Journal of cancer research and therapeutics最新文献

Abstract: Liposarcoma is a rare mesenchymal neoplasm commonly involving deep soft tissues and the retroperitoneum. Among the various types of liposarcoma, myxoid liposarcoma is the most frequently encountered in adolescents and young adults, with a predilection for lower extremities. Fine needle aspiration allows easy assessment and rapid on-site evaluation for distinguishing benign from malignant lipomatous lesions. Here, we present a case of myxoid liposarcoma in the calf region of a 19-year-old boy, diagnosed via fine needle aspiration cytology, and subsequently confirmed by histopathological examination after surgical resection. The intention behind this case report is to highlight the cytological features of myxoid liposarcoma and to improve understanding of this tumor entity, aiming to prevent misdiagnosis by inexperienced pathologists when evaluating cytology specimens.

Background: Reports suggested that hormone replacement therapy decreased the incidence of squamous cell carcinoma (SCC) of the oral cavity.

Aim: The aim of this study was to analyze and quantify the serum 17β-estradiol (E2) level by chemiluminescence immunoassay in four groups, Group I (control group with no habit of tobacco and areca), Group II (control group with a habit of tobacco and areca), Group III (potentially malignant disorder-leukoplakia), and Group IV (oral squamous cell carcinoma (OSCC)). It was the first study to evaluate E2 in four study groups with and without the habit of tobacco.

Method: The serum analysis was carried out in Cobas e411 analyzer by electrochemiluminescence immunoassay analysis.

Results: As per the Kruskal--Wallis test, statistically significant rise in estradiol levels in Group IV as in comparison to Group III as compared with Groups II and I.

Conclusion: This study proved that irrespective of the gender bias, the female sex hormone, estradiol levels were significantly raised in OSCC patients. This study suggests that E2 may play a vital role in determining the patient prognosis in OSCC with tobacco habit. The confounding results of this preliminary study opened up new advents emphasizing the role of E2 in OSCC. The role of E2 in estrogen receptor regulation can also be a subject of study for targeted therapies in improving the patient's prognosis.

Objectives: To assess and compare the quality of life (QOL) in Oral Cancer patients undergoing 3-DCRT with or without concomitant Chemotherapy at three different time intervals.

Materials and methods: This unicentric longitudinal study included 50 patients of oral cancer undergoing 3-DCRT with or without concomitant chemotherapy. QOL was recorded using the EORTC H and N 35 Questionnaire at baseline, end of treatment (EOT), and 3 months after treatment.

Results: Maximum deterioration of most QOL domains were noted at End of treatment (EOT) in all the patients. A highly statistically significant difference was noted between different time intervals with the highest scores noted at the EOT ( P < 0.01). There was a statistically significant difference in patients undergoing 3DCRT with chemotherapy when compared to those with 3DCRT without chemotherapy ( P < 0.05).

Conclusion: There is substantial deterioration in QOL at the EOT after head-neck irradiation by 3-DCRT with or without concomitant Chemotherapy although it gradually improves over time. However, 3DCRT results in clinically meaningful and statistically better QOL scores at 3 months after treatment compared to baseline and EOT.

Aim: Older patients with locally advanced head and neck cancers (LA-HNC) are under-represented in clinical trials and denied standard treatment with concurrent chemo-radiation. Most are treated with radiotherapy (RT) alone. However, with the use of Intensity Modulated Radiation Therapy (IMRT) and good supportive care, even this cohort of patients can be considered for chemo-radiation.

Methods and materials: 69 patients with age >65 years with LA-HNC treated between April 2015 and December 2019 in our Institute were prospectively evaluated for treatment compliance and outcomes. All patients were planned to receive 70 Gy in 33-35 fractions with IMRT and weekly Cisplatin at a dose of 40 mg/m2 (or Carboplatin-AUC-2). Loco-regional control (LRC), Overall survival (OS), and prognostic factors were evaluated.

