vikas jagtap | NEIGRIHMS - Academia.edu (original) (raw)

Papers by vikas jagtap

Cureus, 2021

Non-small-cell lung carcinoma (NSCLC) is a disease characterized by the upregulation of programme... more Non-small-cell lung carcinoma (NSCLC) is a disease characterized by the upregulation of programmed death ligand 1 (PD-L1) along with alterations in epidermal growth factor receptor (EGFR) and HER2-neu (HER2) amplification in addition to EGFR mutation. In the present study, the expression of PD-L1 and EGFR and HER2-neu in NSCLC was studied and their expression in relation to various clinicopathological parameters was analysed. We studied 49 core biopsy specimens of NSCLC for PD-L1, EGFR and HER2-neu expressions using immunohistochemistry. Scoring was based on the intensity and percentage of tumour cells expressing the immunomarkers. PD-L1, EGFR and HER2-neu expression was seen in 20.4%, 32.7% and 14.2% of NSCLC, respectively. The analysis showed no significant difference in PD-L1 expression in relation to any clinicopathological parameters. Low or negative EGFR expression was significantly associated with positive lymph node status (P=0.04). HER2-neu expression showed a significant d...

The Journal of medical research, 2016

This is a case report of a 13 year old boy who has been operated for Pigmented Villonodular Synov... more This is a case report of a 13 year old boy who has been operated for Pigmented Villonodular Synovitis (PVNS) and treated with adjuvant post-operative radiotherapy for incomplete surgical resection. This report mainly highlights the role of radiotherapy in managing this rare benign condition with emphasis on improving local control rates with functional joint preservation and avoiding repeated surgeries.

Recurrence of cancer within radiation field is the most dreaded news after curative radiation the... more Recurrence of cancer within radiation field is the most dreaded news after curative radiation therapy in head and neck cancer patients. Surgical treatment of these sites is always challenging, which becomes worse after radiation. With the introduction of conformal modalities, the chances of re-irradiation of recurrent cancer are being explored for many years now. In spite of increased use of reirradiation there are not much published criteria or guidelines in these groups of patients. The objective of this literature review is to identify the most commonly used patient selection criteria, radiation doses, fields, impact of newer technology and outcomes in terms of local control and survival.

Indian Journal of Surgical Oncology

The process of tumorigenesis in gastric carcinoma involves multiple genetic alterations including... more The process of tumorigenesis in gastric carcinoma involves multiple genetic alterations including overexpression of PD-L1, amplification of Her2neu, and mutation of p53. In the present study, the expressions of PD-L1 and Her2neu were analyzed in relation to clinicopathological parameters including p53 in gastric and gastroesophageal junction adenocarcinoma. We examined 100 biopsy and resection samples of gastric and gastroesophageal junction carcinomas for PD-L1, Her2neu, and p53 protein expressions using immunohistochemistry. Scorings were done based on intensity and percentage of tumor cells expressing the markers. Follow-up and survival analyses were done wherever data was available. PD-L1 and Her2neu were seen in 37% and 38% respectively. The analysis showed PD-L1 expression was significantly associated with depth of invasion (p = 0.0007), nodal metastasis (p = 0.0003), and AJCC staging (p = 0.0085). Her2neu negative including equivocal expression was significantly associated with histological grading (p = 0.0043), Lauren classification (p = 0.0042), depth of invasion (p = 0.04), and nodal metastasis (p = 0.017). Combined analysis of PD-L1 and Her2neu showed significant association with histological grading (p = 0.017), Lauren classification (p = 0.005), depth of invasion (p = 0.0035), and nodal metastasis (p = 0.00073). Univariate Cox regression analysis showed that depth of invasion, nodal metastasis, distant metastasis, AJCC staging, and p53 were negative prognostic factors for patients’ overall survival. In multivariate analysis, distant metastasis and Her2neu negativity including equivocal cases were independent prognostic factors. PD-L1 positivity was seen in cases with advanced pathological features, which suggest its role in the tumorigenesis of gastric and gastroesophageal junction adenocarcinoma. Her2neu positivity showed no correlation with advanced pathological features as well as no prognostic significance, which could be attributed to tumor heterogeneity, endoscopic nature of the biopsies, and non-confirmation of equivocal cases by fluorescent in situ hybridization.

