Rohitashwa Dana - Academia.edu (original) (raw)
Papers by Rohitashwa Dana
Indian Journal of Palliative Care, 2017
Squamous cell carcinoma of the head and neck (SCCHN) is one of the most common cancers seen in In... more Squamous cell carcinoma of the head and neck (SCCHN) is one of the most common cancers seen in India, constituting up to 25% of the overall cancer burden. A sizeable majority present with locoregionally advanced disease. [1,2] Extensive locoregional spread, poor general condition of the patient, distant metastasis, or comorbidities preclude curative treatment. This group of patients requires some form of treatment to control their locoregional disease and to alleviate symptoms. A palliative radiotherapy schedule should target symptom control and tumor regression within a short overall treatment time with minimal side effects. [3,4] Various palliative schedules have been used in head and neck cancer. Our study retrospectively assesses the 25 Gy/4 fr/1 fr per week schedule which has been practiced at the department. [5] Our institute serves as a comprehensive cancer care center in the NorthWestern India and caters to the needs of people of Rajasthan as well as eastern Uttar Pradesh, Haryana, and Madhya Pradesh. subjects and Methods Ninety-eight patients with inoperable, head, and neck cancer not fit for radical treatment were treated with a short course of radiotherapy (July 2015-June 2016) after obtaining informed consent. Patients with stage IV American Joint Committee on Cancer (AJCC) who had received no prior radiotherapy or chemotherapy, no previous history of cancer and of Eastern Cooperative Oncology Group performance status 2 and 3 were included for this retrospective study. The consideration for palliative approach was based on factors which included Medically inoperable, fixed, and unresectable disease; very advanced locoregional disease; poor general condition/comorbidities;
PubMed, Dec 1, 1996
Efficacy of oral hydration was compared with that of traditional intravenous hydration along with... more Efficacy of oral hydration was compared with that of traditional intravenous hydration along with comparison of furasemide with mannitol in 65 patients of solid tumours undergoing Cisplatin based anterior chemotherapy. Incidence of reversible uremia was found to be equivalent in the series. Our results suggest superiority of oral hydration and furosemide diuresis owing to cost efficiency and patient comfort.
International Journal of Advanced Research
The aim of a quality assurance (QA) program is to assist a radio-diagnostic facility in consisten... more The aim of a quality assurance (QA) program is to assist a radio-diagnostic facility in consistently obtaining adequate radiological information with a minimum of dose and a minimum of cost. An integrated part of a quality assurance program is quality control (QC) in which a series of examinations and checks on equipment performance are undertaken, so that any changes can be objectively monitored and remedies made. The main objective of the present work was to carry out an independent audit of the important features of QA tests and radiation safety parameters in medical X-ray installations, which would reflect the safety status and to assess the regulatory requirements of the safety code. We conducted a radiological safety and quality assurance audit of 32 medical X-ray diagnostic machines installed in SMS hospital, Jaipur. A QA kit consisting of a kVp test meter, ionization chamber-based radiation survey meter and other standard accessories were used for the required measurements. ...
Asian Pacific Journal of Cancer Care
Background: Present study compares two high-dose-rate intracavitary brachytherapy (ICBT) planning... more Background: Present study compares two high-dose-rate intracavitary brachytherapy (ICBT) planning methods using two-dimensional orthogonal radiography and three-dimensional computed tomography (3D-CT) with regard to dose to target volume and organs at risk (OAR) in carcinoma cervix. Methodology: ICBT plans for 22-patients were compared using 2D planning and three-dimensional computed tomography (3D-CT) planning techniques. 2D treatment plans were generated using 2D-orthogonal images and dose was prescribed at Point A while 3D-CT plans were generated using 3D-CT images after contouring target volume and organs at risk. In 2D planning rectal and bladder doses were assessed as per ICRU-38 and in 3D planning, 0.1cc, 0.2cc, 0.5cc and 1cc doses of bladder and rectum were evaluated. Doses to target and organ at risks (rectum and bladder) were compared for each planning method. Results: Mean dose received by D90, D95 and D100 was 8.05±1.59Gy, 7.19±1.43Gy and 4.79±0.93Gy respectively. ICRU b...
International Journal of Advanced Research
Radioactive Cobalt-60 teletherapy machines find a prominent place in radiation therapy department... more Radioactive Cobalt-60 teletherapy machines find a prominent place in radiation therapy departments in India. The first teletherapy cobalt machine in SMS hospital (Picker Advance Tele Cobalt (ATC) C/9) was installed in 1995. The initial activity of the cobalt source was 333 TBq (9000 Ci).In March 2019, the source output became lesser than 50 cGy/hr at normal treatment distance (NTD) of 80cm which is clinically not acceptable for patient treatment because of increase in treatment time. The decommissioning of the machine was considered due to ageing of machine and vendor was not providing services anymore. This present study describes radiation safety aspect of the planning of decommissioning of teletherapy machine and transport of the decayed Cobalt-60 source for disposal and personnel dose measurements during the procedure. Decommissioning of the cobalt machine began with preparation of a plan and its submission for approval by competent national authority. Radiation survey of the so...
