15 research outputs found
Research Focus in Palliative Care
This brief article on pre-conference CME topic ‘How to plan Research in Palliative Care’ is aimed to provide an overview of the background, concept, domains, present research activities and the future prospect for research opportunities. Advances in Palliative Care are made with a focus to address the quality of medical practice and ‘quality of death’, in those patients who have advanced stage diseases where cure may or may not be possible. The issues which can improve the palliative care delivery and the areas where evidence of practice is still weak can be identified by forming network and collaborative groups for the application of study and research methods in India
Malignant melanoma: A retrospective series from a regional cancer center in India
Purpose : To present our experience in treating malignant melanoma
patients. Methods and Materials : All melanoma patients treated at the
Department of Radiotherapy, All India Institute of Medical Sciences,
New Delhi, India, from 1995 to 2007 were studied retrospectively. The
endpoints were loco-regional recurrence, distant recurrence,
recurrence-free survival (RFS), and duration of follow-up (DOFU). RFS
and DOFU were analyzed with respect to the factors like age, sex,
tissue of origin, site of disease, number of nodes, lymphadenopathy,
ulceration, stage, and operability to find out any association.
Results : Seventy-two patients were found evaluable with 40 males and
32 females (median age 46.5 years). Eye was the commonest primary site
with visual disturbance as the commonest symptom. Overall, 87% of the
lesions were single, with most of the nonocular lesions presenting in
the advanced stage. During the disease course, regional lymphadenopathy
and distant metastases were seen in 33% and 32% of cases, respectively.
Highest incidence of lymphadenopathy was seen in skin lesions and in
primaries from trunk and extremities. Of all treated patients, 47%
achieved complete response, 18% partial response, and others had either
stable or progressive disease. The median DOFU was 6.2 months. RFS was
studied only in curatively treated cases with a median of 10 months.
Operability at presentation was the only prognostic factor influencing
DOFU. Conclusion : Malignant melanoma is an uncommon disease in India
carrying a lot of morbidity due to late presentation. Its management is
still not clear regarding the optimum use and schedule of treatment
modalities. More prospective studies in the future are required to come
to a definite conclusion
Malignant melanoma: A retrospective series from a regional cancer center in India
Purpose : To present our experience in treating malignant melanoma
patients. Methods and Materials : All melanoma patients treated at the
Department of Radiotherapy, All India Institute of Medical Sciences,
New Delhi, India, from 1995 to 2007 were studied retrospectively. The
endpoints were loco-regional recurrence, distant recurrence,
recurrence-free survival (RFS), and duration of follow-up (DOFU). RFS
and DOFU were analyzed with respect to the factors like age, sex,
tissue of origin, site of disease, number of nodes, lymphadenopathy,
ulceration, stage, and operability to find out any association.
Results : Seventy-two patients were found evaluable with 40 males and
32 females (median age 46.5 years). Eye was the commonest primary site
with visual disturbance as the commonest symptom. Overall, 87% of the
lesions were single, with most of the nonocular lesions presenting in
the advanced stage. During the disease course, regional lymphadenopathy
and distant metastases were seen in 33% and 32% of cases, respectively.
Highest incidence of lymphadenopathy was seen in skin lesions and in
primaries from trunk and extremities. Of all treated patients, 47%
achieved complete response, 18% partial response, and others had either
stable or progressive disease. The median DOFU was 6.2 months. RFS was
studied only in curatively treated cases with a median of 10 months.
Operability at presentation was the only prognostic factor influencing
DOFU. Conclusion : Malignant melanoma is an uncommon disease in India
carrying a lot of morbidity due to late presentation. Its management is
still not clear regarding the optimum use and schedule of treatment
modalities. More prospective studies in the future are required to come
to a definite conclusion
Setting up a palliative care clinic within a radiotherapy department: a model for developing countries
Patient profile and treatment outcome of rectal cancer patients treated with multimodality therapy at a regional cancer center
BACKGROUND: Incidence of rectal cancer has wide geographical variation. Disease pattern in developing countries is different from developed countries as majority of the patients present in advanced stage because of delayed referral and lack of uniform treatment practices. AIMS: Present study describes the patient profile and treatment results from a tertiary care cancer center in India. SETTING AND DESIGN: Tertiary care Regional cancer center. Retrospective analysis 89 patients with rectal adenocarcinoma treated between 1995 and 2002 were analyzed. METHODS: Patients with adenocarcinoma rectum were evaluated in a G.I. Oncology clinic and were treated using multimodality protocols involving surgery, radiotherapy and adjuvant chemotherapy. STATISTICAL ANALYSIS: A descriptive analysis of patient and disease profile,treatment patterns and out come was performed. Survival analysis was performed using Kaplan-Meier method. RESULTS: Mean age of the patients was 45.4 years and majority of them had tumor in lower third of rectum with evidence of extrarectal spread. Seventy five percent of the patients underwent curative resection with abdominoperineal resection being the commonest procedure. Forty seven percent of patients were given short course preoperative radiotherapy and the remaining received postoperative radiotherapy. Sixty four percent of patients could complete planned adjuvant chemotherapy. Operative mortality was 2% and 23% had morbidity. Local recurrence rate was 8.9%. 5-year disease free and overall survival was 54% and 58% respectively. CONCLUSION: Majority of rectal cancer patients present with locally advanced and low rectal growths leading to low sphincter salvage rates. Despite the advanced stage of presentation optimal oncologic results can be obtained by using a good surgical techniques in combination with adjuvant radiotherapy and chemotherapy. Short course preoperative radiotherapy seems to be more feasible in Indian context. Timely referral and uniform treatment guidelines throughout the country are needed for optimal management of rectal cancer in India