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Papers by dr puneet bagri

Research paper thumbnail of Pros and Cons of Adding of Neoadjuvant Chemotherapy to Standard Concurrent Chemoradiotherapy in Cervical Cancer: a Regional Cancer Center Experience

Annals of Oncology, Sep 1, 2014

Research paper thumbnail of Addition of magnetic resonance imaging to computed tomography-based three-dimensional conformal radiotherapy planning for postoperative treatment of astrocytomas: Changes in tumor volume and isocenter shift

South Asian Journal of Cancer, 2015

Introduction: Postoperative radiotherapy is the current gold standard treatment in astrocytomas. ... more Introduction: Postoperative radiotherapy is the current gold standard treatment in astrocytomas. Computed tomography (CT)-based radiotherapy planning leads to either missing of the tumor volume or underdosing. The aim of this prospective study was to study the changes in tumor volume on addition of magnetic resonance imaging (MRI) to CT-based three-dimensional radiotherapy treatment planning of astrocytomas. Materials and Methods: Twenty-five consecutive patients of astrocytoma (WHO grades I-IV) for postoperative three-dimensional conformal radiotherapy were included in this prospective study. Postoperative tumor volumes were contoured on CT-based images and recontoured on CT-MRI images after automated MRI co-registration on treatment planning system Eclipse 8.9.15 as per ICRU-50 report. Tumor volumes were compared with each other. Result: The MRI-based mean and median tumor volume was 24.24 cc ± 13.489 and 18.72 cc (range 5.6-46.48 cc), respectively, while for CT it was 19.4 cc ± 11.218 and 16.24 cc (range: 5.1-38.72 cc), respectively. The mean and median isocenter shift between CT and MRI was 4.05 mm and 4.39 mm (range 0.92-6.32 mm), respectively. There is a linear relationship between MRI and CT volume with a good correlation coefficient of R 2 = 0.989, and MRI-based tumor volume was 1.208 times as compared to CT volume. Statistical analysis using paired sample t-test for the difference in CT and MRI tumor volume was highly significant (P < 0.001). Conclusion: Addition of MRI to the CT-based three-dimensional radiation treatment planning reduces the chances of geographical miss or tumor under dosing. Thus, MRI should be an integral part of three-dimensional planning of astrocytomas.

Research paper thumbnail of Astroblastoma of cerebrum: A rare case report and review of literature

Journal of Cancer Research and Therapeutics, 2015

Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2... more Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2.8% of all the neuroglial tumors. This tumor is usually localized in the cerebral hemisphere of young adults and children. The authors report a case of low-grade astroblastoma in a 16-year-old male and review the relevant literature. The patient presented with 2 months history of progressive headache with projectile vomiting for last 2 months. He underwent gross total resection of the lesion through right temporo-occipital craniotomy. Since tumor showed no evidence of high-grade lesion, adjuvant radiotherapy was not planned. However, the patient developed recurrence of the tumor after 12 months. Localized three-dimensional conformal radiotherapy was planned. In patients harboring anaplastic astroblastoma, gross-total resection and adjuvant therapy after the initial surgery seems to be the best choice. They can be easily misdiagnosed as they are rarely encountered in clinical practice and share common radiological and histopathologic appearance with other glial neoplasms.

Research paper thumbnail of 39P A tertiary care hospital based retrospective study evaluating epidemiology of lung cancers in a western state of India

Journal of Thoracic Oncology, Apr 1, 2016

Research paper thumbnail of 249P Optimal duration of neoadjuvant androgen deprivation therapy for prostate volume reduction in locally advanced prostate cancer radiotherapy

Annals of Oncology, Dec 1, 2015

Research paper thumbnail of 269PD A comparative evaluation of radiotherapy with concurrent weekly cisplatin versus concurrent weekly paclitaxel in patients with locally advanced carcinoma cervix

Annals of Oncology, Dec 1, 2015

Research paper thumbnail of 435P Bone metastases in non-small cell lung cancer: a retrospective study

Annals of Oncology, Dec 1, 2015

Research paper thumbnail of Gemcitabine in Brief Standard Dose Versus Prolonged Low-Dose Infusion, Both Combined with Cisplatin for Advanced Non-Small Cell Lung Cancer