M alignant peripheral nerve sheath tumors (MPNST) are uncommon, accounting for 5% of softtissue s... more M alignant peripheral nerve sheath tumors (MPNST) are uncommon, accounting for 5% of softtissue sarcomas [1]. Typically, they originate from nerves of the extremities and trunk or preexisting neurofibromas. Those involving intracranial nerves are highly exceptional. They usually occur de novo or in the setting of neurofibromatosis Type 1 where there is a transition from a plexiform neurofibroma. It is very rare for a schwannoma to transit into MPNST [2]. There is a male predilection with a male to female ratio of 2.5:1 and it mainly occurs between the fourth and sixth decade [3]. The incidence of MPNST is high in patients who have received prior radiation therapy. It is extremely rare for MPNST to occur intracranially. If it occurs, they are highly aggressive with a poor outcome. The incidence of this subtype is as low as 0.001% and is graded as the WHO Grade IV tumor [4]. The main treatment for MPNST is surgery. Chemotherapy and radiation therapy should be considered for incomplete unresected tumors [5]. We report a rare case of MPNST in a 60-year-old male with MPNST of the left parietotemporal region which is quite an unusual site of presentation. We report this case because of its unique presentation and aggressive multimodality treatment requirement. CASE REPORT A 60-year-old male presented to the neurosurgery outpatient department with complaints of progressive headache and vertigo of 1-month duration. The headache was initially mild in severity which had progressed over a period of month to severe. It was dull-aching, continuous, involving predominantly the left temporo parietal region, it was not associated with seizure, visual disturbance, nausea, vomiting and not relieved on taking the over-the-counter analgesics. The vertigo was lasted for around one minute. It was not associated with decreased hearing or tinnitus. There was no history of loss of consciousness. On examination, the patient was conscious and coherent. On general examination, vitals were stable. Cardiovascular, respiratory, and abdominal examinations were normal. Neurological examination showed no notable abnormalities and there were no signs of Von Recklinghausen disease. Routine baseline investigations including hematological, renal, and liver function tests were normal. Contrast-enhanced magnetic resonance imaging (CEMRI) brain scan showed a heterogeneous mass lesion approximately 63 × 74 × 46 mm eccentric solid and cystic/necrotic component with moderate perilesional edema of the left parietotemporal hemisphere. It was hypointense on T1 and heterogeneously hyperintense on T2W and the cystic area was mildly hyperintense on T2W/FLAIR. It was causing compression over the left lateral ventricles and midbrain. The pre-operative provisional diagnosis was glioma (Fig. 1).
International Journal of Radiation Oncology*Biology*Physics, 1983
Forty-two patients, with a variety of advanced pelvic malignancies, have been treated with a hypo... more Forty-two patients, with a variety of advanced pelvic malignancies, have been treated with a hypofractionated radiotherapy regimen. The most common schedule was 30 Gy in three fractions at monthly intervals. This has provided effective palliation with acceptable morbidity in the select patient group treated. The results in advanced rectal and ovarian tumors were particularly encouraging. The most effective dose/fraction and interfraction interval is, at present, under active investigation within our institution.
Indian Journal of Medical and Paediatric Oncology, 2009
Phalanx bone metastasis as the initial manifestation of lung cancer is a rare presentation. A 70-... more Phalanx bone metastasis as the initial manifestation of lung cancer is a rare presentation. A 70-year-old man presented with swelling and pain in his right ring finger. He had no other complaints or abnormal findings on clinical examination. A right hand radiograph showed an osteolytic lesion in the first phalanx of the ring finger. Fine needle aspiration cytology of the swelling suggested a metastatic adenocarcinoma. A skeletal survey, hematological, biochemical, and other radiological tests were found to be normal, except for an opacity seen in the right lung midzone. A bronchoscopic biopsy revealed adenocarcinoma of the lung.
Recent Advances in Biology and Medicine, 2015
Intestinal-type sinonasal adenocarcinoma accounts for about 3% of cancers of the upper aero-diges... more Intestinal-type sinonasal adenocarcinoma accounts for about 3% of cancers of the upper aero-digestive tract. It is commonly seen in men in the age group of 55-60 years. We present the case of a 60-year-old woman having extensive disease in the right half of the nasal cavity extending to the dura of the anterior cranial fossa, and the right orbital contents. The patient was given induction chemotherapy to make the condition surgically amenable, but the regression was modest, and hence she has been put on concurrent chemo-radiotherapy.
