65 research outputs found
Prospective subjective evaluation of swallowing function and dietary pattern in head and neck cancers treated with concomitant chemo-radiation
Aim : Prospective subjective evaluation of swallowing function and
dietary pattern in locally advanced head and neck cancer patients
treated with concomitant chemo-radiotherapy (CRT). Materials and
Methods : Prospective evaluation of swallowing function with
performance status scale for head and neck cancer patients (PSSHN) at
pre-CRT, CRT completion and at subsequent follow-ups in adult with
loco-regionally advanced head and neck squamous cell carcinoma (HNSCC)
patients. Results : In 47 patients (40 male, seven females; mean age
53; 72% smoker 53%, oropharyngeal cancer), the mean total PSSHN score
at pre-CRT was 258.5 and decreased to 225.2 and 219.2 at two and six
months respectively. Understandability of speech, normalcy in diet and
eating in public at pre-CRT and six months were 91.5 and 84.4; 80.4 and
63.1; 87.3 and 76.6 respectively. In univariate analysis, pre-CRT PSSHN
scores were significantly lesser in patients with severe pre-CRT
dysphagia (P = 0.001), hypopharyngeal cancer (P = 0.244) and advanced
T-stage (T3/4) disease (P = 0.144). At CRT completion, there was
significant reduction of PSSHN scores in patients with severe pre-CRT
dysphagia (P = 0.008), post-CRT weight loss (>10%) and disease
progression (P = 0.039). At two months and six months, 17 (57%) and 11
(73.5%) patients respectively showed change in dietary habit. Mean
increase in meal time was 13% and 21% at two and six-month follow-up.
Conclusions : HNSCC patients show deterioration in swallowing function
after CRT with normalcy of diet in maximum and eating in public least
affected. Pre-CRT severity of dysphagia, weight loss> 10% and
disease progression have significant correlation with higher swallowing
function deterioration after CRT
Accelerated partial breast irradiation: An advanced form of hypofractionation
Altered fractionation schedules are being increasingly investigated in the treatment of breast cancer. Two such schedules that are frequently compared are hypofractionated external beam radiation therapy (HERT) and accelerated partial breast irradiation (APBI). Though these two modalities are considered separately, APBI is an actually an advanced form of hypofractionation, where acceleration of the treatment is possible due to the smaller volume being irradiated. HERT as well as APBI are investigational at present and are being tested in randomized trials. This article looks at the advantages of APBI as a hypofractionation schedule
Accelerated partial breast irradiation: An advanced form of hypofractionation
Altered fractionation schedules are being increasingly investigated in
the treatment of breast cancer. Two such schedules that are frequently
compared are hypofractionated external beam radiation therapy (HERT)
and accelerated partial breast irradiation (APBI). Though these two
modalities are considered separately, APBI is an actually an advanced
form of hypofractionation, where acceleration of the treatment is
possible due to the smaller volume being irradiated. HERT as well as
APBI are investigational at present and are being tested in randomized
trials. This article looks at the advantages of APBI as a
hypofractionation schedule
Accelerated partial breast irradiation: An advanced form of hypofractionation
Altered fractionation schedules are being increasingly investigated in
the treatment of breast cancer. Two such schedules that are frequently
compared are hypofractionated external beam radiation therapy (HERT)
and accelerated partial breast irradiation (APBI). Though these two
modalities are considered separately, APBI is an actually an advanced
form of hypofractionation, where acceleration of the treatment is
possible due to the smaller volume being irradiated. HERT as well as
APBI are investigational at present and are being tested in randomized
trials. This article looks at the advantages of APBI as a
hypofractionation schedule
Review Article - Management of locally advanced breast cancer: Evolution and current practice
Locally advanced breast cancer (LABC) accounts for a sizeable number
(30-60%) of breast cancer cases and is a common clinical scenario in
developing countries. The treatment of LABC has evolved from single
modality treatment, consisting of radical mutilating surgery or higher
doses of radiotherapy in inoperable disease to multimodality
management, which along with the above two included systemic therapy.
Neoadjuvant chemotherapy (NACT) has made a tremendous impact on the
management of LABC. NACT was initiated to institute systemic therapy
upfront at the earliest in this group of patients with a high risk of
micrometastasis burden. While NACT did not yield a survival advantage,
it has however made breast conservation possible in selected group of
cases. Large number of studies and many randomised trials have been
done in women with LABC in order to improve the therapeutic decisions
and also the local control and survival. With this background we have
reviewed various treatment options in patients with LABC which should
possibly help in guiding the clinicians for optimal management of LABC
Review Article - Management of locally advanced breast cancer: Evolution and current practice
Locally advanced breast cancer (LABC) accounts for a sizeable number
(30-60%) of breast cancer cases and is a common clinical scenario in
developing countries. The treatment of LABC has evolved from single
modality treatment, consisting of radical mutilating surgery or higher
doses of radiotherapy in inoperable disease to multimodality
management, which along with the above two included systemic therapy.
Neoadjuvant chemotherapy (NACT) has made a tremendous impact on the
management of LABC. NACT was initiated to institute systemic therapy
upfront at the earliest in this group of patients with a high risk of
micrometastasis burden. While NACT did not yield a survival advantage,
it has however made breast conservation possible in selected group of
cases. Large number of studies and many randomised trials have been
done in women with LABC in order to improve the therapeutic decisions
and also the local control and survival. With this background we have
reviewed various treatment options in patients with LABC which should
possibly help in guiding the clinicians for optimal management of LABC
Patterns of locoregional treatment of breast cancer among radiation oncologists in India: A practice survey
Background: The objective of the study was to assess and evaluate the
practice patterns of locoregional treatment of early and advanced
breast cancer among radiation oncologists (ROs) in India. Materials and
Methods: This questionnaire-based survey was served to practicing ROs
through electronic mails and personal communication between November
2006 and March 2008. Patterns of practices with respect to locoregional
treatment of breast cancer in patients with ductal carcinoma in situ,
early breast cancer (EBC), locally advanced and metastatic breast
cancer (MBC) were studied. Results: We analyzed sixty completed forms
from ROs in India. The median number of breast cancer patients
evaluated per year by the treating oncologist was 130, wherein EBC
comprised 30%; locally advanced breast cancer (LABC), 50%; and MBC,
20%. A median 46% of the ROs favored breast-conserving therapy (BCT) in
EBC and 92% of this subgroup advised adjuvant radiation therapy (RT) in
BCT. For LABC, a majority 90% of the respondents advocated a modified
radical mastectomy, whereas 42% chose to include the axilla in their RT
portals. Conclusions: The survey highlights the prevalent varied
treatment policies followed across the country and encourages us to
understand and adopt a uniform consensus for the management of breast
cancer
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