Autopsy and Case Reports

Histiocytic sarcoma (HS) is a rare hematolymphoid malignant neoplasm with an aggressive clinical ... more Histiocytic sarcoma (HS) is a rare hematolymphoid malignant neoplasm with an aggressive clinical course. It can arise de novo or from low-grade B-cell lymphoma. We describe the case of a 16-year-old boy referred to our hospital with generalized lymphadenopathy, weight loss, and decreased appetite for one month. The patient died undiagnosed on the 7 th day of hospitalization. Lymph node and bone marrow biopsies were performed one day before the patient died. The lymph node biopsy revealed an architectural effacement with a diffuse proliferation of large pleomorphic neoplastic cells containing large, multilobulated nuclei, coarse vesicular chromatin, prominent nucleoli, and a moderate amount of eosinophilic cytoplasm. The bone marrow aspiration smears and biopsy also showed evidence of infiltration by these above-mentioned cells. Based on the morphology, along with the exclusion of many differential diagnoses by an extensive panel of immunohistochemical markers, a diagnosis of HS was made. This case report aims at evaluating all the clinical and immunophenotypic features of a case of HS with multifocal presentation and an aggressive clinical course in order to give a correct and definite diagnosis at the proper time.

South Asian Journal of Cancer

Objective: The objective of this study is comparision of local and distant control rates with hig... more Objective: The objective of this study is comparision of local and distant control rates with high-dose versus standard-dose radiotherapy along with concurrent chemotherapy in esophageal cancer – a prospective randomized study. Materials and Methods: Histologically proven Stage I–III patients with carcinoma esophagus were randomized into two groups. One group has been treated with standard-dose radiotherapy, i.e., a total dose of 50.4 Gy (1.8 Gy/day, 28#, 5 days/week). The other group (study arm) has received high-dose radiotherapy, i.e. a total dose of 64.8 Gy (1.8 Gy/day, 36#, 5 days/week). Both groups have received 2 cycles of 3 weekly concurrent chemotherapy (cisplatin 75 mg/m[2] on day 1 and 5-fluorouracil 750 mg/m[2] continuous intravenous infusion over 24 h on day 1–4). Follow-up response evaluation was done by both endoscopy and computed tomography scan after 6–8 weeks and after 2 months thereafter. Results: Out of a total of 28 patients, 68% showed a complete response, 14% ...

British Journal of Clinical Pharmacology

This study prospectively quantified wastage of cancer chemotherapeutic drugs in oncology unit to ... more This study prospectively quantified wastage of cancer chemotherapeutic drugs in oncology unit to find the associated cost in three months. Retrospective analysis of drug usage for 12 months was also conducted to determine the expected drug loss in one year. The effect of vial sharing was evaluated under the assumption of sharing. A significant drug wastage of 19.72% (95% CI, 14.52%-24.93%) in three months and 17.14% [95% CI 14.69%-19.59%] in one year occurred in our oncology unit. Number of vials purchased (r = 0.362, p < 0.01), weight (r = -0.146, p < 0.01) and body surface area (r = -0.26, p < 0.01) correlated with the drug wasted. Vial sharing assumption showed a 9% (95% CI, 2.5%-15.5%) reduction in cost in one year.

$Research paper thumbnail of Hypofractionated radiotherapy in post mastectomy locally advanced breast cancer: a study from a regional cancer center in North East India$

Background: Adjuvant radiotherapy has increased local-regional and overall survival rates in brea... more Background: Adjuvant radiotherapy has increased local-regional and overall survival rates in breast cancer. Conventional fractionation delivering 50-60 Gray (Gy) over 5-6weeks is a standard approach. A shorter duration of hypofractionated treatment will be more convenient for patients and treatment providers if found safe and equally effective. Methods: Around 50 high risk breast cancer patients who underwent mastectomy were enrolled and randomized into the study arms-CF (Conventional Fractionation) Arm (50Gy/25 Fr @ 2 Gy/fraction/day 5 days a week over 5weeks) and HF (Hypo-Fractionation) arm (40.05 Gy/15 Fr @ 2.67 Gy/fraction/day 5 days a week over 3weeks). Treatment related acute and late toxicities, loco-regional recurrence; distant metastasis and survival rates were recorded for comparison. Results: Twenty-five patients were enrolled in each arm with baseline characters well matched. At median follow up of 44 months, OS was 80% in HF arm against 64% in CF arm (p-value: 0.292). HF arm also showed better DFS at 4 years of 76% compared to 64% in CF arm (p-value: 0.411). Although the difference was not significant statistically, the Hazard Ratio of 1.543 (95% CI: 0.549-4.339) for DFS and 1.801 (95% CI: 0.603-5.377) for OS indicated trends towards better outcomes in HF arm in terms of disease control and survival. Acute and late toxicities were also lesser in HF arm, though not statistically significant (all p-values >0.05). Conclusions: In post mastectomy setting, HFRT is comparable to CFRT in terms of safety and efficacy, will be more convenient for patients and care givers and hence can be a routine standard practice.