Research paper thumbnail of A Phase III Trial Comparing Folfirinox Versus Gemcitabine for Metastatic Pancreatic Cancer

Annals of Oncology, Sep 1, 2014

compared with 7.4 months in the gemcitabine group (hazard ratio for death, 0.48; 95% confidence i... more compared with 7.4 months in the gemcitabine group (hazard ratio for death, 0.48; 95% confidence interval [CI], 0.41 to 0.68; P < 0.001). Median progression-free survival was 5.6 months in the FOLFIRINOX group and 3.1 months in the gemcitabine group (hazard ratio for disease progression, 0.44; 95% CI, 0.29 to 0.49; P < 0.001). The objective response rate was 29.6% in the FOLFIRINOX group versus 8.3% in the gemcitabine group (P < 0.001). More adverse events were noted in the FOLFIRINOX group; 4.8% of patients in this group had febrile neutropenia. At 6 months, 29% of the patients in the FOLFIRINOX group had a definitive degradation of the quality of life versus 59% in the gemcitabine group (hazard ratio, 0.45; 95% CI, 0.29 to 0.68; P < 0.001). Conclusions: As compared with gemcitabine, FOLFIRINOX was associated with a survival benefit at the cost of increased toxicity. Thus, FOLFIRINOX is an option for the treatment of patients with metastatic pancreatic cancer having good performance status.

Research paper thumbnail of Malignant Mesenchymal Tumor Of Male Breast

Iranian journal of cancer prevention, 2015

Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of... more Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of the breast. Pure and primary chondrosarcoma of the male breast would be an extremely rare tumor. It might arise either from the breast stroma itself, or from underlying bone or cartilage. A 65-year-old man has presented with a rapidly growing breast mass since 5 months. Physical examination has established a large firm to hard mass with regular margins in the region of right breast. There was no axillary lymphadenopathy. Contrast enhanced MRI of breasts has shown a mixed-signal intensity multi lobulated cystic-solid mass (10.4 cm × 10.3 cm ×9.9 cm) appearing predominantly hyper intense on T2W and hypo intense on T1W. The tumor has diagnosed as a low-grade chondrosarcoma of the breast by histopathological and immunohistochemistry analysis. Right sided radical mastectomy with grafting has done. It has seemed to be very important to identify the mammary primary sarcomas as entity separated...

Research paper thumbnail of Case report Psychotic manifestations as an initial presentation in glioma: two case reports and review of literature

Psychotic manifestation as an initial presentation of brain tumor is a rare manifestation of the ... more Psychotic manifestation as an initial presentation of brain tumor is a rare manifestation of the primary disease. A 32-year-old male patient presented with auditory and visual hallucinations, delusion of persecution and profound agitation. The patient was initially suspected as a case of acute psychosis; however, on imaging work-up, a large central space-occupying lesion (SOL) in the brain was detected. Following surgical removal of the brain tumor, psychotic manifestations disappeared. The pathology revealed astrocytoma grade III. Similar presentation was observed in a 28-year-old woman who first visited the psychiatry department. Imaging revealed an SOL in the right parietal lobe. She underwent craniotomy and gross total resection of the tumor. The histopathology of the surgical specimen revealed astrocytoma grade II. Neuropsychiatric manifestations may have a large impact on the quality of life of patients with primary brain tumors and should therefore be adequately managed.

Research paper thumbnail of 377PDA randomized controlled trial evaluating honey for radiation induced mucositis in head & neck cancer patients

Research paper thumbnail of Palbociclib: Will the race against endocrine resistance end?

Clinical Cancer Investigation Journal, 2015

775 Sir, Nearly, 80% of the breast cancers express estrogen receptors (ERs), progesterone recepto... more 775 Sir, Nearly, 80% of the breast cancers express estrogen receptors (ERs), progesterone receptors, or both. Endocrine therapies remain the backbone of the systemic treatment for hormone receptor positive cancers by substantially reducing the risk of relapse.[1] Many women still relapse during or after completing adjuvant therapy. Further systemic therapy remains considerably challenging for these patients. Fulvestrant, a selective ER modulator has modest activity in these patients[2,3] and the development of effective therapies that can reverse resistance to endocrine therapy, is of clinical importance.