Brachytherapy, 2016
doses to the organs at risk. Among the three treatment plans generated, the hybrid IGBT was able ... more doses to the organs at risk. Among the three treatment plans generated, the hybrid IGBT was able to achieve the lowest dose for the rectum 65.24 Gy, bladder 72.13 Gy and sigmoid 54.52 Gy. Intracavitary image-guided brachytherapy alone may achieve similar HR-CTV doses as with the hybrid IGBT but it could only be achieved with accompanying higher doses to the organs at risk. At 6 months follow-up, patient was noted with smooth cervix, free bilateral parametria and with no evidence of disease. Conclusions: Our pilot case study showed that hybrid image-guided brachytherapy for locally advanced cervical cancer may improve dose coverage to the HR-CTV, reduce dose to organs at risk and offer good local control of the disease. Further case series is recommended to improve on the application of the technique in the local setting and document treatment outcomes.
A 40–year old female non–smoker of average build, presented with swelling in the left lumbar regi... more A 40–year old female non–smoker of average build, presented with swelling in the left lumbar region along with dragging pain for 3 months, with no his-tory of dysuria, hematuria, trauma or previous sur-gery. She was non–hypertensive and non–diabetic and had no family history of malignancy. Ultraso-nography (USG) showed a large (17.4 x 13 x 12 cm) predominantly cystic mass with solid components and internal septas which appeared to be arising exophytically from the lower pole of the left kid-ney. On further evaluation, the CT findings showed a large (19 x 14 x 17 cm) left retroperitoneal mass with solid and cystic components on the inferior as-pect of the left kidney (Figure 1) showing effaced fat planes, inseparable from the lower pole of the kid-ney, with mild–moderate left hydronephrosis due to compression of the left ureter. Soft tissue stranding was observed in the adjacent retroperitoneal fat and thickening of the perinephric fat. The duodenojeju-nal junction and descending col...
Middle East Journal of Cancer, 2017
Background: This study evaluated sexual function in cervical cancer survivors after concurrent ch... more Background: This study evaluated sexual function in cervical cancer survivors after concurrent chemoradiotherapy. Methods: Study participants comprised survivors of locally advanced cervical cancer (stages IIB-IVA) who completed concurrent chemoradiotherapy along with intracavitary brachytherapy at least two years prior at Dr S.N.Medical College, Jodhpur, Rajasthan, India. We used the Female Sexual Function Index questionnaire to assess sexual function. The cut-off score of the Female Sexual Function Index that identified female sexual arousal disorder was 26.55. A score less than 26.55 indicated the presence of female sexual arousal disorder. Results: A total of 48 locally advanced cervical cancer survivors enrolled in the study. Survivors had a mean age of 46.5 years. All received chemoradiotherapy along with intracavitary brachytherapy. The average time for treatment was 53.5 days. Patients had an average score for sexual desire of 2, 2.3 for arousal, 2.3 for sexual satisfaction,...
International journal of scientific research, 2016
Breast cancer is the most common malignancy in women worldwide. With improving survival figures a... more Breast cancer is the most common malignancy in women worldwide. With improving survival figures and early breast cancer detection, treatment related long term adverse effects of radiotherapy have become a concern. Contralateral breast cancer due to scattered radiation during radiotherapy of diseased breast is one of them. This prospective clinical study was conducted to measure the dose received by the contralateral breast and compare the different techniques which influence this dose. It was found that in post mastectomy patients, treatment with telecobalt unit, medial tangential field contribute more dose to contralateral breast compared to supraclavicular field and lateral tangential fields. The mean dose received by contralateral breast during irradiation of chest wall was 168.29 cGy which was 3.36 percentage of the prescribed dose.
