Role of metastasectomy and chemotherapy in carcinoma of uterine cervix

Squamous cell carcinoma of uterine cervix is potentially a curable disease; however, many patients treated with definitive chemoradiotherapy develop distant metastases, with few of them having a single metastatic deposit. There are no guidelines for the treatment of patients with oligometastatic cervical cancer.We present a case of a patient with International Federation of Gynecology and Obstetrics (FIGO) Stage IIB squamous cell carcinoma of uterine cervix. She was successfully treated with concurrent chemoradiotherapy with definitive intent. One year later, she developed a solitary pulmonary nodule for which she underwent resection followed by chemotherapy. She is free of any local or distant disease at 5 years of regular follow-up

Incidental renal cell carcinoma in pelvic malignancies

Simultaneous diagnosis of renal cell carcinoma with pelvic malignancies is rare but a well-documented phenomenon. It is not uncommon to have incidental renal masses on imaging done for investigating other tumors. There are no established guidelines for the treatment of patients with dual malignancies. The management of such patients is challenging and requires a multidisciplinary approach. We present a series of three cases with a diagnosed pelvic malignancy but further workup revealed a kidney tumor. Both the malignancies were evaluated individually and diagnosed as two different primary neoplastic lesions. This case series examines each distinct patient\u27s presentation, discusses the diagnosis, and compares and contrasts the findings while discussing the literature on this topic

Hidradenocarcinoma: Five years of local and systemic control of a rare sweat gland neoplasm with nodal metastasis

Hidradenocarcinoma is a rare and locally aggressive tumor rendering a poor prognosis. Furthermore, very few cases present with nodal metastasis. Diagnosing such an entity, and then differentiating it from a benign counterpart, poses a great challenge to the clinicians. There are no established treatment guidelines for the management of this disease, particularly in patients with nodal involvement. We present a case of a young male who was diagnosed with hidradenocarcinoma of the scalp, along with a neck swelling. A thorough diagnostic evaluation was done with endoscopy, pathological, and radiological investigations. He was successfully treated with resection of the scalp lesion and right-sided neck dissection followed by adjuvant concurrent chemoradiation. He remains free of any local and distant disease after five years of regular follow-up

Chemoradiation and the role of adjuvant chemotherapy in lymph nodal-metastatic cervical cancer

Purpose: To report the long-term outcome in lymph nodal-metastatic cervical squamous cell cancer after chemoradiation followed by adjuvant chemotherapy.Patients and Methods: Between 2010 and 2013, five patients were diagnosed with advanced cervical cancer with clinically involved para-aortic lymph nodes (ie, International Federation of Gynecology and Obstetrics stage IVB). These patients were treated with concurrent chemoradiation therapy followed by adjuvant chemotherapy. Concurrent chemoradiation consisted of cisplatin given once per week concomitantly with extended-field radiation therapy followed by high-dose-rate brachytherapy. Adjuvant chemotherapy comprised four courses of carboplatin and paclitaxel given every three weeks. The primary outcomes were local and distant failures.Results: None of the patients had local recurrence or distal failure after a minimum follow-up time of 3 years.Conclusion: Adjuvant chemotherapy after chemoradiation has a probable role in the management of lymph nodal-metastatic cervical cancer

Impact of peer review in the radiation treatment planning process: Experience of a tertiary care university hospital in Pakistan

Purpose: To evaluate and report the frequency of changes in radiation therapy treatment plans after peer review in a simulation review meeting once a week.Materials and Methods: Between July 1 and August 31, 2016, the radiation plans of 116 patients were discussed in departmental simulation review meetings. All plans were finalized by the primary radiation oncologist before presenting them in the meeting. A team of radiation oncologists reviewed each plan, and their suggestions were documented as no change, major change, minor change, or missing contour. Changes were further classified as changes in clinical target volume, treatment field, or dose. All recommendations were stratified on the basis of treatment intent, site, and technique. Data were analyzed by Statistical Package for the Social Sciences and are presented descriptively.Results: Out of 116 plans, 26 (22.4%) were recommended for changes. Minor changes were suggested in 15 treatment plans (12.9%) and a major change in 10 (8.6%), and only one plan was suggested for missing contour. The frequency of change recommendations was greater in radical radiation plans than in palliative plans (92.3% v 7.7%). The head and neck was the most common treatment site recommended for any changes (42.3%). Most of the changes were recommended in the technique planned with three-dimensional conformal radiation therapy (50%). Clinical target volume (73.1%) was identified as the most frequent parameter suggested for any change, followed by treatment field (19.2%) and dose (0.08%).Conclusion: Peer review is an important tool that can be used to overcome deficiencies in radiation treatment plans, with a goal of improved and individualized patient care. Our study reports changes in up to a quarter of radiotherapy plans

Entomopathogenic nematodes for the control of oriental fruit fly Bacterocera dorsalis (Diptera: Tephritidae)

Background: Fruit fly species are most damaging pests around the globe which reduced the commercial value of fruits at maturity. Entomopathogenic nematodes (EPNs) from genera Heterorhabditis and Steinernema cause death by inducing septicimia in insect pests in the soil, moreover, endemic nearly all soils. Current study was planned to manage the oriental fruit fly, Bacterocera dorsalis (Hendel.) (Diptera: Tephritidae) hazards by using indigenous EPNs (Heterorhabditis bacteriophora, H. indica, Steinernema asiticum, S. corpocapsae and S. glasseri) as they have host finding ability and recognise as potential eco-friendly biocontrol agent over synthetic chemicals. Methods: Study for the assessment of EPNs concentrations, various temperatures, soil type and soil moisture levels against mortality (%) of fruit fly (B. dorsalis) larvae was conducted in completely randomized design (CRD) under factorial arrangements. Results: EPNs concentrations (70 IJs/ml, 110 IJs/ml, 150 IJs/ml) showed that S. asiaticum (150 IJs/ml) showed maximum mortality (94.97 %) of B. dorsalis as compared to other used EPNs along with their respective concentrations. Impact of various temperatures (20 °C, 24 °C, 28 °C, 32 °C, 36 °C) with respect to used EPNs exhibited that H. indica (36 °C) showed maximum mortality (94.33 %) of B. dorsalis as compared to all other treatment. Various soil types (Sandy, Sandy loam, Loam, Clay) impacted the infectivity of EPNs against fruit fly, In case of sandy loam soil, S. asiaticum showed maximum mortality (98.05 %) of B. dorsalis followed by all used treatments. Soil moisture level (12 %, 18 %, 24 %, 30 %) also significantly influenced the infectivity of EPNs against mortality of fruit fly. In case of 12% moisture level, S. asiaticum showed maximum mortality (99.06 %) of B. dorsalis over all the applied treatments along with respective moisture levels. Conclusion: In crux, Steinernema asiaticum higher concentration exhibited efficient control of fruit fly larvae in sandy loam soil with 12 % moisture level at 36 °C over the used EPN species. While application of EPNs against fruit fly is most suitable strategy to manage the fruit fly hazards and it should be included as a part of integrated pest management control programme