Zalfa A. Azeez, D. Fernandes, Sandesh Rao, H. Krishnaraj, T. Jacob, Lanisha Sequeira
Background: Radiotherapy is an important treatment modality for locally advanced breast cancer and includes irradiation of the chest wall and supraclavicular nodes, with or without the axilla. Since the esophagus is close to the supraclavicular nodes, patients may experience acute radiation esophagitis during treatment which decreases their quality of life. Objective: To identify the dosimetric parameters of the esophagus which may affect the occurrence of esophagitis in patients with breast cancer who received supraclavicular nodal irradiation. Materials and Methods: This was a single-center retrospective observational study carried out from January 2021 to June 2022 at Father Muller Medical College Hospital, Mangalore, India. We enrolled patients with histologically proven breast cancer, who had received post-mastectomy radiation to the chest wall and supraclavicular nodes to a dose of 50 Gy in 25 fractions, 2 Gy per fraction, 5 fractions per week with 6 MV photon linear accelerator by intensity modulated radiation therapy. Toxicities were recorded every week. The parameters documented included the mean esophageal dose, maximum dose to the esophagus, and length of the esophagus within the treatment area. Results: We enrolled 25 patients with infiltrating ductal carcinoma of the breast who had undergone mastectomy and received neoadjuvant or adjuvant chemotherapy. The median age was 53 years (IQR, 44.5-63.5). Esophagitis (any grade) was noted in 18 of the 25 patients (72%). Grade 2 esophagitis developed in all 6 patients (100%) who had received a mean esophageal dose >20 Gy, and in none of the 19 (0%) who received a dose <20 Gy; P < 0.001. The development of esophagitis was not significantly associated with the esophageal length included in the treating area (P = 0.62), the maximum dose to the esophagus (P = 0.09), V10 (P = 0.49), or V20 (P = 1). The esophageal mean dose (Dmean) was the sole predictive factor for the development of esophagitis; P = 0.04. Conclusion: In patients with breast cancer receiving post-mastectomy radiation to the chest wall and supraclavicular area, the mean esophageal radiation dose is the only factor that correlates with the development of esophageal toxicity. Thus, esophageal toxicity can be reduced by prescribing dose constraints to the esophagus, thereby potentially improving the quality of life of patients.
{"title":"Radiation-induced esophagitis in patients with breast cancer receiving supraclavicular nodal irradiation: A retrospective observational study","authors":"Zalfa A. Azeez, D. Fernandes, Sandesh Rao, H. Krishnaraj, T. Jacob, Lanisha Sequeira","doi":"10.4103/crst.crst_10_23","DOIUrl":"https://doi.org/10.4103/crst.crst_10_23","url":null,"abstract":"Background: Radiotherapy is an important treatment modality for locally advanced breast cancer and includes irradiation of the chest wall and supraclavicular nodes, with or without the axilla. Since the esophagus is close to the supraclavicular nodes, patients may experience acute radiation esophagitis during treatment which decreases their quality of life. Objective: To identify the dosimetric parameters of the esophagus which may affect the occurrence of esophagitis in patients with breast cancer who received supraclavicular nodal irradiation. Materials and Methods: This was a single-center retrospective observational study carried out from January 2021 to June 2022 at Father Muller Medical College Hospital, Mangalore, India. We enrolled patients with histologically proven breast cancer, who had received post-mastectomy radiation to the chest wall and supraclavicular nodes to a dose of 50 Gy in 25 fractions, 2 Gy per fraction, 5 fractions per week with 6 MV photon linear accelerator by intensity modulated radiation therapy. Toxicities were recorded every week. The parameters documented included the mean esophageal dose, maximum dose to the esophagus, and length of the esophagus within the treatment area. Results: We enrolled 25 patients with infiltrating ductal carcinoma of the breast who had undergone mastectomy and received neoadjuvant or adjuvant chemotherapy. The median age was 53 years (IQR, 44.5-63.5). Esophagitis (any grade) was noted in 18 of the 25 patients (72%). Grade 2 esophagitis developed in all 6 patients (100%) who had received a mean esophageal dose >20 Gy, and in none of the 19 (0%) who received a dose <20 Gy; P < 0.001. The development of esophagitis was not significantly associated with the esophageal length included in the treating area (P = 0.62), the maximum dose to the esophagus (P = 0.09), V10 (P = 0.49), or V20 (P = 1). The esophageal mean dose (Dmean) was the sole predictive factor for the development of esophagitis; P = 0.04. Conclusion: In patients with breast cancer receiving post-mastectomy radiation to the chest wall and supraclavicular area, the mean esophageal radiation dose is the only factor that correlates with the development of esophageal toxicity. Thus, esophageal toxicity can be reduced by prescribing dose constraints to the esophagus, thereby potentially improving the quality of life of patients.","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"37 1","pages":"209 - 214"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77905071","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}