The National Medical Journal of India
Background. Management of tumour bleeding remains a challenge in oncology. With a number of metho... more Background. Management of tumour bleeding remains a challenge in oncology. With a number of methods available, radiotherapy still holds a crucial place. There are no standard guidelines for dose fractionation of haemostatic radiotherapy (HRT), and it varies from case to case. We aimed to study the effectiveness of HRT. Methods. We retrospectively analysed the effectiveness of HRT in 70 patients in terms of control of bleeding and overall survival, who presented to us with advanced cancers from July 2014 to June 2017. Results. The median age was 48 (range 23–76) years, and male to female ratio was 2.18:1. The most common malignancy encountered was lung and gynaecological (both 17.1%). Stage IV was the most common stage (48.6%) of the primary tumour. The site of bleeding was the primary tumour in 50 (71.4%) patients, whereas fungating regional nodes were the cause in the remaining. The median duration between initial diagnosis and HRT was 5 (range 0–19) months. Seventeen patients (24.3%) had a history of prior radiotherapy. Fifty-one patients (72.8%) required at least 1 unit of blood transfusion. Hypofractionated HRT schedules were used in all patients with the most common being 30 Gy in 10 daily fractions for 5 days a week (18, 25.7%). At the end of HRT, bleeding was effectively controlled in 53 patients (75.7%). The median survival was 13 (range 1–26) months. The 1- and 2-year survival rates were 55.7% and 4.3%, respectively. Conclusions. HRT is safe and effective in achieving haemostasis in advanced tumours presenting with bleeding from either the primary or the regional lymph nodes. Although optimal dose fractionation has not yet established, hypofractionated radiotherapy is preferred, with the total dose depending on several factors. However, the overall prognosis remains poor.
Indian Journal of Radiology and Imaging, 1999
Introduction: Locally advanced head and neck carcinomas (HNSCC) constitute a substantial proporti... more Introduction: Locally advanced head and neck carcinomas (HNSCC) constitute a substantial proportion of cancer patients in India. This is treated by combined multimodality which includes surgery, radiotherapy, and chemotherapy. Aims: To investigate tumor response and toxicity in HNSCC using hypofractionated schedule compared with conventional fractionation. Material and Methods: In conventional arm (Arm A), each patient received 70 Gy/2 Gy/fraction/7 weeks. In hypofractionated arm (Arm B), each patient received 55 Gy/2.75 Gy/fraction/4 weeks. Both arms received weekly cisplatin (40 mg/m 2 ). The end points were tumor response, acute and late toxicities, and overall survival (OS). Results: 17 patients (68%) in a conventional arm (Arm A) achieved a complete response (CR) and 15 patients (60%) in hypofractionated arm (Arm B) had a CR (p=0.55). The acute skin toxicity (grade≥2) was significantly higher in Arm B than in Arm A (28% vs. 17%; p ≤ 0.001). Grade ≥ 2 mucositis was also higher i...
Abdominal wall recurrence is not seen commonly with uterine cervix carcinoma. We present here two... more Abdominal wall recurrence is not seen commonly with uterine cervix carcinoma. We present here two cases of scar site recurrence and one abdominal wall recurrence, after radical surgery in uterine cervix carcinoma. Review of the literature showed 45 cases of abdominal recurrence after surgery in uterine cervix carcinoma. Two possible mechanisms of recurrence after surgery may be direct implantation of tumor cells at the time of surgery or fibrin platelet deposits in the microcirculation of the surgical wound that may have trapped circulating tumor cells. Recurrences with such atypical manifestations call for more vigilance in follow up of uterine carcinoma cervix.
Asian Pacific Journal of Cancer Care
Background: Incidence of Esophageal cancer (EC) is increasing now a days and it has became a sixt... more Background: Incidence of Esophageal cancer (EC) is increasing now a days and it has became a sixth leading cause of cancer related death in world. EC is associated with multiple risk factors. Despite various advances in the treatment of EC, it remains one of the least responsive tumors to cancer therapy, thereby overall prognosis remains poor. The current status of EC in North West India in relation to the demographics, diagnosis, staging, multimodality treatment, and the future perspectives are discussed. Methods and Materials: This is a retrospective analysis of medical records of the EC patients registered in the Department of Radiation Oncology SMS Medical and Attached Hospitals Jaipur from January 2015 to December 2019. Results: Out of 10,464 patients with various malignancies registered in SMS hospital for radiotherapy via Co-60 technique in the previous 5 years from 2015-2019; 449 were having EC. 40.25% patients were in 6th decade and male to female ratio was 1.49:1. EC was m...
International Journal of Contemporary Medical Research [IJCMR]
International Journal of Medical and Biomedical Studies
Background: The purpose of our study is to identify the incidence of hypothyroidism following rad... more Background: The purpose of our study is to identify the incidence of hypothyroidism following radiotherapy in head and neck cancer patients in Rajasthan India and to assess the time period for the development of hypothyroidism for early treatment to reduce hypothyroid related morbidity and mortality. Methods: A prospective study conducted in Department of Radiation Oncology, S.M.S Medical College and attached group of hospital, Jaipur, Rajasthan. with 50 patients of histopathologically proven head and neck cancer receiving external beam to whole neck on telecobalt. Results: The patients were followed up for a period of six months. 7 (14%) patients were found to have hypothyroidism which was strongly significant with the p value of 0.02. Conclusion: We concluded that thyroid function tests should be made routine prior RT and during follow up period as early as 6 months and carried out lifelong. Keywords: Thyroid function test, Head neck cancer, Follow-up.