Results: Median age at presentation was 67 years (65-81). 54 were male. 64% had Karnofsky Performance Status of >90. 42% had Oropharyngeal Primary. 17% had co-morbidities, 66% had T3 disease, 77% had Node positive disease, and 54% had Stage III disease. All patients completed 70 Gy and 81% patients received at least 5 (>200 mg/m2) chemotherapy cycles. Acute grade-3 toxicity was seen in 20% of patients and 64% had complete response. With a median follow up of 23.6 months (3-71), OS was 53.5%. Estimated 2-year LRC was 60%; estimated 2- and 5-year OS was 53.5% and 34.3%, respectively. On univariate analysis, age <70 years, Cisplatin use, limited nodal disease, Stage III, and complete response to treatment showed good OS (p < 0.05).

Conclusion: Definitive chemo-IMRT approach in older patients with LA-HNC is well tolerated with good clinical outcomes. Hence, older age should not be a barrier for standard treatment.

Abstract: We wanted to present a rare case of metastatic grade 2 spinal ependymoma with an atypical course at the time of diagnosis. Temozolomide plus capecitabine chemotherapy was started in May 2018 on a 30-year-old female patient with sacral ependymoma who had extensive lung metastases at the time of diagnosis. The patient remained in remission for approximately 29 months, and the current chemotherapy was continued until it progressed in November 2020. According to this case report, a combination of temozolomide and capecitabine may be the best treatment option for ependymoma patients.

Abstract: Mammary analogue secretory carcinoma (MASC) is a recently defined entity among salivary gland tumors. MASC bores a striking resemblance to secretory carcinoma of breast along with the characteristics of ETV6-NTRK3 translocation. Hence, the entity was designated as MASC and was formally included in the 4th edition of World Health Organization classification of head and neck tumors in 2017. To the best of our knowledge, around 12 cases of MASC have been described in the Indian literature. MASC commonly involves parotid gland (70%). Involvement of submandibular gland is still rarer (7%). Prognosis of MASC is comparable to other low grade salivary gland malignancies; however, aggressive behavior has also been reported in few cases. This case is one of the very few reported cases describing MASC with detailed clinical, cytology, and microscopy findings along with special stains and immunohistochemistry.

Background: Superficial lobe constitutes 80% of the parotid and is situated lateral to mandible and can be better spared during intensity modulated radiation therapy (IMRT) for head and neck cancer (HNC). This study aimed to see the impact of bilateral superficial parotid gland (PG) sparing IMRT on xerostomia and quality of life (QOL) in patients with HNC receiving radiation.

Study design: Prospective, questionnaire-based study.

Materials and methods: Thirty-four patients with histopathologically proven non-nasopharyngeal non-oral cavity HNC were included in this study. IMRT technique was used and a constraint of 24 Gy was given to combined superficial PG. Physician- and patient-rated xerostomia and QOL scores were recorded at baseline and two weeks, three months, and six months post-radiation therapy (RT). The combined superficial PG dose correlated with xerostomia and QOL scores.

Results: The combined superficial PG and combined whole PG mean dose was 18.71 Gy and 30 Gy, respectively, and the difference was statistically significant (P-< 0.001). At two weeks, three months, and six months post-RT, the odds of xerostomia scores were 0.11, 0.071, 0.042, respectively for a median dose of <18 Gy compared to >18 Gy and was statistically significant P=(0.001).

Conclusion: Bilateral superficial PG sparing IMRT is beneficial in reducing xerostomia and translates to a better QOL.

Background: We aimed to investigate effect of radiotherapy (RT) applications with different dose rates on cytogenetic damages, which focused on micronucleus (MN) formation, and evaluate how this damage varies by cisplatin in rats receiving head-neck RT.