International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 2018

Aim: Dosimetric analysis of three different Radiotherapy techniques in patients with Breast Cance... more Aim: Dosimetric analysis of three different Radiotherapy techniques in patients with Breast Cancer and their impact on OAR's. Materials and Methods: 12 patients of Carcinoma Breast who received breast radiotherapy were selected for analysis. Computed tomography (CT) simulation image data sets were retrieved. Planning target Volume (PTV), heart and ipsilateral lung were contoured for planning and analysis of doses. Three different plans using conventional bi-tangential fields were prepared, Plan 1 with SAD full beam with wedge (SAD-FBW), Plan 2 with SSD half beam with wedge (SSD-HBW) and plan 3 with SSD half beam without wedge techniques (SSD-HBO) in CMS Xio TPS. Statistical analysis was done using SPSS version 16.0. Results: The PTV coverage was significantly better in SAD-FBW techniques when compared with the other two techniques i.e. SSD-HBW (mean = 92.33, SD = 4.69, p = 0.005) and SSD-HBO (mean = 75.05, SD = 11.92, p = 0.002). The mean heart doses were significantly better in SAD-FBW compared to SSD-HBW (mean = 3.75, SD = 2.27, p = 0.017) but in SSD-HBO technique mean heart doses were better than SAD-FBW technique (mean = 3.27, SD = 1.94, p = 0.004). Similarly, the left lung V20 values were significantly better in SSD-HBO technique than SAD-FBW technique (mean = 11.75, SD = 4.34, p = 0.004) but there was statistically insignificant difference between the SAD-FBW and SSD-HBW techniques.

Radiotherapy and Oncology

To report the incidence of clinical, pathological and radiological fat necrosis (FN) in women tre... more To report the incidence of clinical, pathological and radiological fat necrosis (FN) in women treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy (BRT) for early-stage breast cancer and to study certain variables associated with it. Between May 2000 and August 2008, 171 women were treated with APBI using high dose rate (HDR) BRT. Patients were treated to a dose of 34 Gy/10 fractions/1 week with two fractions/day after intraoperative/postoperative placement of catheters. At a median follow up of 48 months (SD: 28) 20 women developed FN with median time to detection being 24 months (range: 4-62 months, SD: 20). Actuarial 5 and 7 year FN rate was 18% and 23%, respectively. Grade 1 FN was seen in 4, grade 2 in 8 and grade 4 in 8 women. Additional investigations such as aspiration/biopsy were done in 9 patients. Volume of excision was the only significant factor affecting FN (p=0.04). Actuarial FN rate of 18% at 5 years in our study was comparable ...

Asian Pacific Journal of Cancer Care

The current global pandemic of Corona virus has impacted the health care severely. Many of the no... more The current global pandemic of Corona virus has impacted the health care severely. Many of the non-emergency cases and general illness cases have been asked to avoid hospital visit or wait for elective surgeries. The same may not be possible for the patients suffering from cancer as it considered a major health problem owing to the risk of metastasis as well as disease becoming unresectable with time. Unfortunately, we don’t have studies weighing the risk versus benefit ratio of delaying oncological treatment weighted against an added comorbidity of COVID infection. Radiotherapy being an integral part of cancer care is affected the most as it is delivered, continuous over a long period of time and unplanned gap because of travel restriction on patients makes decision making more difficult for radiation oncologist. In this article we’ve highlighted few major problems in delivering radiation to cancer patients at this time of global pandemic of corona virus and tried to find out possi...