Indian Journal of Palliative Care, 2017
Squamous cell carcinoma of the head and neck (SCCHN) is one of the most common cancers seen in In... more Squamous cell carcinoma of the head and neck (SCCHN) is one of the most common cancers seen in India, constituting up to 25% of the overall cancer burden. A sizeable majority present with locoregionally advanced disease. [1,2] Extensive locoregional spread, poor general condition of the patient, distant metastasis, or comorbidities preclude curative treatment. This group of patients requires some form of treatment to control their locoregional disease and to alleviate symptoms. A palliative radiotherapy schedule should target symptom control and tumor regression within a short overall treatment time with minimal side effects. [3,4] Various palliative schedules have been used in head and neck cancer. Our study retrospectively assesses the 25 Gy/4 fr/1 fr per week schedule which has been practiced at the department. [5] Our institute serves as a comprehensive cancer care center in the NorthWestern India and caters to the needs of people of Rajasthan as well as eastern Uttar Pradesh, Haryana, and Madhya Pradesh. subjects and Methods Ninety-eight patients with inoperable, head, and neck cancer not fit for radical treatment were treated with a short course of radiotherapy (July 2015-June 2016) after obtaining informed consent. Patients with stage IV American Joint Committee on Cancer (AJCC) who had received no prior radiotherapy or chemotherapy, no previous history of cancer and of Eastern Cooperative Oncology Group performance status 2 and 3 were included for this retrospective study. The consideration for palliative approach was based on factors which included Medically inoperable, fixed, and unresectable disease; very advanced locoregional disease; poor general condition/comorbidities;
PubMed, Dec 1, 1996
Efficacy of oral hydration was compared with that of traditional intravenous hydration along with... more Efficacy of oral hydration was compared with that of traditional intravenous hydration along with comparison of furasemide with mannitol in 65 patients of solid tumours undergoing Cisplatin based anterior chemotherapy. Incidence of reversible uremia was found to be equivalent in the series. Our results suggest superiority of oral hydration and furosemide diuresis owing to cost efficiency and patient comfort.
International Journal of Advanced Research
The aim of a quality assurance (QA) program is to assist a radio-diagnostic facility in consisten... more The aim of a quality assurance (QA) program is to assist a radio-diagnostic facility in consistently obtaining adequate radiological information with a minimum of dose and a minimum of cost. An integrated part of a quality assurance program is quality control (QC) in which a series of examinations and checks on equipment performance are undertaken, so that any changes can be objectively monitored and remedies made. The main objective of the present work was to carry out an independent audit of the important features of QA tests and radiation safety parameters in medical X-ray installations, which would reflect the safety status and to assess the regulatory requirements of the safety code. We conducted a radiological safety and quality assurance audit of 32 medical X-ray diagnostic machines installed in SMS hospital, Jaipur. A QA kit consisting of a kVp test meter, ionization chamber-based radiation survey meter and other standard accessories were used for the required measurements. ...
Asian Pacific Journal of Cancer Care
Background: Present study compares two high-dose-rate intracavitary brachytherapy (ICBT) planning... more Background: Present study compares two high-dose-rate intracavitary brachytherapy (ICBT) planning methods using two-dimensional orthogonal radiography and three-dimensional computed tomography (3D-CT) with regard to dose to target volume and organs at risk (OAR) in carcinoma cervix. Methodology: ICBT plans for 22-patients were compared using 2D planning and three-dimensional computed tomography (3D-CT) planning techniques. 2D treatment plans were generated using 2D-orthogonal images and dose was prescribed at Point A while 3D-CT plans were generated using 3D-CT images after contouring target volume and organs at risk. In 2D planning rectal and bladder doses were assessed as per ICRU-38 and in 3D planning, 0.1cc, 0.2cc, 0.5cc and 1cc doses of bladder and rectum were evaluated. Doses to target and organ at risks (rectum and bladder) were compared for each planning method. Results: Mean dose received by D90, D95 and D100 was 8.05±1.59Gy, 7.19±1.43Gy and 4.79±0.93Gy respectively. ICRU b...
International Journal of Advanced Research
Radioactive Cobalt-60 teletherapy machines find a prominent place in radiation therapy department... more Radioactive Cobalt-60 teletherapy machines find a prominent place in radiation therapy departments in India. The first teletherapy cobalt machine in SMS hospital (Picker Advance Tele Cobalt (ATC) C/9) was installed in 1995. The initial activity of the cobalt source was 333 TBq (9000 Ci).In March 2019, the source output became lesser than 50 cGy/hr at normal treatment distance (NTD) of 80cm which is clinically not acceptable for patient treatment because of increase in treatment time. The decommissioning of the machine was considered due to ageing of machine and vendor was not providing services anymore. This present study describes radiation safety aspect of the planning of decommissioning of teletherapy machine and transport of the decayed Cobalt-60 source for disposal and personnel dose measurements during the procedure. Decommissioning of the cobalt machine began with preparation of a plan and its submission for approval by competent national authority. Radiation survey of the so...
