Formulation of normal tissue irradiation volumes in Co-60 and Ir-192 HDR ICBT of Ca cervix using Total Reference Air Kerma (TRAK)

AimThe aim of this study was to formulate isodose volume relations encompassed by isodose surfaces in Co-60 and Ir-192 HDR intracavitary brachytherapy (ICBT) of cervix carcinoma using the Total Reference Air Kerma (TRAK).BackgroundThe TRAK and isodose volumes are radioactive source related. The formulated relations can easily estimate the irradiated isodose volume if the TRAK and dose are known. The C0-60 can also be used for brachytherapy because of its longer half life and comparable OAR doses to Ir-192.Materials and methodsIsodose volumes encompassed by different isodose surfaces and TRAK were obtained from 22 Ca cervix ICBT treatment plans in Co-60 and Ir-192 HDR brachytherapy with 9Gy prescription to point A. Isodose volume relations were formulated both for Co-60 and Ir-192 brachytherapy source from the slopes and intercepts of the linear fit in the plot between isodose volumes and TRAKs.ResultsThe TRAK value of Co-60 was higher than Ir-192 by about 7.16%. The isodose volumes at low doses for Co-60 were higher than Ir-192. But no significant differences in the dose to the bladder and rectum were observed due to these sources. For dose to 2cm3 bladder and rectum volume, the differences were 1.07% and 0.75%, respectively. The correlation coefficient with the 2-tailed significance of correlation (p value) between TPS measured isodose volume and calculated isodose volumes using the formulated relations at different dose values were statistically significant as

Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data

There is a need to develop and validate biomarkers for treatment response and survival in tubo-ovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to review current evidence to determine whether the CRS is prognostic in women with tubo-ovarian HGSC treated with NACT.This article is freely available via Open Access. Click on the Publisher URL to access the full-text via the publisher's site

Comprehensive molecular characterization of the hippo signaling pathway in cancer

Hippo signaling has been recognized as a key tumor suppressor pathway. Here, we perform a comprehensive molecular characterization of 19 Hippo core genes in 9,125 tumor samples across 33 cancer types using multidimensional “omic” data from The Cancer Genome Atlas. We identify somatic drivers among Hippo genes and the related microRNA (miRNA) regulators, and using functional genomic approaches, we experimentally characterize YAP and TAZ mutation effects and miR-590 and miR-200a regulation for TAZ. Hippo pathway activity is best characterized by a YAP/TAZ transcriptional target signature of 22 genes, which shows robust prognostic power across cancer types. Our elastic-net integrated modeling further reveals cancer-type-specific pathway regulators and associated cancer drivers. Our results highlight the importance of Hippo signaling in squamous cell cancers, characterized by frequent amplification of YAP/TAZ, high expression heterogeneity, and significant prognostic patterns. This study represents a systems-biology approach to characterizing key cancer signaling pathways in the post-genomic era

Breast cancer in males: A PGIMER experience

Aim: Male breast cancer is a rare disease representing 1% of all breast cancers and less than 1% of all cancers in men. Because of its rarity, carcinoma breast has not been studied extensively and this prompted us to carry out this retrospective study. The aim of the study was to observe the clinical and pathological features, evaluate the prognostic factors and to co-relate the outcome in patients of male breast cancer. Materials and Methods : Thirty patients of male breast cancer treated in the department of radiotherapy from year 1996-2000 were retrospectively analyzed. Results: The actuarial five- year disease free survival was 40%. Three out of 30 i.e. 10% patients had loco-regional recurrence and all of them had locally advanced disease at presentation. Distant metastasis occurred in 9 patients of whom 6 patients had T3-T4 tumor and 1 patient had T1-T2 tumor. Conclusion: Modified radical mastectomy followed by external radiation therapy is the standard treatment for male breast cancer. Hormone therapy, as an adjuvant treatment, is the first line approach in a majority of patients and chemotherapy is reserved for patients with poor prognostic factors