Material and methods: Thirty-six Sprague Dawley rats were divided into five groups. The first and second groups were irradiated at a dose rate of 300 monitor unit/minute (MU/min) and 600 MU/min, respectively. The third group was irradiated at a dose rate of 300 MU/min and given cisplatin. The fourth group was irradiated at a dose rate of 600 MU/min and given cisplatin. The fifth group received neither irradiation nor cisplatin (control group). One thousand polychromatic erythrocytes were scored, and MN frequency in polychromatic erythrocytes was determined for each rat.

Results: There was a significant difference among five groups in terms of the number of MN (p: 0.001). The number of MN was significantly higher in the 600 MU/min + cisplatin group (fourth group) compared to the control group [9.5 (1.0-23.0) vs. 1.5 (1.0-2.0), respectively]. It was also significantly higher in 600 MU/min + cisplatin group (fourth group) compared to 300 MU/min group (first group) [9.5 (1.0-23.0) vs. 2.0 (1.0-3.0), respectively]. On the other hand, there was no significant difference among other groups.

Conclusions: Our findings suggest that RT given at a higher dose rate causes more cytogenetic damage, and this damage is increased by concurrent administration of cisplatin.

Purpose: Peer review is an essential step in clinical quality assurance for radiation therapy. There are very little data on peer reviews from low-middle-income countries (LMIC). With increasing access to advanced technologies in LMIC also, peer review is becoming more important to ensure quality and standard of care. We evaluated cloud-based e-Peer review in our network of cancer centers in India with an aim to study its feasibility and impact on care.

Materials and methods: Four out of 13 cancer centers across India were selected for this pilot study. All team members were trained on the e-Peer review platform before the initiation of the study. A lead dosimetrist from a centralized planning site was selected to share new cases every week. Cases treated with only definitive intent were selected. The link to the cases was sent through an email to reviewing physicians. The following aspects were reviewed for each case. 1) Work up and staging. 2) Treatment intent and prescription. 3) Target contours. 4) Normal organ at risk contours. 5) Dose-volume-histogram (DVH) with clinical goals attached. Cases were marked as "Not Appropriate," "Appropriate," "Appropriate with minor finding," and "Represent with major revisions" as per volume and plan review.

Results: Over a period of 3 months, 100 cases underwent peer review before the start of treatment. Median turnover time was 48 (interquartile range: 24-96) hours. The median time for review was 8 min with time to review cases requiring major and minor changes being 12 and 6 min, respectively (P < 0.001). Of all the cases reviewed, no changes, minor changes, and major changes were suggested for 36%, 48%, and 16% of cases, respectively. The most frequent reason for major changes was contouring corrections (15%). Also, 31.3% of major changes underwent recontouring and replanning before initiation of treatment.

Conclusion: Peer review was feasible in our setting through this cloud-based peer review system, with median turnover time and time taken for review being 48 h and 8 min, respectively. Like published data from the Western world, peer review led to changes that could impact patient care delivery and outcome. We plan to implement this across the remaining centers in our network.

Background: Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a newly added entity in the fourth edition of the WHO Classification of Tumors of Endocrine Organs (2017). It is regarded as a neoplasm with very low malignant potential, thus affecting further treatment of the patients.

Aims: To study the recently diagnosed entity, NIFTP, as not many cases have been reported of the same.

Materials and methods: A retrospective analysis of all thyroid neoplasms received in the Department of Pathology of our institute over two years was done. Out of the 188 cases that we reported, 38 were of non-invasive follicular neoplasms.

Results: Thirty-two patients were female, whereas six patients were male. Thirty-five patients presented with solitary thyroid nodule and the others had an ill-defined thyroid swelling. Thirty-four patients had normal thyroid profile while two patients each presented with hypothyroidism and hyperthyroidism.

Conclusion: It is crucial to carefully study the histopathological features of solitary thyroid swellings and correlate with clinical and radiological findings. The recently added diagnostic category of NIFTP helps clinicians prevent over-treatment of a group of low-risk thyroid tumors.