M alignant peripheral nerve sheath tumors (MPNST) are uncommon, accounting for 5% of softtissue s... more M alignant peripheral nerve sheath tumors (MPNST) are uncommon, accounting for 5% of softtissue sarcomas [1]. Typically, they originate from nerves of the extremities and trunk or preexisting neurofibromas. Those involving intracranial nerves are highly exceptional. They usually occur de novo or in the setting of neurofibromatosis Type 1 where there is a transition from a plexiform neurofibroma. It is very rare for a schwannoma to transit into MPNST [2]. There is a male predilection with a male to female ratio of 2.5:1 and it mainly occurs between the fourth and sixth decade [3]. The incidence of MPNST is high in patients who have received prior radiation therapy. It is extremely rare for MPNST to occur intracranially. If it occurs, they are highly aggressive with a poor outcome. The incidence of this subtype is as low as 0.001% and is graded as the WHO Grade IV tumor [4]. The main treatment for MPNST is surgery. Chemotherapy and radiation therapy should be considered for incomplete unresected tumors [5]. We report a rare case of MPNST in a 60-year-old male with MPNST of the left parietotemporal region which is quite an unusual site of presentation. We report this case because of its unique presentation and aggressive multimodality treatment requirement. CASE REPORT A 60-year-old male presented to the neurosurgery outpatient department with complaints of progressive headache and vertigo of 1-month duration. The headache was initially mild in severity which had progressed over a period of month to severe. It was dull-aching, continuous, involving predominantly the left temporo parietal region, it was not associated with seizure, visual disturbance, nausea, vomiting and not relieved on taking the over-the-counter analgesics. The vertigo was lasted for around one minute. It was not associated with decreased hearing or tinnitus. There was no history of loss of consciousness. On examination, the patient was conscious and coherent. On general examination, vitals were stable. Cardiovascular, respiratory, and abdominal examinations were normal. Neurological examination showed no notable abnormalities and there were no signs of Von Recklinghausen disease. Routine baseline investigations including hematological, renal, and liver function tests were normal. Contrast-enhanced magnetic resonance imaging (CEMRI) brain scan showed a heterogeneous mass lesion approximately 63 × 74 × 46 mm eccentric solid and cystic/necrotic component with moderate perilesional edema of the left parietotemporal hemisphere. It was hypointense on T1 and heterogeneously hyperintense on T2W and the cystic area was mildly hyperintense on T2W/FLAIR. It was causing compression over the left lateral ventricles and midbrain. The pre-operative provisional diagnosis was glioma (Fig. 1).
International Journal of Radiation Oncology*Biology*Physics, 1983
Forty-two patients, with a variety of advanced pelvic malignancies, have been treated with a hypo... more Forty-two patients, with a variety of advanced pelvic malignancies, have been treated with a hypofractionated radiotherapy regimen. The most common schedule was 30 Gy in three fractions at monthly intervals. This has provided effective palliation with acceptable morbidity in the select patient group treated. The results in advanced rectal and ovarian tumors were particularly encouraging. The most effective dose/fraction and interfraction interval is, at present, under active investigation within our institution.
Indian Journal of Medical and Paediatric Oncology, 2009
Phalanx bone metastasis as the initial manifestation of lung cancer is a rare presentation. A 70-... more Phalanx bone metastasis as the initial manifestation of lung cancer is a rare presentation. A 70-year-old man presented with swelling and pain in his right ring finger. He had no other complaints or abnormal findings on clinical examination. A right hand radiograph showed an osteolytic lesion in the first phalanx of the ring finger. Fine needle aspiration cytology of the swelling suggested a metastatic adenocarcinoma. A skeletal survey, hematological, biochemical, and other radiological tests were found to be normal, except for an opacity seen in the right lung midzone. A bronchoscopic biopsy revealed adenocarcinoma of the lung.
Recent Advances in Biology and Medicine, 2015
Intestinal-type sinonasal adenocarcinoma accounts for about 3% of cancers of the upper aero-diges... more Intestinal-type sinonasal adenocarcinoma accounts for about 3% of cancers of the upper aero-digestive tract. It is commonly seen in men in the age group of 55-60 years. We present the case of a 60-year-old woman having extensive disease in the right half of the nasal cavity extending to the dura of the anterior cranial fossa, and the right orbital contents. The patient was given induction chemotherapy to make the condition surgically amenable, but the regression was modest, and hence she has been put on concurrent chemo-radiotherapy.