{"title":"Fabrication of an interim obturator prosthesis for a patient with hypersensitive gag reflex","authors":"L. Gupta, S. Gurav, Avinash Kumar","doi":"10.4103/crst.crst_43_23","DOIUrl":"https://doi.org/10.4103/crst.crst_43_23","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"31 1","pages":"321 - 324"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87446520","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}
Anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC) is a molecularly distinct subgroup of oncogene-addicted NSCLC, accounting for 3-5% of cases. These are mainly genomic rearrangements resulting in a fusion oncoprotein, thus causing persistent constitutive signaling. Recent developments and approvals of various generations of ALK inhibitors have revamped the therapeutic and prognostic landscape of this disease entity. For the preparation of this review, we searched various databases such as PubMed, Embase, and Scopus, using the keywords “ALK,” “ALK crizotinib,” “Oncogene NSCLC,” and “Alectinib,” and we finally included 46 articles. In this review, we describe the molecular biology and pathologic and clinical characteristics of ALK-rearranged NSCLC. The detection methods, therapeutic strategies, and trials will be discussed in the next part of this biomarker review series.
{"title":"ALK-driven NSCLC: A narrative review - Part I","authors":"S. Nathany, M. Sharma, U. Batra","doi":"10.4103/crst.crst_75_23","DOIUrl":"https://doi.org/10.4103/crst.crst_75_23","url":null,"abstract":"Anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC) is a molecularly distinct subgroup of oncogene-addicted NSCLC, accounting for 3-5% of cases. These are mainly genomic rearrangements resulting in a fusion oncoprotein, thus causing persistent constitutive signaling. Recent developments and approvals of various generations of ALK inhibitors have revamped the therapeutic and prognostic landscape of this disease entity. For the preparation of this review, we searched various databases such as PubMed, Embase, and Scopus, using the keywords “ALK,” “ALK crizotinib,” “Oncogene NSCLC,” and “Alectinib,” and we finally included 46 articles. In this review, we describe the molecular biology and pathologic and clinical characteristics of ALK-rearranged NSCLC. The detection methods, therapeutic strategies, and trials will be discussed in the next part of this biomarker review series.","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"78 1","pages":"272 - 278"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83318934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/crst.crst_176_23
Jaspreet Kaur, Ajay Singh, M. Shah, P. Chandrani, A. Chougule, O. Shetty, T. Pai, S. Menon, S. Yadav, A. Kapoor, B. Mishra, A. Dutt, V. Noronha, K. Prabhash
{"title":"Erdafitinib for tumors with FGFR3 mutation: A promising targeted therapy","authors":"Jaspreet Kaur, Ajay Singh, M. Shah, P. Chandrani, A. Chougule, O. Shetty, T. Pai, S. Menon, S. Yadav, A. Kapoor, B. Mishra, A. Dutt, V. Noronha, K. Prabhash","doi":"10.4103/crst.crst_176_23","DOIUrl":"https://doi.org/10.4103/crst.crst_176_23","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"95 1","pages":"288 - 295"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79549632","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}
{"title":"Advanced imaging techniques in deep inferior epigastric perforator (DIEP) flap breast reconstruction: The role of CT angiography","authors":"Shani George","doi":"10.4103/crst.crst_59_23","DOIUrl":"https://doi.org/10.4103/crst.crst_59_23","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"175 1","pages":"152 - 153"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72521746","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}
{"title":"VIJAYA-The one who fights to win","authors":"Vandana N. Mahajan","doi":"10.4103/crst.crst_5_23","DOIUrl":"https://doi.org/10.4103/crst.crst_5_23","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"2 1","pages":"65 - 67"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78359142","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}
{"title":"Prognostic role of NRAS-related pharmacogenetics in metastatic papillary thyroid carcinoma","authors":"P. Bhargav, S. Mayilvaganan","doi":"10.4103/crst.crst_56_23","DOIUrl":"https://doi.org/10.4103/crst.crst_56_23","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"159 1","pages":"170 - 171"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88677679","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}
R. Shekhawat, Daideepya C Bhargava, Meenakshi Kumar
{"title":"Rethinking euthanasia in the Indian context: Another perspective","authors":"R. Shekhawat, Daideepya C Bhargava, Meenakshi Kumar","doi":"10.4103/crst.crst_42_23","DOIUrl":"https://doi.org/10.4103/crst.crst_42_23","url":null,"abstract":"","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"6 1","pages":"133 - 134"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85347084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/crst.crst_262_23
Kunal N. Jobanputra