Research paper thumbnail of Astroblastoma of cerebrum

Journal of Cancer Research and Therapeutics, 2015

Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2... more Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2.8% of all the neuroglial tumors. This tumor is usually localized in the cerebral hemisphere of young adults and children. The authors report a case of low-grade astroblastoma in a 16-year-old male and review the relevant literature. The patient presented with 2 months history of progressive headache with projectile vomiting for last 2 months. He underwent gross total resection of the lesion through right temporo-occipital craniotomy. Since tumor showed no evidence of high-grade lesion, adjuvant radiotherapy was not planned. However, the patient developed recurrence of the tumor after 12 months. Localized three-dimensional conformal radiotherapy was planned. In patients harboring anaplastic astroblastoma, gross-total resection and adjuvant therapy after the initial surgery seems to be the best choice. They can be easily misdiagnosed as they are rarely encountered in clinical practice and...

Research paper thumbnail of The Comparative Evaluation of Radiotherapy with Concurrent Weekly Cisplatin Versus Concurrent 3-WEEKLY Cisplatin and Etoposide in Patients with Unresectable Locally Advanced Non Small Cell Lung Cancer

A prospective study to compare weekly cisplatin versus weekly paclitaxel as concurrent chemothera... more A prospective study to compare weekly cisplatin versus weekly paclitaxel as concurrent chemotherapy with standard radiotherapy in locally advanced carcinoma cervix. METHODS The study was carried out between November 2013 and August 2104; 60 newly diagnosed women with histopathologically proven squamous cell carcinoma cervix (FIGO stage IB2 to IVA were enrolled into this study and randomized to receive on weekly basis either 40 mg/m 2 cisplatin (Control Group: 30 patients) or 50 mg/m 2 paclitaxel (Study Group: 30 patients) concurrently with radiotherapy total dose for radiotherapy 80 Gy for both the groups (50 Gy from EBRT and 30 Gy from HDR brachytherapy). Followup time was 6 months. RESULTS The mean number of chemotherapy cycles was comparable with 86.7% and 80% of patients receiving 5 doses in control and study group respectively. At the completion of treatment 20 patients (66.7%) in control group and 15 patients (50%) in study group had complete response; 10 patients (33.3%) in control group and 15 patients (50%) in study group had partial response. After 6 months of followup, 23 patients (76.7%) in control group and 19 (63.3%) patients of study group had complete response and 7 (23.4%) patients of control group and 10 (33.4%) patients of study group had partial response respectively. One patient of study group developed progressive disease during followup period. CONCLUSION This small prospective study shows that weekly paclitaxel does not provide any clinical advantage over weekly cisplatin for concurrent chemoradiation for locally advanced carcinoma cervix and associated with more gastrointestinal and haematological toxicities.

Research paper thumbnail of Using social networks in oncology: Is it justifiable??

Clinical Cancer Investigation Journal, 2015

Clinical Cancer Investigation Journal | July-August-2015 | Vol 4 | Issue 4 593 Sir, In 21st centu... more Clinical Cancer Investigation Journal | July-August-2015 | Vol 4 | Issue 4 593 Sir, In 21st century, Internet and social networking tools such as Facebook, Twitter, and WhatsApp have become the major communication mediums for people, especially the younger generation. This drastic transformation in communication methods can be applied on changing the doctor‐patient relationship,[1] making it difficult to keep their personal and professional lives separate.

Research paper thumbnail of Palliative care: Bridging the unmet spiritual, physiotherapy, and emotional aspects in cancer patients

International Journal of Yoga - Philosophy, Psychology and Parapsychology, 2014

Background: Palliative care is a technique to enhance the quality of life of patient suffering fr... more Background: Palliative care is a technique to enhance the quality of life of patient suffering from devitalizing illness. This literature review is the work accomplished to pave the strong foundation of palliative care to the needy patients and their families. At the level of hospice care, besides doctors' and nurses' skills, tender care and affectionate support is much more needed then medicines. Materials and Methods: Literature search was performed using the terms palliative care, spiritual, physiotherapy, cancer patients and emotional aspects. The full articles available in English were reviewed. Results: Palliative care is a sophisticated requirement in cancer patients. Most of the available literature has stressed that there is a large gap between the actual demands and provision of palliative care including spiritual, physiotherapy, and emotional aspects in cancer patients. Conclusions: This article discusses various aspects of palliative care and how they influence attitude of the patient and his or her family toward the curing therapy. This provides guidance how nurses and doctor can create non-medication environment for ending suffering and pain for better quality of life by tending them spiritually, physically, and emotionally.