Brachytherapy, 2016
doses to the organs at risk. Among the three treatment plans generated, the hybrid IGBT was able ... more doses to the organs at risk. Among the three treatment plans generated, the hybrid IGBT was able to achieve the lowest dose for the rectum 65.24 Gy, bladder 72.13 Gy and sigmoid 54.52 Gy. Intracavitary image-guided brachytherapy alone may achieve similar HR-CTV doses as with the hybrid IGBT but it could only be achieved with accompanying higher doses to the organs at risk. At 6 months follow-up, patient was noted with smooth cervix, free bilateral parametria and with no evidence of disease. Conclusions: Our pilot case study showed that hybrid image-guided brachytherapy for locally advanced cervical cancer may improve dose coverage to the HR-CTV, reduce dose to organs at risk and offer good local control of the disease. Further case series is recommended to improve on the application of the technique in the local setting and document treatment outcomes.
A 40–year old female non–smoker of average build, presented with swelling in the left lumbar regi... more A 40–year old female non–smoker of average build, presented with swelling in the left lumbar region along with dragging pain for 3 months, with no his-tory of dysuria, hematuria, trauma or previous sur-gery. She was non–hypertensive and non–diabetic and had no family history of malignancy. Ultraso-nography (USG) showed a large (17.4 x 13 x 12 cm) predominantly cystic mass with solid components and internal septas which appeared to be arising exophytically from the lower pole of the left kid-ney. On further evaluation, the CT findings showed a large (19 x 14 x 17 cm) left retroperitoneal mass with solid and cystic components on the inferior as-pect of the left kidney (Figure 1) showing effaced fat planes, inseparable from the lower pole of the kid-ney, with mild–moderate left hydronephrosis due to compression of the left ureter. Soft tissue stranding was observed in the adjacent retroperitoneal fat and thickening of the perinephric fat. The duodenojeju-nal junction and descending col...
Middle East Journal of Cancer, 2017
Background: This study evaluated sexual function in cervical cancer survivors after concurrent ch... more Background: This study evaluated sexual function in cervical cancer survivors after concurrent chemoradiotherapy. Methods: Study participants comprised survivors of locally advanced cervical cancer (stages IIB-IVA) who completed concurrent chemoradiotherapy along with intracavitary brachytherapy at least two years prior at Dr S.N.Medical College, Jodhpur, Rajasthan, India. We used the Female Sexual Function Index questionnaire to assess sexual function. The cut-off score of the Female Sexual Function Index that identified female sexual arousal disorder was 26.55. A score less than 26.55 indicated the presence of female sexual arousal disorder. Results: A total of 48 locally advanced cervical cancer survivors enrolled in the study. Survivors had a mean age of 46.5 years. All received chemoradiotherapy along with intracavitary brachytherapy. The average time for treatment was 53.5 days. Patients had an average score for sexual desire of 2, 2.3 for arousal, 2.3 for sexual satisfaction,...
International journal of scientific research, 2016
Breast cancer is the most common malignancy in women worldwide. With improving survival figures a... more Breast cancer is the most common malignancy in women worldwide. With improving survival figures and early breast cancer detection, treatment related long term adverse effects of radiotherapy have become a concern. Contralateral breast cancer due to scattered radiation during radiotherapy of diseased breast is one of them. This prospective clinical study was conducted to measure the dose received by the contralateral breast and compare the different techniques which influence this dose. It was found that in post mastectomy patients, treatment with telecobalt unit, medial tangential field contribute more dose to contralateral breast compared to supraclavicular field and lateral tangential fields. The mean dose received by contralateral breast during irradiation of chest wall was 168.29 cGy which was 3.36 percentage of the prescribed dose.
The National Medical Journal of India
Background. Management of tumour bleeding remains a challenge in oncology. With a number of metho... more Background. Management of tumour bleeding remains a challenge in oncology. With a number of methods available, radiotherapy still holds a crucial place. There are no standard guidelines for dose fractionation of haemostatic radiotherapy (HRT), and it varies from case to case. We aimed to study the effectiveness of HRT. Methods. We retrospectively analysed the effectiveness of HRT in 70 patients in terms of control of bleeding and overall survival, who presented to us with advanced cancers from July 2014 to June 2017. Results. The median age was 48 (range 23–76) years, and male to female ratio was 2.18:1. The most common malignancy encountered was lung and gynaecological (both 17.1%). Stage IV was the most common stage (48.6%) of the primary tumour. The site of bleeding was the primary tumour in 50 (71.4%) patients, whereas fungating regional nodes were the cause in the remaining. The median duration between initial diagnosis and HRT was 5 (range 0–19) months. Seventeen patients (24.3%) had a history of prior radiotherapy. Fifty-one patients (72.8%) required at least 1 unit of blood transfusion. Hypofractionated HRT schedules were used in all patients with the most common being 30 Gy in 10 daily fractions for 5 days a week (18, 25.7%). At the end of HRT, bleeding was effectively controlled in 53 patients (75.7%). The median survival was 13 (range 1–26) months. The 1- and 2-year survival rates were 55.7% and 4.3%, respectively. Conclusions. HRT is safe and effective in achieving haemostasis in advanced tumours presenting with bleeding from either the primary or the regional lymph nodes. Although optimal dose fractionation has not yet established, hypofractionated radiotherapy is preferred, with the total dose depending on several factors. However, the overall prognosis remains poor.
