentation and planning of radiation to the left breast on the free breathing (FB) and DIBH simulation scan was performed for 50 left-sided breast cancer patients treated with DIBH technique. Physical parameters, namely DIBH amplitude, anterior sternal displacement, diaphragmatic excursion, ratio of lung volume (cc) in DIBH scan to lung volume in FB scan (cc), and delta heart volume in field (DHVIF), were extracted and were compared with magnitude of heart dose reduction (mean heart dose, V30Gy, and D5%).

Results: Forty-eight (96%) patients achieved reduction in the mean heart dose with DIBH technique, while all patients had reduction in V30Gy. The median reduction was 41%, 89.7%, and 63% in the mean dose, V30Gy, and D5%, respectively. While DIBH did not correlate with heart dose reduction, ratio of lung volumes and DHVIF showed a strong positive correlation with heart dose reduction (P < 0.05). Sternal displacement correlated weakly with heart dose reduction but strongly with DHVIF, demonstrating to be an indirect predictor.

Conclusions: Physical parameters like anterior sternal displacement, ratio of lung volumes of DIBH to FB, and possibly diaphragmatic movement can predict the dose reduction before the dose calculations by the physicist. These parameters can be used to construct a model to predict heart dose reduction.

Objective: To develop new two-dimensional geometric parameters for pulmonary and cardiac dose estimation in left-sided breast cancer radiation therapy without dose-volume histogram (DVH).

Methods: On the CT image of 90 patients with left breast cancer, treatment planning was performed using two opposed tangent fields with/without supraclavicular. The field-in-field technique and 6MV photons were used. From DVH dosimetric parameters of mean dose, Vx (x (Gy) =5, 10, 15, 20, 30, 40, 50) were calculated, and from heart and lung outlines on the beam's eye view, new geometric parameters of percent of lung area in tangent and supraclavicular fields (%area of the lung in the tangent (ALT), %ALS) and percent of heart in tangent field (%area of the heart in the tangent (AHT)) were measured. Correlation, regression, and diagnostic performance by receiver operating characteristic curve (ROC) were investigated for statistical analysis.

Results: The Pearson coefficient between %ALT and Vx (x = 10, 15, 20, 30, 40) show strong correlation in patient treatment with only opposed tangents (>0.85) and weaker in treatment by opposed tangents with supraclavicular (0.56-0.88), the %ALS indicate weak correlation (<0.5) and %AHT show strong correlation (0.93-0.98). The regression analysis shows a positive relation between %ALT and mean dose (R2 = 0.8), V20Gy (R2 = 0.9) in the lung (tangent treatment), and between %AHT and mean dose (R2 = 0.9), V20Gy (R2 = 1.0) in the heart. The ROC analysis shows by %ALT <20.3 for treatment by just opposed fields, %ALT <22.1% for treatment tangents with supra, and %AHT <11.6%, practical lung and heart dose constraints are addressed.

Conclusion: The proposed geometric parameters could replace previous one-dimensional maximum and central distances for predicting doses to lung and heart.

Advances in knowledge: This study presents simple geometric parameters that could estimate pulmonary and cardiac dose in left breast cancer treatment from a 2D radiograph.

Abstract: Sweet syndrome is a rare, etiologically unknown dermatosis that can be idiopathic or associated with certain clinical conditions. Among these conditions are infections, autoimmune diseases, inflammatory bowel diseases, vaccinations, the use of medications, and neoplasias. Hematological neoplasias, particularly acute myeloid leukemia, are the most commonly described; however, the condition may also be related to solid tumors, being those of the genitourinary tract the most associated with the syndrome. Drug-induced Sweet syndrome has also been reported; however, it is rarely seen. We report a case of 59 years old male patient with a diagnosis of carcinoma urinary bladder, who developed skin eruption after infusion of the first cycle of chemotherapy (gemcitabine and cisplatin) and resolved after treatment with steroids. The diagnosis of Sweet syndrome was confirmed only after skin biopsy, cultures and laboratory investigations. Malignancy as the cause of skin eruptions was eliminated by the fact that it occurred only after infusion of chemotherapy and the tumor was still there in the bladder, and skin eruptions did not occur after stopping steroids.

Abstract: Polymorphous adenocarcinoma (PAC) of head and neck tumors is a rare salivary gland neoplasm of indolent course. We reported a 63-year-old female who presented as an asymptomatic mass in buccal space. The patient, after metastatic workup, underwent complete excision of the lesion with a negative margin. Postoperative histopathology and immunohistochemistry (IHC) were suggestive of PAC. Presently patient is on follow-up as per a multidisciplinary team decision. To conclude, PAC diagnosis is challenging due to morphological diversity, which necessities IHC. In addition, presently treatment of choice as per the literature review is complete excision.

Background: Esophageal cancer (EC) is an extremely aggressive tumor with one of the highest geographic, ethnic, and gender variations. Various factors including tobacco consumption, unhealthy diet, and socioeconomic status have been implicated in the etiology of EC. Despite the advent of modern treatments, the prognosis of EC is dismal. This study has been undertaken to review the clinical and pathologic profiles, treatment approach, and survival pattern in patients with EC in a tertiary care hospital in northeast India.

Materials and methods: A retrospective descriptive study was done with 179 EC patients presented to our department between January 2013 and December 2020. Statistical analysis was done by using IBM Statistical Package for the Social Sciences version 21. P- value <0.05 was considered significant.

Results: The majority of the patients presented in the sixth decade of life from rural areas with male to female ratio of 3.7:1. Dysphagia was the most common presenting feature. High incidence of tobacco and alcohol use was found. Mid-esophagus is the most common site and squamous cell carcinoma is the most common type. Fifty-two (29.1%) and 71 (39.6%) patients presented in stages III and IV, respectively. Twenty-four (13.4%) patients presented with metastatic disease, the lung being the most common site. Patients were treated with surgery, chemotherapy, radiotherapy, or combination of any of these. Overall median survival for the EC patients was 6 months. Patients treated with concurrent chemoradiation had better survival.

Conclusion: EC is a serious malignancy with a dismal prognosis due to the advanced stage at presentation. Larger clinical trials using new therapeutic strategies are the need of the hour.