Research paper thumbnail of Analysis of patterns of palliative radiotherapy in north west India: A regional cancer center experience

Indian Journal of Palliative Care, 2015

Background: Palliative radiotherapy (PRT) is the eventual requirement in 30-50% of all cancer pat... more Background: Palliative radiotherapy (PRT) is the eventual requirement in 30-50% of all cancer patients. PRT is primarily aimed to relieve pain and prevent/treat collapse or fracture in case of bone metastasis, to reduce edema in patients with cranial metastasis, and to control distressing symptoms of rapid primary growth. An audit of PRT planned in a busy cancer center can help in the characterization of the requirements of the patients and the formulation of institutional policies. Materials and Methods: In total, 516 patients who received PRT in our regional cancer center from January 2012 to December 2012 and whose complete records were available for analysis were selected for this retrospective study. Medical records and radiotherapy files were analyzed to obtain data such as sociodemographic parameters, prescription of PRT, and follow up. Descriptive statistics were evaluated in terms of frequencies and percentages to allow comparisons. Results: Of the 516 patients, 73% patients were male; the median age of the patients receiving PRT was 62 years (range 13-83 years). About 48% (n = 248) patients received PRT at the primary site while rest (52%) were given PRT at the metastatic site. The most common indication of PRT was pain (56.8% cases), followed by cytostatic PRT (19.8%) and raised ICT (12.4%). The median dose prescribed was 30 Gy (range 8-36 Gy) delivered in 1-12 fractions over the duration of 1-18 days. The overall response rate was about 43% at 2 weeks of completion of PRT; the median follow-up of the patients was 154 days (range 9-256 days). The long-term symptom relief at median follow up was 8%. Conclusions: Good clinical judgment and expertise is required in prescribing correct fractionation schedule to achieve effective symptom palliation with lowest possible cost and inconvenience to the patients and relatives. Hypofractionated radiotherapy is a feasible treatment option in patients with advanced incurable disease to achieve effective palliation.

Research paper thumbnail of Malignant mesenchymal tumor of male breast: primary chondrosarcoma

Iranian journal of cancer prevention

Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of... more Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of the breast. Pure and primary chondrosarcoma of the male breast would be an extremely rare tumor. It might arise either from the breast stroma itself, or from underlying bone or cartilage. A 65-year-old man has presented with a rapidly growing breast mass since 5 months. Physical examination has established a large firm to hard mass with regular margins in the region of right breast. There was no axillary lymphadenopathy. Contrast enhanced MRI of breasts has shown a mixed-signal intensity multi lobulated cystic-solid mass (10.4 cm × 10.3 cm ×9.9 cm) appearing predominantly hyper intense on T2W and hypo intense on T1W. The tumor has diagnosed as a low-grade chondrosarcoma of the breast by histopathological and immunohistochemistry analysis. Right sided radical mastectomy with grafting has done. It has seemed to be very important to identify the mammary primary sarcomas as entity separated...

Research paper thumbnail of Myoepithelioma of parotid: A case report and review of literature

Journal of Oral Research and Review, 2014

Myoepithelioma (ME) is a rarely encountered tumor of salivary gland accounting for about 1% of al... more Myoepithelioma (ME) is a rarely encountered tumor of salivary gland accounting for about 1% of all salivary gland tumors. Though they were first identified long back, still their histopathologic features and immunohistochemistry (IHC) profile are not well characterized and there is no definitive criterion for this tumor with complex and varied features remaining a major barrier. We present a case of parotid enlargement in an 18-year-old girl in whom the IHC studies of superficial parotidectomy specimen revealed positive staining for Cytokeratin 5/6, HMW CK, Smooth muscle actin (SMA), S100, calponin, vimentin, and p63. CD45, EMA, CK7, carcinoembryonic antigen (CEA), BerEP4, GCDFP-15, and Glial fibrillary acidic protein (GFAP)-stained negative. With these IHC findings, the diagnosis of ME of parotid was established. This report highlights the importance of IHC studies along with a brief review of the literature.