Indian Journal of Radiology and Imaging, 1999
Introduction: Locally advanced head and neck carcinomas (HNSCC) constitute a substantial proporti... more Introduction: Locally advanced head and neck carcinomas (HNSCC) constitute a substantial proportion of cancer patients in India. This is treated by combined multimodality which includes surgery, radiotherapy, and chemotherapy. Aims: To investigate tumor response and toxicity in HNSCC using hypofractionated schedule compared with conventional fractionation. Material and Methods: In conventional arm (Arm A), each patient received 70 Gy/2 Gy/fraction/7 weeks. In hypofractionated arm (Arm B), each patient received 55 Gy/2.75 Gy/fraction/4 weeks. Both arms received weekly cisplatin (40 mg/m 2 ). The end points were tumor response, acute and late toxicities, and overall survival (OS). Results: 17 patients (68%) in a conventional arm (Arm A) achieved a complete response (CR) and 15 patients (60%) in hypofractionated arm (Arm B) had a CR (p=0.55). The acute skin toxicity (grade≥2) was significantly higher in Arm B than in Arm A (28% vs. 17%; p ≤ 0.001). Grade ≥ 2 mucositis was also higher i...
Abdominal wall recurrence is not seen commonly with uterine cervix carcinoma. We present here two... more Abdominal wall recurrence is not seen commonly with uterine cervix carcinoma. We present here two cases of scar site recurrence and one abdominal wall recurrence, after radical surgery in uterine cervix carcinoma. Review of the literature showed 45 cases of abdominal recurrence after surgery in uterine cervix carcinoma. Two possible mechanisms of recurrence after surgery may be direct implantation of tumor cells at the time of surgery or fibrin platelet deposits in the microcirculation of the surgical wound that may have trapped circulating tumor cells. Recurrences with such atypical manifestations call for more vigilance in follow up of uterine carcinoma cervix.
Asian Pacific Journal of Cancer Care
Background: Incidence of Esophageal cancer (EC) is increasing now a days and it has became a sixt... more Background: Incidence of Esophageal cancer (EC) is increasing now a days and it has became a sixth leading cause of cancer related death in world. EC is associated with multiple risk factors. Despite various advances in the treatment of EC, it remains one of the least responsive tumors to cancer therapy, thereby overall prognosis remains poor. The current status of EC in North West India in relation to the demographics, diagnosis, staging, multimodality treatment, and the future perspectives are discussed. Methods and Materials: This is a retrospective analysis of medical records of the EC patients registered in the Department of Radiation Oncology SMS Medical and Attached Hospitals Jaipur from January 2015 to December 2019. Results: Out of 10,464 patients with various malignancies registered in SMS hospital for radiotherapy via Co-60 technique in the previous 5 years from 2015-2019; 449 were having EC. 40.25% patients were in 6th decade and male to female ratio was 1.49:1. EC was m...
International Journal of Contemporary Medical Research [IJCMR]
International Journal of Medical and Biomedical Studies
Background: The purpose of our study is to identify the incidence of hypothyroidism following rad... more Background: The purpose of our study is to identify the incidence of hypothyroidism following radiotherapy in head and neck cancer patients in Rajasthan India and to assess the time period for the development of hypothyroidism for early treatment to reduce hypothyroid related morbidity and mortality. Methods: A prospective study conducted in Department of Radiation Oncology, S.M.S Medical College and attached group of hospital, Jaipur, Rajasthan. with 50 patients of histopathologically proven head and neck cancer receiving external beam to whole neck on telecobalt. Results: The patients were followed up for a period of six months. 7 (14%) patients were found to have hypothyroidism which was strongly significant with the p value of 0.02. Conclusion: We concluded that thyroid function tests should be made routine prior RT and during follow up period as early as 6 months and carried out lifelong. Keywords: Thyroid function test, Head neck cancer, Follow-up.