Head-and-neck cancers are the most common malignancies in India.[1,2] These cancers exert a significant health burden in India, resulting in myriad social, economic, and psychological implications. The study conducted by Michaelraj et al.[3] meticulously delves into these cancers’ demographic and epidemiological characteristics in western Tamil Nadu. The local perspective from regional data sheds light on the concentrated distribution of these cancers and underscores the influential role of local variation in risk factors. Such insights hold the potential to inform targeted interventions encompassing education, prevention, and early detection strategies for these cancers.[4] The oral cavity predominantly serves as the primary site for head-and-neck cancers among Indian patients.[5] The study by Michaelraj et al.[3] identified the tongue as the most common subsite within this cohort of patients—a trend in line with other research studies conducted in south India. However, buccal mucosa traditionally ranks as India’s most common subsite for oral cavity cancers. It is worth noting that incorporating questions regarding the prevalence and practices of tobacco chewing within the questionnaire could have unveiled valuable insights. Furthermore, an exploration into the gender-based variations in the distribution of head-and-neck cancer sites could have enriched the study. Divergent risk factors across genders might significantly contribute to this disparity.[6] Among the critical determinants of survival in these aggressive cancers, the disease stage plays a major role. Data on the disease stage at presentation could have helped to devise appropriate strategies for earlier detection.[7] Although the study encompasses a cohort of 150 patients from a single tertiary-care institute in western Tamil Nadu, more comprehensive insights could have been gained by including a larger sample size from diverse centers across Tamil Nadu. Furthermore, tracking changes in cancer trends over the past decade could have yielded valuable temporal insights. In light of these considerations, the article by Michaelraj et al.[3] strongly underscores the paramount importance of tobacco, alcohol, and smoking as the foremost risk factors for these cancers.[8] Emphasis on comprehensive community-based tobacco cessation programs[9,10] emerges as a clear imperative. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
{"title":"Demographic insights into head-and-neck cancers","authors":"Kunal N. Jobanputra","doi":"10.4103/crst.crst_262_23","DOIUrl":"https://doi.org/10.4103/crst.crst_262_23","url":null,"abstract":"Head-and-neck cancers are the most common malignancies in India.[1,2] These cancers exert a significant health burden in India, resulting in myriad social, economic, and psychological implications. The study conducted by Michaelraj et al.[3] meticulously delves into these cancers’ demographic and epidemiological characteristics in western Tamil Nadu. The local perspective from regional data sheds light on the concentrated distribution of these cancers and underscores the influential role of local variation in risk factors. Such insights hold the potential to inform targeted interventions encompassing education, prevention, and early detection strategies for these cancers.[4] The oral cavity predominantly serves as the primary site for head-and-neck cancers among Indian patients.[5] The study by Michaelraj et al.[3] identified the tongue as the most common subsite within this cohort of patients—a trend in line with other research studies conducted in south India. However, buccal mucosa traditionally ranks as India’s most common subsite for oral cavity cancers. It is worth noting that incorporating questions regarding the prevalence and practices of tobacco chewing within the questionnaire could have unveiled valuable insights. Furthermore, an exploration into the gender-based variations in the distribution of head-and-neck cancer sites could have enriched the study. Divergent risk factors across genders might significantly contribute to this disparity.[6] Among the critical determinants of survival in these aggressive cancers, the disease stage plays a major role. Data on the disease stage at presentation could have helped to devise appropriate strategies for earlier detection.[7] Although the study encompasses a cohort of 150 patients from a single tertiary-care institute in western Tamil Nadu, more comprehensive insights could have been gained by including a larger sample size from diverse centers across Tamil Nadu. Furthermore, tracking changes in cancer trends over the past decade could have yielded valuable temporal insights. In light of these considerations, the article by Michaelraj et al.[3] strongly underscores the paramount importance of tobacco, alcohol, and smoking as the foremost risk factors for these cancers.[8] Emphasis on comprehensive community-based tobacco cessation programs[9,10] emerges as a clear imperative. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.","PeriodicalId":9427,"journal":{"name":"Cancer Research, Statistics, and Treatment","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135784565","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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