Research paper thumbnail of Pros and Cons of Adding of Neoadjuvant Chemotherapy to Standard Concurrent Chemoradiotherapy in Cervical Cancer: a Regional Cancer Center Experience

Annals of Oncology, Sep 1, 2014

Research paper thumbnail of Addition of magnetic resonance imaging to computed tomography-based three-dimensional conformal radiotherapy planning for postoperative treatment of astrocytomas: Changes in tumor volume and isocenter shift

South Asian Journal of Cancer, 2015

Introduction: Postoperative radiotherapy is the current gold standard treatment in astrocytomas. ... more Introduction: Postoperative radiotherapy is the current gold standard treatment in astrocytomas. Computed tomography (CT)-based radiotherapy planning leads to either missing of the tumor volume or underdosing. The aim of this prospective study was to study the changes in tumor volume on addition of magnetic resonance imaging (MRI) to CT-based three-dimensional radiotherapy treatment planning of astrocytomas. Materials and Methods: Twenty-five consecutive patients of astrocytoma (WHO grades I-IV) for postoperative three-dimensional conformal radiotherapy were included in this prospective study. Postoperative tumor volumes were contoured on CT-based images and recontoured on CT-MRI images after automated MRI co-registration on treatment planning system Eclipse 8.9.15 as per ICRU-50 report. Tumor volumes were compared with each other. Result: The MRI-based mean and median tumor volume was 24.24 cc ± 13.489 and 18.72 cc (range 5.6-46.48 cc), respectively, while for CT it was 19.4 cc ± 11.218 and 16.24 cc (range: 5.1-38.72 cc), respectively. The mean and median isocenter shift between CT and MRI was 4.05 mm and 4.39 mm (range 0.92-6.32 mm), respectively. There is a linear relationship between MRI and CT volume with a good correlation coefficient of R 2 = 0.989, and MRI-based tumor volume was 1.208 times as compared to CT volume. Statistical analysis using paired sample t-test for the difference in CT and MRI tumor volume was highly significant (P < 0.001). Conclusion: Addition of MRI to the CT-based three-dimensional radiation treatment planning reduces the chances of geographical miss or tumor under dosing. Thus, MRI should be an integral part of three-dimensional planning of astrocytomas.

Research paper thumbnail of Astroblastoma of cerebrum: A rare case report and review of literature

Journal of Cancer Research and Therapeutics, 2015

Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2... more Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2.8% of all the neuroglial tumors. This tumor is usually localized in the cerebral hemisphere of young adults and children. The authors report a case of low-grade astroblastoma in a 16-year-old male and review the relevant literature. The patient presented with 2 months history of progressive headache with projectile vomiting for last 2 months. He underwent gross total resection of the lesion through right temporo-occipital craniotomy. Since tumor showed no evidence of high-grade lesion, adjuvant radiotherapy was not planned. However, the patient developed recurrence of the tumor after 12 months. Localized three-dimensional conformal radiotherapy was planned. In patients harboring anaplastic astroblastoma, gross-total resection and adjuvant therapy after the initial surgery seems to be the best choice. They can be easily misdiagnosed as they are rarely encountered in clinical practice and share common radiological and histopathologic appearance with other glial neoplasms.

Research paper thumbnail of 39P A tertiary care hospital based retrospective study evaluating epidemiology of lung cancers in a western state of India

Journal of Thoracic Oncology, Apr 1, 2016

Research paper thumbnail of 249P Optimal duration of neoadjuvant androgen deprivation therapy for prostate volume reduction in locally advanced prostate cancer radiotherapy

Annals of Oncology, Dec 1, 2015

Research paper thumbnail of 269PD A comparative evaluation of radiotherapy with concurrent weekly cisplatin versus concurrent weekly paclitaxel in patients with locally advanced carcinoma cervix

Annals of Oncology, Dec 1, 2015

Research paper thumbnail of 435P Bone metastases in non-small cell lung cancer: a retrospective study

Annals of Oncology, Dec 1, 2015

Research paper thumbnail of Gemcitabine in Brief Standard Dose Versus Prolonged Low-Dose Infusion, Both Combined with Cisplatin for Advanced Non-Small Cell Lung Cancer