Split-Course radiotherapy: A nonideal treatment in a nonideal patient

Background: Radical chemoradiation is the standard of care for locally advanced head-and-neck cancer. However, patients with pretreatment poor risk features exhibit a poor tolerance to these rigorous regimens and are then usually prescribed short-course palliative radiotherapy which provides symptomatic relief; however, survival outcomes are poor. However, a proportion of these patients may tolerate higher dose of radiation with planned treatment break which in turn may translate into improved locoregional control. Materials and Methods: Patients with histologically confirmed nonmetastatic locally advanced squamous cell carcinoma of oropharynx with poor risk features, treated with split-course radiotherapy were included in this retrospective study. A dose of 35 Gy in 15# 3 weeks was initially prescribed. After planned treatment break of 2 weeks, an additional dose of 25 Gy in 10# 2 weeks was delivered. A weekly assessment of radiation reactions was performed during the treatment course, and response to the treatment was assessed clinically at 8 weeks after treatment completion and on subsequent follow-up. Survival analysis was done at median follow-up. Results: Of the 117 eligible patients, 14 (11.9%) had Stage III (with poor Karnofsky Performance Score) and 103 (88.1%) had Stage IV disease. Toxicity was observed as Grade I 80/117 (68.4%), Grade II 20/117 (17.1%), and Grade III as 17/117 (14.5%). A complete clinical response was observed in 45.3% patients at first follow-up. Patients had a median follow-up of 20 months (range 0–62 months). Median progression-free survival and overall survival were 12 and 16 months, respectively. Conclusions: This regimen can be delivered effectively and has an acceptable toxicity profile. It can be used as a treatment option in patients with poor risk pretreatment features

Patterns of failure and prognostic factors for radically treated patients of oropharyngeal cancers planned by two-dimensional radiotherapy: An audit from a regional cancer center

Objectives: To review the patterns of failure and analyze various prognostic factors influencing the outcomes of radically treated patients of oropharyngeal squamous cell cancer treated at our institute with two-dimensional planning (2D). Materials and Methods: Case records of 100 oropharyngeal squamous cell cancers, which were treated radically with radiation or concurrent chemoradiation to an equivalent dose of 66 Gy in conventional fractionation, in our department between 2011 and 2013 were retrospectively analyzed for locoregional control (LRC), progression-free survival (PFS), patterns of failure, and various prognostic factors. Results: Median age of presentation was 53 years, 95% being males. Ninety-three percent had a history of tobacco use. Base of tongue was the most common site in 63% of patients followed by tonsil in 26%. All patients were of Stage III and IV. Among these patients, 27% received concurrent chemoradiation while others received radical radiation. At a median follow-up of 28 months, 57% of the patients were disease free and the LRC was 60%. Among the recurrences, 17% had local failures while 23% had nodal failures as the first site of recurrence. There were no marginal failures. On multivariate analysis, stage of the disease was the single most important prognostic factor determining the PFS and LRC. Conclusion: Stage appears to be the most important prognostic factor affecting LRC and PFS. Absence of marginal failures in our study implies adequacy of coverage with 2D treatment planning while in-field failures mandate attempts to use increased dose, chemosensitizers or nodal dissection postradical radiation

GST and automotive sector in India: Issues and challenges addressed so far

Being one of the major financial reforms, GST has impacted almost all the major and minor sectors of our economy. It has came out with both the sides of a coin, that is, along with the advantages it has put forward a number of challenges and issues before different industries, which are still tackling the problems with respect to GST mechanism. Goods and Services Tax is a soleoutstanding tax mechanism built on the nucleus of ‘one nation one tax’. Guarded by innumerable legislative, political and technical hurdles, the giant tax structure came into effect on 1st July 2017. With the advent of GST, the Automobile Industry has benefitted to a considerable extent but is also faced with a number of technical and other challenges which will be discussed in this paper. This paper will focus on the brief introduction of the Goods and Services Tax, Indian Automobile Industry and will analyse the positive as well as negative aspects and impact of GST implementation with respect to Automobile Industry in India

A case report of peritoneal malignant mesothelioma presenting as primary ovarian mass

Malignant mesotheliomas are aggressive neoplasms arising from mesothelial cells lining the body cavities. Malignant peritoneal mesothelioma (MPM) account for about one-third of the cases. Though the ovarian involvement may be seen in the background of a diffuse peritoneal involvement, the presentation of MPM as a primary ovarian mass is rare. Here we present such a case who underwent surgery but had residual progressive lesion. She received further chemotherapy resulting in a complete response and is disease free for almost a year

Original Article - Breast cancer in males: A PGIMER experience

Aim: Male breast cancer is a rare disease representing 1% of all breast cancers and less than 1% of all cancers in men. Because of its rarity, carcinoma breast has not been studied extensively and this prompted us to carry out this retrospective study. The aim of the study was to observe the clinical and pathological features, evaluate the prognostic factors and to co-relate the outcome in patients of male breast cancer. Materials and Methods : Thirty patients of male breast cancer treated in the department of radiotherapy from year 1996-2000 were retrospectively analyzed. Results: The actuarial five- year disease free survival was 40%. Three out of 30 i.e. 10% patients had loco-regional recurrence and all of them had locally advanced disease at presentation. Distant metastasis occurred in 9 patients of whom 6 patients had T3-T4 tumor and 1 patient had T1-T2 tumor. Conclusion: Modified radical mastectomy followed by external radiation therapy is the standard treatment for male breast cancer. Hormone therapy, as an adjuvant treatment, is the first line approach in a majority of patients and chemotherapy is reserved for patients with poor prognostic factors