Research paper thumbnail of A Phase III Trial Comparing Folfirinox Versus Gemcitabine for Metastatic Pancreatic Cancer

Annals of Oncology, Sep 1, 2014

compared with 7.4 months in the gemcitabine group (hazard ratio for death, 0.48; 95% confidence i... more compared with 7.4 months in the gemcitabine group (hazard ratio for death, 0.48; 95% confidence interval [CI], 0.41 to 0.68; P < 0.001). Median progression-free survival was 5.6 months in the FOLFIRINOX group and 3.1 months in the gemcitabine group (hazard ratio for disease progression, 0.44; 95% CI, 0.29 to 0.49; P < 0.001). The objective response rate was 29.6% in the FOLFIRINOX group versus 8.3% in the gemcitabine group (P < 0.001). More adverse events were noted in the FOLFIRINOX group; 4.8% of patients in this group had febrile neutropenia. At 6 months, 29% of the patients in the FOLFIRINOX group had a definitive degradation of the quality of life versus 59% in the gemcitabine group (hazard ratio, 0.45; 95% CI, 0.29 to 0.68; P < 0.001). Conclusions: As compared with gemcitabine, FOLFIRINOX was associated with a survival benefit at the cost of increased toxicity. Thus, FOLFIRINOX is an option for the treatment of patients with metastatic pancreatic cancer having good performance status.

Research paper thumbnail of Malignant Mesenchymal Tumor Of Male Breast

Iranian journal of cancer prevention, 2015

Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of... more Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of the breast. Pure and primary chondrosarcoma of the male breast would be an extremely rare tumor. It might arise either from the breast stroma itself, or from underlying bone or cartilage. A 65-year-old man has presented with a rapidly growing breast mass since 5 months. Physical examination has established a large firm to hard mass with regular margins in the region of right breast. There was no axillary lymphadenopathy. Contrast enhanced MRI of breasts has shown a mixed-signal intensity multi lobulated cystic-solid mass (10.4 cm × 10.3 cm ×9.9 cm) appearing predominantly hyper intense on T2W and hypo intense on T1W. The tumor has diagnosed as a low-grade chondrosarcoma of the breast by histopathological and immunohistochemistry analysis. Right sided radical mastectomy with grafting has done. It has seemed to be very important to identify the mammary primary sarcomas as entity separated...

Research paper thumbnail of Case report Psychotic manifestations as an initial presentation in glioma: two case reports and review of literature

Psychotic manifestation as an initial presentation of brain tumor is a rare manifestation of the ... more Psychotic manifestation as an initial presentation of brain tumor is a rare manifestation of the primary disease. A 32-year-old male patient presented with auditory and visual hallucinations, delusion of persecution and profound agitation. The patient was initially suspected as a case of acute psychosis; however, on imaging work-up, a large central space-occupying lesion (SOL) in the brain was detected. Following surgical removal of the brain tumor, psychotic manifestations disappeared. The pathology revealed astrocytoma grade III. Similar presentation was observed in a 28-year-old woman who first visited the psychiatry department. Imaging revealed an SOL in the right parietal lobe. She underwent craniotomy and gross total resection of the tumor. The histopathology of the surgical specimen revealed astrocytoma grade II. Neuropsychiatric manifestations may have a large impact on the quality of life of patients with primary brain tumors and should therefore be adequately managed.

Research paper thumbnail of 377PDA randomized controlled trial evaluating honey for radiation induced mucositis in head & neck cancer patients

Research paper thumbnail of Palbociclib: Will the race against endocrine resistance end?

Clinical Cancer Investigation Journal, 2015

775 Sir, Nearly, 80% of the breast cancers express estrogen receptors (ERs), progesterone recepto... more 775 Sir, Nearly, 80% of the breast cancers express estrogen receptors (ERs), progesterone receptors, or both. Endocrine therapies remain the backbone of the systemic treatment for hormone receptor positive cancers by substantially reducing the risk of relapse.[1] Many women still relapse during or after completing adjuvant therapy. Further systemic therapy remains considerably challenging for these patients. Fulvestrant, a selective ER modulator has modest activity in these patients[2,3] and the development of effective therapies that can reverse resistance to endocrine therapy, is of clinical importance.

Research paper thumbnail of Astroblastoma of cerebrum

Journal of Cancer Research and Therapeutics, 2015

Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2... more Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2.8% of all the neuroglial tumors. This tumor is usually localized in the cerebral hemisphere of young adults and children. The authors report a case of low-grade astroblastoma in a 16-year-old male and review the relevant literature. The patient presented with 2 months history of progressive headache with projectile vomiting for last 2 months. He underwent gross total resection of the lesion through right temporo-occipital craniotomy. Since tumor showed no evidence of high-grade lesion, adjuvant radiotherapy was not planned. However, the patient developed recurrence of the tumor after 12 months. Localized three-dimensional conformal radiotherapy was planned. In patients harboring anaplastic astroblastoma, gross-total resection and adjuvant therapy after the initial surgery seems to be the best choice. They can be easily misdiagnosed as they are rarely encountered in clinical practice and...

Research paper thumbnail of The Comparative Evaluation of Radiotherapy with Concurrent Weekly Cisplatin Versus Concurrent 3-WEEKLY Cisplatin and Etoposide in Patients with Unresectable Locally Advanced Non Small Cell Lung Cancer

A prospective study to compare weekly cisplatin versus weekly paclitaxel as concurrent chemothera... more A prospective study to compare weekly cisplatin versus weekly paclitaxel as concurrent chemotherapy with standard radiotherapy in locally advanced carcinoma cervix. METHODS The study was carried out between November 2013 and August 2104; 60 newly diagnosed women with histopathologically proven squamous cell carcinoma cervix (FIGO stage IB2 to IVA were enrolled into this study and randomized to receive on weekly basis either 40 mg/m 2 cisplatin (Control Group: 30 patients) or 50 mg/m 2 paclitaxel (Study Group: 30 patients) concurrently with radiotherapy total dose for radiotherapy 80 Gy for both the groups (50 Gy from EBRT and 30 Gy from HDR brachytherapy). Followup time was 6 months. RESULTS The mean number of chemotherapy cycles was comparable with 86.7% and 80% of patients receiving 5 doses in control and study group respectively. At the completion of treatment 20 patients (66.7%) in control group and 15 patients (50%) in study group had complete response; 10 patients (33.3%) in control group and 15 patients (50%) in study group had partial response. After 6 months of followup, 23 patients (76.7%) in control group and 19 (63.3%) patients of study group had complete response and 7 (23.4%) patients of control group and 10 (33.4%) patients of study group had partial response respectively. One patient of study group developed progressive disease during followup period. CONCLUSION This small prospective study shows that weekly paclitaxel does not provide any clinical advantage over weekly cisplatin for concurrent chemoradiation for locally advanced carcinoma cervix and associated with more gastrointestinal and haematological toxicities.

Research paper thumbnail of Using social networks in oncology: Is it justifiable??

Clinical Cancer Investigation Journal, 2015

Clinical Cancer Investigation Journal | July-August-2015 | Vol 4 | Issue 4 593 Sir, In 21st centu... more Clinical Cancer Investigation Journal | July-August-2015 | Vol 4 | Issue 4 593 Sir, In 21st century, Internet and social networking tools such as Facebook, Twitter, and WhatsApp have become the major communication mediums for people, especially the younger generation. This drastic transformation in communication methods can be applied on changing the doctor‐patient relationship,[1] making it difficult to keep their personal and professional lives separate.

Research paper thumbnail of Palliative care: Bridging the unmet spiritual, physiotherapy, and emotional aspects in cancer patients

International Journal of Yoga - Philosophy, Psychology and Parapsychology, 2014

Background: Palliative care is a technique to enhance the quality of life of patient suffering fr... more Background: Palliative care is a technique to enhance the quality of life of patient suffering from devitalizing illness. This literature review is the work accomplished to pave the strong foundation of palliative care to the needy patients and their families. At the level of hospice care, besides doctors' and nurses' skills, tender care and affectionate support is much more needed then medicines. Materials and Methods: Literature search was performed using the terms palliative care, spiritual, physiotherapy, cancer patients and emotional aspects. The full articles available in English were reviewed. Results: Palliative care is a sophisticated requirement in cancer patients. Most of the available literature has stressed that there is a large gap between the actual demands and provision of palliative care including spiritual, physiotherapy, and emotional aspects in cancer patients. Conclusions: This article discusses various aspects of palliative care and how they influence attitude of the patient and his or her family toward the curing therapy. This provides guidance how nurses and doctor can create non-medication environment for ending suffering and pain for better quality of life by tending them spiritually, physically, and emotionally.

Research paper thumbnail of Analysis of patterns of palliative radiotherapy in north west India: A regional cancer center experience

Indian Journal of Palliative Care, 2015

Background: Palliative radiotherapy (PRT) is the eventual requirement in 30-50% of all cancer pat... more Background: Palliative radiotherapy (PRT) is the eventual requirement in 30-50% of all cancer patients. PRT is primarily aimed to relieve pain and prevent/treat collapse or fracture in case of bone metastasis, to reduce edema in patients with cranial metastasis, and to control distressing symptoms of rapid primary growth. An audit of PRT planned in a busy cancer center can help in the characterization of the requirements of the patients and the formulation of institutional policies. Materials and Methods: In total, 516 patients who received PRT in our regional cancer center from January 2012 to December 2012 and whose complete records were available for analysis were selected for this retrospective study. Medical records and radiotherapy files were analyzed to obtain data such as sociodemographic parameters, prescription of PRT, and follow up. Descriptive statistics were evaluated in terms of frequencies and percentages to allow comparisons. Results: Of the 516 patients, 73% patients were male; the median age of the patients receiving PRT was 62 years (range 13-83 years). About 48% (n = 248) patients received PRT at the primary site while rest (52%) were given PRT at the metastatic site. The most common indication of PRT was pain (56.8% cases), followed by cytostatic PRT (19.8%) and raised ICT (12.4%). The median dose prescribed was 30 Gy (range 8-36 Gy) delivered in 1-12 fractions over the duration of 1-18 days. The overall response rate was about 43% at 2 weeks of completion of PRT; the median follow-up of the patients was 154 days (range 9-256 days). The long-term symptom relief at median follow up was 8%. Conclusions: Good clinical judgment and expertise is required in prescribing correct fractionation schedule to achieve effective symptom palliation with lowest possible cost and inconvenience to the patients and relatives. Hypofractionated radiotherapy is a feasible treatment option in patients with advanced incurable disease to achieve effective palliation.

Research paper thumbnail of Malignant mesenchymal tumor of male breast: primary chondrosarcoma

Iranian journal of cancer prevention

Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of... more Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of the breast. Pure and primary chondrosarcoma of the male breast would be an extremely rare tumor. It might arise either from the breast stroma itself, or from underlying bone or cartilage. A 65-year-old man has presented with a rapidly growing breast mass since 5 months. Physical examination has established a large firm to hard mass with regular margins in the region of right breast. There was no axillary lymphadenopathy. Contrast enhanced MRI of breasts has shown a mixed-signal intensity multi lobulated cystic-solid mass (10.4 cm × 10.3 cm ×9.9 cm) appearing predominantly hyper intense on T2W and hypo intense on T1W. The tumor has diagnosed as a low-grade chondrosarcoma of the breast by histopathological and immunohistochemistry analysis. Right sided radical mastectomy with grafting has done. It has seemed to be very important to identify the mammary primary sarcomas as entity separated...

Research paper thumbnail of Myoepithelioma of parotid: A case report and review of literature

Journal of Oral Research and Review, 2014

Myoepithelioma (ME) is a rarely encountered tumor of salivary gland accounting for about 1% of al... more Myoepithelioma (ME) is a rarely encountered tumor of salivary gland accounting for about 1% of all salivary gland tumors. Though they were first identified long back, still their histopathologic features and immunohistochemistry (IHC) profile are not well characterized and there is no definitive criterion for this tumor with complex and varied features remaining a major barrier. We present a case of parotid enlargement in an 18-year-old girl in whom the IHC studies of superficial parotidectomy specimen revealed positive staining for Cytokeratin 5/6, HMW CK, Smooth muscle actin (SMA), S100, calponin, vimentin, and p63. CD45, EMA, CK7, carcinoembryonic antigen (CEA), BerEP4, GCDFP-15, and Glial fibrillary acidic protein (GFAP)-stained negative. With these IHC findings, the diagnosis of ME of parotid was established. This report highlights the importance of IHC studies along with a brief review of the literature.